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News
More than a third of infants previously flagged for peanut allergy may not actually have one. A large Australian study found that oral food challenges (OFCs) before immunotherapy were negative in 34.8% of cases, allowing those babies to eat peanuts freely. The challenge was safe and well-managed, even when anaphylaxis occurred.
A new study out of Australia is challenging how we diagnose peanut allergy in the youngest patients. Researchers reviewed data from 778 infants under 18 months — all with a prior peanut reaction and signs of sensitization — who underwent an oral food challenge (OFC) before starting peanut oral immunotherapy (OIT). The result? 34.8% had a negative challenge, meaning they tolerated peanuts just fine and could be immediately "delabeled" and cleared for regular peanut consumption.
For those who did react, the OFC also proved its worth: 97.5% of infants who began immunotherapy using the challenge-determined starting dose tolerated it at their first updosing visit — a near-perfect success rate. Anaphylaxis occurred in 7.8% of all challenges but was well managed across all 10 hospital sites.
Why it matters: Misdiagnosis of peanut allergy carries real burdens — unnecessary dietary restrictions, family anxiety, and avoidable treatment. This study makes a strong case for routine OFCs in infants, regardless of whether immunotherapy or avoidance is planned, to ensure only truly allergic children carry that label.
