Low Dose Multi-Nut Oral Immunotherapy in Pre-schoolers (LMNOP) Pilot Trial

Project status: Complete

Research area: Population Health > Population Allergy

Low Dose Multi-Nut Oral Immunotherapy in Pre-schoolers (LMNOP)

A pragmatic randomised controlled trial of low dose multi-nut oral immunotherapy versus standard care to treat multi-nut allergies in young children.

LMNOP explored whether over 18 months, children undergoing low dose, multi-nut oral immunotherapy (OIT) treatment could safely achieve sustained unresponsiveness at a higher rate than children under standard care (avoidance of allergic nuts) develop natural tolerance. OIT involves parents giving their child small amounts of two nuts they are allergic to daily at home, over 18 months. Sustained unresponsiveness was defined as a participant being able to pass an oral food challenge after having paused treatment for several weeks.

Study overview

Participants consisted of children between the ages of 18 and 36 months with a doctor-diagnosed allergy to 2 or more of:

Peanut
Almond
Cashew
Hazelnut
Walnut

Participants were randomised to either the multi-nut OIT treatment group or the no-treatment group.

Under clinical supervision, participants in the multi-nut OIT treatment group were given small amounts of the two nuts they are allergic to by their parents, each day for 18 months.

Participants in the no-treatment group were asked to avoid the nuts they are allergic to for 18 months.

We wanted to see whether more children in the OIT group could eat the nuts without reacting compared to the group getting no treatment.