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News
Adding abatacept to peanut oral immunotherapy (OIT) didn't significantly reduce the rise in peanut-specific IgE levels in adolescents and adults with severe peanut allergy, a small phase 2a trial found. However, patients on abatacept experienced notably fewer anaphylactic reactions than those on placebo. The findings suggest limited tolerance benefits but a possible safety advantage worth exploring in larger studies.
A small Canadian phase 2a trial tested whether adding abatacept — a T-cell co-stimulation blocker — to peanut oral immunotherapy (OIT) could help promote immune tolerance in patients with severe peanut allergy. The answer, at least for the primary endpoint, was no. The ratio of peanut-specific IgE to total IgE rose in both groups, and the difference between abatacept and placebo didn't reach statistical significance.
That said, the abatacept group experienced meaningfully fewer adverse events overall and far fewer anaphylactic reactions — a notable finding even in this small trial. Both groups also maintained tolerance to a median of 3,000 mg of peanut protein after four weeks off OIT.
By the Numbers:
Why it matters: Peanut OIT can be effective but is often limited by side effects, including anaphylaxis. While abatacept didn't hit its immunological target, its apparent ability to reduce anaphylaxis during OIT could make the therapy safer and more tolerable — a meaningful clinical benefit if confirmed in larger trials.
