Curious about the recently approved treatment for peanut allergy?  Read our FAQ below!

What is this new treatment that we have read about in the news?

There was recently approval of purified peanut powder (very similar to peanut flour) to perform oral immunotherapy in children with documented peanut allergy ages 4-17. Oral immunotherapy is a process by which a person is introduced to very small amounts of peanut powder increasing gradually over time. The “dose” is ingested on a daily basis and the amount of peanut protein is increased every 2 weeks (in office under the supervision of your allergist).

Is this a cure for peanut allergy?

No, definitely not. The hope is that this will protect from small, accidental exposures. The study did not show that patients could then eat peanut as they wish, though that may be possible for some people. Also, peanut will have to be ingested on a regular basis for the rest of the person’s life in order to maintain their tolerance, or ability to not react to small amounts (at least to the best of our current knowledge). In the trial, only 70% of participants were able to tolerate 2 peanut kernels.

What are the risks?

With the daily ingestion and up-dosing, the risk is of allergic reactions. The most common reactions will be stomach pain, nausea and vomiting. Hives or anaphylaxis may also occur. This is unfortunately a risk with each ingestion and not just up-dosing. Long term risks include eosinophilic esophagitis EoE, a disorder where an allergic person develops swelling in the esophagus and often develops difficulty swallowing because of this. In the trials, about 15% of participants had anaphylaxis requiring injectable epinephrine.

Will my child be a candidate?

This depends on your child’s individual situation. Some children will be so reactive that they react to the initial dosing (the very lowest dose). Other children will have significant stomach issues or develop EoE and will not be able to do this. Other families will find that the daily risk is unacceptable to them or that the particulars of the therapy are too difficult (the child needs to not be physically active or get hot for 2-4 hours after ingestion, and it is not recommended that they take their dose before school because they cannot be directly observed).

What are the costs?

It is unknown at this time. It is approximately $10,000 per year per the manufacturer, but this may be covered by some insurance companies. Additional cost will be incurred by the regular doctor’s visits needed to conduct the up-dosing (every 2 weeks until maintenance is achieved).

Are foods other than peanut offered?

The FDA approved product is just peanut- no other foods are currently offered. A similar process could be conducted with any food, however, and may be available in the future. Other foods are currently under investigation.

Can I get this through your office?

Not currently. Further investigation will need to be done into whether our office can adequately support the extra time and office visits that will be necessitated by introducing this procedure.  We also want to consider whether we feel this is in the best interest of the patient in terms of risk versus reward. If we do offer this, we will have a conversation with each patient/family considering it. We consider this a high risk procedure similar to regular food challenges.

I hope this helps! I know a lot of you have been waiting a long time for treatment for food allergy. Unfortunately, I think that this particular treatment is imperfect and has many downsides. We have researched it carefully and will continue to stay on top of the latest food allergy research and treatment.

Sincerely,

Dr. Auerbach, Medical Director