# Oral Immunotherapy with Standardized Peanut Extract: A Game-Changer for Peanut Allergy
## 3 Results
### Efficacy  
For clarity purposes, results outlining the characteristics of each study, comparing safety, efficacy, and quality of life improvements, are summarized in Table 1.  
In the studies analyzed, the efficacy of PTAH AIT was evaluated through an exit double-blind placebo-controlled food challenge (DBPCFC), with different doses depending on the study. In the POSEDION study, children aged 1 to 3 years maintained or improved their desensitization levels over several years, with associated immunological changes indicating a durable shift toward tolerance. These findings are critical, as they suggest that initiating OIT at a younger age enhances the efficacy of desensitization and aligns with immunological theories, suggesting a crucial window for tolerance development in  
\begin{table}
\begin{tabular}{p{56.9 pt} p{56.9 pt} p{56.9 pt} p{56.9 pt} p{56.9 pt} p{56.9 pt}} \hline \hline  & **PALISADE** & **ARTEMIS** & **POSEDON** & **ARC004** & **ARC008** \\ \hline \multirow{3}{*}{**Type of study**} & Randomized double-blind placebo-controlled trial (phase 3) & Randomized double-blind placebo-controlled trial (phase 3) & Randomized double-blind placebo-controlled trial (phase 3) & Open-label long-term study (2 years) & Open-label, longer-term (\(>\)5 years) \\ \hline \multirow{3}{*}{**Population**} & 551 participants, 4–55 yo (372 treated vs. 124 placebo) & 175 participants, 4–17 yo vs. 432 bleeding & 14 participants, 1–4 yo (98 treated vs. 48 placebo) & 261 patients, 4–17 yo (long-term extension) & 1127 patients, 4–17 yo (long-term extension) & 1127 patients, 4–17 yo (long-term extension) & 1127 patients, 4–17 yo (long-term extension) & 1127 patients, 4–17 yo (long-term extension) \\ \hline \multirow{3}{*}{**Inclusion criteria**} & Positive challenge of \(\leq\)100 mg of peanut protein & dose-limiting symptoms to \(\leq\)300 mg of peanut protein & dose-limiting symptoms from \(\leq\)300 mg of peanut protein & Completion of \(\leq\)300 mg of \(\leq\)300 mg of peanut protein & Completion of \(\leq\)300 mg of \(\leq\)300 mg of peanut protein & Completion of \(\leq\)300 mg of \(\leq\)  
young children [12; 27]. These studies demonstrate that PTAH can significantly increase the threshold of peanut protein tolerated by allergic individuals. However, the varying doses of peanut powder used in both inclusion criteria and exit food challenges across these trials necessitate careful consideration when comparing efficacy outcomes. On one hand, patients experiencing dose-limiting symptoms at low doses of peanut powder at baseline might not be able to reach the tolerability threshold of the DBPCFC.  
On the other hand, higher exit challenge doses, as seen in ARTEMIS [22], POSEIDON [23], and ARC004 [26] may reflect greater desensitization but also present more stringent criteria for success, potentially impacting the perceived efficacy rates. For example, in ARTEMIS, the success rate of exit DBPCFC was somewhat lower than in PALISADE [21] (58% vs. 67%), probably due to a higher threshold. However, it still demonstrated a profound improvement over the placebo.