Patching for Peanuts

Wearable skin patch was effective in treating peanut allergy in children, according to National Institute of Allergy and Infectious Diseases.

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A peanut butter and jelly sandwich is a great lunch for most kids, but risky to those who deal with peanut allergies. A new, convenient option might change that.

The trial for a wearable patch that delivers small amounts of peanut protein through the skin was effective in allowing children to consume peanut protein without a reaction.

Food allergies are a problem for many American children. Peanuts are one of the top foods that cause 90 percent of food allergies. Although many children outgrow allergies to other foods like wheat, eggs or milk, peanut allergies tend to be lifelong. Reactions can range from mild itching to a severe, life-threatening condition called anaphylaxis.

Previous therapies have used very small amounts of peanut proteins given orally, but about 10 to 15 percent of children and adults with peanut allergies have been unable to tolerate the treatment.

Researchers from the Consortium of Food Allergy Research evaluated a skin patch containing peanut protein. Called epicutaneous immunoptherapy (EPIT), the patch is applied once a day to various points on the body. The peanut protein is slowly absorbed through the skin.

Stacie Jones, MD, of the University of Arkansas for Medical Sciences and Arkansas Children's Hospital, lead the study. Dr. Jones is a pediatrician, allergist and immunologist.

The idea behind EPIT is that very small amounts of the protein can gradually accustom the body to the peanut protein. The idea is not to allow children to eat peanuts with impunity, but to protect them from the accidental ingestion of foods containing peanuts that might provoke a life-threatening reaction.

Dr. Jones and the research colleagues randomly assigned 74 study participants between the ages of four and 25 to treatment with either a high or low-dose patch or a placebo patch. Patients wore each patch for 24 hours and then replaced it with a new patch for one year.

Prior to the study, each participant was tested to determine how much peanut protein he or she could consume before reacting. At the end of the year the researchers tested study participants' ability to consume 10 times more of the peanut protein than they could eat at the beginning of the trial.

Both high-dose and low-dose patches showed a successful response: 46 percent in the low-dose group and 48 percent in the high-dose group. Only 12 percent of the placebo group showed improvement.

The effects were greater in children ages 4 to 11 than in those 12 or older.

Although most participants experienced itching or rash under the patch, none had serious side effects.

So what about the dangers of using one of these patches?

"As with all forms of immunotherapy, the potential risk is with a more severe allergic reaction known as anaphylaxis," Dr. Steve Cole, a member of the medical staff at the Baylor University Medical Center at Dallas, said. "The adverse events reported in this study were confined to localized itching and redness of the skin, but a study of this size would not necessarily pick up on those less common but potentially life-threatening events."

Dr. Cole said that there were not currently any patches for other foods that commonly cause allergic reactions.

"But this study examining peanut allergies looks promising as a potential treatment for other types of food in the future," Dr. Cole said.

The study was published in the Oct. issue of the Journal of Allergy and Clinical Immunology.

The trial was sponsored by the National Institute of Allergy and Infectious Diseases (NIAID).

Patches were developed and provided by biopharmaceutical company DBV Technologies under the trade name Viaskin.

Details on study funding and information on conflict of information was not available.

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