A recent study suggests that children with mild peanut sensitivity may be able to overcome their allergy by gradually consuming store-bought peanut butter. All 32 children in the study were able to tolerate the equivalent of three tablespoons of peanut butter after undergoing 18 months of immunotherapy. The findings, published in NEJM Evidence, emphasize that this approach should only be undertaken under the guidance of an allergist.
About 1% to 2% of children and adults in the US have a peanut allergy, according to the American Academy of Allergy, Asthma, and Immunology. Lead author Dr. Scott Sicherer, from the Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, noted that previous research focused on severe cases, while this study targeted children who could consume at least half a peanut.
Parents are advised against attempting this therapy independently and encouraged to consult an allergist. The trial, sponsored by the National Institute of Allergy and Infectious Diseases, included 73 children, ages 4 to 14, with 32 undergoing immunotherapy.
Starting with a small amount of peanut butter, the children gradually increased their intake every eight weeks. Once they could tolerate a tablespoon daily, they were instructed to consume two tablespoons per week. Regular monitoring by an allergist ensured safety during the treatment.
Notably, none of the children in the immunotherapy group required emergency epinephrine at home, demonstrating the treatment’s success. Subsequent tests showed that 26 out of 30 children maintained their tolerance to peanuts after an eight-week break from peanut consumption.
The study’s promising results offer hope for children with peanut allergies, highlighting the potential of immunotherapy in managing this common food allergy.
“This is a pretty easy process to follow and it was very successful,” Sicherer said. “It has the potential to be a game changer for the families and the children.” While it will be necessary to follow children for a longer term to validate the results, “the ability to induce tolerance to a food is incredibly exciting,” said Dr. Joel Brooks, an assistant professor of pediatrics and an associate program director of allergy and immunology at the Columbia University Vagelos College of Physicians and Surgeons in New York City.
“Now these children won’t have to carry an EpiPen with them,” he said. “They won’t have to avoid foods with peanuts. They are allergy-free for life.” Often, when children develop a peanut allergy, it has a profound impact on the family, Brooks said.
“The children stop going to birthday parties and a lot of them stop going out to eat with their families. Fear keeps them from summer camp and going away to visit friends for the holidays,” he said. “If you can take away the risk, it would make a world of difference to the children and their families.”
Brooks was also happy to see that the researchers published their protocol. “Once there is a standardized protocol, more practices can utilize it to help their patients,” he said. “It may not be every patient’s choice, but it’s another tool in our toolboxes.” He reiterated the advice to parents not to try to do the immunotherapy protocol on their own.
“There’s a risk any time we do a food challenge that there could be a severe life-threatening reaction,” he said. “So this should be done only under the supervision of an allergist.”
