The National Institutes of Health has announced that a recent experimental treatment demonstrated a way that a skin patch could reduce allergic reactions to peanuts – one of the most common food allergies.
A treatment called oral immunotherapy has been shown in recent tests to be able to reduce, by feeding small amounts of a food to which one is allergic, allergic reactions to a point the ‘patient’ can, after repeated treatments, consume reasonable amounts of the allergenic food without having a negative reaction to it.
Another approach to dealing with the same issue, called epicutaneous (on the skin) immunotherapy, or EPIT, is being studied, as well.
A phase 1 study of the oral immunotherapy approach demonstrated the safety and tolerability of a wearable patch developed by DBV Technologies. The patch, named Viaskin, delivers small amounts of peanut protein through the skin.
An ongoing trial to further evaluate peanut EPIT is sponsored by NIH’s National Institute of Allergy and Infectious Diseases (NIAID) and conducted by the NIAID-funded Consortium of Food Allergy Research (CoFAR). Researchers randomly assigned 74 peanut-allergic volunteers, ages 4 to 25 years, to either a high-dose (250 micrograms peanut protein), low-dose (100 micrograms peanut protein), or placebo patch. Each day, the participants applied a new patch to an arm or between their shoulder blades. After one year, the researchers assessed the treatments’ success. Success was defined as being able to eat at least 10 times more peanut protein than they could eat before starting EPIT. Results were published online on October 26, 2016, in the Journal of Allergy and Clinical Immunology.The low-dose and high-dose regimens offered similar benefits (46% and 48% success, respectively, compared with 12% in the placebo group). Treatment success was higher among the younger children, ages 4 to 11 years, than the older ones, where there was minimal benefit.
Nearly all study participants followed the EPIT regimen as directed. None reported serious systemic reactions to the patch, although most experienced mild skin reactions, such as itching or rash, where the patch was applied.
“The clinical benefit seen in younger children highlights the promise of this innovative approach to treating peanut allergy,” says Dr. Daniel Rotrosen, director of NIAID’s Division of Allergy, Immunology and Transplantation. “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% of children and adults to tolerate.”
Because EPIT appears to cause few, if any, systemic reactions and appears to be well tolerated, it may be possible to administer it for longer periods of time. The CoFAR study will continue to assess the long-term safety and effectiveness of peanut EPIT in this group. Additional studies in larger groups of children will be needed before the patch could be approved for wider use.