The Next Wave of Peanut Allergy Treatments: Pills, Patches, and Tablets

I wrote a guide to current peanut allergy treatments earlier this year covering OIT and Xolair — the tools allergists can actually prescribe today. But the research pipeline has been moving fast, and 2026 has delivered some genuinely exciting clinical trial results. For the first time, it feels like we might be looking at a future where treating a peanut allergy doesn’t necessarily mean daily doses of the thing you’re allergic to.

Here’s what’s coming, and why I’m cautiously optimistic.

Remibrutinib: a daily pill that works in a week

This is the one that made me sit up straight. Remibrutinib is a BTK (Bruton’s tyrosine kinase) inhibitor — originally developed for chronic hives — that showed dramatic results for peanut allergy in a clinical trial presented at the AAAAI 2026 annual meeting. In the study, adults with confirmed peanut allergy took the pill twice daily, and some participants were able to tolerate significantly more peanut protein within as little as one week.

Why that matters: OIT takes months of gradually increasing doses. Xolair injections work over weeks. A pill that raises your threshold in days would be a fundamentally different experience for patients. It works by blocking the signaling pathway that mast cells use to trigger allergic reactions — so instead of retraining the immune system slowly, it essentially puts a brake on the reaction itself.

The caveats are real: this was a relatively small study, it’s been tested in adults so far, and we don’t yet know whether protection holds long-term or only while you’re taking the pill. But the speed and simplicity of a daily pill is hard to overstate. A larger trial is expected.

The Viaskin Peanut patch: treatment you wear

Viaskin Peanut from DBV Technologies takes a completely different approach called epicutaneous immunotherapy (EPIT). It’s a small adhesive patch worn on the skin that delivers tiny amounts of peanut protein through the outer layers of skin, gradually building tolerance without anything being swallowed.

The VITESSE Phase 3 trial studied the patch in children ages 4–7 with peanut allergy, and DBV presented additional data at AAAAI 2026. A long-term safety study called REALISE has also been encouraging. The appeal here is obvious for families: no daily dosing of peanut protein, no frequent allergist visits for dose escalations — just a patch the child wears. The trade-off is that the desensitization is modest compared to OIT, raising the threshold enough to protect against accidental exposures rather than allowing large amounts of peanut.

An earlier version of the Viaskin Peanut patch was rejected by the FDA in 2020 over manufacturing concerns, not efficacy. DBV redesigned it and ran the new Phase 3 trial, so the path to approval is being retraveled — but with stronger data this time around.

A peanut SLIT tablet: dissolves under the tongue

Sublingual immunotherapy (SLIT) delivers peanut protein as a tablet that dissolves under the tongue. It’s the same basic concept as OIT — expose the immune system to small, increasing amounts — but the under-the-tongue route tends to cause fewer and milder side effects than swallowing peanut protein directly.

In mid-2026, a peanut SLIT tablet moved to Phase 3 clinical trials after a study showed it boosted peanut tolerance in both children and adults and was well tolerated. The ALLIANCE trial also found SLIT to be safe in children with peanut allergy. If the Phase 3 succeeds, this could become the first SLIT product approved specifically for peanut allergy — and for many families, a gentler alternative to OIT.

Ozureprubart: next-generation anti-IgE

Xolair blocks IgE, the antibody that drives allergic reactions, and it’s already approved for food allergies. Ozureprubart (RPT904) is a next-generation anti-IgE therapy being developed by RAPT Therapeutics that aims to do the same job more potently and less often. Where Xolair requires injections every 2–4 weeks, ozureprubart may work with dosing roughly every 12 weeks — and it’s designed to not only block new IgE but also strip IgE that’s already bound to cells, which Xolair doesn’t do as effectively.

RAPT initiated a Phase 2b trial (called prestIgE) for patients with food allergies, including peanut. It’s earlier-stage than the other therapies here, but the mechanism is promising, especially for people with multiple food allergies who need broad protection rather than allergen-by-allergen treatment.

What this means right now

None of these treatments are available to prescribe today. Every one of them is still in clinical trials, and the path from promising data to an FDA-approved therapy is long and uncertain. But here’s what I think is worth taking from this:

The field isn’t stuck on one approach anymore. A few years ago, the options were “eat tiny amounts of peanut” or “block IgE with an injection.” Now there are at least four distinct mechanisms being tested — a pill, a patch, a tablet, and a better biologic — each with different trade-offs in terms of speed, convenience, side effects, and who it’s suited for. That diversity matters, because peanut allergy patients aren’t one-size-fits-all either.

If you’re considering treatment options that are available today, my current treatments guide covers OIT, Xolair, and what to ask your allergist. And whatever happens in the pipeline, the non-negotiables don’t change: carry your epinephrine, read your labels, and have a plan.

Sources

Not medical adviceThis is an educational overview of publicly reported research and clinical trials, not a recommendation. Treatment decisions must be made with a qualified allergist.

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