Home-based peanut oral immunotherapy (OIT)
Why traditional OIT requires repeated clinic visits
In other hospital-based programmes, the dose is increased at intervals of one to two weeks.
During this time:
- the same dose is taken daily
- the immune system adapts gradually
When the dose is increased, it often needs to be raised by a relatively large step — usually 25–100%.
Because these increases are substantial, they carry a higher risk of reaction and are therefore this obliges families to come into clinic for long supervision visits.
A different approach to dose escalation
Our approach uses smaller, more frequent dose increases.
After the initial low dose introductory stage:
- doses are adjusted daily, rather than fortnightly
- increases are very small (for example, around 5% at a time)
This avoids large step changes in dosing.
Instead, the dose increases in a smooth, gradual and controlled way.
Why this allows treatment at home
Because dose increases are smaller and more incremental, the changes between doses are less abrupt. This removes the need for frequent supervised dose increases in clinic.
As a result, much of the treatment can be carried out at home within a structured clinical framework.
How we manage dosing
Doses are contained within capsules which are emptied into an everyday food and eaten. The capsules are presented in easy-to-use packaging indicating clearly the order in which they should be consumed. The doses of the capsules increases very slightly (~5%) on most days.
Continuous clinical oversight
Although treatment is delivered at home, patients remain under active clinical supervision.
This includes:
- a bespoke patient diary app to record daily dosing and any symptoms
- regular review of progress by the clinical team
- a dedicated communication channel for advice and support
This allows treatment to be monitored continuously, rather than only at clinic visits.
A structured programme — not self-treatment
Treatment is delivered through:
- defined dosing protocols
- clear instructions at each stage
- ongoing specialist supervision
Patients and families are supported throughout the programme.
Additional safety measures
This approach is supported by:
- Careful patient selection
- Use of regulated medicinal products
- Ongoing monitoring and review
- Open communication channels
- Training in emergency medication use
What this means for patients
For many families, this approach allows treatment to fit more easily into everyday life.
It can address:
- the need for repeated hospital visits
- time away from school or work
- the burden of ongoing travel
- lack of local OIT services
while maintaining a structured and supervised treatment pathway.