New oral treatment reduces severity of peanut allergy reactions in children
A new treatment for children with peanut allergy has been shown to reduce the severity of allergic reactions in an international trial involving Southampton researcher Dr Mich Lajeunesse.
The AR101 oral immunotherapy treatment led to a ‘rapid desensitisation to peanut protein’ in 175 patients taking part in the AR101 Trial in Europe Measuring Oral Immunotherapy Success in peanut-allergic children (ARTEMIS), published in The Lancet Child & Adolescent Health.
Treating peanut allergy
Peanut allergy is the leading cause of food-related anaphylaxis – a severe, potentially life-threatening allergic reaction that can cause an asthma attack.
The standard treatment for children with peanut allergy is to avoid peanuts completely to prevent triggering an allergic reaction. However, this can be difficult due to traces of peanut in a range of foods due to food processing practices and does little to reduce the risk of a severe reaction if they do accidentally eat something containing peanut.
The ARTEMIS trial aimed to see if a controlled oral immunotherapy treatment, which gradually introduces very small amounts of peanut protein, could lessen the severity of reactions in children.
Reduced sensitivity
This phase 3 trial ran at 18 hospitals across Europe, in Ireland, France, Germany, Italy, Spain, Sweden and the UK. It involved 175 children aged 4-17 years, who develop allergic symptoms in response to the equivalent of one or less peanuts (300mg).
They were randomly assigned to either receive daily doses of the AR101 treatment or a placebo that tasted the same but lacked any peanut protein, to control for any positive effect of simply taking a treatment.
The dose was increased every two weeks for six months, or until a dose of 300mg was reached and maintained for three months.
After nine months, they assessed how many participants could consume a single dose of 1000mg peanut protein without developing dose-limiting allergic symptoms - the equivalent of 3 to 4 peanuts.
Out of the 132 participants in the AR101 group, 77 (58%) tolerated 1000mg peanut protein, compared to just one (2%) of the 43 participants in the placebo group.
The researchers also found improvements in food allergy-related quality of life. Side effects were common, but were mostly mild and improved over time.
The researchers suggest these results could help inform doctors, patients and their caregivers, giving them a new treatment option and the information they need to decide the best way to manage their peanut allergy.
Dr Mich Lajeunesse and his team are running other trials and studies on peanut immunotherapy for children. Please email UHS.SouthamptonCRF@nhs.net to find out more and take part.