Feeding toddlers tiny amounts of peanuts could treat their allergy within three years, a study suggests.
Peanut allergy affects about one in 50 children in the UK, it is often lifelong and can lead to constant worry about severe allergic reactions.
While mild reactions can cause an itchy mouth and nausea, severe allergic reactions cause anaphylaxis – a swelling of the tongue and throat.
But researchers at Karolinska Institutet have successfully treated children aged one to three years with peanut allergies by feeding them small amounts daily, which were gradually increased over time until they didn’t have an allergic reaction.
“All children who followed the protocol achieved the goal of eating three and a half peanuts without experiencing an allergic reaction, and most were able to consume up to 25 peanuts,” said Professor Caroline Nilsson, from the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, and senior consultant at Sachs’ Children and Youth Hospital.
“We consider the treatment to be safe if it is carried out under controlled conditions in a healthcare setting,” she added.
For the study published in The Lancet Regional Health – Europe, 75 children aged one to three years in Stockholm, Sweden, with confirmed peanut allergies of varying severity were spilt into two groups. Fifty of the children were given peanut puffs, while the remaining 25 children completely avoided peanuts.
Treatment began in hospital with a very low dose and was then continued at home with daily intake. Every four to six weeks, the dose was increased until the children reached a low maintenance dose equivalent to approximately one and a half peanuts per day.
“This is the first randomised study of oral immunotherapy in toddlers involving a slow up-dosing and a low maintenance dose,” Prof Nilsson said. “The peanut puffs were easily ingested, which made the treatment simple for families to follow, and we were surprised by how positive the results were.”
After three years of eating the peanut puffs, 82 per cent of the children could eat at least three and a half peanuts without having an allergic reaction – even after taking a four week break from the treatment.
In comparison, only 12 per cent of children in the control group that avoided peanuts could tolerate eating three and a half peanuts.
Although some side effects did occur, in most cases they were mild and caused an itchy mouth or skin rashes. Serious allergic reactions did happen when the dose of peanuts was increased and some children required an adrenaline injection.
Researchers stressed that the treatment is not to be done at home and should always take place under controlled conditions, in close contact with healthcare professionals and with medical follow-up.
“The cautious treatment approach appears to play an important role in safety, but this is not something that parents should attempt at home, as serious reactions can still occur,” Professor Anna Asarnoj, at the Department of Women’s and Children’s Health, Karolinska Institutet.
