13 Jan Flinders Trial Tests Boiled Peanuts to Treat Peanut Allergic Children
MedicalResearch.com Interview with:
A/Prof Luke GrzeskowiakPhD | BPharm(Hons) | GCertClinEpid | AdvPracPharm | FSHP
Associate Professor (Practitioner Fellow)
Channel 7 Children’s Research Foundation Fellow in Medicines Use and Safety
College of Medicine & Public Health
Affiliate Research Fellow – South Australian Health & Medical Research Institute (SAHMRI)
Specialist Pharmacist – Flinders Women & Children, Flinders Medical Centre
Adjunct Research Fellow – Faculty of Pharmacy and Pharmaceutical Sciences, Monash University
Adjunct Research Fellow – Robinson Research Institute, The University of Adelaide
MedicalResearch.com: What is the background for this study?
Response: Peanut allergy affects 1-3% of children in Western countries, making it the most common food-related allergen. Only a small percentage (20%) of children grow out of their peanut allergy, with allergen avoidance and provision of rescue medications for the management of allergic reactions being the recognised mainstay of treatment for many years. However, avoidance of peanuts provides many challenges for children and their caregivers and requires children and caregivers to be hypervigilant regarding peanut ingestion, creating a significant burden. This burden can have a real impact on quality of life for children and their families.
In more recent years there has been emerging interest in what is referred to as oral immunotherapy as an active preventive treatment to reduce the risk of accidental peanut exposure. Oral immunotherapy involves exposing children to an extremely small dose of peanut, typically in the form of peanut flour, and then gradually increasing that dose over time to build tolerance. We have been looking at opportunities for making oral immunotherapy safer, which would then make it more suitable for more people. Our previous research showed that boiling peanuts alters its protein structure and allergic properties, meaning they were less likely to cause a severe allergic reaction, but were still able to improve tolerance to peanut allergens.
MedicalResearch.com: What did the trial involve?
Response: We recruited 70 children aged 6 to 18-years who had a peanut allergy and asked them to consume peanuts boiled for 12 hours for 12 weeks, 2 hour boiled peanuts for 20 weeks, and roasted peanuts for 20 weeks. The goal was to have children be able to consume 12 roasted peanuts daily at the end of the year.
MedicalResearch.com: What are the main findings?
Response: The results show 56 of the 70 (80%) participants became desensitized to the target dose of peanuts. Treatment-related adverse events were reported in 43 (61%) of participants, however most adverse events were mild. Only 3 participants withdrew from the trial as a result of adverse events and 3 experienced severe allergic reactions requiring administration of epinephrine, demonstrating a favourable safety profile.
MedicalResearch.com: What should readers take away from your report?
Response: Our clinical trial shows promising early signs in demonstrating that boiling peanuts may provide a safe and effective method for treating peanut allergic children with sequential doses of boiled and roasted peanuts over an extended period of time.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Unfortunately, oral immunotherapy doesn’t work for everyone and we are in the process of improving our understanding of how these treatments work and what factors can influence how people respond to treatment. This will be really important for assessing individual suitability for treatment and improve treatment decisions in the future.
Furthermore, while the findings of our clinical trial hold great promise that current approaches to oral immunotherapy could be made safer and more effective, this requires confirmation in a larger definitive clinical trial before this approach could be recommended in practice.
Disclosures: The research was funded by the Channel 7 Children’s Research Foundation. None of the study authors have any conflicts of interest to declare.
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