#4 Therapy for Peanut Allergies

Overview

It’s a terrifying reality for 2.5 percent of parents – the possibility that at any moment, their child might be unable to breathe. A meal at a restaurant, a snack on-the-run, a cupcake for a school birthday – it’s often impossible to be 100% certain of the ingredients in your child’s food. The possibility of an allergen slip up is all too real. And with a percentage of the adolescent population with a peanut allergy 21% higher than in 2010, possible traces of peanut in foods poses a constant threat for more than just a few children.

We all recognize the need for immediate action upon symptoms of an allergic reaction – skin reactions, itching, a tightening throat, nausea, vomiting, coughing and inability to breathe. And though emergency epinephrine and FDA regulations to include the top allergens on food packaging have reduced the severity and risk of accidental exposure, these precautions are not enough to quell the ever-present anxiety. Parents, children, and the world need something more by way of protection against pending attack.

Medications for food allergies have been in the works for some time, though often thought idealistic and improbable. But breakthroughs in targets for peanut allergies have been made in recent years. A new immunotherapy for the condition has presented some fascinating data and is the food allergy therapy closest to the hands of patients.

The substance is a peanut-derived, oral biologic drug that delivers a target daily maintenance dose of 300 milligrams of peanut protein. The treatment functions by way of building up enough tolerance to peanuts so that people with an allergy can become more confident in their food choices, and handle accidental exposure without issue. In a recent study of effectiveness of the new oral immunotherapy, each person received increasing doses of the therapy until they reached the maintenance dose. By the end of the study, approximately 80 percent of participants reached the daily maintenance dose (300 milligrams; one peanut) and nearly two-thirds of participants could tolerate the equivalent of two peanuts per day after 9-12 months of treatment. Nearly half even tolerated exposure to the substance at a four peanut level. 

Moreover, participants reported far fewer side effects throughout the trial than predicted by the leading researchers. To sum the results, on average, participants were able to tolerate a 100-fold higher dose of peanut at the end of the study than they did at the beginning, and symptoms caused by the 100-fold higher dose at the study end were ironically less severe than the symptoms experienced with the lower dose at the study start.

Though the treatment is not a cure for allergy and may not work for all who suffer, in September 2019, an FDA expert panel recommended its approval. Development of this agent and an uptick in research in the allergy and immunology space hold the promise of life-changing solutions for those, and the parents of those, who live in constant fear.

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