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Doubts over peanut immunotherapy

Friday April 26th, 2019

So-called immunotherapy has often been hailed as a cure for peanut allergy – but international studies show it does in fact increase rates of anaphylaxis and allergic reactions, according to a new analysis.

Researchers have placed too much emphasis on clinical tests – and have failed to monitor real life impact on patients undergoing the treatments, according to a report in The Lancet.

Immunotherapy is meant to sensitise patients to peanuts by introducing them to gradually increasing doses of allergen.

The latest analysis studies the findings of 12 randomised controlled trials conducted in the USA, UK and Australia and involving more than 1,000 patients in total.

According to the findings, immunotherapy increased the risk and frequency of anaphylaxis three-fold and doubled the risk of serious adverse events – which affected more than 11% of treated patients.

There was no evidence of improvement in quality of life after treatment, the researchers found.

Researcher Dr Derek Chu, of McMaster University, Canada, said treatments appeared to achieve desensitisation because patients could pass a supervised food challenge.

He said: "Our results do not denounce current research in oral immunotherapy, but the method needs to be more carefully considered, improvements in safety made, and measures of success need to be aligned with patients' wishes."

He added: "Considering the current view of peanut allergy oral immunotherapy as a model for other food allergies, and the increasing global prevalence of food allergies, these findings are significant and important to the ongoing development of food allergy treatments."

Writing for the journal, Dr Graham Roberts, of Southampton University, UK, says that epicutaneous therapy may be safer than oral therapy.

He adds: "We should not forget that we now know that the early introduction of peanut products into the infant diet can prevent most cases of peanut allergy. Moving forward we need to develop implementation strategies to reduce number of patients with peanut allergy."

Lancet 25 April 2019

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30420-9/fulltext

Tags: Allergies & Asthma | Diet & Food | North America | UK News

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