A peanut allergy treatment trial involving 200 children has brought remission in about half of the group, allowing them to stop treatment and safely eat peanut as frequently as they liked four years later.
The research, led by the Murdoch Children’s Research Institute (MCRI) in Melbourne, found two treatments—a combination of a probiotic together with oral immunotherapy (the gradual introduction of the allergenic food) and oral immunotherapy alone—significantly induced remission and desensitization. Both treatments also provided substantial improvement in quality of life compared with current standard care.
The addition of a probiotic was not found to significantly improve effectiveness compared to oral immunotherapy alone, however the researchers reported the probiotic appeared to enhance tolerability of the treatment, with fewer gastrointestinal symptoms, especially in children between one and five years of age.
After 18 months of treatment, 74 per cent of children who received the oral immunotherapy tolerated roughly a standard serve of peanut, equal to a snack pack of peanut M&Ms. Fifty-one per cent achieved clinical remission and were able to stop treatment altogether, while the remaining 24 percent were desensitized to this amount of peanut. In the placebo group, only 5 per cent of children achieved clinical remission.
Children who were in clinical remission had fewer reactions to peanut compared with those who were just desensitized. Being desensitized still requires continued daily treatment and allergen avoidance, indicating that remission is a better outcome for children.
The peanut oral immunotherapy approach used in the trial applies a proprietary high dose, rapid escalation regimen that is being developed by Australian biotech company Prota Therapeutics as a lead candidate for the treatment of peanut allergy, PRT120.