A Skin Patch for Peanut Allergies? Not Nuts, Says Pediatric Allergist

Blog Peanut Allergy Web

The quarter-sized patch won’t allow kids with allergies to eat a PB&J sandwich, but it will protect them daily from inadvertent exposure to even the smallest crumb of a peanut.

A worldwide rash of claims that a skin patch is the answer to protecting kids from the dreaded hives, digestive troubles and fatal attacks that can result from peanut allergies isn’t just sensational medicine, says an Indiana University Health pediatric allergist.

In fact, the concept behind the adhesive patch – that infuses small amounts of peanut protein into the skin --  is nearly identical to an oral immunotherapy drug in late-stage trials at Riley Hospital for Children at IU Health.

Both the patch, created by the French biopharmaceutical firm DBV Technologies, and the oral therapy, created by Aimmune Therapeutics, based in San Francisco, aim to eradicate the current treatment for peanut allergies, which is to avoid the nut altogether.

Instead, the two new treatments would desensitize the body to even small traces of the nut by gradually making the body familiar to the peanut protein. 

“It’s not going to allow you to have a peanut butter and jelly sandwich. That concept is called tolerance,” said Frederick Leickly, M.D., a pediatric allergist at IU Health North in Carmel and lead coordinator for the oral therapy study. “It will protect against that inadvertent exposure, that little peanut crumb they accidentally eat.”

While neither treatment is on the market, both could become available as early as spring of 2018 with the proper U.S. Food and Drug Administration approval.

“Both the patch and the immunotherapy are head to head in competition right now,” Dr. Leickly said.  

In a heated rivalry to give the estimated 5.4 million people, including 2 million children, in the United States and Europe an option other than carrying around a ready-made injection of epinephrine.

“Right now if there is a peanut allergy,” Dr. Leickly said, “the only way of treating it is to stay away from it.”

Take a look at details of the two potential peanut allergy treatment options:

  • The oral immunotherapy drug, AR101, feeds incremental amounts of peanut protein over an extended period of time to build immune tolerance. It is in Phase III of its study. If approved, patients would initially be given the appropriate dosing of the drug at a doctor’s office with  home dosing in between visits.  Eventually, patients would take an ongoing, daily maintenance dose of AR101 at a set amount to preserve desensitization to peanuts. Both at home and at the allergist’s office, patients would take AR101 mixed with foods such as applesauce, pudding, yogurt or mashed potatoes.
  • The skin patch, known as epicutaneous immunotherapy, is an approach that relies on an adhesive patch about the size of a quarter to deliver small amounts of peanut protein through the skin. The goal is that chronic, low-grade exposure will eliminate allergic reaction to peanuts. The patch is worn between the shoulder blades or on the arm, and changed daily.

The FDA has already given Fast Track Designation status to both treatments, “for their potential to treat a serious condition and fill an unmet medical need.”

-- By Dana Benbow, Senior Journalist at IU Health.
   Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow

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