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LMNOP Pilot Trial

Research project

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 for the treatment of multi-nut allergies in young children

What is LMNOP?

LMNOP is looking at whether over a period of 18 months, children undergoing low dose, multi-nut oral immunotherapy (OIT) treatment can safely achieve sustained unresponsiveness (participant is able to pass an oral food challenge after having paused treatment for several weeks) 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.

Who may be eligible to take part?

  • Children between the ages of 18 and 36 months
  • Children who have a doctor diagnosed allergy to 2 or more of: Peanut, Almond, Cashew, Hazelnut or Walnut
  • Living in Greater Melbourne, Victoria

What will I be asked to do?

If your child is eligible to take part, they will be randomised to either the multi-nut OIT treatment group or the no-treatment group.

  • If your child is in the multi-nut OIT treatment group, we will ask you to give them small amounts of the two nuts they are allergic to each day for 18 months.
  • If your child is in the no-treatment group, we will ask you to make sure they avoid the nuts they are allergic to for the 18 months.
  • Parents in both groups will be asked to complete online diaries so we can monitor this, and to fill out some online questionnaires.
  • Parents in both groups will be asked to attend the Melbourne Children’s Trial Centre, MCRI, for some scheduled appointments.

At the end of this, we want to see if more children in the OIT group can eat the nuts without reacting. We will compare them to the group getting no treatment.

How can I find out more?

To find out more about the study, please email the team at