New Peanut Allergy Treatment Demonstrates Effectiveness and Safety

A new peanut allergy treatment has shown effectiveness and safety, according to researchers from the University of North Carolina Health Care.

The treatment, called sublingual immunotherapy, or SLIT, involved placing a miniscule amount of liquefied peanut protein under the tongue, where it can be immediately absorbed into the blood stream. This process desensitizes the immune system to larger amounts of peanut protein.

Trial participants tolerated between 10 and 20 times more peanut protein than it would take for someone to get sick.

Edwin Kim, MD and assistant professor of medicine at the UNC School of Medicine, said this is important data for understanding protection options for those with peanut allergies.

"As a parent of 2 children with nut allergies, I know the fear parents face and the need for better treatments," Kim said in a statement. "We now have the first long-term data showing that sublingual immunotherapy is safe and tolerable, while offering a strong amount of protection."

Other immunotherapy methods include releasing a small amount of peanut protein through a patient's skin, and oral immunotherapy involving ingesting a small portion of peanut protein daily. SLIT is the newest promising option.

Because the peanut protein avoids digestion, patients are given much less peanut protein—just about 0.0002 initially—which then increases over the course of months to 2 mg.

The study began in 2011, when Kim and colleagues conducted a small study of just 18 patients. In the 8 years since, the researchers have followed 48 patients in the SLIT protocol of 2 mg daily for 5 years. They found that 67% of those patients were able to tolerate at least 750 mg of peanut protein without serious side effects, and about 25% could tolerate 5,000 mg.

Although the study was much small, the research suggests that SLIT was about as effective as oral immunotherapy, with much less risk of serious adverse effects. The most common adverse effect was itchiness around the mouth that lasted around 15 minutes and did not require treatment.

The researchers are also studying SLIT in a subset of children ages 1 to 4 years because separate oral immunotherapy data indicated that these young patients have a stronger, more lasting benefit from immunotherapy.

"We focus on the idea there is no 1 perfect drug for food allergy," Kim said in a statement. "There will have to be a lot of shared decisions between physicians, patients, and parents about what method of treatment is best for each patient."

Reference

New Peanut Allergy Treatment Passes Phase 2 Trial, Shows Effectiveness and Safety. UNC Health Care & UNC School of Medicine Newsroom. https://news.unchealthcare.org/news/2019/september/new-peanut-allergy-treatment-passes-phase-2-trial-shows-effectiveness-and-safety. Published September 4, 2019.