New peanut allergy treatment from Aimmune side effects data

Hollis Johnson

• Researchers are working on new medications to treat allergies by targeting the body’s immune system.
• According to data published Sunday in the New England Journal of Medicine, biotech company Aimmune found that after a year on its a peanut allergy treatment, 67% of kids with high peanut allergies were able to tolerate about two peanuts, compared to only 4% of those who got the placebo.
• But the path wasn’t easy. The majority of trial participants who received the drug experienced some sort of reaction, and in 14% of those cases, the reaction was severe enough to require the use of epinephrine, the emergency allergy medication found in EpiPens. 
• The hope with these treatments is to lessen the responses to an allergen. That way, instead of an intense reaction, you can survive an accidental bite of a cookie or muffin.

We’re starting to get a better picture of treatments that aim to make peanut allergies less severe. 

There’s a big need for new ways to tackle extreme allergies: An estimated 4% to 6% of children in the US have food allergies, with peanuts being one of the worst offenders. Roughly 1.5 million children in the US are allergic to peanuts, an allergy that can often be so severe that even the smallest amount can set off an extreme reaction.

It’s something companies are working to treat, by re-training the body’s immune system not to overreact to peanut protein. That involves re-introducing it to the body, increasing the amount of protein over time.

One company just published some very promising results of a pill designed to lessen the severity of peanut allergies. But there are some big caveats to be aware of.

The company, Aimmune, found that of the roughly 500 kids with peanut allergies between the ages of 4-17 who were part of the trial, 67% of those who received the treatment were able to tolerate 600 milligrams of peanut protein — that’s about two peanuts — after about a year of treatment. That’s a much better results than in kids who got the placebo.

The drug is made of peanut protein, and the goal is to desensitize people with the allergy. The hope is to lessen the responses to an allergen, so instead of really intense reactions, you can take an accidental bite of a cookie or muffin, without needing to go to the hospital.

Because the drugs are essentially made out of peanuts, the journey to that tolerability can be tough. Lots of the kids in the trial experienced side effects. Aimmune’s shares were down as much as 7% as of Monday morning. 

In some cases, the reactions were severe enough to require an emergency injection.

In the group that received the drug, 52 of 372 people required an injection of epinephrine, the emergency medication found in devices like the EpiPen. And 43 participants who were receiving the drug withdrew from the trial because of side effects, while three participants in the placebo group did. 

Read more: The strange history of the EpiPen, the device developed by the military that turned into a billion-dollar business and now faces generic competition between Mylan and Teva

Still, the company’s expecting to file with the FDA for a potential approval by the end of the year. 

Efforts to find new ways to treat extreme allergies like those to peanuts have been gaining traction in recent years. On November 12, Nestle Health Science made a $98 million investment in Aimmune, its third in the company. In total, the food giant has invested $273 million. 

And Aimmune faces competition from DBV Technologies, a company that failed a key trial for its peanut allergy patch in 2017 but still planned to go to the FDA for approval. It submitted its data to the FDA for a potential approval in October. 

Rethinking food allergies

With these advancements in what we know about allergies and how to treat them, you might be asking: Could we one day cure allergies? The short answer is no, not exactly.

There are a lot of efforts going on to figure out whether the allergy can be prevented by exposing children to peanut proteins at a young age.

One major study from the UK found that by eating a peanut-containing snack, infants who were at high risk for developing a peanut allergy were able to prevent developing the allergy. In a study of 600 high risk children, only 3% of those who were exposed to the snack developed a peanut allergy, compared to 17% of those in the group that avoided peanuts.

But, of course, that still leaves 3%.

“As we learn more and more about that, and we begin to intervene earlier and earlier, are we going to cure allergy? Probably not, but perhaps in some of those kids but I would doubt in all of them,” Aimmune’s chief medical officer Dr. Dan Adelman, an allergist and immunologist, told Business Insider in January.

“There’s always going to be room for a therapeutic intervention for those who still go on to develop allergy.”

Instead, former Aimmune CEO Stephen Dilly in January envisioned a future in which people living with allergies have what’s known as “functional cures.” That is, they’re able to live with the condition impacting their day to day lives too heavily. It might still mean avoiding peanuts or other allergens, but it might mean that the fear of accidentally coming in contact with it doesn’t mean a trip to the emergency room.

Or, for foods that are harder to avoid like milk and eggs — which can negatively impact on a person’s overall nutritional health — it might mean getting to the point where people are able to reintroduce them into their diets.

It’s what Aimmune’s doing with its treatments.

“Can we get to that kind of level? That looks attractive,” Dilly said.