November 2020
Breakthrough treatment trial for peanut allergy
A new oral treatment can reduce sensitivity to peanuts which is the leading cause of food-related anaphylaxis and fatalities.
Professor Jonathan Hourihane
Published in The Lancet Child & Adolescent Health, the findings from one of the world’s largest peanut allergy immunotherapy trials could lead to new treatment approaches for people living with peanut allergy.
Professor Jonathan Hourihane, Professor of Pediatrics at RCSI University of Medicine and Health Sciences and CHI Temple Street led the ARTEMIS immunotherapy trial in Ireland.
The trial demonstrated that after undergoing a new immunotherapy treatment using a since licenced immunotherapy product known as Palforzia (previoulsly AR101) 67% of treated peanut allergic children could tolerate eating up to three peanuts after the treatment was administered over a nine-month period.
Researchers also found that the children who still experienced allergic reactions to peanuts after the treatment had much milder reactions and used emergency adrenaline injections less often than those children who had been on a placebo treatment.
The treatment programme works by introducing initially minute, controlled amounts of peanut protein, with escalation over a sustained period of six to twelve months, building up a patient’s tolerance to peanut.
Patients who were highly allergic to very small doses, equivalent in some cases to just one tenth of a peanut, are able to manage to eat the equivalent of two or three peanuts without a significant reaction following treatment. Other work has shown that this increase of threshold is likely to protect them from most levels of accidental exposures they might encounter.
Peanut allergy is a condition in which the body’s immune system mistakenly identifies even small amounts of peanut as harmful. Peanut allergy is one of the most common food allergies, which affects over 17 million people in Europe. The prevalence of peanut allergy in Europe has doubled between 2005 and 2015, and allergists would expect every school to have at least one and sometimes up to twenty peanut allergic students, each at risk of anaphylaxis, a potentially life-threatening reaction. Peanut allergy accounts for the majority of food allergy-related deaths.
Peanut allergy usually persists into adulthood and there currently are no approved treatment options in Europe though AR101 has been approved for licencing this month. Despite vigilance, accidental exposures may occur and cause reactions of unpredictable severity, leading to a lifelong risk of severe reactions.
ARTEMIS (AR101 Trial in Europe Measuring Oral Immunotherapy Success) evaluated the efficacy and safety of AR101 in 175 peanut-allergic participants aged 4 to 17 years across 18 sites in seven European countries - France, Germany, Ireland, Italy, Spain, Sweden and the United Kingdom.
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