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Peanuts are one of the food allergens most commonly associated with anaphylaxis, a sudden and potentially deadly condition that requires immediate attention and treatment. In recent years, both awareness about peanut allergy in children and the number of peanut allergy cases have risen. Though doctors advise their patients to avoid peanuts, this is difficult in practice as peanuts are often hidden in prepared foods or can cross-contaminate other foods during preparation.
This is just one of the many reasons why researchers have turned to preventing peanut allergies. Two common approaches have been to provide peanut protein to children at a young age and desentitizing children to peanut through oral or sublingual immunotherapy. Another approach is epicutaneous immunotherapy—using skin patches containing peanut protein.
In the international clinical trial led by David Fleischer, MD, researchers exposed 356 children, aged 4 to 11, to a very small amount of peanut to see if it would desensitize them. All had been diagnosed with peanut allergy and were asked to wear either a skin patch with a very tiny amount of peanut allergen (250 micrograms) or a placebo patch without any allergen. The participants were later tested with a "peanut challenge" where the children were gradually fed small doses of peanut (from 1 milligram up to over 3,000 milligrams total). About one-third of the children in the trial increased the amount of peanut they could eat to meet study criteria as a responder to the therapy. The other two-thirds had some improvement in the amount they could eat compared to their initial amount, but not as much improvement as needed to meet responder study criteria.
“It is very exciting that we now have not just one but two possible treatments for children with a peanut allergy,” said Dr. Fleischer, Director, Allergy and Immunology Center at Children’s Colorado. “For the first time, we are seeing treatment options for patients that may improve their quality of life, and that is something we haven’t been able to offer before. Most importantly, other than how well the patch worked, was the safety and high compliance with the use of the patch. Compliance was over 95%, which also points to the convenience of using a patch over other types of food immunotherapy.”
Most of these participants have continued in another open-label study. In this study, patients who were initially on the peanut patch continue using it for up to an additional 4 years, and the patients on placebo begin wearing a peanut patch.
“The most recent results of this study are incredibly promising,” said, Matthew Greenhawt, MD, Director, Food Challenge and Research Unit at Children’s Colorado. “As seen in the prior phase two trial, we hope to find that continued use of the patch results in more desensitization to peanut exposure – meaning that longer use of the patch will provide higher tolerated amounts of peanut over time.”
Learn more about allergy and immunology research at Children's Colorado.