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Most caregivers of infants and toddlers undergoing peanut oral immunotherapy (OIT) prefer a mix of in-office, video, and phone visits for updosing — not just one format. A new study found reaction rates were similarly low across all settings, and 71.7% of families favored the hybrid approach. The findings suggest allergists can safely expand telehealth options without compromising safety.
Peanut oral immunotherapy (OIT) is effective — but it's also a logistical marathon for families, typically requiring frequent in-office visits. A new study published in Annals of Allergy, Asthma & Immunology suggests there's a more flexible path forward. Researchers at Rochester Regional Health found that caregivers of infants and toddlers undergoing peanut OIT strongly preferred a hybrid updosing model combining in-office, video, and telephone encounters over any single format alone.
The study followed 53 children aged 6 to 47 months through a 14-step updosing protocol — starting at 2 mg of peanut protein and scaling up to 3,000 mg (about 12 peanuts) over an average of 26 weeks. All children ultimately achieved ad-lib peanut consumption. Crucially, reaction rates during updosing were not significantly different from those during home maintenance dosing, and the risk of needing epinephrine stayed below 0.5% across all modalities.
By the Numbers:
Why it matters: These findings give allergists a green light to offer more telehealth flexibility in OIT protocols — potentially reducing barriers for families who struggle with frequent clinic visits, without sacrificing safety.
