Hazelnut oral immunotherapy in children with hazelnut allergy
What it found
In 124 children with hazelnut allergy, a treatment that gives small amounts of hazelnut by mouth helped 43.5% reach the target maintenance dose, but 31.5% stopped treatment.
Reactions during treatment were common, including 9 cases of anaphylaxis.
What they found
Studies in people
Reaching target dose
54 of 124 children (43.5%) reached the target maintenance dose, taking a median of 24 months. Another 31 children (25.0%) stayed on a lower, partial maintenance dose, with a median tolerated dose of 1000 mg of ground hazelnut.
Stopping treatment
31.5% of children stopped treatment. More than half of those (53.9%) stopped because they were lost to follow-up.
Reactions during treatment
102 of 124 children (82.3%) had a reaction during treatment. Most reactions resolved on their own (72.5%), and 14.7% happened at home. Nine reactions were anaphylaxis (8.8%); only one needed adrenaline, and two happened at home because of a cofactor.
Allergy test changes
The prick-by-prick test diameter and Cor a 14 IgE levels went down significantly over the study.
Family history and completion
Children with a positive family history of atopy were less likely to complete the treatment.
What the authors conclude
“H-OIT may be an effective treatment option for children with HA despite the high discontinuation rate.”
Also in their conclusions
- They say H-OIT may be an effective treatment option for children with hazelnut allergy despite the high discontinuation rate.
- They note that one quarter of patients remained on a lower, partial maintenance dose.
- They say that although the overall safety profile seems acceptable, anaphylactic events are a significant burden for families and must be carefully considered when weighing the risks and benefits of OIT.
How it was done
Hazelnut oral immunotherapy is seen as a promising treatment for hazelnut allergy. The authors wanted to assess its safety and effectiveness in children and describe their clinical and allergy features.
They enrolled 124 children who had hazelnut oral immunotherapy at a pediatric hospital allergy unit in Italy between April 2015 and December 2024. They recorded demographic and clinical features, allergy test results, and information about the treatment.
What it can’t tell you
- We summarised it from the abstract only.
- This was a single-center retrospective study, so it cannot prove that the treatment caused the improvements seen.
- The results may not apply to children treated elsewhere or in different settings.
Who paid
- Conflicts
- M.G. reports personal fees from Sanofi, Thermo Fisher Scientific. S.B. reports personal fees from Nutricia, Sanofi, and Firma. All other authors declare that they have no conflict of interests to disclose in relation to this paper.
- Authors work at
- Meyer Children's Hospital IRCCS, Italy; University of Florence, Italy
The paper
- Title
- Hazelnut oral immunotherapy in children: An Italian single-center retrospective cohort study
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Abstract only
- Cite
- Barni S, Pessina B, Della Femina S, et al (2026). Hazelnut oral immunotherapy in children: An Italian single-center retrospective cohort study. Pediatric allergy and immunology. doi:10.1111/pai.70287Free full textPubMed 41729124DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error