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New research · AI in Medicine
The Journal of allergy and clinical immunology · 1w
Randomized trialThe Journal of allergy and clinical immunology · 2026

Epitope-Specific IgE Profiles are Predictive of Desensitization and Remission in the IMPACT Trial.

Julie Wang, Samane Khoshbakht, Kyung Won Lee … Hugh A Sampson
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AI in MedicineRandomized trial

A 9-antibody epitope IgE model predicted peanut immunotherapy remission with 88.2% accuracy

Epitope-Specific IgE Profiles are Predictive of Desensitization and Remission in the IMPACT Trial.

Julie Wang … Hugh A Sampson
The Journal of allergy and clinical immunology · 2026
Background

From the IMPACT trial suggest that initiation of peanut oral immunotherapy (pnOIT) before age 4 years can increase chances of achieving desensitization and remission.

Purpose

We sought to assess sequential (linear) epitope-specific (es-)IgE and es-IgG4 profiles over the course of pnOIT and determine whether they can predict desensitization and remission outcomes.

Methods

In the IMPACT trial (NCT03345160) were randomized to pnOIT or placebo for 134 weeks.

Results

Model correctly classified 88.2% of children as achieving remission or not

83.3%
Sensitivity
90%
Specificity
More results

PnOIT was associated with an overall decrease in es-IgE and increase in es-IgG4 levels.

Younger subjects (<2.3 years of age) had lower baseline es-IgE binding and lower fold-change in es-IgE and es-IgG4 binding during pnOIT.

“
Conclusion · 1 of 3

Baseline epitope IgE profiles can predict remission outcome for children undergoing pnOIT. Age and baseline peanut IgE remain important factors across models.

Conclusion · 2 of 3

Notably, pnOIT prevented the epitope spreading of es-IgE observed in placebo-treated children, suggesting a treatment effect on the breadth of the allergic response that may be especially relevant in young children.

Conclusion · 3 of 3

These profiles may help identify patients who are more likely to benefit from pnOIT.

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