by Amy Norton
THURSDAY, May 11, 2023 (HealthDay News) — A new clinical trial shows that a “peanut patch” worn on the skin may help protect children with potentially life-threatening peanut allergies.
The patch is a form of immunotherapy, which means it exposes children with peanut allergies to small portions of peanut protein over time — with the goal of training the immune system to better tolerate it.
In the experiment, researchers found that young children who wore a peanut patch every day for a year, two-thirds showed a significant reduction in their sensitivity to peanut protein: They were able to eat the equivalent of one to four peanuts without experiencing the allergy. reaction.
While this may sound like a peanut, experts said the level of tolerance is important.
Dr. Alexis Togias, of the US National Institute of Allergy and Infectious Diseases, said the goal of immunotherapy is to prevent a severe reaction if a child accidentally eats a small amount of peanuts.
“This is a positive study,” said Togias, who wrote an editorial published with the results May 10. New England Journal of Medicine.
The patch tested in the trial, called Viaskin, is being developed by French biotech company DVB Technologies, which funded the research. It has not yet been approved by the US Food and Drug Administration.
“If I get approved, I think that will only be a good thing,” Togias said.
An estimated 2% of American children have a peanut allergy, and for most children the allergy persists into adulthood. This makes it the most common food allergy among children, and the third most common among adults, according to the Food Allergy Research and Education (FARE) organization.
People with a peanut allergy can experience reactions, sometimes severe, to eating even a small amount of the food—the amounts usually lurking in processed or prepared foods. So they (or their parents) should read food labels seriously and take other precautions to avoid exposure to peanuts.
It’s not easy, Togias said, and accidents happen.
In terms of treatment, there is an oral form of immunotherapy approved by the FDA for peanut allergy, called Palforzia. It is a peanut flour product that can be mixed with food, such as applesauce. But it is only approved for children 4 years of age and older.
“There are currently no FDA-approved treatment options for young children younger than 4 years old,” said Dr. Matthew Greenhout, principal investigator of the new trial.
Oral immunotherapy under study for young children with peanut allergy. But Greenhawt said it’s always good to have multiple options on the table.
“What works for one family may not work for another,” he said.
In addition, the patch approach may have fewer side effects, according to Greenhout, MD, professor of pediatrics at Children’s Hospital Colorado/University of Colorado School of Medicine.
He said the patch “takes advantage” of the fact that the skin is the largest organ of the body’s immune system. This means that a smaller dose of peanut protein can be used, which helps avoid systemic side effects sometimes caused by oral immunotherapy – such as stomach upset, throat irritation and shortness of breath.
Greenhawt, who also serves as a medical advisor for DBV Technologies, said these types of problems rarely appear with the patch.
The trial included 362 children, ages 1 to 3, who were randomly assigned to wear either a peanut patch or a placebo patch (inactive) every day for a year. Overall, 67% of the children in the real treatment met the end goal of the trial: Their immune tolerance was built up to the point where they could eat the equivalent of one to four peanuts without an allergic reaction.
This compared to 33% of the children in the placebo group.
Rash was the most common side effect with the peanut patch, while less than 2% of children developed systemic symptoms that were considered ‘mild to moderate’.
How does this stack up against peanut powder?
It’s difficult to judge, Togias said, because no trial has compared the methods head-to-head.
But he pointed to a trial published last year that tested oral immunotherapy for children ages 1 to 3 with a peanut allergy. The results suggest the oral approach may have stronger effects in desensitizing the immune system, Togias said.
On the other hand, he added, a skin patch may be safer.
One of the biggest questions about immunotherapy for peanut allergy, Togias said, is whether there is a point at which it can be stopped. Palforzia is taken daily indefinitely, to maintain immune system tolerance to peanuts.
The peanut patch is also designed for daily use, Greenhawt said, and so far the trials (including one in an older child) have followed patients for up to three years of use.
Jennifer Buford, vice president of clinical operations for FARE, agreed that having multiple types of immunotherapy would be beneficial for families.
Buford also noted that many people with a peanut allergy are sensitive to other foods as well. “It would be interesting to see if it was dermatitis [via the skin] Desensitization can be achieved for other common food allergens.”
While there is positive news on the treatment front, Togias stressed another point: Peanut allergies can also be prevented, by introducing peanut products into babies’ diets once they start eating solid foods.
FARE contains more about peanut allergy.
SOURCES: Matthew Greenhout, MD, MBA, MSc, Professor, Pediatrics, Division of Allergy and Immunology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora; Alexis Togias, MD, chief of the Allergy, Asthma, and Airway Biology Branch, US National Institute of Allergy and Infectious Diseases, Bethesda, MD; Jennifer Buford, MS, vice president, clinical operations, food allergy research and education, McLean, VA; New England Journal of Medicine, May 11, 2023