Sex Influences Quality-of-Life Outcomes in Peanut Oral Immunotherapy: Study

A new study published in the journal of Pediatric Allergy and Immunology showed that that sex assigned at birth modifies health-related quality of life (HRQL) outcomes during peanut oral immunotherapy. Males showed significant improvement from active treatment, while females experienced stronger placebo-related gains.

The need for therapeutic solutions that enhance patients' HRQL is highlighted by the high prevalence of peanut allergies. However, little is known about how sex assigned at birth affects treatment-related outcomes. The purpose of this study was to determine if treatment effects on changes in overall and subdomain HRQL throughout the PPOIT-003 trial were influenced by sex.

A total of 201 children with peanut allergies (ages 1–10) participated in this study PPOIT-003, which was divided into 3 groups: placebo, peanut oral immunotherapy alone (OIT), and combination probiotic and peanut oral immunotherapy (PPOIT). The Food Allergy Quality of Life–Parent Form (FAQLQ‐PF) was used to evaluate participant HRQL at baseline, at the conclusion of therapy, and a year after treatment. For both males (N = 128, 63.68%) and females (N = 73, 36.32%), the association between therapy and HRQL was examined using multivariable linear regression with an interaction term.

Between baseline and the conclusion of the 12-month follow-up, there was a sex-modification of the overall FAQLQ-PF scores (p =.008). During this period, the active group significantly outperformed the placebo group in terms of improvement in FAQLQ-PF scores for males (PPOIT vs. Placebo: −1.003 [95% CI: −1.571, −0.436]; OIT vs. Placebo: −1.250 [95% CI: −1.805, −0.695]), but not for females, where the placebo group also showed improvement (PPOIT vs. Placebo: −0.148 [95% CI: −0.914, 0.617]; OIT vs. Placebo: 0.252 [95% CI: −0.547, 1.052]).

In areas linked to food anxiety (p =.037) and the emotional impact of allergies (p =.063), sex effect modification was higher during treatment than during post-treatment follow-up, according to a separate analysis of research phases. Overall, sex allocated at birth may alter treatment effects on HRQL, according to the PPOIT-003 trial's results of sex differences in FAQLQ-PF change scores during the treatment period.

Also, one interesting discovery was that OIT had a similar HRQL effect for both males and females, but that females benefited more from the placebo intervention, especially during the active treatment phase, whereas males did not. This highlights the psychological processes behind changes in HRQL and suggests the use of psychosocial, educational, and counselling treatments to lessen the effects of food allergies, especially in women.

Source:

Rosser, S. A., Lloyd, M., Loke, P., Ashley, S., O’Sullivan, M. D., Quinn, P., Gold, M., & Tang, M. L. K. (2025). Sex assigned at birth may modify health-related quality of life in children treated with peanut oral immunotherapy. Pediatric Allergy and Immunology: Official Publication of the European Society of Pediatric Allergy and Immunology, 36(8),. https://doi.org/10.1111/pai.70177