Landmark study offers hope for peanut allergy sufferers

Researchers from King’s College London and Evelina London Children’s Hospital have taken part in a major study that could lead to a ground-breaking new treatment for peanut allergy.

Peanut allergy is a potentially life-threatening condition and affects around one in 50 children in the UK. Peanut allergy is rarely outgrown and is the most common cause of food allergy deaths.

Emily Pratt peanutThe PALISADE trial recruited nearly 500 children aged four to 17 from more than 60 sites across the US and Europe. Evelina London was one of the lead recruiters to the study which is the largest ever peanut allergy treatment trial.

During the study participants were randomly assigned into groups that either received capsules of peanut protein or a dummy powder (placebo). The amount given gradually increased every two weeks over a period of about six-months, with participants continuing on a maintenance dose of peanut for a further six-months.

The results, published in the New England Journal of Medicine, found that two-thirds (67%) of children and teenagers were able to tolerate at least 600mg of peanut protein, about two whole peanuts, at the end of the trial. This compared with just 4% of participants on a placebo. Participants started the study not being able to tolerate exposure to a tenth of a single peanut.

The results of the PALISADE study mean people living with severe peanut allergy could be protected from life-threatening reactions that arise through accidental exposure by building their tolerance level.

[Image: Emily, aged six, who took part in the PALISADE study.]

Sophie Pratt, who enrolled her six-year-old daughter Emily in the PALISADE study, said:

The study has completely changed our lives. Before Emily took part we were uncomfortable being more than twenty minutes away from a hospital and she wasn’t able to attend play dates or parties without me or my husband being there.
We had to constantly study food labels to ensure peanuts were completely eliminated from Emily’s diet. Her allergy was very severe so even a small amount of peanut could lead to a very serious reaction. The impact on our family life was huge.
Emily took part in the study for a year and at the end of the trial she was able to tolerate around seven peanuts. We can now let her socialise with friends and do all the normal things that other children do without worrying that she might have a severe reaction.

Professor George du Toit, children’s allergy consultant at Evelina London and the UK chief investigator for the study, said:

The results of this ground-breaking study are very promising and suggest that we will be able to protect children who are allergic to peanuts from having a severe reaction after accidental exposure.
This is extremely good news as the number of children being diagnosed with peanut allergy in the UK has more than doubled over the past two decades. Peanut allergy is extremely difficult to manage for children and their families, as they have to follow a strict peanut free diet. Families live in fear of accidental exposure as allergic reactions can be very severe, and can even lead to death.
Until recently there has been nothing to offer peanut allergy suffers other than education around peanut avoidance and recognition and self-treatment of allergic reactions.
These findings could lead to a significant shift in our management of peanut allergy.

Read more on the Evelina London website.

The King’s Health Partners Allergy, Respiratory, Critical Care, Anaesthetics and Pain Clinical Academic Group has world class specialist clinics in interstitial lung disease, sleep, cystic fibrosis, bronchiectasis, lung cancer, chronic obstructive pulmonary disease and asthma, providing services to children and adults.