Leaping toward Tolerance

The LEAP (Learning Early About Peanut allergy) trial established that early introduction of peanuts in high-risk infants prevents the childhood development of peanut allergy for most.1 LEAP-Trio, a 12-year follow up of the LEAP participants, published in this issue of NEJM Evidence, demonstrates long-term protection from peanut allergy.2 In comparison with the 80% reduction of peanut allergy in LEAP, LEAP-Trio found a 75% reduction in the early peanut consumption group compared with the avoidance group, despite ad libitum consumption of peanuts in children who were originally peanut-tolerant.2 Clinically, LEAP-Trio demonstrates that early introduction of peanuts in high-risk children results in long-lived tolerance.