{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:03:08Z","timestamp":1790820188475,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Unmet needs remain for disease\u2010modifying interventions for the treatment of severe persistent food allergies. In mice models, abatacept, a cytotoxic T lymphocyte\u2010associated antigen\u20104 (CTLA\u20104) immunoglobulin fusion protein, promotes immune tolerance to food proteins, and suppresses the initial allergen\u2010related induction of specific immunoglobulin E (IgE) when used as an adjuvant to allergen immunotherapy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this Phase 2a placebo\u2010controlled clinical trial, 14 peanut\u2010allergic participants (14\u201350\u2009years old) with specific IgE >\u200950\u2009kU\/L were randomized 1:1 to adjuvant abatacept vs. placebo to peanut oral immunotherapy (OIT) for 24\u2009weeks, followed by 12\u2009weeks of OIT alone. With the hypothesis that abatacept suppresses the transient OIT\u2010induced increase in specific IgE, the primary outcome was the relative change from baseline of the peanut\u2010specific\/total IgE ratio at 24\u2009weeks. Sustained unresponsiveness was assessed as a secondary outcome with repeated oral food challenges (OFCs) following incremental periods of peanut avoidance.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n No significant difference in the relative change in peanut\u2010specific\/total IgE ratio from baseline was observed between groups (placebo group 87.9% vs. abatacept group 48.2%,\n p<\/jats:italic>\n \u2010value 0.26). Median minimal reactive doses on repeated OFCs were similar in both groups (3000\u2009mg) after 4\u2009weeks of peanut avoidance. Lower adverse event rates including anaphylaxis were observed in the abatacept group (5.9 vs. 10 per participant,\n p<\/jats:italic>\n \u2010value 0.006).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Compared to placebo, abatacept did not suppress the allergen\u2010related induction of peanut\u2010specific IgE relative to their total at 24\u2009weeks, but improved OIT tolerability in this severely allergic adult population. Independently of abatacept, most participants achieved sustained unresponsiveness with OIT.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/all.70531","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:26:02Z","timestamp":1790817962000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Abatacept Versus Placebo During Peanut Oral Immunotherapy for Adults With Severe Peanut Allergy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0994-8047","authenticated-orcid":false,"given":"Marie\u2010Lee","family":"Simard","sequence":"first","affiliation":[{"name":"D\u00e9partement D'immunologie et Allergie P\u00e9diatrique CHU Sainte\u2010Justine Montr\u00e9al Qu\u00e9bec Canada"},{"name":"D\u00e9partement D'immunologie et Allergie CHU de Qu\u00e9bec Qu\u00e9bec Qu\u00e9bec 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CHU Sainte\u2010Justine Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010\u00c8ve","family":"Gingras","sequence":"additional","affiliation":[{"name":"Service de Biochimie Centre Hospitalier de L'universit\u00e9 de Montr\u00e9al (CHUM) Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6410-2629","authenticated-orcid":false,"given":"Fran\u00e7ois","family":"Graham","sequence":"additional","affiliation":[{"name":"D\u00e9partement D'immunologie et Allergie P\u00e9diatrique CHU Sainte\u2010Justine Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3947-4735","authenticated-orcid":false,"given":"Anne","family":"Des Roches","sequence":"additional","affiliation":[{"name":"D\u00e9partement D'immunologie et Allergie P\u00e9diatrique CHU Sainte\u2010Justine Montr\u00e9al Qu\u00e9bec 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Temerty Faculty of Medicine Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9089-4604","authenticated-orcid":false,"given":"Philippe","family":"B\u00e9gin","sequence":"additional","affiliation":[{"name":"D\u00e9partement D'immunologie et Allergie P\u00e9diatrique CHU Sainte\u2010Justine Montr\u00e9al Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_12_2_1","first-page":"20","article-title":"CSACI Guidelines for the Ethical, Evidence\u2010Based and Patient\u2010Oriented Clinical Practice of Oral Immunotherapy in IgE\u2010Mediated Food Allergy","volume":"16","author":"B\u00e9gin P.","year":"2020","journal-title":"Allergy, Asthma and Clinical Immunology"},{"issue":"1","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1111\/all.16345","article-title":"EAACI Guidelines on the 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