BACKGROUNDPeanut allergy, for which there are no approved treatment options, affects patients who are at risk for unpredictable and occasionally life-threatening allergic reactions.
METHODS
Randomization and BlindingEligible participants were randomly assigned, in a 3:1 ratio, to receive either AR101, a peanut-derived pharmaceutical product that was manufactured
The day-to-day challenges involved in caring for a child with food allergies can be a significant stress within a family. As the child with a food allergy grows up, developmental changes as well as external influences such as bullying and peer pressure can further influence these stressors.
When the child with a food allergy is young, the family may be limited on where they can vacation or go out to restaurants, which can cause tension and frustration within the family. Hypervigilance and fear of accidental exposure to the allergen takes an emotional and physical toll on the
child with a food allergy and the child’s family. Socially, children with a food allergy may have to limit participation in school events, parties, or camps. These limitations can cause feelings of isolation for the child and feelings of guilt for the parents. As the child becomes an
adolescent and young adult (AYA), increased autonomy of dining options and a desire to fit in with peers can trigger higher risk-taking behavior, which can be a source of anxiety for the AYA as well as the caregivers. The aim of this review was to describe potential negative psychosocial impacts
of having a food allergy for the family. Data were reviewed from a literature search of medical literature data bases between 2010 and 2020 by using the search terms “food allergy,” “psychosocial,” “anxiety,” and” quality of life.” As we better
recognize the psychosocial issues associated with food allergies, we will have a better ability to develop effective interventions to improve the quality of life for these families.
With peanut allergy therapies under development, peanutallergic children are completing clinical trials wishing to maintain desensitization. We describe our experience transitioning children to real food equivalents of peanut following trial completion. METHODS: Children who completed peanut clinical trials with interest in continuing (post-oral immunotherapy [OIT]) or starting (post-epicutaneous immunotherapy [EPIT]) daily peanut ingestion were offered an oral food challenge (OFC) for the starting dose, which was determined based on study dose/eliciting dose during exit OFC. Dose-escalation to 2000 mg peanut protein was offered. The charts of post-study participants transitioned to daily peanut ingestion from May 2016-May 2019 were reviewed. Families without recent follow-up were contacted by telephone. This study was IRB approved. RESULTS: Twenty children (80% male; median age 7.6 years, range 4-15 years; n55 post-EPIT, n515 post-OIT) were transitioned to daily peanut ingestion. The median starting dose was 300 mg (post-EPIT: 100 mg [range 30-300 mg]; post-OIT: 400 mg [range 30-2000 mg]). Four participants started at 2000 mg; 11/16 dose-escalated. Thirteen participants reached a daily dose >1000 mg. Median follow-up was 1.7 years. Seventeen participants (85%) continued dosing for at least one year or were confirmed to currently actively dose if transitioned in the past year. Two participants discontinued due to side effects (gastrointestinal, hives, wheezing); one was lost to follow-up. CONCLUSIONS: Most post-study children transitioned to daily peanut reached a maintenance dose of >1000 mg and continued dosing long-term with real food equivalents. This suggests that families are motivated to followthrough with daily peanut to maintain desensitization after study completion.
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