Epicutaneous immunotherapy for the treatment of peanut allergy in children and young adults
Stacie M. Jones,Scott H. Sicherer,A. Wesley Burks,Donald Y.M. Leung,Robert Lindblad,Peter Dawson,Alice K. Henning,M. Cecilia Berin,David Y. Chiang,Brian P. Vickery,Robbie D. Pesek,Christine B. Cho,Wendy F. Davidson,Marshall Plaut,Hugh A. Sampson,Robert A. Wood +15 more
TLDR
Peanut EPIT administration was safe and associated with a modest treatment response after 52 weeks, with the highest responses among younger children, and when coupled with a high adherence and retention rate and significant changes in immune pathways, supports further investigation of this novel therapy.Abstract:
Background Peanut allergy is common, life-threatening, and without therapeutic options We evaluated peanut epicutaneous immunotherapy (EPIT) by using Viaskin Peanut for peanut allergy treatment Objective We sought to evaluate the clinical, safety, and immunologic effects of EPIT for the treatment of peanut allergy Methods In this multicenter, double-blind, randomized, placebo-controlled study, 74 participants with peanut allergy (ages 4-25 years) were treated with placebo (n = 25), Viaskin Peanut 100 μg (VP100; n = 24) or Viaskin Peanut 250 μg (VP250; n = 25; DBV Technologies, Montrouge, France) The primary outcome was treatment success after 52 weeks, which was defined as passing a 5044-mg protein oral food challenge or achieving a 10-fold or greater increase in successfully consumed dose from baseline to week 52 Adverse reactions and mechanistic changes were assessed Results At week 52, treatment success was achieved in 3 (12%) placebo-treated participants, 11 (46%) VP100 participants, and 12 (48%) VP250 participants ( P = 005 and P = 003, respectively, compared with placebo; VP100 vs VP250, P = 48) Median change in successfully consumed doses were 0, 43, and 130 mg of protein in the placebo, VP100, and VP250 groups, respectively (placebo vs VP100, P = 014; placebo vs VP250, P = 003) Treatment success was higher among younger children ( P = 03; age, 4-11 vs >11 years) Overall, 144% of placebo doses and 798% of VP100 and VP250 doses resulted in reactions, predominantly local patch-site and mild reactions ( P = 003) Increases in peanut-specific IgG 4 levels and IgG 4 /IgE ratios were observed in peanut EPIT-treated participants, along with trends toward reduced basophil activation and peanut-specific T H 2 cytokines Conclusions Peanut EPIT administration was safe and associated with a modest treatment response after 52 weeks, with the highest responses among younger children This, when coupled with a high adherence and retention rate and significant changes in immune pathways, supports further investigation of this novel therapyread more
Citations
More filters
Journal ArticleDOI
Epicutaneous sensitization to food allergens in atopic dermatitis: What do we know?
Elizabeth Huiwen Tham,Elizabeth Huiwen Tham,Mohana Rajakulendran,Bee Wah Lee,Hugo Van Bever,Hugo Van Bever +5 more
TL;DR: The mechanisms underpinning the development of epicutaneous sensitization to food allergens and progression to clinical food allergy are described and current evidence for interventions to halt the progression is summarized to highlight unmet needs and directions for future research.
Journal ArticleDOI
Peanut Allergy: New Advances and Ongoing Controversies
TL;DR: The dual-allergen exposure hypothesis now supports transcutaneous sensitization to peanut as a likely pathophysiologic mechanism for peanut allergy development, and there is emerging evidence that early peanut introduction has a role in peanut allergy prevention.
Journal ArticleDOI
Food allergy and anaphylaxis.
TL;DR: The clinical manifestations of anaphylaxis are broad and may involve multiple body systems, and long-term management is generally focused on strict allergen avoidance and more recently on food desensitization using immunotherapy.
Journal ArticleDOI
Current and Future Treatment of Peanut Allergy.
TL;DR: Data from recent trials of investigational peanut oral and epicutaneous immunotherapies are reviewed, the pipeline of novel therapies in early development is explored, and future research needs and priorities are identified.
Journal ArticleDOI
Epicutaneous immunotherapy in rhino-conjunctivitis and food allergies: a review of the literature.
Susanna Esposito,Chiara Isidori,Alessandra Pacitto,Cristina Salvatori,Laura Sensi,Franco Frati,Giuseppe Di Cara,Francesco Marcucci +7 more
TL;DR: Overall, the EPIT study results, even if they were affected by great heterogeneity among the methodologies applied, have shown not only the high safety and adherence with this kind of immunotherapy but also suggested the possibility for obtaining definitive evidence of the efficacy of EPIT, especially for food allergies.
References
More filters
Journal ArticleDOI
Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report
Joshua A. Boyce,Amal Assa'ad,A. Wesley Burks,Stacie M. Jones,Hugh A. Sampson,Robert A. Wood,Marshall Plaut,Susan F. Cooper,Matthew J. Fenton,S. Hasan Arshad,S. Hasan Arshad,Sami L. Bahna,Lisa A. Beck,Carol Byrd-Bredbenner,Carlos A. Camargo,Lawrence F. Eichenfield,Lawrence F. Eichenfield,Glenn T. Furuta,Glenn T. Furuta,Jon M. Hanifin,Carol Jones,Monica Kraft,Bruce D. Levy,Phil Lieberman,Stefano Luccioli,Kathleen M. McCall,Lynda C. Schneider,Ronald A. Simon,F. Estelle R. Simons,Stephen J. Teach,Barbara P. Yawn,Barbara P. Yawn,Julie M. Schwaninger +32 more
TL;DR: The National Institute of Allergy and Infectious Diseases, working with 34 professional organizations, federal agencies, and patient advocacy groups, led the development of clinical guidelines for the diagnosis and management of food allergy, which include a consensus definition for food allergy.
Journal ArticleDOI
The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States
Ruchi Gupta,Elizabeth E. Springston,Manoj R. Warrier,Bridget Smith,Bridget Smith,Rajesh Kumar,Jacqueline A. Pongracic,Jacqueline A. Pongracic,Jane L. Holl +8 more
TL;DR: Findings suggest that the prevalence and severity of childhood food allergy is greater than previously reported and that disparities exist in the clinical diagnosis of disease.
Journal ArticleDOI
US prevalence of self-reported peanut, tree nut, and sesame allergy: 11-year follow-up
TL;DR: Although caution is required in comparing surveys, peanut allergy, TN allergy, or both continue to be reported by more than 1% of the US population and appear to be increasingly reported among children over the past decade.
Journal ArticleDOI
Clinical efficacy and immune regulation with peanut oral immunotherapy.
Stacie M. Jones,Laurent Pons,Joseph L. Roberts,Amy M. Scurlock,Tamara T. Perry,Mike Kulis,Wayne G. Shreffler,Pamela H. Steele,Karen A. Henry,Margaret Adair,James M. Francis,Stephen R. Durham,Brian P. Vickery,Xiao-Ping Zhong,A. Wesley Burks +14 more
TL;DR: Microarray data suggest a novel role for apoptosis in OIT, which induces clinical desensitization to peanut, with significant longer-term humoral and cellular changes.
Journal ArticleDOI
Oral immunotherapy for treatment of egg allergy in children.
A. Wesley Burks,Stacie M. Jones,Robert A. Wood,David Fleischer,Scott H. Sicherer,Robert Lindblad,Donald Stablein,Alice K. Henning,Brian P. Vickery,Andrew H. Liu,Amy M. Scurlock,Wayne G. Shreffler,Marshall Plaut,Hugh A. Sampson +13 more
TL;DR: These results show that oral immunotherapy can desensitize a high proportion of children with egg allergy and induce sustained unresponsiveness in a clinically significant subset.
Related Papers (5)
AR101 Oral Immunotherapy for Peanut Allergy
Brian P. Vickery,Andrea Vereda,Thomas B. Casale,Kirsten Beyer,George Du Toit,Jonathan O'b Hourihane,Stacie M. Jones,Stacie M. Jones,Wayne G. Shreffler,Annette Marcantonio,Rezi Zawadzki,Lawrence Sher,W. Carr,Stanley Fineman,Leon Greos,Rima Rachid,M Dolores Ibáñez,Stephen A. Tilles,Amal Assa'ad,Caroline Nilsson,Ned Rupp,Michael J Welch,Gordon Sussman,Sharon Chinthrajah,Katharina Blumchen,Ellen Sher,Jonathan M. Spergel,Frederick E Leickly,Stefan Zielen,Julie Wang,Georgiana M Sanders,Robert A. Wood,Amarjit Cheema,Carsten Bindslev-Jensen,Stephanie A. Leonard,Rita Kachru,Douglas T Johnston,Frank C Hampel,Edwin H. Kim,Aikaterini Anagnostou,Jacqueline A. Pongracic,Moshe Ben-Shoshan,Hemant P Sharma,Allan Stillerman,Hugh H Windom,William H. Yang,Antonella Muraro,José Manuel Zubeldia,Vibha Sharma,Morna J. Dorsey,Hey Chong,Jason A. Ohayon,J. Andrew Bird,Tara F. Carr,Dareen Siri,Montserrat Fernandez-Rivas,David K Jeong,David Fleischer,Jay A. Lieberman,Anthony E.J. Dubois,Marina Tsoumani,Christina E. Ciaccio,Jay M. Portnoy,Lyndon E Mansfield,Stephen B Fritz,Bruce J. Lanser,Jonathan Matz,Hanneke N G Oude Elberink,Pooja Varshney,Stephen G Dilly,Daniel C. Adelman,A. Wesley Burks +71 more
Sustained unresponsiveness to peanut in subjects who have completed peanut oral immunotherapy.
Brian P. Vickery,Amy M. Scurlock,Michael D. Kulis,Pamela H. Steele,J. Kamilaris,Jelena P. Berglund,Caitlin M. Burk,Anne Hiegel,Suzanna K. Carlisle,Lynn Christie,Tamara T. Perry,Robbie D. Pesek,Saira Z Sheikh,Yamini V. Virkud,P. Brian Smith,Mohamed H. Shamji,Stephen R. Durham,Stacie M. Jones,A. Wesley Burks +18 more