Welcome to Asthma and Allergy Affiliates
Serving the North Shore community of Massachusetts since 1972
Board-Certified Specialists in the Care of Adult and Pediatric Asthma, Allergy and Immunology
Our patient-centered philosophy will ensure that you receive individualized care and attention
Our physicians specialize in the care of seasonal allergies, indoor allergies, food allergies, asthma, eczema, and other allergic conditions. Let us help you take control of your allergies and asthma today
Extensive array of services and programs to present a comprehensive and integrated diagnosis and treatment plan for you beginning from the moment you first step through our doors
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Palforzia for Peanut Allergy
- Protection from accidental ingestion of 1-3 peanuts
- Must be taken daily; for life
- Does not cure peanut allergy
- Epinephrine needed in 14% of kids taking peanut OIT in largest clinical study
- Intolerable GI side effects in 6.5% of kids
- Systematic review of all peanut OIT showed overall increased epinephrine use in those who were desensitized
- No evidence of change in quality of life, decreased ER visits, or deaths
- Approximately 5% of foods with voluntary cautionary labels actually contain peanut
- <1% of those tolerating a 1.5mg test-dose were likely to react to products with voluntary cautionary labels.
For the past few years, researchers have tried to find new methods for helping kids and adults with food allergies avoid having severe allergic reactions. In January 2020, the FDA approved the first oral immunotherapy (OIT) for peanut. As of early February 2020, this product is not yet available to patients nor is there information on insurance coverage yet (listed price is $890 per month).
Peanut OIT allows those with an allergy to tolerate small amounts of peanut by introducing peanut slowly through a process called desensitization. The process starts in the office, beginning with 0.5mg of peanut protein (a peanut has approximately 100mg of protein). The dose is gradually increased (11 visits over 22 weeks) until the final 300mg dose is achieved (equivalent to about 3 peanuts). Once the patient successfully tolerates a 300mg dose, they must continue to take it every day to maintain this desensitized state. If the patient misses a certain number of doses, they will have to start the entire process over.
The final dose is felt to be protective of an accidental exposure of 1-3 peanuts. It does NOT allow kids to eat PB&Js, peanut M&Ms, or any other form of peanut or peanut butter. Patients must continue to carry an EpiPen.
The risks of peanut OIT include reactions to the medication itself that can occur either in the doctor’s office, or at home. Approximately 1 in 7 children undergoing peanut OIT required treatment with epinephrine for a reaction, and many of those reactions occurred outside of the doctor’s office. Another 1 in 15 developed intolerable gastrointestinal symptoms that required stopping the treatment.
A large meta-analysis of all peanut OIT studies done to date showed that peanut OIT led to increased cases of anaphylaxis and the need for epinephrine treatment. There was no improvement in quality of life among families in the studies. There were also no decreases in the need to go to the emergency room, and no change in deaths in the kids that took peanut OIT.