Young children with a peanut allergy may be treated effectively through controlled exposure, according to a new study of an investigational treatment.
Researchers found nearly 80% of those enrolled in the clinical trial eventually were able to eat foods containing peanut.
“These findings, if confirmed in larger studies, could transform the care of peanut-allergic children early in life,” Brian P. Vickery, M.D., lead author and assistant professor of pediatrics at the University of North Carolina at Chapel Hill, said in a news release.
Roughly 1.5% to 3% of children are allergic to peanuts and typically develop the allergy early in life, according to the study “Early oral immunotherapy in peanut-allergic preschool children is safe and highly effective” (Vickery BP, et al. J Allergy Clin Immunol. Aug. 10, 2016, http://dx.doi.org/10.1016/j.jaci.2016.05.027).
Researchers set out to study early oral immunotherapy through a double-blind study of 37 children ages 9 to 36 months who were allergic to peanut. Children received either 300 milligrams or 3,000 milligrams of peanut protein daily, while a control group of 154 children with peanut allergies avoided peanut.
During the treatment, which lasted a median of 29 months, most experienced allergic side effects, but they were mild to moderate. After treatment, they abstained from peanut for four weeks, then consumed it in a controlled setting. If successful, peanut was introduced into their diet.
Roughly 78% were able to consume peanut without experiencing allergic symptoms, including 85% of the low-dose group and 71% of the high-dose group. Children who received treatment were 19 times more likely to be able to eat peanut than the control group.
The success of the treatment may be attributable to “the lower average psIgE (peanut-specific immunoglobulin E) levels typically seen in young children and/or the plasticity of a relatively immature immune response,” authors wrote. They are continuing to study the long-term effectiveness of the treatment.
Early peanut exposure also has been found to be beneficial to infants who are at risk of peanut allergy. Last year, the Academy was one of 10 medical organizations that endorsed Consensus Communication on Early Peanut Introduction and the Prevention of Peanut Allergy in High-risk Infants, which stemmed from findings of the Learning Early About Peanut allergy (LEAP) study. The interim guidance says high-risk infants ages 4 to 6 months may benefit from evaluation for a possible peanut allergy. If they are not allergic, a clinician may introduce them to peanut products that do not pose a risk of choking.
Scott H. Sicherer, M.D., FAAP, co-author of the consensus statement and past chair of the AAP Section on Allergy and Immunology Executive Committee, said he was interested to see that in the new study from Vickery and his colleagues, so many young children already determined to have an allergy were able not only to tolerate the treatment but maintain protection even after not eating peanut for a month. He called the study results “promising.”
“They were very good results and it may well be that this younger age group is the time to get started on this strategy once this strategy is FDA (Food and Drug Administration) approved,” Dr. Sicherer said.
