Pediatrics | Published March 9, 2020 | Written by Faoud Ishmael, MD, PhD, Mount Nittany Physician Group Allergy & Immunology

What to know about the new oral treatment for peanut allergy

Faoud Ishmael, MD, PhD, Mount Nittany Physician Group Allergy & Immunology

If a child in your life has a peanut allergy, it’s likely you’ve heard about the first oral immunotherapy treatment for peanut (Palforzia) just approved by the U.S. Food and Drug Administration. Perhaps you’re wondering about the science behind the treatment and whether it’s appropriate for your child.

The background on food allergies
It’s no secret that food allergies are on the rise. In fact, the number of people with food allergies has been steadily increasing over the past 30 years, with up to 10 percent of Americans affected.

Peanut allergy is one of the most common food allergies. The number of people with peanut allergy has tripled since the 1990’s, and once a peanut allergy develops, it is usually lifelong.

People with food allergies are at risk of severe reactions with accidental exposure; reactions can include hives, swelling, vomiting, diarrhea, difficulty breathing and drop in blood pressure.

What is immunotherapy?
Immunotherapy is a method of reprogramming the immune system. Exposing the immune system to small amounts of allergen and gradually increasing the dose actually turns off allergic responses.

This particular treatment involves adding small amounts of peanut powder to food and ingesting daily. The amount of peanut protein is incrementally increased every two weeks. The first dose of each escalation is given in a physician’s office and patients continue subsequent doses at home. At the end of the process, patients maintain treatment by taking 300 mg of peanut powder daily.

The treatment, which is limited to patients between the ages of 4-17 years of age, has been shown in studies to be effective in 60 to 80 percent of patients.

Limitations in therapy
Immunotherapy is not likely to be a cure for peanut allergy. Patients on this treatment will be protected from reactions to small amounts of peanut, such as an accidental ingestion. If the immunotherapy is discontinued, the sensitivity to peanut may go back to pre-treatment state. However, this may be highly variable and depends on many factors, including patient age and duration of the allergy.

Allergic reactions may occur during immunotherapy. The risk of reactions is higher in patients with uncontrolled asthma and certain gastrointestinal conditions such as eosinophilic esophagitis. Severe allergic reactions (anaphylaxis) occurred in about 10 percent of patients on peanut immunotherapy.

Still wondering if immunotherapy is right for your child? To schedule an appointment, call 814.278.4688, or make an appointment online at mymountnittanyhealth.com.

To learn more about this and other healthy living topics, visit mountnittany.org. 

Faoud Ishmael, MD, PhD, is a board certified allergy and immunology physician with Mount Nittany Physician Group Allergy & Immunology, and offers particular expertise in allergy management and testing, including testing for allergies related to foods and medicines.