Boiled peanut oral immunotherapy for the treatment of peanut allergy

INTERVENTION: Following double blind oral food challenges (DPBPFC) to boiled and roasted peanut and placebo, peanut allergic children aged 5‐16 years will undergo randomisation to 3 arms of 12 months of treatment with 1. Increasing doses of boiled peanut daily commencing at 0.5 grams. 2. Increasing doses of roasted peanut daily commencing at 0.5 gram. For arms 1 and 2‐ Induction phase with updosing over 6 months and further 6 months maintenance (8g) daily. Updosing under supervision. Peanut preparations suppled to parents for daily home administration between updosing and during maintenance. Compliance by daily diary. Arm 3. No treatment (delayed start) to cross over at 12 months to boiled peanut OIT as per arm 1 following further DBPCFC. Children roasted allergic/boiled tolerant will proceed directly to daily boiled peanut maintenance at 8g over 12 months. CONDITION: peanut allergy PRIMARY OUTCOME: Change in threshold dose of roasted peanut at double blind placebo controleld oral food challenge SECONDARY OUTCOME: Change in peanut allergen component specific IgE binding‐ by immunoblot fusing patient serum. Change in threshold dose of roasted peanut at double blind placebo controlled oral food challenge side effects: any allergic reactions during oral immunotherapy INCLUSION CRITERIA: Double blind placebo controlled challenge proven roasted peanut allergy at study commencement