Palforzia for peanut allergy: Panacea or predicament

Perkin, Michael R.

doi:10.1111/cea.14145

Cited by 11 publications

(9 citation statements)

References 9 publications

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“…[63][64][65] 'real food' format-mean that allergic patients still have to contend with scientific and medical uncertainties. 63,66 This is not the least because external factors, such as stress, have historically been thought…”

Section: Con S Truc Ting the Ris K Of Food Allergymentioning

confidence: 99%

Historical and social science perspectives on food allergy

Smith

2023

Clin Experimental Allergy

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This article provides an overview of the insights social scientists, historians and other health humanities scholars have made to our understanding of food allergies. It shows how humanities and social science scholars have tended to address three pivotal issues related to food allergies: first, they have addressed the epidemiology of food allergies, including the apparent rise in the rate of food allergies and the emergence of theories that purport to explain why food allergies may be increasing. These include theories related to changes in food consumption and the hygiene hypothesis. Second, humanities and social science scholars have researched how risks related to food allergies have been constructed, understood, experienced and mitigated. Third, humanities and social science scholars have investigated the experiences of food allergy sufferers and those who care for them, providing valuable qualitative insights that can inform how we respond to food allergy and our understanding of the aetiology of food allergy. The article concludes with three recommendations. First, there should be a more interdisciplinary approach to food allergy research that involves social scientists and health humanities scholars. Second, humanities and social sciences scholars should be more willing to unpack and scrutinise the theories put forward to explain the aetiology of food allergies, rather than accepting them at face value. And finally, humanities and social sciences scholars can play a major role in ensuring that the experiences of patients and their carers are articulated and fed into debates about food allergy, including its causes and how to respond to it.

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Section: Con S Truc Ting the Ris K Of Food Allergymentioning

confidence: 99%

Historical and social science perspectives on food allergy

Smith

2023

Clin Experimental Allergy

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“…6 Despite this approval, the role of OIT in the management of peanut allergy remains controversial. 6 A recent meta-analysis of 12 trials demonstrated that, while peanut OIT significantly increased the likelihood of passing a supervised food challenge (RR 12•42; 95% CI 6•82-22•61), it also led to significantly increased anaphylaxis risk (RR 3•12; 95% CI 1•76-5•55) and anaphylaxis frequency (incidence rate ratio [IRR] 2•72; 1•57-4•72) and epinephrine use (RR 2•21; 1•27-3•83). 7 This led the authors to conclude that safer peanut allergy treatments that are rigorously tested in randomized-controlled trials are necessary before routine use of peanut OIT in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

“…In 2020, Palforzia® became the first and only approved oral immunotherapy (OIT) for peanut allergies by the Food and Drug Administration in the United States of America 6 . Despite this approval, the role of OIT in the management of peanut allergy remains controversial 6 . A recent meta‐analysis of 12 trials demonstrated that, while peanut OIT significantly increased the likelihood of passing a supervised food challenge (RR 12·42; 95% CI 6·82–22·61), it also led to significantly increased anaphylaxis risk (RR 3·12; 95% CI 1·76–5·55) and anaphylaxis frequency (incidence rate ratio [IRR] 2·72; 1·57–4·72) and epinephrine use (RR 2·21; 1·27–3·83) 7 .…”

Section: Introductionmentioning

confidence: 99%

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Oral immunotherapy using boiled peanuts for treating peanut allergy: An open‐label, single‐arm trial

Grzeskowiak

Tao

Aliakbari

et al. 2023

Clin Experimental Allergy

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Background Peanut allergy affects 1%–3% of children in Western countries. Boiling peanuts has been demonstrated to result in a hypoallergenic product that may provide a safer way of inducing desensitization in peanut‐allergic patients by first inducing tolerance to boiled peanut. We aimed to assess the efficacy and safety of oral immunotherapy (OIT) using sequential doses of boiled peanuts followed by roasted peanuts for treating peanut allergy in children. Methods In this open‐label, phase 2, single‐arm clinical trial, children aged 6–18 years with a positive history of peanut allergy and positive peanut skin prick test ≥ 8 mm and/or peanut‐specific IgE ≥ 15 kU/L at screening underwent OIT involving sequential up‐dosing with 12‐hour boiled peanut for 12 weeks, 2‐hour boiled peanut for 20 weeks and roasted peanut for 20 weeks, to a target maintenance dose of 12 roasted peanuts daily. Primary outcome: proportion of children passing open‐label oral food challenge involving cumulative administration of 12 roasted peanuts (12 g peanuts; approximately 3000 mg peanut protein) 6–8 weeks after reaching the target maintenance dose. Secondary outcomes included treatment‐related adverse events and use of medications for treating allergy symptoms. Results Between 1 July 2017 and 22 June 2018, 70 participants were enrolled and commenced OIT. Desensitization was successfully induced in 56 of 70 (80%) participants. Withdrawal due to treatment‐related adverse events was infrequent (n = 3). Treatment‐related adverse events were reported in 43 (61%) participants, corresponding to a rate of 6.58 per 1000 OIT doses. Medication use associated with treatment‐related adverse events was infrequent, with rescue epinephrine use reported by three (4%) participants (0.05 per 1000 doses). Conclusion Oral immunotherapy using boiled followed by roasted peanuts represents a pragmatic approach that appears effective in inducing desensitization and is associated with a favourable safety profile.

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“…NICE estimates that within 3 years just over 2000 children a year will receive treatment with Palforzia eventually reaching 3000 of the estimated population of 141 000 children a year by 2026 19. Treating 2000 children a year would require 24 000 day case visits for administration of Palforzia alone and as the NHS currently only has capacity to provide just over 30 000 food challenges per year, 80% of all current food challenges would need to cease to create the capacity to deliver Palforzia safely 20…”

Section: Introductionmentioning

confidence: 99%

▼Palforzia for oral desensitisation to peanut in allergic children

2022

DTB

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Palforzia for peanut allergy: Panacea or predicament

Cited by 11 publications

References 9 publications

Historical and social science perspectives on food allergy

Historical and social science perspectives on food allergy

Oral immunotherapy using boiled peanuts for treating peanut allergy: An open‐label, single‐arm trial

▼Palforzia for oral desensitisation to peanut in allergic children

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