While additional data on immunotherapy for tree nuts is somewhat lacking, peanut immunotherapy, specifically OIT, has emerged as a potential approach for induction of tolerance in allergic individuals. Recently, a few meta-analyses of immunotherapy for food have been published, including a Cochrane review specifically on peanut OIT.73 Overall, the analyses concluded that peanut OIT with short-term incremental doses of the allergen seems to be effective for inducing desensitization in some patients who are able to tolerate the regimen, but none of the studies showed induction of tolerance by OIT and no trials followed subjects for >2 years.74 One study published in 2014 demonstrated that 50% of subjects with peanut allergy treated with OIT for up to 5 years had sustained unresponsiveness for 4 weeks after cessation of therapy.75 Similar studies with patients followed for longer time periods after discontinuation of OIT are required to support this result. In all studies of OIT in food allergy, the rates of adverse reaction are not insignificant (up to 90%) in the treatment groups.74 Most reactions are mild, but further studies are needed to adequately assess risk and safety before recommending this treatment in clinical practice. An additional alarming statistic reported in a recent meta-analysis includes the development of eosinophilic esophagitis in up to 2.7% of patients undergoing OIT.76 This further illustrates the need for additional long-term follow-up studies on OIT in food allergy.