It’s possible to limit the risks of a peanut allergy by giving people with the allergy a minuscule and sustained dose of the nut itself. The method proved so successful in the laboratory setting that the US Food and Drug Administration (FDA) is now reviewing a new, peanut-derived drug produced by Aimmune Therapeutics that may one day help people develop a tolerance to peanut exposure.
Researchers around the world have in the past worked to test whether or not the human body can be reprogrammed out of having a peanut allergy. In August 2017, for instance, the Murdoch Children’s Research Institute in Australia released research that showed how peanuts could be combined with probiotics to help the body’s immune system build up a tolerance to the nuts. It worked for 82% of the 48 children who were part of that study.
Researchers in the Aimmune Therapeutics study administered small doses of a peanut-protein powder drug—known for now as AR101—to participants for a full year. According to the drug’s manufacturer, it was the largest and most rigorously conducted experiment on an oral immunotherapy for the peanut allergy ever conducted. It involved a double-blind, placebo-controlled trial that took place at 66 sites in 10 countries across North America and Europe. The trial sites screened 842 people, all of them allergic to peanuts and the vast majority of whom were between the ages of 4 to 17.
“Our hope when we started the study was that by treating patients with the equivalent of one peanut per day, many would tolerate as much as two peanuts,” said lead researcher Stephen Tilles in a statement.
It was a success, according to a new study published in the New England Journal of Medicine. After a year, half the study participants were able to tolerate as many as four peanuts per day.
The positive results come with a caveat. The treatment does not eliminate a person’s allergy to peanuts. In fact, people who would take the drug would still be advised to steer very clear of them. What the drug would do, though, is provide protection in cases of accidental exposure.
For decades, the peanut allergy was the top cause of anaphylaxis in the US, which within seconds can trigger the body to release chemicals that can send a person into shock. In the US each year, more than 200,000 people require emergency care related to an anaphylactic reaction to an allergen, and 22% of those cases are caused by exposure to peanuts. Recent studies have shown the number of people exhibiting such reactions to peanut products is on the rise.
If the drug gets FDA approval, it would represent the first major immunotherapy advance for treating peanut allergies. Right now, people with peanut allergies often must practice constant vigilance to ensure they don’t come anywhere near peanuts out of fear of an allergic reaction. If approved, AR101 would allow people with those allergies to live without those fears. The FDA’s standard drug-approval process takes around 10 months.