Dr. Mansfield: Oral Immunotherapy for Peanut Anaphylaxis With Peanut Flour and Peanuts: Presented at ACAAI; PeerVoice, 2007

Oral Immunotherapy for Peanut Anaphylaxis With Peanut Flour and Peanuts: Presented at ACAAI
By Carole Bullock

DALLAS, TX — November 16, 2007 — An oral peanut flour challenge provided a novel immunotherapy for peanut allergies, according to a small study, reported here at the American College of Allergy, Asthma and Immunology (ACAAI) 65th annual meeting.

“Peanut anaphylaxis (PA) and other food anaphylaxis is a cause of great anxiety in parents and young children. Avoidance and autoinjectors of epinephrine are not always successful,” Lyndon Mansfield, MD, Director, Western Sky Medical Research, El Paso, Texas, United States, said in a presentation on November 12.

“Even though sublingual immunotherapy with peanut extract has been reported to offer protection against PA, the reagent is not available for clinical use,” he noted.

The researchers explored the novel immunotherapy in group of 7 patients with PA, using a carefully monitored oral peanut flour challenge. The dose was gradually increased to 8 grams of peanut flour twice daily. Maintenance dosing was either peanut flour or 4 to 8 peanuts first BID, then QD and QOD.

“Our longest clinical experience is 30 months without any further PA in spite of several small accidental exposures to peanut or peanut butter,” he reported.

The researchers said that their protocol can “provide clinical benefit for patients, particularly young children, who cannot self-administer epinephrine and control accidental exposures.”

Commenting on the research, Joseph Bellanti, MD, Professor of Pediatrics and Microbiology/Immunology, Georgetown University, Washington, DC, United States, said, “The study shows the technique is successful and an a sublingual alternative, but is needs to have standardisation to make sure patients aren’t put at risk for anaphylaxis.”

No funding was provided for this study. The author and commentator have no disclosures.

[Presentation title: Oral Immunotherapy For Peanut Anaphylaxis (Pa)With Peanut Flour and Peanuts (PFAP). Abstract 50]

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