Kim EH, Yang L, Ye P, et al. - Among children with peanut allergy, long-term sublingual immunotherapy (SLIT) was tested for its safety, clinical efficacy, and associated immunologic changes. For up to 5 years, researchers put children with peanut allergy (aged 1 to 11 years) to extended maintenance SLIT with 2 mg/d peanut protein. Early cessation of therapy was permitted to participants with peanut skin test wheals of less than 5 mm and peanut-specific IgE levels of less than 15 kU/L. To evaluate desensitization, they performed a double-blind, placebo-controlled food challenge (DBPCFC) with up to 5000 mg of peanut protein following completion of SLIT dosing. They further evaluated sustained unresponsiveness by using identical DBPCFCs following 2 to 4 weeks without peanut exposure. Findings revealed the majority of the children with peanut allergy experienced clinically meaningful desensitization after extended-therapy peanut SLIT. This effect was balanced with ease of administration and a favorable safety profile.