Is the better part of valor truly discretion?

Peanut allergy affects 1.4% to 4.5% of children, depending on the study and methodology. Self-reported estimates have shown an alarming 3-fold increase in US populations over 10 years, whereas UK data from a longitudinal birth cohort with challenge-based evidence have not reflected such an alarming increase.1–4 Unfortunately, for years, the common peanut allergy management paradigm was to strictly avoid any potential exposure (including trace amounts) and carry self-injectable epinephrine. Now, we find the field on the cusp of what could be 2 therapies approved by the US Food and Drug Administration (FDA) for the treatment of peanut allergy in children in late 2018 or early 2019 (a commercial low-dose oral immunotherapy [OIT] capsule and an epicutaneous patch).

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