Race to pro­vide treat­ment for life-threat­en­ing peanut al­lergy

Weekend Post (South Africa) - - EAT, DRINK & BE MERRY - Iain Withers

A NEWLY built peanut prod­uct fac­tory in Clear­wa­ter, Florida, on the Gulf of Mex­ico, is gear­ing up to ship mil­lions of pack­ets of nuts a year. So far, so nor­mal.

But the com­pany be­hind the fa­cil­ity isn’t roast­ing them, or salt­ing them, or cov­er­ing them in choco­late.

It is grind­ing them up into tiny, tightly con­sis­tent amounts and putting them in drug cap­sules for the treat­ment of chil­dren with life-threat­en­ing peanut al­ler­gies.

The idea is that by raising the dose in a con­trolled way over time, chil­dren who would oth­er­wise die with­out treat­ment on accidental ex­po­sure to even traces of peanut can eat a small hand­ful with­out a ma­jor re­ac­tion.

In on­go­ing clin­i­cal tri­als the prod­uct, code-named AR101, is on track to do just that. “Our goal is to give bite-proof level of pro­tec­tion,” says Stephen Dilly, chief ex­ec­u­tive of Cal­i­for­nia-based drug firm Aim­mune, which is pro­duc­ing AR101.

“So if a child was to take a bite of a friend’s peanut but­ter sand­wich, they would be fine.”

It is not an en­tirely novel ap­proach – a hand­ful of pri­vate clin­ics ex­ist that of­fer in­creased dos­ing of nuts in a con­trolled clin­i­cal set­ting.

But AR101 is po­ten­tially the first scal­able, af­ford­able and con­sis­tently safe prod­uct that has a chance of pass­ing muster with medicines reg­u­la­tors in the US and Europe, ready for mass distri­bu­tion.

Aim­mune is one of the firms lead­ing the global race to find long-term treat­ments, and po­ten­tially cures, for food al­ler­gies, a grow­ing blight for mil­lions of fam­i­lies around the world, and a mar­ket fore­cast to be worth $8-bil­lion (R109-bil­lion).

Aim­mune is in a bat­tle with French ri­val DBV Tech­nolo­gies to de­velop the first long-term treat­ment for peanut al­lergy suf­fer­ers, the largest nut al­lergy mar­ket with roughly six mil­lion suf­fer­ers in the US and Europe alone.

It is also the most deadly, ac­count­ing for 100-200 deaths in chil­dren in the US a year.

While both com­pa­nies com­mand bil­lion-dol­lar-plus mar­ket val­u­a­tions on New York’s Nas­daq stock ex­change, they are tak­ing sub­tly dif­fer­ent ap­proaches.

DBV’s prod­uct in­creases a pa­tient’s ex­po­sure to peanuts through patches ap­plied to the skin, although it is an open ques­tion whether this can be as ef­fec­tive as oral in­ges­tion, as Aim­mune is pur­su­ing.

Nei­ther com­pany pur­ports to of­fer a cure – they are of­fer­ing de­sen­si­ti­sa­tion to peanuts – and both also come with the po­ten­tial for side ef­fects.

For its part, Aim­mune en­vis­ages the first few doses of AR101 should be taken un­der su­per­vi­sion in spe­cial­ist al­lergy clin­ics in case of ad­verse re­ac­tions. But ex­cite­ment none the less sur­rounds both prod­ucts, which are nav­i­gat­ing fi­nal clin­i­cal tri­als and near­ing launch. AR101 could be on the mar­ket as early as 2019, and in the UK by 2020. “It’s been a long jour­ney to get here,” Aim­mune’s Dilly says. “Ini­tially drug mak­ers weren’t in­ter­ested, they’d say ‘you can’t patent a peanut’. “But it’s sur­pris­ingly tough to make an agri­cul­tural prod­uct into a medicine. “There are as many as 13 pro­teins in peanuts that can trig­ger re­ac­tions, so you need to make sure that they are all spread in the same ra­tio in the drug. “You need to con­trol ev­ery step of the process, from con­sis­tent grow­ing fa­cil­i­ties, to how you shell them and ground them.” If Aim­mune has suc­cess with peanuts, it has plans to move into treat­ments for the other tree-nut al­ler­gies, in­clud­ing hazel­nut, wal­nut, pecan and Brazil, as well as shell­fish. – The Daily Tele­graph

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