First FDA-approved peanut allergy treatment

The first FDA-approved peanut oral immunotherapy product is now available for the treatment of peanut allergy in children. Is this type of product the future of immunotherapy? What risks are associated with Palforzia?

At the end of January 2020, the FDA approved Palforzia [Peanut (Arachis hypogaea) Allergen Powder-dnfp], a peanut allergy ‘drug’ developed by Aimmune Therapeutics.

Is this type of product the future of immunotherapy? What risks are associated with Palforzia?

An allergic reaction to peanuts occurs when an allergic individual’s immune system mounts an IgE response to peanut protein that is considered harmless to non-allergic individuals.

Patients with severe peanut allergies are advised to always carry an epinephrine auto injector (EpiPen) with them; but even with prompt administration, peanut reaction can in rare cases still lead to severe reactions.

What is Palforzia?

Palforzia is a peanut oral immunotherapy programme, and does not offer a cure. Oral immunotherapy involves introducing miniscule doses of food allergen into the diet daily, in this case, peanut, and then increasing the dose to a level that will induce a degree of tolerance by the immune system to that allergen. It is designed to reduce the risk associated with accidental peanut exposure, offering a great deal of relief to peanut-allergic children and their caregivers. It is important to note that allergic individuals must continue to actively avoid peanut, even if they are on the programme.

Currently, it is approved for administration to children of ages 4 to 17; but it can be used as part of the maintenance programme beyond the age of 18.

Stages of the Palforzia programme

The programme consists of three phases, spanning a couple of months. Initial dose escalation and the first dose of each up-dosing cycle must be administered under the supervision of a healthcare professional, due to risk of adverse reaction associated with these steps.

Are there any associated risks?

Anaphalaxes or other adverse reactions are possible at any stage of the programme, but are especially likely during the initiation phase, and when the first dose of each up-dosing cycle is administered. Once the 11 up-dose cycles have been completed successfully, patients continue with the maintenance programme for the rest of their lives. For more information on Palforzia, click here .

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