Food allergies have become increasingly common among kids, and peanuts are one of the main culprits.
In the past 10 to 20 years, the number of children in the United States with peanut allergies has nearly doubled.
Peanuts are also the leading cause of life-threatening food allergy reactions.
But research suggests that new treatments may be on the horizon.
Results from the first year of the trial were recently published in the Journal of Allergy and Clinical Immunology.
The study is sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the National Institutes of Health (NIH).
The treatment is called epicutaneous immunotherapy (EPIT), and consists of a simple skin patch that people apply daily to their arm or between their shoulder blades.
In general, people with food allergies must be highly cautious about the foods they eat and places they go in order to avoid allergens. “One goal of experimental approaches such as epicutaneous immunotherapy is to reduce this burden by training the immune system to tolerate enough peanut to protect against accidental ingestion or exposure,” said NIAID Director, Dr. Anthony S. Fauci, in a
Researchers studied the effects of the EPIT patch on 74 people, between the ages of 4 and 25, with peanut allergies.
Participants were given patches containing either a high-dose of peanut protein, a low-dose, or a placebo.
Researchers report that 48 percent of high-dose patients and 46 percent of low-dose patients achieved treatment success, which is defined as the person’s ability to consume at least 10 times more peanut protein than they could before starting the trial.
“The high adherence to the daily peanut patch regimen suggests that the patch is easy-to-use, convenient, and safe,” said Dr. Marshall Plaut, chief of NIAID’s Division of Allergy, Immunology, and Transplantation’s (DAIT) Food Allergy, Atopic Dermatitis, and Allergic Mechanisms Section. “The results of this study support further investigation of epicutaneous immunotherapy as a novel approach for peanut allergy treatment.”
In the trial, the EPIT patch was more effective on participants between the ages of 4 and 11.
Epicutaneous vs. oral immunotherapy
Epicutaneous immunotherapy is similar to another method for allergy treatment: oral immunotherapy.
In previous studies, doctors have reported positive results using oral immunotherapy to treat peanut allergies.
“Fundamentally, they aim to do the same thing,” Dr. Matthew Greenhawt, a specialist in allergy and immunology at Children’s Hospital Colorado, told Healthline.
“They aim to take an allergic subject and increase the amount of the allergen that they can tolerate.”
Greenhawt said that the initial data on epicutaneous immunotherapy is promising.
“In the data released to date, there have been minimal side effects. Most of them have been mainly skin-related, where the patch has been applied. There have not been a host of some of the side effects that have been noted in oral immunotherapy trials — such as significant anaphylaxis or gastrointestinal events,” he explained.
Experts believe that oral and epicutaneous immunotherapies could complement one another, but more studies will need to be conducted.
“I think a lot of investigators and practitioners see these as potential tandem therapies — you start with one and transition to the other,” said Greenhawt. “That’s certainly something that could be explored in the future. Nobody really knows how these compare. I think they may be parallel therapies, they may be complementary therapies, but more research ought to be done to get to that point.”
More research needed
The EPIT study has shown promising results after its first year, but research is ongoing.
Moving forward, all study participants will be switched to high-dose daily patches, which showed the highest success rate.
Researchers will conclude the study after participants have used EPIT patches for a total of two and a half years.
One major unknown is how frequently patients would have to use EPIT patches in order to reduce the severity of their peanut allergies.
“We don’t know what the long-term outcomes are. We don’t know what the ultimate duration is. We don’t know if there is a difference if you stay on this for a long time,” said Greenhawt.
“It could possibly be a limitation to some consumers wanting to use this — although, given the alternative, I think that some people would not mind having to do this every day if it meant protection.”
Many aspects of the patch remain to be investigated before it could become a standard treatment.
“I think there’s tremendous cause for hope, but there has to be guarded optimism because there will still be significant unknowns about long-term effects, cost effectiveness, and comparative effectiveness of these therapies that will need to be established,” Greenhawt added. “Ultimately, we want to put the right patient on the right therapy.”