Allergy UK Welcomes Adult Peanut Allergy Trial Results

Allergy UK is pleased to hear the positive results of the first immunotherapy clinical trial to test whether adults allergic to peanuts can be desensitised. The announcement is especially timely given it has come during Allergy Awareness Week and our campaign to highlight the importance of people knowing #these3things about allergies

1. Allergies can appear at any age
2. Diagnosis matters because it unlocks a number of treatment pathways
3. Allergies can interact and affect other health conditions

Immunotherapy is one such treatment pathway that is possible for some people who are affected by allergies such as food, house dust mite and hay fever. Allergy UK’s Head of Clinical Services, Amena Warner, has appeared in a number of interviews today, including BBC Breakfast and GMB, to talk about the trial and to highlight the importance of a diagnosis in allergies. The Grown-Up Peanut Immunotherapy (GUPI) clinical trial is the first study entirely in adults with severe allergy to test whether daily doses of peanuts taken under strict supervision can be safely tolerated.

The approach, known as oral immunotherapy, has seen success in trials in infants and children worldwide. The findings of the first trial in an exclusive adult cohort has been published by a research team from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust. The study is funded by the National Institute for Health and Care Research (NIHR) Research for Patient Benefit Programme.

Amena Warner says: “The fear of a life-threatening reaction is an enormous burden for people who have peanut allergy. If adults can also be desensitised, their quality of life will be greatly enhanced. It’s important people understand that this is a clinical trial so at the moment this isn’t a treatment which is yet available on the NHS or any other means, but the results are promising.”

The Phase II trial recruited twenty-one adults between 18 and 40 with a clinical diagnosis of peanut allergy at Guy’s and St Thomas’ NHS Foundation Trust. Allergy was confirmed via skin prick test, blood test and then an oral food challenge.

In a clinical setting, participants received the first dose of 0.8mg peanut flour mixed in with food, then 1.5 mg 30 minutes later followed by 3mg a further 30 minutes later.

Participants who tolerated 1.5mg or 3mg of peanut flour continued on a daily dose at home for 2 weeks. This is the equivalent of 0.5-1% of a whole peanut.

Then participants returned at 2-weekly intervals for supervised doses of more peanut protein, increasing from 6mg (around 1/40th of a whole peanut) to 1g (four whole peanuts). If participants could tolerate 50-100mg of peanut protein, participants were switched to eating whole peanuts, peanut butter or peanut products, with the first dose being under supervision of the clinical team.

Once participants achieved a daily dose of 1g they remained on this dose for at least four weeks before undergoing a double‐blind placebo‐controlled food challenge. This involved being given increasing doses of either peanut or placebo (dummy) on separate days under close supervision to test their tolerance. Participants then continued daily dosing for at least three months before exiting the trial as well as the option of continuing post-study.

Two thirds of the cohort were able to exit the trial consuming the equivalent of four peanuts without reacting. The findings provide the hope that in future people may be able to access a treatment that reduces their risk to accidental exposure.  The aim would be for the treatment to provide a better level of protection, but it is not a cure or a reversal of the allergy. The treatment is not yet available on the NHS.