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Cracking Open Hope for Peanut Allergy Sufferers

Friday, February 07, 2020 10:40 AM

Millions of Americans have food allergies, including about 1 in 13 children, and the numbers have increased in recent years. Peanut allergies, in particular, are the most common and most dangerous amongst children, with approximately 1 in 4 affected children winding up in the emergency room every year.

For so long, doctors had nothing to offer those with peanut allergies, but that’s about to change.

Peanut Allergy

A life-changing, prescription-only treatment is about the hit the market for children and teens with peanut allergies. Recently approved by the Food and Drug Administration (FDA), Palforzia is a specially prepared peanut powder that’s swallowed in tiny amounts and is gradually increased over months. The result? It trains children’s and teen’s bodies to better tolerate peanut in case it’s accidentally consumed.

The treatment is considered “Oral Immunotherapy,” which is the idea of administering small doses of food protein by mouth and gradually increasing the amount being administered. Once the desired dose has been achieved, the patient will take the same dose of food allergen every day for an indefinite period of time. The belief is that giving small doses of food allergen to someone with a food allergy has the potential to induce significant desensitization in most patients who are allowed to tolerate the therapy.

Who is eligible?
The treatment is going to be available for children aged 4 years through 17 years only, through a restricted program called Palforzia REMS (Risk Evaluation and Mitigation Strategy), because of the risk of anaphylaxis from the treatment program. The treatment is not FDA approved for adults because they didn’t respond well in studies.

How does it work?
The program involves one full day under supervision initially in a doctor’s office and then at minimum about 11 additional two-hour visits over six months, with additional visits for dose adjustments according to any side effects.

“This is not a cure,” said Jennifer S. Kim, MD, Allergist/Immunologist at NorthShore. “This requires a commitment to a daily therapy that carries likely side effects (allergic reactions) aiming to increase the threshold of reaction. If the therapy is stopped, any benefit is typically gradually lost.”

What are the reactions?
Adverse reactions are very common and experienced by nearly all patients. Local symptoms (oral itching, transient abdominal pain) are the most common, and reactions are generally mild, requiring no treatment or treatment with antihistamines alone. Moderate reactions, such as wheezing, vomiting and hives, occur in some patients at a spectrum of doses. Some patients who experience severe effects are unable to continue with the treatment.

Final thoughts:
Dr. Kim stresses that oral immunotherapy like Palforzia is a way to desensitize an individual with allergies, however, it doesn’t allow the patient to gain a tolerance, which means you can eat the food whenever you want without a schedule.

“The FDA-approved product’s benefit is that very small doses (down to 3 mg peanut protein) can be administered consistently as the doses are pre-measured,” said Dr. Kim. “We intend to offer Palforzia at NorthShore, but at this time we are awaiting more information on release dates, availability, insurance approaches and registration for administering the treatment."

For more information about allergies and immunology care, book an appointment with one of our specialists.