New drug could save children from violent reactions to peanuts

Irish scientists help develop immunotherapy drug which desensitises people with allergies

Principal investigator at the Infant Centre, Prof Jonathan Hourihane, with a new oral immunotherapy which reduces sensitivity to peanuts. Photograph: Diane Cusack

Principal investigator at the Infant Centre, Prof Jonathan Hourihane, with a new oral immunotherapy which reduces sensitivity to peanuts. Photograph: Diane Cusack

 

The threat of children dying from violent reactions to peanuts can be removed using a “game-changer” treatment developed by scientists in Ireland and five other countries.

More than two-thirds of children on the trial for a new immunotherapy can now safely eat peanuts, according to the results published in the prestigious New England Journal of Medicine.

The drug, AR101, which is derived from peanut flour, desensitises people with a peanut allergy. More than 30 Irish children were involved in the two-year trial, the largest of its kind yet undertaken.

In the study, 67 per cent of children taking AR101 capsules were able to consume a final “challenge dose” of four peanuts.

Even among those children who remained sensitive, their reactions were greatly reduced and few had to use adrenaline, the most common treatment for anaphylactic shock, according to Prof Jonathan Hourihane of the Infant Centre in University College Cork.

“This is a game changer. If someone is anaphylactic or suffers severe reactions, this is life changing,” said Prof Hourihane, who led the global trial in Ireland.

“This treatment now gives parents, children and adults with peanut allergy a safety in the community they have never had.”

Suppressing responses

The drug works by suppressing the allergic response in the body. “It trains your body not to panic when it sees a peanut,” explains Prof Hourihane.

“By introducing initially minute controlled amounts of peanut protein, with escalation over a sustained period of six to 12 months, it builds up a patient’s tolerance to peanut.

“We have seen patients go from being highly allergic to very small doses, like one-tenth of a peanut, to being able to manage to eat the equivalent of two or three peanuts without a significant reaction.”

Further research was needed to ascertain whether the treatment had a longer term effect after treatment was stopped, he said.

About 1,200 children a year are diagnosed with peanut allergy – 2 per cent of the population – and an estimated 20,000 children have the condition in total.

In only one in five cases does the allergy resolve itself over time.

“It’s a high-profile and emotive condition that is the main cause of anaphylaxis in the community. The allergy inhibits the lives of families in how they live, through its effects on school time, sleepovers and every aspect of a child’s life.”

Of 551 children who took part in the research by the Palisade Group of Clinical Investigators, 32 were screened in Ireland.

The treatment needs approval by regulatory authorities but could be on the market within a year.

“This is an example of the excellent, world-leading clinical research ongoing at the Infant Centre at UCC, which is making a huge difference to the lives of children and their families, not just in Ireland but all over the world,” said Geraldine Boylan, director of the centre.

Infant, Ireland’s first perinatal research centre, has been at the centre of controversy in recent months after Science Foundation Ireland decided not to provide a new round of funding to it.

Prof Hourihane said the centre was still disappointed at the withdrawal of funding but the peanut study demonstrated the kind of leading research the Government should be supporting.