Peanut allergy makes life more
difficult for the millions of people who live with it. "Possible
traces" of peanuts in foods pose a constant hidden threat for them, but a
newly developed treatment could soon help people with peanut allergy become
more confident in their food choices.
Peanut allergy may soon become less
of a concern thanks to an effective new treatment.
Information provided last year by
specialists from the American College of Allergy, Asthma, and Immunology
(ACAAI) indicates that almost 2.5 percent of all children in the United States may live
with peanut allergy.
This number represents a 21 percent
increase in the number of possible peanut allergies in childhood since 2010,
the specialists also found.
A critical challenge for those
living with peanut allergy is distinguishing between food products that are 100
percent safe to eat, and those that may trigger an allergy episode.
For some people, the allergy can be
significant enough to lead to anaphylaxis,
a severe, life-threatening reaction. Many food items may contain traces of
peanuts because the factories that produce them also handle peanuts.
However, a new treatment developed
by experts from research institutions across the world hopes to help
individuals with this type of food allergy. The
treatment aims to build up enough tolerance to peanuts so that people with a
peanut allergy can handle accidental exposure without any problems.
"We're excited about the
potential to help children and adolescents with peanut allergy protect
themselves against accidentally eating a food with peanut in it," says
study author Dr. Stephen Tilles, who is also past president of ACAAI, and
consulting advisor for the biotech company Aimmune Therapeutics.
The researchers presented their
results today at the ACAAI Annual Scientific Meeting in Seattle, WA.
These findings also appear in The New England Journal of Medicine.
Participants
see increase in tolerance
"Because there is no approved
treatment for peanut allergy, the standard of care has been a strict
elimination diet and the timely administration of rescue medications in case of
an allergic reaction on accidental exposure," the study authors write.
"However, despite vigilance,
accidental exposures may occur and cause reactions of unpredictable severity,
even with small amounts of allergen, leading to a lifelong risk of severe
reactions," they continue.
The recent study tested the
effectiveness of a new oral immunotherapy for peanut allergy called AR101,
which is "a [...] peanut-derived, oral biologic drug that delivers a
target daily maintenance dose of 300 [milligrams] of peanut protein," as
the researchers explain in the study paper.
The research team worked with
participants aged from 4 to 55 years old, though most of these fell in the 4 to
17 age range. All of the participants lived with peanut allergy.
At the beginning and the end of the
study, the volunteers undertook an oral food challenge so that the scientists
could establish the severity of their allergic reactions.
Of the total number of participants,
two-thirds received AR101, while a third received a placebo. Each person
received their assigned substance in increasing doses until they reached the
maintenance dose — they continued to take this amount tor the duration of the
study.
The
researchers found that by the end of the study, 80 percent of the participants
successfully reached the daily maintenance dose, which was the equivalent of
about one peanut.
As Dr. Tilles explains, many
participants saw a significant increase in their tolerance to peanuts.
"Our hope when we started the study was that by treating patients with the
equivalent of one peanut per day, many would tolerate as much as two
peanuts," the study author says.
"We were pleased to find that two-thirds of the people
in the study were able to tolerate the equivalent of two peanuts per day after
9 to 12 months of treatment, and half the patients tolerated the equivalent of
four peanuts."
Dr.
Stephen Tilles
Treatment
may soon become available
Moreover, participants reported far
fewer side effects throughout the trial than the researchers had predicted. No
more than 6 percent of the participants experienced gastrointestinal side
effects that caused them to leave the trial, while as many as one-third of the
volunteers only experienced mild side effects.
As Dr. Tilles points out,
"Reactions from the oral challenges at the end of the study were much
milder than prior to treatment."
"On average, the participants
were able to tolerate a 100-fold higher dose of peanut at the end of the study
than they did at the beginning. In addition, the symptoms caused by the
100-fold higher dose at the end of [the] study were milder than the symptoms on
the lower dose at the beginning of the study," he adds.
However, "This is not a quick
fix, and it doesn't mean people with peanut allergy will be able to eat peanuts
whenever they want," notes another one of the study's authors, Dr. Jay
Lieberman, who is vice chair of the ACAAI Food Allergy Committee.
"But,"
he says, "it is definitely a breakthrough." He also expresses the
hope that very soon, the US Food and Drug Administration (FDA) will review the
treatment, and that it may be more widely available "in the second half of
2019."
"If that happens," Dr.
Lieberman adds, "people who receive and are able to tolerate this
treatment should be protected from accidental exposures."
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