First Peanut Allergy Treatment

Approximately 1.6 million children in the U.S. had peanut allergies in 2018[1]. Image courtesy of Southern Exposure Seed Exchange[2].

An advisory board to the Food and Drug Administration(FDA), which is the federal administration responsible for the safety of drugs, our food, and much more, has finally endorsed the first treatment for peanut allergies (allergies occur when the immune system reacts to any foreign substance such as peanuts or bee venom and can vary in severity from rashes to difficulty breathing and shock)[3]. The treatment, created by Aimmune Therapeutics, is called AR101 or Palforzia and can help reduce allergic reactions to peanuts. While the FDA itself is not required to follow the decisions of the advisory board, the FDA usually agrees with the board. Should the FDA concur with the advisory board, Palforzia would be the first allergy treatment approved by the FDA[4].

Palforzia works by having patients taking pills with controlled amounts of peanut protein in order to acclimate their immune system to peanuts[4]. This is called oral immunotherapy and is offered by about 200 allergists in the United States. Palforzia is different from traditional oral immunotherapy in that it uses capsules that contain a fixed amount of peanut proteins. Throughout treatment, the amount of peanut proteins will increase as the patient’s immune system becomes accustomed to peanuts.[4] For example, patients start treatments with 0.001 mg of peanut protein (one peanut has 250 mg of peanut proteins) and end treatment with 8 peanuts.[5]

Now, if you have a peanut allergy, don’t go off and start eating peanuts all in the name of curing yourself after learning about oral immunotherapy. Reviews of oral immunotherapy have shown that children who undergo treatment have a 20% chance of anaphylaxis, a life-threatening allergic reaction[6]. This percentage is nearly three times larger than the 7% chance of anaphylaxis from people who avoid peanuts[7]. In other words, Palforzia is not a miracle drug that cures peanut allergies. There is a real risk of undergoing oral immunotherapy and using Palforzia. But that risk might be worth it to some.

With an estimated 2.2% of children in America being allergic to peanuts[7], Palforzia and treatments that come after it can have a tremendous impact on the lives of millions of people. If Palforzia gains FDA approval within the next year, it could be possible that many people with peanut allergies can be treated. While this is in no way a cure for those with peanut allergies, the chance of having a serious reaction goes down: any decrease in allergic symptoms could mean the difference between life and death.

By Nathan Chan

Works Cited

[1] https://www.foodallergy.org/about-fare/blog/eight-percent-of-us-children-have-food-allergy-pediatrics-study-finds

- Study from 2018 published in Pediatrics estimates 5.6 million children are allergic to multiple foods. A number that has risen and seems to continue rising.

[2] http://www.southernexposure.com/carolina-african-runner-peanut-28-g-p-1971.html

- Image of peanuts from Southern Exposure Seed Exchange.

[3] https://www.mayoclinic.org/diseases-conditions/allergies/symptoms-causes/syc-20351497

[4] https://www.sciencemag.org/news/2019/09/first-peanut-allergy-treatment-gains-backing-fda-advisory-panel

- Science magazine article about Palforzia as well as its history, risks, and benefits.

[5] https://oitcenter.com/oit.htm

- Website about oral immunotherapy that has the starting and ending doses of certain treatments

[6] https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis

- Explanation of anaphylaxis by the American Academy of Allergy, Asthma, and Immunology.

[7] https://www.npr.org/sections/health-shots/2019/09/13/760670237/fda-committee-recommends-approval-for-oral-immunotherapy-treatment-for-peanut-al

- NPR article focusing on the advisory board’s meeting on Palforzia.