Peanut Allergy

Topic: Peanut Allergy Drops Safe, Effective for Toddlers

Allergy drops administered under the tongue are safe and effective as treatment for peanut allergy, even in children as young as 1, according to new research.

In a double-blind, placebo-controlled trial of 36 children ages 1 to 4 years old who were allergic to peanuts, those who were randomly assigned to receive peanut immunotherapy drops showed significant desensitization to peanuts at the end of the 3-year trial compared with children who received placebo.

In addition, there was a “strong potential” that the treatment lasted 3 months after the trial ended for the toddlers who received the active treatment, according to the researchers.

The findings were presented in a at the 2021 American Academy of Allergy, Asthma & Immunology virtual annual meeting. Allergy drops and other orally-given immunotherapies are used as treatments for allergies in children, but usually not in children as young as toddlers.

“We have learned from some studies … that strongly suggest that the immune systems in younger patients may be more amenable to change, and there may be some justification for early intervention,” study lead author Edwin H. Kim, MD, director of the UNC Food Allergy Initiative at the University of North Carolina School of Medicine in Chapel Hill, said in an interview with Medscape.

“Based on both of those ideas, we wanted to take our … approach, which we have shown to have a pretty good efficacy in older children, and bring it down to this younger group and see if it still could have the same efficacy and also maintain what seems to be a very good safety signal,” he said.

Last year, the FDA Palforzia, a peanut allergen powder, for the treatment of peanut allergy in children 4 and older. “It is a great option, but I think what we have learned over time is that this approach is not for everybody,” Kim said.

Palforzia is a powder made from peanuts that is mixed in food like yogurt or pudding that the child then eats daily, according to a rigorous schedule. But Palforzia treatment presents some difficulties. It must be mixed with food, like pudding or apple sauce. Then, the child must eat it, which can be a challenge with some children.

“It tastes and smells like peanut which can cause aversion. Kids have to refrain from exercise or strenuous activity for at least 30 minutes before and after dosing and have to be observed for up to 2 hours postdose for symptoms,” Kim said.

Topic Discussed: Peanut Allergy Drops Safe, Effective for Toddlers

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