Published August 08, 2023
There are some new options available in the treatment of peanut allergies. Around 8% of children in the U.S. have food allergies and around 1-2% of those children have a peanut allergy.
The “peanut patch” is a form of epicutaneous immunotherapy. That means instead of ingesting peanuts orally, children with a peanut allergy wear a patch on their skin that contains small amounts of peanut proteins. The goal of this kind of treatment is to slowly desensitize the patient to peanuts.
A study published in The New England Journal of Medicine found after a year of treatment, the patch helped to reduce the likelihood of an allergic reaction in children between the ages of one and three.
Pediatric allergist Stephanie Leeds, MD, MHS, of the Yale New Haven Children’s Hospital Pediatric Food Allergy Prevention Program and assistant professor of Clinical Pediatrics at Yale School of Medicine, says while the patch is not yet commercially available, the research is promising.
“Data supports that early immunotherapy in infants and toddlers may be most effective,” Dr. Leeds said. “The patch also overcomes some of the challenges of oral immunotherapy, in which infants and toddlers are required to orally ingest peanut in an effort towards desensitization. Infants and toddlers can be picky eaters and the patch does not require any active eating on the part of the patient.”
In years past parents were told to wait to introduce allergens like peanuts. Now the guidance is to introduce allergens early and often. Dr. Leeds recommends the safe introduction of peanut around four to six months old, particularly in high-risk infants. This can come in the form of small amounts of peanut butter thinned out with breast milk or formula, or a baby-safe peanut puff that dissolves easily in the mouth. Other common allergens kids should be exposed to early include:
When introducing allergens to babies, it’s best to introduce those foods one a time. That way if there is a reaction, parents will know what is causing it.
While recent data shows about one third of children may outgrow their peanut allergy, it’s unclear why this happens to some kids and not to others. Therefore, if a child has an allergy, they should be monitored by a board-certified allergist who can offer different forms of immunotherapy to help treat their allergy and monitor any changes.
Patients with severe allergies may already rely on an EpiPen to treat symptoms of an allergic reaction. But in February, the FDA approved the first medication to reduce the risk of a reaction after an accidental exposure.
Xolair (omalizumab) is a monoclonal antibody that binds to IgE, or the “allergic” antibody circulating in our blood. A study published in The New England Journal of Medicine found that treatment with Xolair for 16 weeks was superior to a placebo in increasing the reaction threshold for peanuts, as well as other common allergens including milk, egg and wheat.
Dr. Leeds says patients will need to discuss the benefits and risks before trying any new therapeutic option.
“This may be useful in patients with multiple food allergies with a history of severe reactions, particularly if their food allergens are hard to avoid. But for all patients, they will still need to avoid their allergens and carry an epinephrine autoinjector,” she said.
Learn more about treatment at the Pediatric Food Allergy Prevention Program.
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