New drug could help reduce kids’ reactions to peanuts, but doctors urge caution

CHICAGO — Lauren Tilmont didn’t believe it when her doctor told her a few years ago that he had a treatment that might allow her to eat peanuts, despite a lifelong allergy to them.

“The first thing I told him was, ‘You’re crazy. That doesn’t happen,’” said Tilmont, 25.

She had been told nearly her whole life that peanuts could kill her. She lived in fear of them. But Tilmont decided to give her doctor’s treatment plan a try.

He gave her a tiny bit of peanut protein and monitored her in his office for allergic reactions. Gradually, he stepped up the amount she ate, over the course of about 10 months. Today, peanut butter still upsets her stomach, but she can snack on Snickers bars and munch on peanut M&Ms without a problem.

Tilmont called the treatment the most difficult thing she’s ever done, but she no longer fears accidentally touching a surface that has peanuts on it or eating at restaurants that use peanut oil.

“It has empowered me,” she said. It’s a somewhat controversial treatment that hasn’t been widely available, despite high demand. But a similar approach may be about to go mainstream.

Earlier this month, a U.S. Food and Drug Administration expert panel recommended approval of the first drug designed to reduce allergic reactions in children with peanut allergies. The recommendation makes it likely that the drug, Palforzia, made by Aimmune Therapeutics, will get FDA approval.

The drug is not meant as a cure or a path to snacking on peanuts. Rather, it’s designed to decrease the amount and severity of allergic reactions after accidental exposure to peanuts. But many families dealing with peanut allergies say it could be life-changing, potentially freeing them from the worry that their kids could go into anaphylaxis or even die because of a simple mistake or oversight.

Doctors and patients who’ve used a somewhat similar treatment for years agree that the drug has the potential to help more people avoid deadly allergic reactions. But they also warn that the process may not be right for everyone and isn’t as easy as it might seem at first blush.

“We are glad this is coming to the forefront, but it is not for all patients,” said Paul Detjen, the physician who treated Tilmont.

Palforzia delivers a daily dose of peanut protein that’s gradually increased over time, for children ages 4 to 17. After about a year of taking the drug, about two-thirds of children in a clinical trial were able to eat the equivalent of at least two peanuts without an allergic reaction, according to a study published last year in the New England Journal of Medicine.

Nearly one-third of kids who took the drug for a year still experienced moderate or severe symptoms when they ate peanuts. Also, children who took the drug suffered more allergic reactions during the treatment period than those who took a placebo.

Detjen, and more than 100 other private practice doctors across the U.S., have been performing similar treatments for years — though such therapy for peanut allergies isn’t widely recommended. Currently, the standard of care for food allergies is to avoid the allergycausing food and carry an EpiPen.