Identifying infants at high risk of peanut allergy: The Learning Early About Peanut Allergy (LEAP) screening study George Du Toit, MBBCh, FRCPCH, Graham.

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Identifying infants at high risk of peanut allergy: The Learning Early About Peanut Allergy (LEAP) screening study George Du Toit, MBBCh, FRCPCH, Graham.

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Presentation transcript:

Identifying infants at high risk of peanut allergy: The Learning Early About Peanut Allergy (LEAP) screening study George Du Toit, MBBCh, FRCPCH, Graham Roberts, MD, Peter H. Sayre, MD, PhD, Marshall Plaut, MD, Henry T. Bahnson, MPH, Herman Mitchell, PhD, Suzana Radulovic, MD, Susan Chan, MD, Adam Fox, MD, Victor Turcanu, MD, Gideon Lack, MD, FRCPCH Journal of Allergy and Clinical Immunology Volume 131, Issue 1, Pages 135-143.e12 (January 2013) DOI: 10.1016/j.jaci.2012.09.015 Copyright © 2012 Terms and Conditions

Fig 1 Flow of participants into the LEAP screening study. Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig 2 Peanut-specific IgE levels by group (A), SPT responses (B), and SCORAD scores (C). Each bar represents the percentage of infants in each range of peanut-specific IgE level. Numbers within bars represent the percentage of participants in each group with IgE values at or above 0.35 kU/L. Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig 3 Total, peanut-specific, and hen's egg white–specific IgE levels compared with race. Black lines denote medians, and blue lines denote geometric means. P values are the Tukey HSD between categories using log-transformed values. The sensitization threshold of 0.35 kU/L and percentages greater than and less than the threshold value have been added to the peanut-specific IgE plot. Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig 4 SPT responses stratified by race and specific IgE (sp-IgE) levels. Before stratification, black race appears to be associated with a higher probability of a large SPT response, but after stratifying by peanut-specific IgE level, the effect is reversed, a phenomenon known as the Simpson paradox. The relationship between SPT response and specific IgE level differs significantly by race (P < .001). Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig E1 LEAP study design. Eligible participants were allocated to SPT response–negative or SPT response–positive strata on the basis of peanut SPT responses at screening and randomized to early or late introduction of peanuts into the diet within strata. Participants assigned to the early introduction group were first given peanut as an open challenge on the clinical trials unit. All participants will be assessed for PA at 60 months of age. Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig E2 Determination of PA using open challenge and double-blind, placebo-controlled food challenge. Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig E3 Determination of PA in the absence of peanut challenge results using dietary and reaction history, SPT response, and IgE level. Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions

Fig E4 Five common food allergens were assessed based on SPT responses and 9 based on specific IgE levels. Each bar represents the percentage of infants with an increasing number of foods to which they had SPT responses of 3 mm or greater (A) and sensitized specific IgE levels (B). Journal of Allergy and Clinical Immunology 2013 131, 135-143.e12DOI: (10.1016/j.jaci.2012.09.015) Copyright © 2012 Terms and Conditions