Ground-breaking trial gives new hope for peanut allergies

By Oliver Morrison contact

- Last updated on GMT

Getty/Neydtock
Getty/Neydtock

Related tags: Peanut, Peanut allergy, Allergy

A trial suggests that oral immunotherapy treatment, which involves repeated exposure over time to gradually increase doses of the allergen, could allow sufferers to increase their tolerance to peanuts. They would not be able to eat nuts at will, but their reactions could be reduced.

The ARTEMIS study at the Evelina London Children’s Hospital recruited nearly 200 children and young people aged four to 17 from across Europe to take part in one of the largest peanut allergy treatment trials that had ever been conducted.

Participants either received peanut allergen protein (AR101) or a placebo powder. Doses were gradually increased every two weeks for a year.

The results, which were recently published in the journal Lancet Child and Adolescent Health​, found that more than half of the participants (58%) treated with the peanut protein could tolerate at least 3 to 4 peanuts compared to just 2% of participants on the placebo.

Professor George du Toit, paediatric allergy consultant at Evelina London and the study's chief investigator, said: “This study provides yet more evidence that by gradually ingesting small amounts of well-characterised peanut protein, allergy sufferers can increase their tolerance and protect themselves from severe reactions in the event of accidental exposure.

“It means we are now a step closer to an effective peanut allergy treatment and gives hope to the peanut allergy sufferers. The study is also the first to show that this type of treatment can massively improve quality of life for families affected by peanut allergy."

Peanut allergy, a potentially life-threatening condition, has doubled over the last two decades and affects about 1 in 50 children in the UK. The allergy is rarely outgrown and is the most common cause of food allergy deaths.

In Europe and North America, more than 6 million people are affected, including up to 8% of children and 2-3% of adults. Although allergy to milk and egg are commonly outgrown by the age of 5-10 years, allergies such as to peanut are lifelong in 80-85% of cases and affect 2% of children and 1% of adults in high-income countries.

The unpredictable and potentially life-threatening nature of food allergic reactions is associated with substantial anxiety and impaired quality of life for patients. There is no treatment for allergies, other than avoidance and medication to treat allergic reactions or anaphylaxis.

“Peanut allergy can be very difficult to manage, especially for children and young people, and many families are extremely concerned about having a severe reaction, which can be life-threatening,”​ continued du Toit.

UK schoolboy James Redman, 12, was diagnosed with a severe peanut allergy aged three. After taking part in the trial, he was able to tolerate the equivalent of seven whole peanuts, meaning he is less likely to have a severe reaction in the future.

Zoe Redman, James’ mother, said: “The trial has taken a huge weight off our shoulders. We are now less fearful of James having a serious reaction.

“James still has a peanut allergy and he will probably have to live with it for the rest of his life but he is now less likely to have a severe reaction if he is accidentally exposed. Taking part in the trial has made a huge difference to our lives.”

Lynne Regent, CEO of the Anaphylaxis Campaign, said: "The Anaphylaxis Campaign is delighted to hear about the success of the ARTEMIS trial, and that James has had such a positive response to the treatment he received. Whilst not a cure for peanut allergy, desensitisation treatments such as AR101 can reduce the risk of a severe, life- threatening reaction occurring. This is another positive step towards this treatment eventually becoming available for all children in the UK who need it."

Source

'Efficacy and safety of oral immunotherapy with AR101 in European children with a peanut allergy (ARTEMIS): a multicentre, double-blind, randomised, placebo-controlled phase 3 trial'

The Lancet Child & Adolescent Health

https://doi.org/10.1016/S2352-4642(20)30234-0

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