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06 Sep Long-Term Sublingual Peanut Immunotherapy Offers Significant Protection Against Allergic Reactions

Posted at 13:46h in Allergies, Author Interviews by

MedicalResearch.com Interview with:

Edwin H. Kim, MD, MS Assistant Professor of Medicine & Pediatrics, Division of Rheumatology, Allergy & Immunology Program Director, UNC Allergy and Immunology Fellowship Program Director, UNC Food Allergy Initiative Medical Director, UNC Allergy & Immunology Clinic UNC School of Medicine Chapel Hill, NC

Dr. Edwin H. Kim

Edwin H. Kim, MD, MS
Assistant Professor of Medicine & Pediatrics, Division of Rheumatology
Allergy & Immunology
Program Director, UNC Allergy and Immunology Fellowship Program
Director, UNC Food Allergy Initiative
Medical Director, UNC Allergy & Immunology Clinic
UNC School of Medicine
Chapel Hill, NC

MedicalResearch.com: What is the background for this study?

Response: In 2011, Kim and colleagues – including Wesley Burks, MD, dean of the UNC School of Medicine – conducted a small study of 18 patients to show that sublingual immunotherapy (SLIT) was safe and effective over the course of one year. Since then, Kim and colleagues followed 48 patients in the SLIT protocol of 2 mg daily for five years. In the JACI paper, the researchers showed that 67 percent of these patients were able to tolerate at least 750 mg of peanut protein without serious side effects. About 25 percent could tolerate 5000 mg

MedicalResearch.com: What are the main findings? 

Response: Sublingual immunotherapy participants tolerated between 10 and 20 times more peanut protein than it would take for someone to get sick. We think this provides a good cushion of protection – maybe not quite as good as OIT – but with an easier mechanism (sublingually) and, as far as we can tell right now, a better safety signal. 

MedicalResearch.com: What should readers take away from your report?

Response: We recommend a large, multi-center phase 3 clinical trial of peanut Sublingual immunotherapy so that we can confirm the effectiveness that we have seen in our small study and at the same time ensure that it is safe for patients. This would be a key step towards the FDA considering peanut SLIT as another way for allergists to help protect people against allergic reactions to peanut. It would also be important to continue research into understanding how long the protective effect lasts, and develop new studies that would expand the age range to our at-risk preschool and younger peanut-allergic population.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: We focus on the idea there is no one perfect drug for food allergy. There will have to be a lot of shared discussions between physicians, patients, and parents about what method of treatment is best for each patient. We think SLIT could be a good option for a subset of these patients.

Citation:

Long-term sublingual immunotherapy for peanut allergy in children: Clinical and immunologic evidence of desensitization

Edwin H. Kim MD, MS, Luanna YangMD, Ping Ye PhD, Rishu Guo PhD, Quefeng Li PhD
Michael D.Kulis PhD, A. WesleyBurksMD

https://doi.org/10.1016/j.jaci.2019.07.030 

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Last Updated on September 6, 2019 by Marie Benz MD FAAD

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