A study has suggested that peanut powder can be used daily to help children with allergies.
The effects of gradually increasing peanut intake were tested on just 100 children with the allergy. They were given 0.1mg of peanut protein powder to begin with — the equivalent of 0.03 per cent of an individual nut.
Seventy-one percent of those who were given 16 peanuts two and a half years after the incident did not suffer a reaction. Only two percent, however, were able to avoid a reaction in the placebo group.
But not all the children were considered ‘cured’ — only a fifth met the definition of remission.
However, the scientists — led by a team at the University of Arkansas — say success rates of immunotherapy were highest among babies, suggesting there is a ‘window of opportunity’ in treating children early on.
Allergies can cause anaphylactic shock — a deadly immune system overreaction that can kill within minutes.
Peanut allergies are a serious condition that can lead to death. They affect approximately one out of 50 UK residents. People with peanut allergies are told not to eat peanuts, and to keep EpiPens (or other life-saving autoinjectors) in their possession just in case of an allergic reaction.
Previous studies have shown immunotherapy can reduce reactions to peanuts, but the treatment is not yet widespread.
NHS England last month secured a deal with Palforzia — a branded immunotherapy pill that will be given once a month to 600 allergic children aged four to 17. It was approved by the US in January 2020 and is now available worldwide.
Top graph shows: The proportion of children with peanut allergies given immunotherapy (blue) — a slow increase of peanut intake — who avoided a reaction when given the equivalent of 16 peanuts after two-and-a-half years (left) and 26 weeks after treatment ended (right) compared to those not given the treatment (orange)
This graph shows how 26-weeks after treatment, children with a mild reaction to the medication (blue), were less likely to have a reaction than those who had a severe allergic reaction (red).
Graph: Peanut allergies can be overcome at all ages, regardless of the severity of your initial reaction
The new research, published in The Lancet, suggests the powder form of immunotherapy can also work — and is more effective on younger children.
Dr Wesley Burks from North Carolina University at Chapel Hill, who participated in the study, stated: “The severe and unpredictable nature of food allergy reactions can be worrisome to affected children and their families.
“Aside from medication and avoidance of allergic reactions, there is no other treatment option. This puts a significant burden on parents and caregivers and makes it difficult for children to be exposed to allergic substances.
In extreme cases this may restrict the freedoms of peanut allergic children, especially when it comes down to navigation daycares or schools, public places, and other spaces that place young children at risk for a safe diet.
“Exploring effective and safe treatment options for peanut allergy in children is critical to improve quality of life, especially since most of these children will be allergic throughout their lives.”
Study included 146 children affected by peanut allergies, aged between one and four years old in the US. The researchers followed them for two-and a-half year.
In order to measure their allergies, it meant children had to suffer from allergic reactions during the first part of the study.
Initial tests showed that they were able to tolerate peanut protein powder up to 25 mg per day.
Ninety-six children were then given daily doses of the powder, starting at just 0.1mg before slowly increasing to 2,000mg. Others were then given a placebo.
Parents generally gave their children doses, but doctors determined the exact amounts.
To ensure that any reactions to doses can be quickly treated, parents always had an EpiPen and another auto-injector with them.
21 out of 21 children treated with the drug experienced severe reactions and required emergency medical care.
98% of those hives were mild, with stomach pain (78%), wheezing (75%), and stomach discomfort (88%).
The researchers administered 5,000mg to the children at the end, in order to compare the effect of the powder with the placebo.
The immunotherapy treatment was nearly 35 times as effective as the placebo. Nearly three quarters of those who received the treatment had no reaction.
All children were then treated, and the scientists could measure the rate of’remission.
This test was repeated 26 weeks later by children. Only two percent of placebo-treated kids had reactions.
However, success rates for one-year olds were much higher (71%), as compared with 35% for two-years-olds, and only 19% for three-years-olds.
Researchers stated that there was a window for peanut allergy treatment at an early age.
They said that more research was needed in order to determine how peanuts affect children’s reactions to them in real life.
Stacie Jones is a University of Arkansas paediatrician. She said that remission was more common in younger children. The best results were seen for children under one years old. This suggests that early intervention may be the most effective way to get remission.
“However, we only had a small number of one-year old children enrolled in this study. Therefore, more research is needed to confirm these findings.”
A life-changing treatment for peanut allergies is first offered to a nine-year old girl
Emily Pratt, nine, became one of the first children in Europe to receive Palforzia, an immunotherapy pill that helps to reduce the severity of symptoms including anaphylaxis after a reaction to peanuts
The treatment will change the lives of children with peanut allergy in the United States.
NHS England has secured a deal for Palforzia, an immunotherapy pill that helps to reduce the severity of symptoms including anaphylaxis after a reaction to peanuts.
Evelina London Children’s Hospital took part in two large peanut allergy trials — the Palisade and Artemis studies.
Sophie Pratt stated that her family had experienced a change after Emily (age nine) took part in Palisade’s trial.
She stated that the clinical trials had made a huge difference in her family’s lives. We received treatment that has allowed Emily to be free of all limits. She no longer fears that she might make a mistake that could endanger her life. It has also removed the worry and tension that we felt every day about eating.
It was especially noticeable on special occasions such as Christmas, birthdays and other holidays, where special food like cakes and ice cream are frequently available.
‘Since the trial, Emily can go to parties and playdates with confidence, eat in restaurants without us having to call ahead to check the menu, and we’ve managed to have her first holiday abroad to New York and even taken part in feeding animals at zoo experiences – which is Emily’s passion.
“We couldn’t be more thankful.”
Artemis’ study showed that six of 10 children aged four to 17, who were allergic to peanut protein (around 10g) at the beginning of the trial, could take 1,000mg in the final two weeks. That is well beyond the level of accidental exposure.
A deal between the NHS and the NHS means that 600 children four- to seventeen years old will receive treatment this year. Children in England are the first to get the treatment. The NHS will treat another 2,000 patients every year.
One in fifty children suffer from peanut allergy in the UK.
Stephen Powis (NHS medical director) said, “This groundbreaking treatment can be life changing for patients and their family and, thanks to a deal the NHS has made, the people of this area will be among the first to receive it in Europe.”
It will help patients and their loved ones who suffer from this allergy, as well as those with families that have carried around emergency medications just in case.
“They should all be able and able to travel together, enjoy food out and holidays without fear of an allergic reaction.
For both trials, Professor George du Toit was the senior investigator from the UK. He is an expert in children’s allergies at Evelina London.
He stated that this was a great development for peanut allergy sufferers, especially young children. Palforzia’s approval is a major step towards better care for allergic sufferers. We will have immediate access to Palforzia, the first licensed treatment to lower the severity and protect from accidental peanut exposure.
“This will greatly impact the everyday lives of patients and their loved ones.”