D3.216 - Audit of Peanut Allergy Patients Eligible for Oral Immunotherapy (OIT) in a Paediatric Cohort at Galway University Hospital (2020-2023)

Peanut allergy (PA) is a significant health concern, with a growing prevalence in paediatric populations globally. There is a pressing need for effective management strategies in Ireland, including the potential introduction of Oral Immunotherapy (OIT) for PA. However, the limited availability of such services restricts treatment options. This study aimed to evaluate the clinical characteristics of paediatric patients with PA at Galway University Hospital and assess the potential need for OIT.

A retrospective analysis was conducted on 170 paediatric patients diagnosed with PA at Galway University Hospital between 2020 and 2023. Demographic data, clinical characteristics, allergic comorbidities, triggers, diagnostic methods, and symptoms were recorded. Additionally, allergen protein sensitivities and the eligibility of patients for OIT were assessed.

The mean age of the participants was 7.7 years (range 0–16 years), with the highest prevalence of PA observed in the 5-10 year age group (50.6%). The cohort consisted of 63.5% males and 36.5% females. PA was commonly associated with other atopic conditions: 46.5% had asthma, 52.4% had dermatitis, and 34.7% had rhinitis. Poly-sensitisation was prevalent, with 11.8% of patients having both peanut and egg allergies and 16.5% having peanut and dander allergies. Diagnostic triggers included peanut butter (27.6%), whole peanuts (12.4%), and peanut bars (7.1%), with skin prick tests being the most common diagnostic tool (10.6%). Adrenaline auto-injector prescriptions were given to 71.2% of patients, but only 12.4% had used it. Urticaria (51.8%) was the most common symptom, followed by bronchospasm (11.8%) and cough (5.9%). Sensitisation to peanut allergen proteins h2 (65.3%) and h6 (67.6%) was prevalent, while h1 was less frequent. Regarding OIT eligibility, 77.1% of patients (131/170) were deemed eligible, excluding those with severe asthma or anaphylaxis.

This study highlights the significant burden of peanut allergy in paediatric patients, with many being eligible for OIT. The findings suggest a potential demand for OIT services at Galway University Hospital, supporting the need for further investigation into the feasibility and implementation of such a program in Ireland.