The Food and Drug Administration (FDA) has for the first time given the green light for the use of a drug to treat peanut allergies in children in the US. Known as Palforzia, the medication does not cure allergies but is intended to lessen the risk of a major reaction in the event of accidental exposure to peanuts.
It is thought that at least 3 million Americans suffer from peanut and tree nut allergies, with avoidance being the only form of protection currently available. For some, however, even tiny particles of a nut can cause potentially fatal anaphylactic reactions, which makes certain environments – such as airplanes – highly dangerous.
Palforzia – which has been approved for children between the ages of four and 17 – uses oral immunotherapy, whereby minuscule amounts of peanut protein are ingested in order to stimulate the body’s immune system to create the necessary antibodies to prevent an allergic reaction. Unlike vaccines, which often only need to be applied once in order to provide lasting protection, Palforzia will need to be taken every day for its effect to be maintained, and discontinuing its use will eliminate any peanut tolerance.
During the first six months of treatment, children will be administered small but increasing doses of the drug under a doctor’s supervision, before being allowed to continue taking it at home in the form of a powder that can be sprinkled on food. Research published last year revealed that when immunotherapy is stopped, cells that had previously been susceptible to peanut proteins continue to react in the same way as they did before treatment began. In other words, this type of therapy provides no lasting protection whatsoever and should be seen as a prevention rather than a cure.
Patients will also have to continue avoiding peanuts, though the drug should at least enable them to tolerate small amounts if they do accidentally come into contact with them.
While Palforzia is set to become available in the US, other countries are yet to follow suit, with many question marks remaining over the effectiveness of oral immunotherapy for allergies. A recent paper in The Lancet found that while peanut tolerance is generally enhanced by oral immunotherapy, the number of anaphylactic events experienced by patients actually tends to increase after beginning treatment.
The study authors say this finding reveals how unpredictable allergic reactions are and how many uncontrollable factors may influence them, meaning that even when this new treatment becomes available, users should still be as careful as ever not to come into contact with peanuts.