Toddlers With Peanut Allergies: Peanut Patch Treatment Is Promising

Published on September 11, 2023 .

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Toddler eating peanuts — Image by triocean via Shutterstock

A peanut allergy has the potential to cause a life-threatening anaphylactic reaction in those who are severely allergic. Children with peanut allergies are in a vulnerable position. A new "peanut patch" has shown great promise in treating peanut allergies in toddlers. Here is what you need to know about peanut allergies and this potential new treatment.

Peanut allergies in children have increased dramatically over the last ten years.
A clinical trial of the peanut patch has shown encouraging results in treating peanut allergies in toddlers.
The peanut patch can now move onto the final phase to receive FDA approval.
Immunotherapy may help raise the threshold of peanut consumption to produce an allergic reaction.

Peanut patch: Clinical trial results

The phase three clinical trial results for the peanut patch have shown incredibly promising results in treating toddler peanut allergies. The double-blind, randomized, placebo-controlled study was conducted on over 300 children aged one to three.

For one year, toddlers continuously wore a daily patch containing 1/1000^th of a peanut. The dosing of the patch remained the same for the entire length of the one-year study.

At the end of the study, patients were given a dose of peanut protein, and 67% of the toddlers could safely consume the peanut protein equivalent of three to four peanuts (or one peanut, depending on their initial sensitivity to peanuts) without a negative reaction.

How does the patch work?

The peanut patch is an appliable patch that delivers immunotherapy through the skin. Immunotherapy works by causing the individual's immune system to fight against an allergy or disease.

The patch is applied on the back, between the shoulder blades, and changed every 24 hours. It's essential to mention that this is not a cure for allergies. The goal is to increase the amount of peanuts that would trigger a negative allergic reaction.

When may it be available?

The peanut patch is not yet approved by the U.S. Food and Drug Administration (FDA) and is only available to clinical trial participants. The next step is FDA approval, but no timeline has been suggested.

Side effects of the peanut patch

The most reported side effects were redness, itching, and irritation on the patch site, most of which went away over time. The risk of an allergic reaction to the patch was a potential but was not experienced in this toddler group. Patients were advised to avoid peanuts and always to have an epinephrine auto-injector.

Toddler peanut allergies – what you should know:

Out of necessity, public awareness of peanut allergies has risen in recent years. According to a 2017 study, peanut allergies in children have increased by 21% in the last ten years. It is estimated that nearly 2.5% of children in the United States have a peanut allergy. Peanuts are a legume, much like a soybean, though they are often grouped with other nut allergies.

Symptoms of a peanut allergy

Anaphylaxis is a life-threatening body response that requires immediate treatment with epinephrine. It represents the most severe of allergic reactions. However, not every child has an anaphylactic peanut allergy. Below, we list the potential symptoms of both cases.

Anaphylactic reaction symptoms	Difficulty breathing, throat swelling, sudden decrease in blood pressure, pale skin and blue lips, dizziness, and fainting.
Other symptoms	Stomach cramps and vomiting, indigestion, diarrhea, wheezing or shortness of breath, repetitive cough, throat tightening, weak pulse, and hives.

Treatment options for peanut allergies

Treatment for peanut allergies is minimal, and no cure exists. The best way to avoid an allergic reaction is to avoid peanuts. Peanuts and peanut-derived products are common and included in many candies, cereals, and baked goods. It is essential to check labels to see if a product contains peanuts or was processed in a facility that also processes peanuts.

Many individuals with a peanut allergy carry an epinephrine auto-injector for use in an anaphylactic reaction. Epinephrine is a life-saving drug that can treat the most severe of anaphylactic symptoms.

Oral immunotherapy

Peanut immunotherapy slowly exposes peanuts to an allergic child. The goal of the therapy is to make your child's immune system less reactive to peanut protein. In doing so, they may be less likely to suffer from a severe reaction if a peanut product is accidentally consumed.

Several studies and clinical trials have shown promising results for oral immunotherapy using both oral medication and direct ingestion of peanut flour. Peanut protein is consumed in increasing doses over time. Oral immunotherapy should always occur under the direction of a healthcare provider.

Can a peanut allergy be prevented?

Research has shown that peanut allergies can be significantly reduced if peanuts are introduced early in an infant's diet. With the increased frequency of peanut allergies, experts are seeking new ways to identify at-risk children to prevent an allergy. The National Institute for Allergy and Infectious Diseases (NIAID) has established breakthrough guidelines for identifying at-risk infants.

Risk level	Definition	Recommendation
High-risk	Infants with severe eczema, an egg allergy, or both.	Peanut allergy testing is recommended by a skin or blood test. A peanut introduction challenge is recommended in any allergy specialist's office around 4 to 6 months.
Moderate-risk	Infants with mild to moderate eczema who are already consuming solid foods.	They can try peanut-containing food at home around six months of age with the guidance of their pediatrician.
Low-risk	Infants with no eczema or egg allergy.	They are free to try peanut-containing products at the preference of their parent or caregiver around 6 months of age.

Whole peanuts are considered a choking hazard and should not be given to infants beginning solid foods. Instead, mix peanut butter with other pureed or soft foods, thinned with breast milk or formula, or ground into a powder and sprinkled on food.

The good news is that approximately 20% of children outgrow their peanut allergy entirely. While there is no cure for peanut allergies, non-invasive immunotherapy provides promising results by increasing allergic reaction thresholds, a situation that every parent can get behind.