Chinthrajah RS, Purington N, Andorf S, et al. - Through a randomized, double-blind, placebo-controlled, phase 2 study of 152 individuals at the Sean N Parker Center for Allergy and Asthma Research at Stanford University (Stanford, CA, USA) with peanut allergy aged 7–55 years, researchers assessed the sustained impacts of peanut allergy oral immunotherapy (OIT) in a randomized long-term study in adults and children. The most prevalent adverse events were mild gastrointestinal symptoms, which were observed in 90 of 120 patients and skin disorders, which were detected in 50/120 patients. Adverse events reduced over time in all groups. During the 3-year study, two individuals in the peanut groups had serious adverse events. In the peanut-0 group, in which eight of 60 participants passed DBPCFCs at week 156, greater baseline peanut-specific IgG4 to IgE ratio and lower Ara h 2 IgE and basophil activation responses were correlated with sustained unresponsiveness. No treatment-associated deaths were noted. In conclusion, OIT could desensitize individuals with peanut allergy to 4,000 mg peanut protein although discontinuation or even decrease to 300 mg daily, could boost the probability of regaining clinical reactivity to peanut. Since baseline blood tests associated with week 117 treatment outcomes, this study might assist in optimal patient selection for this therapy.