A new study finds that an experimental skin patch shows promise in treating children who are severely allergic to peanuts.
WASHINGTON — An experimental skin patch shows promise for treating toddlers with severe peanut allergies — training their bodies to handle an accidental bite.
Peanut allergy is one of the most common and dangerous food allergies. Parents of allergic children are constantly on guard against exposures that can turn birthday parties and play dates into emergency room visits.
No cure. The only treatment is for children 4 and older who can eat a special peanut powder to protect against a severe reaction.
The patch, named Viaskin, aims to deliver that kind of treatment through the skin instead. In a large trial among youngsters ages 1 to 3, it helped those who could not tolerate even a small portion of peanuts safely eat some, researchers reported Wednesday.
If there is further testing, “it will fill a huge unmet need,” said Dr. Matthew Greenhawt, an allergist at Children’s Hospital Colorado who helped lead the study.
About 2% of US children are allergic to peanuts, some so severe that even a small amount can cause a life-threatening reaction. Their immune system overreacts to foods containing peanuts, triggering an inflammatory cascade that causes rashes, wheezing or worse. Some young people outgrow the allergy but most should avoid peanuts for life and carry rescue medication to prevent a severe reaction if they accidentally ingest some.
In 2020, the Food and Drug Administration approved the first treatment to induce tolerance to peanuts –– an “oral immunotherapy” named Palforzia that children ages 4 to 17 take daily to maintain protection. Aimmune Therapeutics’ Palforzia is also being tested in children.
France’s DBV Technologies is pursuing skin-based immunotherapy as an alternative way to desensitize the body to allergens.
The Viaskin patch is coated with a small amount of peanut protein that is absorbed into the skin. The daily patch is worn between the shoulder blades, where children cannot remove it.
In the new study, 362 children with peanut allergies were first tested to see how high a dose of peanut protein they could tolerate. They were then randomly assigned to use the Viaskin patch or a dummy patch every day.
After a year of treatment, they were tested again and about two-thirds of the young children who used the real patch could safely eat more peanuts, the equivalent of three to four, the researchers concluded. .
That’s compared to about a third of the teens who were given the dummy patch. Greenhawt said they are likely to include children who develop allergies.
For safety, four Viaskin recipients experienced an allergic reaction called anaphylaxis that was considered related to the patch. Three were treated with epinephrine to calm the reaction, and one dropped out of the study.
Some young people accidentally ate foods containing peanuts during the study, and researchers said allergic reactions were more frequent in Viaskin users than in those wearing the dummy patch. The most common side effect is skin irritation at the patch site.
The findings were published in the New England Journal of Medicine.
The results are “excellent news for toddlers and their families as the next step toward a future with more treatments for food allergies,” wrote Dr. Alkis Togias of the National Institutes of Health, who was not involved in the study, in an accompanying editorial.
Togias cautioned that it’s too early to compare oral and skin treatments, but pointed to data suggesting each may have different pros and cons — raising the possibility that oral therapy may be more powerful. but also cause more side effects.
DBV Technologies has struggled for several years to bring the peanut patch to market. Last month the company announced that the FDA wanted some additional safety data for children, and a separate study is already tracking longer treatments. A study of 4- to 7-year-olds is also underway.
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