{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:45:20Z","timestamp":1792626320164,"version":"4.5.0"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T00:00:00Z","timestamp":1763856000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT2008911"],"award-info":[{"award-number":["GNT2008911"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"published-print":{"date-parts":[[2026,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n Introduction<\/jats:title>\n Peanut allergy is the most common food allergy in Australian school\u2010aged children and is rarely outgrown. Access to oral immunotherapy (OIT), a disease\u2010modifying treatment for food allergy, is limited in many regions of the world, including Australia. Clinical trials show high rates of allergic desensitisation and remission are being achieved, particularly in young children, but significant variability in protocols and implementation prevents large\u2010scale evaluation of clinical and patient\u2010reported safety, effectiveness and long\u2010term outcomes. A standardised national model of care OIT program has not been previously attempted. In Australia, the National Allergy Centre of Excellence partnered with 10 paediatric hospitals to develop and implement the ADAPT OIT Program, which aims to change the trajectory from \u2018Allergy Development to an Accelerated Pathway to Tolerance\u2019. The Program was designed after extensive international expert and consumer consultation, and attempts to be pragmatic, feasible by using existing resources, and equitable, with out\u2010of\u2010pocket costs to families limited to the purchase of the OIT product, store\u2010bought peanut flour.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In July 2024, the ADAPT OIT Program was launched. Infants were considered if they had a history consistent with an IgE\u2010mediated allergic reaction to peanut <\u200912\u2009months of age and evidence of sensitisation (peanut SPT \u2265\u20093\u2009mm; peanut sIgE or ara h 2 sIgE \u2265\u20090.35kUA\/L). A threshold oral food challenge (OFC) was done to confirm a diagnosis of peanut allergy using teaspoon measures (1\/64th, 1\/32nd, 1\/16th, 1\/8th, \u00bc, \u00bd, 1 tsp. peanut flour, cumulative dose of 2435\u2009mg peanut protein), and to determine the OIT starting dose unless the index reaction was a CoFAR Grade 3+. In this case, infants started OIT with a microdose escalation commencing with a red microspoon of peanut flour (3\u2009mg peanut protein) up to a maximum of 1\/64th tsp. (15\u2009mg).\n Up\u2010dose stage<\/jats:italic>\n visits were conducted every 4\u2009weeks until the\n maintenance stage<\/jats:italic>\n was achieved (1\/2 tsp. of peanut flour: 650\u2009mg peanut protein). After 2\u2009years of OIT, infants had an 8\u2010week period of strict peanut avoidance followed by an OFC to assess for sustained unresponsiveness (SU). Infants were followed up for a minimum of 12 months post SU OFC.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The ADAPT OIT Program aims to make best\u2010practice peanut OIT accessible to a significant proportion of infants with peanut allergy in Australia. Under a national standardised model, with rigorous and timely evaluation, the Program design enables optimisation over time for maximal impact.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cea.70177","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T04:55:14Z","timestamp":1763960114000},"page":"369-377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Developing a Standardised National Model of Care for Treatment of Peanut Allergy in Infants: The\n ADAPT<\/scp>\n Peanut Oral Immunotherapy Program"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-153X","authenticated-orcid":false,"given":"T. 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S.","family":"Ford","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology The Children's Hospital at Westmead Westmead New South Wales Australia"},{"name":"Faculty of Medicine and Health, Sydney Medical School The University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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