New Immunotherapy Treatment Gives Hope to Those With Peanut Allergies

By DocWire News Editors - Last Updated: February 21, 2023

Researchers recently showed in a study that an immunotherapy treatment may protect those with peanut allergies by gradually increasing their tolerance over time. This research tested the efficacy of the AR101 treatment, an investigational oral immunotherapy drug derived from peanuts, and focused on young patients with the allergy. The findings were published in the New England Journal of Medicine and presented at the 2018 Annual Scientific Meeting of the American College of Allergy, Asthma and Immunology held this week in Seattle.

“Previous studies have suggested that oral immunotherapy is a potential strategy for the treatment of allergy by inducing desensitization, which is generally understood as a transient upward shift in threshold reactivity to an allergen as a result of ongoing controlled exposure to that same allergen,” wrote Dr. Brian P. Vickery, associate professor of pediatrics in the Emory University School of Medicine, and members of the PALISADE Group of Clinical Investigators. They added that “since the evidence from multiple early-stage trials is limited by small sample sizes and differing methods, most practice guidelines current recommend against oral immunotherapy in routine clinical settings.”

In their trial, the researchers screened patients 4 to 55 years of age with peanut allergy for allergic response to 100 mg or less of peanut protein, equal to roughly one third of a peanut kernel. Those who expressed an allergic response were randomly assigned to receive either AR101 or placebo in an “escalating-dose program”. Those who completed the treatment had received 300 mg per day for roughly 24 weeks.

Those who achieved completion then went through a double-blind food challenge at the end of the trial. The end goal was for participants of 4 to 17 years of age to ingest a dose of 600 mg or more without expressing symptoms.

Of the 496 participants who were within this age range, 67.2% of those receiving AR101 were able to ingest this target dosage of peanut protein without showing symptoms. Compared to the 4.0% of placebo patients who were able to tolerate this dosage, these results strongly indicate that AR101 immunotherapy treatment greatly increases peanut tolerance in those with the allergy. Maximum severity of symptoms was moderate in 25% of those receiving treatment (compared to 59% in the placebo group), and severe in only 5% of those receiving AR101 (compared to 11% of those receiving placebo. The researchers note that this efficacy was not present in participants after reaching 18 years of age. If you want to know the cost of allergy immunotherapy, visit this site: https://getcurex.com/blog-posts/allergy-immunotherapy-costs.

“We’re excited about the potential to help children and adolescents with peanut allergy protect themselves against accidentally eating a food with peanut in it,” Dr. Stephen Tilles, ACAAI past president, advisor for Aimmune Therapeutics and co-author said in a press release. “Our hope when we started the study was that by treating patients with the equivalent of one peanut per day, many would tolerate as much as two peanuts. We were pleased to find that two-thirds of the people in the study were able to tolerate the equivalent of two peanuts per day after 9 to 12 months of treatment, and half the patients tolerated the equivalent of four peanuts,” he added.

With specialists from the American College of Allergy, Asthma, and Immunology (ACAAI) estimating that nearly 2.5% of children in the US living with a peanut allergy, enhancing tolerance to avoid risks associated with accidental ingestion has long been an area of concern. With these findings regarding AR101’s efficacy in doing so in children, the immunotherapy drug could present as a useful tool in protecting children with peanut allergies.

PALISADE trial: The peanut-derived protein product AR101 increased the amount of oral peanut protein tolerated in approximately two thirds of children and adolescents with severe peanut allergy in the trial, as compared with 1 in 25 controls. #ACAAI18

— NEJM (@NEJM) November 18, 2018