The importance of reducing risk in peanut allergy: Current and future therapies

Abstract

The prevalence of peanut allergy has steadily increased during the past 10 years, especially in children. A 2009 to 2010 survey of more than 40,000 children (aged 0–17 years) in the United States found that peanut allergy was the most common food allergy, affecting 2% (1.5 million) of children nationwide. [1] Gupta R.S. Springston E.E. Warrier M.R. et al. The prevalence, severity, and distribution of childhood food allergy in the United States. Pediatrics. 2011; 128: e9-e17 Crossref PubMed Scopus (1024) Google Scholar Data from a 2014 meta-analysis of 29 studies from multiple European countries using various reporting methods estimated the occurrence of peanut allergy to be 0.3% (by positive food challenge result) to 4.1% (by peanut specific IgE positivity) in children aged 2 to 5 years and 0.4% (by self-reporting) to 9.8% (by peanut specific IgE positivity) in children aged 6 to 17 years. [2] Nwaru B.I. Hickstein L. Panesar S.S. Roberts G. Muraro A. Sheikh A. Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014; 69: 992-1007 Crossref PubMed Scopus (615) Google Scholar Is the better part of valor truly discretion?Annals of Allergy, Asthma & ImmunologyVol. 120Issue 2PreviewPeanut allergy affects 1.4% to 4.5% of children, depending on the study and methodology. Self-reported estimates have shown an alarming 3-fold increase in US populations over 10 years, whereas UK data from a longitudinal birth cohort with challenge-based evidence have not reflected such an alarming increase.1–4 Unfortunately, for years, the common peanut allergy management paradigm was to strictly avoid any potential exposure (including trace amounts) and carry self-injectable epinephrine. Now, we find the field on the cusp of what could be 2 therapies approved by the US Food and Drug Administration (FDA) for the treatment of peanut allergy in children in late 2018 or early 2019 (a commercial low-dose oral immunotherapy [OIT] capsule and an epicutaneous patch). Full-Text PDF