From the Guidelines
The FDA-approved treatment for peanut allergy is Palforzia, an oral immunotherapy designed to reduce the severity of allergic reactions to peanuts. This treatment is specifically approved for children and teens aged 4-17 years with confirmed peanut allergy, as stated in the 2021 study published in the Journal of Allergy and Clinical Immunology 1.
Key Points
- Palforzia is an oral immunotherapy drug that consists of a characterized peanut powder, which mitigates the risk of allergic reactions, including anaphylaxis, due to accidental peanut ingestion 1.
- Treatment includes ingestion of the contents of a series of capsules with increasing doses of peanut protein, leading to a daily maintenance dose sachet of 300 mg of peanut protein.
- Patients on Palforzia must continue with strict peanut avoidance and continue daily dosing to maintain protection, as the treatment reduces reaction severity but doesn't cure the allergy.
- Common side effects of Palforzia include abdominal pain, vomiting, nausea, oral itching, and throat irritation, and treatment must be administered under medical supervision with access to emergency medication, as anaphylaxis remains a risk 1.
Important Considerations
- Patients should always carry epinephrine auto-injectors even while on Palforzia therapy, in case of accidental exposure or severe allergic reactions.
- The treatment works by gradually exposing the immune system to increasing amounts of peanut protein, helping to desensitize the body over time, as noted in the study published in the Journal of Allergy and Clinical Immunology 1.
From the Research
Approved Treatments for Peanut Allergy
The following are approved treatments for peanut allergy:
- Peanut oral immunotherapy (POIT) has emerged as an active management option for peanut allergy, with an FDA-approved product now available for therapy 2
- Oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT) are also available options for managing peanut allergies 3
Immunotherapy Approaches
Various immunotherapy approaches are being explored for the treatment of peanut allergy, including:
- Oral immunotherapy (OIT) to induce desensitization to peanut 3, 4
- Epicutaneous immunotherapy (EPIT) to induce desensitization to peanut 3, 5
- Sublingual immunotherapy trials using peanut to induce desensitization 4
- Adjuvanted immunotherapy approaches to overcome limitations of OIT and EPIT, such as allergic side effects and daily dosing requirements 5
- Lactic acid bacteria probiotics to down-regulate allergy due to its inherent immunomodulatory properties 4
Management of Anaphylaxis
Management of anaphylaxis during peanut oral immunotherapy is key in optimizing this treatment and patient outcomes, with factors such as tiredness, exercise, and viral illness increasing the risk of anaphylaxis 2