Daily doses of peanuts help adults overcome severe allergies

Daily doses of peanuts help adults overcome severe allergies

The first clinical trial to test whether adults are allergic to peanuts has shown great success with two-thirds of the cohort consuming the equivalent of five peanuts without reacting.

The Adult Study for Peanut Immunotherapy (GUPI) is the first study to test exclusively in adults with severe allergy whether daily doses of peanuts taken under strict supervision can be safely tolerated.

The approach, known as oral immunotherapy, has achieved success in trials on infants and children around the world. The results of the first trial in an exclusive adult cohort were published today in the journalallergyby a research team from King's College London and Guy's and St Thomas' NHS Foundation Trust. The study is funded by the National Institute for Health and Care Research (NIHR) Research for Patient Benefits Program.

The constant fear of life-threatening reactions puts a lot of stress on people with peanut allergies. The only way to treat a peanut allergy is to strictly avoid and treat allergic reactions, including with epinephrine. Although peanut immunotherapy is effective in children, this study provides preliminary evidence that adults can also be desensitized and that this improves quality of life. The average tolerated dose of peanuts increased 100-fold over the course of the trial. “

Professor Stephen Till,Chief InvestigatorPresentProfessor of Allergy at King’s College London

The phase II study recruited twenty-one adults between 6pm and 40pm with a clinical diagnosis of peanut allergy at Guy and St Thomas' NHS Foundation Trust. The allergy was confirmed by skin prick test, blood test and then a mouth food challenge.

In a clinical setting, participants received the first dose of 0.8 mg of peanut flour mixed with food and then 1.5 mg 30 minutes later, followed by 3 mg another 30 minutes later.

Participants who tolerated 1.5 mg or 3 mg of peanut flour continued a daily dose at home for 2 weeks. This is the equivalent of 0.5-1% of a whole peanut.

Then participants returned for monitored doses of more peanut protein at 2-week intervals, increasing from 6 mg (about 1/40 of a whole peanut) to 1 g (four whole peanuts). When participants could tolerate 50-100 mg of peanut protein, participants were transitioned to eating peanuts, peanut butter, or peanut products, with the first dose administered under the supervision of the clinical team.

Once participants reached a daily dose of 1g, they remained at that dose for at least four weeks before undergoing a double-blind, placebo-controlled food challenge. This involved increasing doses of peanut or placebo (dummy) on separate days under close supervision to test their tolerance. Participants then continued daily dosing for at least three months before leaving the trial and the post-study option.

The results showed that 67% of participants were able to consume at least 1.4g of peanut protein - the equivalent of five peanuts - without a reaction. Participants in the trial were then able to consume peanuts at home every day to remain desensitized.

Professor Till said: "We are very pleased with the results. The efficacy rate is broadly in line with the oral peanut immunotherapy studies in children. The next stage of research will confirm this in larger studies and also identify the group of adult patients most likely to benefit from oral immunotherapy and whether it can lead to long-term tolerance in this group using oral immunotherapy in this group."

Hannah Hunter, from Guy's and St Thomas' NHS Foundation Trust, said: "Living with a peanut allergy is a huge burden with the need for constant vigilance and the risk of accidental exposures. Everyday situations such as eating in restaurants and social events cause anxiety. Fear of food also decreased.

Chris, 28, took part in the experiment. Diagnosed with a peanut allergy as a baby, she jumped at the chance to take part in the trial.

He said: "I'm so proud to have been part of this process and so happy to say that I used to be allergic to peanuts, but thanks to this process this was no longer a problem. Me and my family were always worried that even a trace of peanuts could be life-threatening. The trial was an interesting experience because I was diagnosed with a small one and without with a small amount that became with the procedure, with a sinut and the with peanut with peanuts with peanuts with the low and with a deficiency At the end of the experiment, I was able to eat four peanuts in one sitting.

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