New immunotherapy helps toddlers with peanut allergy

AEven small children with peanut allergy could be successfully treated with immunotherapy in the future. This is the result of an international study involving researchers from Frankfurt. Plasters coated with peanut allergen and stuck to the back were tested. As reported by the Goethe University Hospital, the treatment was able to lower the threshold at which allergic reactions set in by a median of 900 milligrams of peanut protein. This amount is contained in three peanuts. The Results were published in the New England Journal of Medicine.

The study lasted from 2017 to 2022, Frankfurt was one of three German locations. 307 children from eight countries between the ages of one and three fully participated. All subjects received a patch once a day for one year. A good third received a placebo, the rest received a daily dose of 250 micrograms of peanut protein. The patch is placed between the shoulder blades and does not need to be removed for bathing or swimming.

The aim was to increase the dose for triggering an allergy to 1000 milligrams if the children initially had an allergic reaction to more than ten milligrams, or to increase the trigger dose to 300 milligrams if ten milligrams or less originally provoked a reaction. This goal was achieved by 67 percent of the children in the group that received patches with the allergen and 33.5 percent in the placebo group.

According to their own statements, the latter did not surprise the researchers. Studies showed that about 29 percent of affected children outgrow their allergy by the age of six. In the median, no increase in the reaction threshold was observed with the sham therapy. At the end of the study, a good 37 percent of the children who received the active ingredient were able to consume a total of 3444 milligrams of peanut protein before an allergic reaction occurred. In the placebo group it was only ten percent.

Only minor side effects observed

According to the information, so-called adverse events occurred in almost all children during the study – including those in the placebo group. The most common side effects were skin reactions around the patch, but these decreased over time. A total of 23 systemic allergic reactions occurred – 19 in the group receiving the peanut allergen patch and four in the placebo group. According to the assessment of the respective study doctor, four of these were due to the treatment with the peanut patch. This corresponds to 1.6 percent of all reported side effects in the group that received the drug. All of these reactions have been described as mild or moderate.

“The study gives hope for small children with peanut allergy and for their families,” says Katharina Blümchen from the Clinic for Pediatric and Adolescent Medicine at the Frankfurt University Hospital. “The patch treatment has proven to be effective and safe.” In another study, the effectiveness and safety of the patch in four to seven-year-olds with a peanut allergy is now being examined.

As the clinic goes on to write, previous studies have already shown that the early intake of peanut protein as complementary food reduces the risk of a later peanut allergy. The immune system seems to be very malleable at an early age. Immunotherapies, in which those affected take small doses of the allergen daily in order to desensitize and raise the reaction threshold, have so far only been approved for children and adolescents over the age of four. With these treatments, families have to stick to sometimes complex diet plans, and side effects can occur.