Patch treatment benefits patients with peanut allergy

Children and young adults who suffer from a peanut allergy may benefit from using a wearable patch that delivers peanut proteins through the skin. The device is currently tested in a clinical trial and has shown promising results, particularly for younger children.

Peanut allergy is the most common food allergy, both in adults and children. For a majority of sufferers, it lasts throughout their lives − four kids out of five stay allergic well into adulthood.

If peanuts are consumed, this can be life-threatening, so it is crucial that sufferers exclude them from the diet. This requires careful monitoring but being vigilant at all times can be problematic as many 'safe' products may contain traces of peanuts.

Some medications called antihistamines can help relieve the symptoms of a mild allergic reaction, while adrenaline delivered by an EpiPen works in the case of more severe allergy manifestations.

None of these drugs, however, 'cure' the person of their allergy. The ongoing clinical trial, funded by the US National Institute of Allergy and Infectious Diseases (NIAID), tries a different approach − it looks at ways to desensitise allergy sufferers to peanuts.

Release of peanut proteins

The patch treatment that scientists are testing is known as epicutaneous immunotherapy (EPIT). In total, five study sites across the US randomly assigned 74 peanut-allergic volunteers aged 4 to 25 years to treatment with a patch releasing either a high-dose of peanut protein or a low-dose, or a placebo patch. The goal was to assess both the safety and efficacy of the method and see if people could get used to peanut proteins.

"Epicutaneous immunotherapy aims to engage the immune system in the skin to train the body to tolerate small amounts of allergen, whereas other recent advances have relied on an oral route that appears difficult for approximately 10 to 15 percent of children and adults to tolerate," explained Daniel Rotrosen, M.D., director of NIAID's Division of Allergy, Immunology and Transplantation.

Starting treatment early

Early findings, published in The Journal of Allergy and Clinical Immunology, suggest that it is safe and well-tolerated, and the method was well-adhered to by the participants. Most of them used the skin patch every day as they had been instructed.

After a year of treatment, the participants were tested to see if they could eat at least 10 times more peanut protein than before the trial. Benefits were identified for both the low-dose and high-dose groups − 46% of people receiving a low-dose and 48% those receiving the high-dose achieved treatment success, compared with 12% of the placebo group.

The effects were more noticeable among young children between 4 and 11 years old, suggesting the benefits of starting treatment early.