No more peanut fear? A safe, at-home method helped kids with mild peanut allergies eat more peanuts without a reaction! Could this work for other food allergies too?
Children with mild peanut allergies who could already eat at least half a peanut without a reaction were able to safely consume three tablespoons of peanut butter after gradually increasing their intake over 18 months. This simple method could help many kids with higher peanut tolerance levels build even greater resistance.
“The inability to take part in prior food allergy treatment trials prevented children with high-threshold peanut allergy from exploring treatment options,” said NIAID Director Jeanne Marrazzo, M.D., M.P.H (1✔ ✔Trusted Source
Peanut Oral Immunotherapy in Children with High-Threshold Peanut Allergy
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).“The report today focuses on this population and demonstrates how many of these children and their families could benefit greatly from a very safe and accessible form of therapy.”
New Approach to Peanut Allergy Management
Current food allergy treatments are made for children with severe peanut allergies who can’t even handle half a peanut. These treatments help reduce the risk of a reaction if they accidentally eat a tiny amount.
However, they don’t help about 8,00,000 kids in the U.S. with milder peanut allergies, who have only had one option until now—completely avoiding peanuts.
To find a simple and affordable way to help children with mild peanut allergies eat more peanuts safely, a trial was conducted with 73 kids aged 4 to 14.
The children were randomly placed into two groups:
- Peanut-eating group – These kids started with a tiny amount of peanut butter (1/8 teaspoon) every day and slowly increased their intake every eight weeks. By the end, they were eating up to 1 tablespoon of peanut butter or a similar peanut product like peanut flour or peanut-based candies.
- Peanut-avoidance group – These kids continued avoiding peanuts completely, as they had been doing before.
The children in the peanut-eating group had their dose increases monitored by doctors at the study center. None of them needed emergency treatment (epinephrine) for severe allergic reactions at home, and only one child required it during a supervised dose increase at the study site. This showed that the gradual peanut exposure was generally safe.
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Gradual Exposure Leads to Better Peanut Tolerance
After following the peanut-eating plan, the children were tested to see how much peanut butter they could safely eat without an allergic reaction. Every child in the peanut-eating group (32 children) was able to handle up to 3 tablespoons of peanut butter.
In comparison, only three out of 30 children in the peanut-avoidance group could do the same. A few more in the avoidance group showed slight improvement but not as much as those who ate peanuts regularly.
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Because this study happened during the COVID-19 pandemic, some families chose not to return for testing. To account for missing results, researchers used a statistical method and found that all the children in the peanut-eating group improved, while only about 21% of those in the avoidance group showed some progress.
After the initial test, the peanut-eating children kept eating at least 2 tablespoons of peanut butter each week for 16 weeks. Then, they completely avoided peanuts for 8 weeks before taking a final test.
By the end, 87% of the peanut-eating children who took the last test could still tolerate 3 tablespoons of peanut butter. This showed that they had built a lasting tolerance.
In contrast, only three kids in the peanut-avoidance group naturally developed the same tolerance. Overall, considering all 73 kids who started the study, about 68% of those who ate peanuts regularly developed long-term tolerance, while only 9% of those who avoided peanuts did.
Based on these encouraging results, the investigators want to learn if the same treatment strategy would work for food allergens other than peanuts. Future follow-up is needed to determine the therapy’s effectiveness at inducing long-lasting tolerance of peanuts.
Reference:
- Peanut Oral Immunotherapy in Children with High-Threshold Peanut Allergy- (https://evidence.nejm.org/doi/10.1056/EVIDoa2400306)
Source-Medindia