New treatment to reduce effects of peanut allergy announced at Evelina London

Evelina London patient, Emily, enjoying a birthday cake without fear of an allergic reaction.

NHS England have secured the first deal of its kind in Europe for a pioneering treatment for peanut allergy.

The treatment, known as Palforzia, helps to reduce the severity of reactions to peanuts - including anaphylaxis - making family holidays abroad, birthday parties, and Christmas treats possible for some children for the first time.

Professor George du Toit, children’s allergy consultant at Evelina London, has been Chief Investigator for the UK in two large peanut allergy trials, PALISADE and ARTEMIS. He said: “This is great news for children and young people with peanut allergies.

“The approval of Palforzia represents a significant step forward towards improving the care for allergy sufferers, and we will now have access to the first treatment licensed to reduce the severity of this allergy and to protect against accidental exposure to peanuts.

“This will make a huge impact to the everyday lives of our patients and their families.”

Thousands of children and young people in England will be the first in Europe to benefit from the treatment. Up to 600 aged four to 17 are expected to be treated this year, rising to as many as 2,000 each year after that.

Peanut allergy affects one in 50 children in the UK, and is one of the most common causes of food-related deaths. Currently, people with the allergy have to strictly avoid peanuts and manage any allergic reactions with emergency medication.

Manufactured by Aimmune Therapeutics, Palforzia is an oral treatment that aims to provide children with a severe allergy with some tolerance to peanut protein so that a serious, or fatal, reaction through accidental exposure can be averted. Patients receive a monthly dose, enabling tolerance to be carefully built over time.

Evelina London Children’s Hospital has taken part in two large peanut allergy trials, PALISADE and ARTEMIS.

The ARTEMIS study is one of the largest peanut allergy trials ever conducted. It found that approximately six in 10 four to 17-year-olds who reacted to around 10mg of peanut protein at the start of the trial were able to take a dose of 1,000mg of peanut protein by the end. That is equivalent to three to four peanut kernels, well beyond the amount typically involved in an accidental exposure.

For nine-year-old Evelina London patient Emily, from London, being part of the PALISADE trial means she has been able to eat birthday cake, go on her first holiday abroad, and even feed animals at the zoo.

Sophie Pratt, Emily’s mother, said: “Being on the clinical trial has changed our whole family’s lives.

“The treatment we received has meant that Emily is free from limits and the fear that the tiniest mistake could put her life at risk, and it has removed all the tension and worry that the simple act of eating loomed over us every day.

“It was particularly noticeable at special occasions like birthdays, Christmas and on holidays where there are often special foods like cakes, ice cream and treats that invariably had warnings ‘may contain peanuts’ or menus not in English.

“Since the trial Emily can go to parties and playdates with confidence, eat in restaurants without us having to call ahead to check the menu, and we’ve managed to have her first holiday abroad to New York and even taken part in feeding animals at zoo experiences – which is Emily’s passion.

“We could not be more grateful.”

Professor Stephen Powis, NHS medical director, explains the importance of new treatments, he said: “This pioneering treatment can be life-changing for patients and their families and, thanks to the deal the NHS has struck.

“It will reduce the fear and anxiety for patients and their families who may have been living with this allergy for years, and carrying around emergency medication just in case.

“They should be able to able to enjoy meals out or holidays abroad together without worrying about an allergic reaction that could land them in hospital or worse.”

The National Institute for Health and Care Excellent (NICE) will publish its final guidance on Palforzia in early 2022, allowing the treatment to be accessed by young people with a peanut allergy.