Every year, new findings, discoveries, treatments and understandings about peanut allergies accelerates, which enhances our understanding of this complex condition. Because food allergies are a dynamic medical condition that aren’t completely understood, there’s still so much to learn. In 2019, food allergy researchers did not disappoint and there were some really big stories, including about food allergy prevention, prevalence and emerging treatments. Here’s a brief summary of what you may have missed in each of these major topics about food allergies.
MORE SUPPORT FOR DIETARY INTERVENTION FOR PREVENTION OF PEANUT ALLERGIES
Preventing food allergies continues to be one of the most important areas of study. After all, if you can prevent disease, don’t you want to? The 2015 LEAP study has received additional credence because of other studies this year that also showed the potential protective ability of feeding infants peanut foods early.
A Canadian study of 2669 children, published online in October in the Journal of Allergy and Clinical Immunology: In Practice, followed these infants to three years of age and found that those who were fed peanut foods in the first 12 months were significantly less likely to develop peanut allergy by three years old. On the other hand, those who were not fed peanut foods were seven times more likely to become sensitized to peanuts. This study provides more support for the protective effect of early feeding to prevent peanut allergies. Limitations were that this study measures association and not causation and sensitization does not necessarily result in clinically relevant allergy, yet allergy doesn’t happen in the absence of sensitization.
FOOD ALLERGIES AREN’T JUST FOR KIDS
Results of a survey of 40,443 subjects published in January surprised most experts when adults self-reported food allergies in huge numbers. About 19% of adults surveyed said they have some sort of food allergy. However, when researchers dug deeper into symptoms and diagnosis, they discovered nearly half were likely not true food allergies. That still left 10.8% of adults with a possible food allergy, an increase from previous estimates. The most common food allergies for adults were shellfish, followed by milk, then peanut. The limitations of this study include that the data is self-reported by self-selected survey participants, which lends to potential bias and inaccurate self-diagnosis.
TREATMENTS 1.0 MAY BE AVAILABLE VERY SOON
This was big year for emerging and potential treatments for peanut allergy. As the research mounted in support of oral immunotherapy as a safe and effective treatment for peanut allergy, two companies petitioned the FDA for approval of their new treatment options.
Firstly, Palforzia, the name given to Aimmune’s peanut oral immunotherapy product, has been recommended for approval for patients 4-17 years old with a confirmed diagnosis of peanut allergy to FDA by an expert panel. Palforzia is a regimen that requires patients to consume a specific amount of peanut protein in increasing doses over months in order to raise the threshold for reactions. It is not a cure for peanut allergies. A decision from FDA regarding the final approval of Palforzia is expected in Q1 2020.
A second potential treatment option for peanut allergy is DBV’s Viaskin peanut patch. Viaskin’s biologic license application (BLA) was accepted by FDA in October 2019 and is to be reviewed by August 2020. In the BLA, DBV has requested approval for the epicutaneous patch therapy for children with peanut allergy ages 4-11 years. Viaskin delivers tiny amounts of peanut protein transdermally (through the skin) in order to increase the threshold for reactions. Like Palforzia, Viaskin is not a cure for peanut allergies. “According to the DBV website, this potential new treatment is not a promise or guarantee for all children and it involves some risk.” Results described in the clinical study may vary in different patient populations.
Biologics are drugs that are isolated from natural sources, either human, animal or microorganism. Some examples include vaccines, gene therapy, tissues and allergenics. In the food allergy research world, there are a few newcomers making news. Some biologics currently being studied for peanut allergy treatment are Omalizumab (Xolair) and Dupilumab, but there are also more than a dozen others in the pipeline. While each one may have a different specific mechanism of action, they are generally used in conjunction with other treatment to help reduce symptoms and severe reactions, but some are also being researched as potential monotherapies (use of a single drug for a disease). Currently, all biologics are in phase I or II and none are approved treatments for peanut allergies, as they are considered experimental.
Overall, it has been an active year in peanut allergy research. Prevention has been confirmed to be a prime opportunity to prevent future cases of peanut allergies. And for those who currently have food allergies, multiple treatment options are on the horizon, though not currently approved for treatment. The National Peanut Board is proud to be invested in peanut allergy research, preventing peanut allergies, and being part of the solution for those with peanut allergies.