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New hope for those with peanut allergies

A new experimental drug can help allergy sufferers to lead more normal lives. The drug, called AR101, is seeking FDA…

A new experimental drug can help allergy sufferers to lead more normal lives. The drug, called AR101, is seeking FDA approval, and a new study has shown the results it produces in children and teens. It does not cure peanut allergy, but it allows those who suffer from a less severe reaction.

These allergies are no joke. People with peanut allergies often have to change how they travel, where they eat and how they live. Exposure – even in very small amounts – can lead to skin rashes, breathing difficulties or even deaths.

Historically, when an allergy developed – often at a young age – parents had few options except to look over their children, and doctors would have life-long avoidance. For many children, this meant serving up to birthday parties with their own sweets and taking a lot of medicines.

What kind of symptoms and reactions do the children need for food they are allergic to?

For some children, an allergic reaction to a particular food can only be an uncomfortable tingle in the lip and mouth. For others, it is a medical emergency that is serious and even life-threatening. Food allergy symptoms usually take between a few minutes and two hours to develop after eating the existing food. The most common signs and symptoms are:

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– Hives or itchy skin

– Swelling of lips, face, tongue and throat or other parts of the body

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– Breathing difficulties

– Gastric ulcer, nausea, vomiting

– Dizziness, lightheadedness

Some children develop anaphylaxis, the difficult reaction that may be life threatening and include a dislocation of respiratory tracts that make it difficult to breathe, a severe blood pressure lowering, fast heart rate, dizziness, lightheadedness or unconsciousness. People with anaphylaxis symptoms should use their epinephrine autoinjector if they carry one and go to ER immediately.

The new study, which used a representative survey of parents of nearly 40,000 US children, found that about one in five children who have food allergy have gone to ER for symptoms of food allergy at least once a year. These data are consistent with previous research which showed that there was almost 200 percent increase in food-induced severe allergic reaction among visitors from 2005 to 2014 among 5 to 17-year-olds.

What are the treatments we now have for serious allergic reactions?

For some people, mild allergic reaction may cause skin rash and pruritus of the throat. For these people, the physician recommends careful monitoring of food that may cause this and taking antihistamines like Benadryl and Pepcid.

If you see someone who has a serious allergic reaction, it’s important to act quickly and immediately call 911. On stage you can use an epinephrine autoinjector and try to keep the person calm.

In the hospital, doctors often treat the person with antihistamines and steroids through an IV, as well as epinephrine, directly into the thigh or arm muscle to treat the reaction and pause a possible recurrence at 4-6 hours after the first exposure.

What is AR101?

A Cambridge University group showed in 2014 that using a processed form of peanut flour can induce a less severe allergic reaction over time in children. Now a new study, called the PALISADES trial, has presented a new option that shows promising results – with AR101.

In the study, published in the New England Journal of Medicine, researchers took people who were very allergic to peanuts, could not tolerate even half of a peanut without serious symptoms, giving them either placebo powder or AR101.

AR101 is oral immunotherapy medicine derived from peanuts themselves. The researchers exposed the group to small amounts of peanut powder. The goal was not to cure the allergies, without causing minor or unintentional exposures without quenching a life-threatening reaction.

After months of taking the oral drug, many of the children can tolerate the equivalent of 2-4 peanuts with a lesser reaction, or no reaction at all. There were some challenges. Side effects caused by treatment caused 11 percent of the drug group to release and 14 percent of children in the drug group stopped using an epinephrine autoinjector for drug-related reactions. This is not a drug to start at home.

As said, like almost one in fifty US children are allergic to peanuts, this new drug is likely to be in high demand. But there are questions that still need to be answered. We do not know the long-term effects of taking allergens and we do not know how long the immune response will last. Nevertheless, most parents would agree to eat a small pill daily to no longer live in fear is a small price to pay. However, it is unknown how much the drug would cost.

Johanna Kreafle, M.D. is an emergency medical practitioner at Carolinas Medical Center in Charlotte, North Carolina, and a member of the ABC News Medical Unit.

Some Shah, M.D. is an emergency medical practitioner in New York City, and a member of the ABC News Medical Unit.

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