Children with mild ways of peanut sensitivity can overcome their allergy by consuming increasing amounts of peanut butter bought in the store, suggests a new study.
The 32 children in the study that received 18 months of this immunotherapy could consume the equivalent of three tablespoons of peanut butter without experiencing reactions, according to the report published Monday in Nejm Evidence.
Parents were informed that this strategy should only be followed under the supervision of an allergist, the researchers warned.
Between 1% and 2% of children and adults in the United States have peanut allergy, according to the American Academy of Allergy, Asthma and Immunology.
Until now, researchers have focused on children with such severe allergies that the smallest peanut could trigger a dangerous reaction, said the main author of the study, Dr. Scott Sicherer, professor of pediatrics and director of Elliot and Roslyn Jaffe Food Allergy Institute at the ICAHN School of Medicine in Mount Sinai in New York City.
“We think that if we could attack children who could consume at least half of a peanut with a therapy that was much easier to use, we could take them to the point where they could treat peanuts like normal food,” he said. “We were surprised how successful we were.”
Sicherer urged parents not to prove the therapy on their own, adding “you should talk to an allergist about the process.”
A total of 73 children, from 4 to 14 years old, were originally entered into the trial, which was sponsored and funded by the National Institute of Allergies and Infectious Diseases. Of the 73, 38 were randomly assigned to obtain immunotherapy, and the other 35 continue to avoid peanut protein.
Children who could eat the equivalent of half -made medium without experiencing reactions could participate in the study. Those who could eat the equivalent of 20 or more peanuts were excluded.
At the end of the essay, six of the children in the immunotherapy group and five in the control group had abandoned, which left 32 in the immunotherapy group and 30 in the group that continued to avoid peanuts.
In the treatment group, the children began with a teaspoon of peanut butter, which gradually increased every eight weeks. Once the children reached ½ teaspoon of peanut butter, they were allowed to replace other foods that contained an equivalent amount of peanut protein, such as sweets, with peanut butter.
The peanut protein increases occurred only when the children were under the care of an allergist, in case they had a reaction.
Once the children were able to eat a tablespoon of peanut butter every day, they were told that they did not need to consume it every day, but they should consume two tablespoons per week.
None of the children in the immunotherapy group had a reaction severe enough when consuming peanut protein at home to need an epinephrine drink and only one needed the medication during a visit to the study site.
The next part of the study was designed to determine whether peanut tolerance obtained by the 32 children would be durable. Of the 32, 30 chose to continue with the study.
They were asked to refrain from eating peanut protein for eight weeks. They were then tested to see if they could still tolerate the equivalent of three tablespoons of peanut butter. Of the 30 children, 26 approved the test, which led researchers to conclude that immunotherapy had allowed these children to exceed their peanut protein allergy.
“This is a fairly easy process to continue and it was very successful,” said Sicherer. “He has the potential to change the game for families and children.”
While it will be necessary to follow children in the long term to validate the results, “the ability to induce tolerance to a meal is incredibly exciting,” said Dr. Joel Brooks, an assistant professor of Pediatrics and director of allergies of the Immunology Associate Program in The College of Physicians and Surgeons of the University of Columbia in New York City.
“Now these children will not have to carry an epipen with them,” he said. “They will not have to avoid food with peanuts. They are free of allergies for life. “
Often, when children develop an allergy to peanuts, it has a deep impact on the family, Brooks said.
“Children stop going to birthday parties and many of them stop going out with their families. Fear keeps them from the summer camp and is going to visit friends for the holidays, “he said.” If you can remove the risk, it would make a big difference for children and their families. “
Brooks was also happy to see that the researchers published their protocol.
“Once there is a standardized protocol, more practices can use it to help your patients,” he said. “It may not be the choice of all patients, but it is another tool in our toolbox.”
He reiterated the advice to parents not to try to do the immunotherapy protocol on their own.
“There is a risk every time we make a food challenge that there could be a potentially deadly severe reaction,” he said. “So this must only be done under the supervision of an allergist.”
