Hope for Peanut Allergy Sufferers After Groundbreaking New Study

A treatment for peanut allergies that could literally save children’s lives just passed a big testing milestone, but uncertainty over pricing looms on the horizon.

Around the world,an estimated0.6 percent and 1.0 percent of the population has a peanut allergy, which can range from mild to severe. Those who do suffer may display a range of symptoms from annoying but harmless ailments like a runny nose or itching and tingling around the mouth to more severe symptoms like developing hives and difficulty breathing.

For people who are severely allergic to peanuts, exposure can bring on a state known as anaphylaxis, where a person may have a sharp drop in blood pressure, constriction of their airway and loss of consciousness. In the most severe cases, anaphylaxis can lead to death.

While there are a range of treatments on the market claiming to help people witha peanut allergy, science has not actually found a solution for this problem. Instead, it has relied on helping people cut their exposure risk and supplying those with the most severe peanut allergies with emergency treatment like EpiPens. But this isn’t a cure, and while there has been a lot of research, no one treatment has emerged as a frontrunner — until now.

Using Gradual Exposure to FightPeanut Allergies

New researchknown as the PALISADE study, a Phase III human trial involvingjust over 500 children aged between four and17 from the US and Europe, has offered up some exciting results.

The trial involved giving three quarters of participants a micro-dose of peanut protein, whichresearchers gradually increased overthe course of the trial. Those participants sprinkled their food with broken-up capsules containing medical grade peanut flour. The remaining group of participants were the control group andused a placebo.

The researchers then carefully tested the children over a six month period before putting the peanut exposure group on a maintenance dose. After the trial, they found that 67 percent of the children and teenagers in the exposure group could tolerate as much as 600mg of peanut protein. This is compared to just four percent of participants in the placebo group being able to tolerate that level of exposure.

To put that in perspective, when the study began most of the children reacted to exposures as low as 10mg. This could be the difference between being able to tolerate a small unintended exposure by, for example, consuming trace amounts of peanuts in a food product, and needing urgent medical care.

This approach of gradual exposure to build tolerance is not exactly new. Case reports have demonstrated that this approach may have clinical worth, and a number of smaller trials have corroborated that fact. However, this is the first time the theory of gradual exposure has been tested so rigorously.

The treatment, known as AR101, used a precise, measured quantity of peanut flour, allowing clinicians to standardize the treatment and gradually increase it over time toup a child’s tolerance.

“It is a pharmaceutical-grade treatment product,”Study co-author Dr Stephen Tillis,of theUniversity of Washington in Seattle, told The Telegraph. “It is not just peanut flour that you can buy somewhere.”

Doctor Tillis adds that the peanut flour is refined to such an extent that it would meet the criteria used by the FDA to licensemedical treatments,so he hopes that it will receive approval within the near future. But the treatment was not without its issues.

Desensitization Was Difficult for Some Patients

Asyou might guess, with this kind of intervention there comes some risk.

During the trial, about 14 percent of the patients receiving the AR101 treatment and three percent of the placebo group experienced what are known as systemic allergic reactions, meaning that they had reactions that occurred throughout the body. This can be the precursor for anaphylaxis, but in a pleasing result only one patient actually had an anaphylactic reaction. Still, there was around a 20 percent drop-out rate in the study, and 12 percent was because of side-effects.

To be absolutely clear, when balancing out this kind of treatment against the rate of severe side-effects demonstrated in this trial, AR101 actually performed well. Immunotherapyis, by its nature, often more aggressive than many other interventions, but other interventions like topical skin treatments for peanut allergies have proved far less successful.

Many parents would argue that they would prefer to have carefully managed risks that lead to a potential desensitization over the alternative of living in a constant state of anxiety over when their child might next have an attack.

There is one major point to note: we don’t know how long-lasting this tolerance is. The research could not follow up on how long a maintenance dose must be used, but it isn’t too ahead of ourselves to suggest that the maintenance dose might be needed for the rest of the person’s life in order to maintain this effect. As such, the pricing of this treatment would have to be affordable, in order to be a help and not a burden for sufferers.

It’s estimated that the FDA will start evaluating the treatment in the first half of next year. AR101′s safety profile will be rigorously evaluated during that time to ensure that the benefits far outweigh potential side-effects, but for many parents with children who have peanut allergies this may be a welcome treatment milestone.

Photo credit: Getty Images.

36 comments

Chad Anderson
Chad Anderson13 days ago

Thank you.

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Shae Lee
Shae Lee14 days ago

Thanks for sharing!

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Dave fleming
Past Member 14 days ago

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Paula A
Paula A15 days ago

Thank you

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Danuta W
Danuta W15 days ago

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Marija M
Marija M16 days ago

Interesting, tks for sharing.

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Tania N
Tania N16 days ago

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Tania N
Tania N16 days ago

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Tania N
Tania N16 days ago

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Louise R
Louise R16 days ago

Thanks for sharing

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