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
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Treatment of gastric eosinophilia by epicutaneous immunotherapy in piglets sensitized to peanuts.
Lucie Mondoulet,Nicolas Kalach,Véronique Dhelft,Thibaut Larcher,Carine Delayre-Orthez,Pierre-Henri Benhamou,Jonathan M. Spergel,Hugh A. Sampson,C. Dupont +8 more
TL;DR: A model of gastric eosinophilia in peanut‐sensitized piglets is established to evaluate the efficacy of epicutaneous immunotherapy (EPIT) for its treatment.
Journal ArticleDOI
Immunotherapy approaches for peanut allergy
TL;DR: There are no perfect treatments for peanut allergy and OIT, EPIT, and SLIT each has its unique pros and cons, so shared decision-making between patients and providers will be essential to achieve optimal care for patients with peanut allergy.
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FDA-approved peanut allergy treatment: The first wave is about to crest.
Stephen A. Tilles,Daniel Petroni +1 more
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Patient-Centered Outcomes in Food Allergy.
Brooke I. Polk,Chitra Dinakar +1 more
TL;DR: While there is a growing momentum toward recognition of food allergic disorders as a condition that profoundly impacts activities of daily living, greater effort needs to be expounded to develop validated tools and interventions that can adequately address these issues.
Journal ArticleDOI
The Current State of Epicutaneous Immunotherapy for Food Allergy: a Comprehensive Review.
TL;DR: Clinical data is lacking, but relatively small and early studies suggest that EPIT has an excellent safety profile, particularly compared to other methods of specific allergen immunotherapy, which is needed to prove efficacy and further demonstrate the safety profile of EPIT for food allergy.
References
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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.
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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.
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