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How should children with peanut allergy be treated?
Recently, there has been increasing evidence that children with peanut allergy should gradually increase their intake of peanuts to reduce the severity of the disease. According to the latest findings, such a gradual increase can even worsen the disease.
A recent study by McMaster University found that a gradual increase in peanut intake in children with peanut allergy can increase the severity of the disease. The results of the study were published in the English language journal "The Lancet".
Oral peanut immunotherapy tripled the anaphylaxis rate
Past studies on food problems have shown that oral immunotherapy, which gradually increases the allergen dose over time, can be effective. However, the latest research from McMaster University raises doubts about this approach. Attempts to desensitize children in the real world have been shown to promote allergic reactions, including severe and potentially fatal anaphylaxis, compared to completely avoiding contact with peanuts. The researchers found that oral peanut immunotherapy tripled the anaphylaxis rate from around 7.1 percent to an impressive 22.2 percent. Allergic reactions leading to vomiting, abdominal pain, itching in the mouth, hives and asthma also increased significantly.
Safety of oral immunotherapy needs to be improved
Numerous studies of different quality have been published on oral immunotherapy, but the effectiveness and reliability of the treatment are still unclear, the authors of the current study explain. The new study includes all previous randomized clinical trials that compared oral peanut therapy to non-immunotherapy to provide the best possible evidence for decision-making. It has been shown that current oral immunotherapy approaches for peanuts can achieve the immunological goal of desensitization, but that this does not lead to the desired goal of avoiding the allergic reaction and anaphylaxis.
Instead, the opposite occurs, with more allergic and adverse reactions to oral immunotherapy compared to avoiding contact with peanuts or taking a placebo, the study authors explain. The results found do not condemn current research in the field of oral immunotherapy, but the method must be examined more carefully, safety improved and the success factors should meet the wishes of those affected, the researchers report.
Many allergies are overcome in the course of early life
Food allergies affect more than six million people in Europe and North America, including eight percent of children and two to three percent of adults. While allergies to milk and egg are often overcome at the age of five to ten years, peanut allergy can be a lifelong problem for those affected. Oral immunotherapy studies measure treatment success by whether a patient can tolerate supervised allergen contact. However, the researchers emphasize that this cannot predict future risks in the real world.
Oral or epicutaneous immunotherapy?
The results of oral (through the mouth) and epicutaneous (skin contact) immunotherapy should be compared. Although epicutaneous immunotherapy is less effective, it has a better safety profile than oral immunotherapy, the researchers explain. It should not be forgotten that the early introduction of peanut products in baby food can prevent most cases of peanut allergy. However, better strategies need to be developed to reduce the number of patients with an existing peanut allergy. (as)