Australia launches peanut allergy immunotherapy program for babies in world first

By Lianne Kolirin, CNN

(CNN) — Babies who have a peanut allergy are now being offered potentially life-changing treatment at hospitals across Australia in a world-first program aimed at building tolerance to them.

It is the first time that a nationwide peanut oral immunotherapy program is being introduced into mainstream care anywhere in the world, according to the partnership between Australia’s National Allergy Centre of Excellence (NACE) and the Murdoch Children’s Research Institute (MCRI).

The ADAPT OIT Program is open to infants under 12 months who have been diagnosed with a peanut allergy and who are under an allergy specialist at one of the ten pediatric hospitals across five states which are participating.

The treatment, which will be free for those deemed eligible, will see patients receiving “a carefully planned daily dosing schedule of peanut powder, taken at home, over two years,” according to an announcement by MCRI.

The overall aim is to transform the approach to the allergy from one of strict avoidance of peanuts to safely building up a tolerance – and hopefully achieving remission.

“Ultimately, we want to change the trajectory of allergic disease in Australia so that more children can go to school without the risk of a life-threatening peanut reaction,” said Professor Kirsten Perrett, director of the NACE and population allergy lead at MCRI, said in the statement.

In a telephone interview with CNN, she described the new program, which is already underway, as “really exciting.”

“Babies who have a diagnosis of peanut allergy under 12 months of age will be offered the treatment program as a new standardized model of care across those ten paediatric hospitals, and it will be free which is a really incredible thing. These are public hospitals in Australia.”

Perrett is expecting demand to be high.

“Australia is the allergy capital of the world and we have 5 million people with allergic disease and peanut allergy affects around 3 per cent of 12-month-old children in Australia. So obviously there are a lot of children who may be eligible and we expect there to be hundreds of babies who will get treated on this program in the first couple of years.”

Funded by Australia’s federal government, the results of the program will be evaluated by the NACE in the hope of rolling it out to more hospitals and allergy clinics if it proves successful. Eventually, it may even be extended to older children, but for now the focus is on babies, said Perrett.

“We’re working with children here who have established peanut allergy and how we can modulate their immune system while their immune system is malleable at an early age and that’s what the evidence shows – that younger children respond very well to this oral immunotherapy approach, both from having a better effectiveness and a reduced risk of reactions.”

The family of Hunter Chatwin is hopeful that the treatment could help him after his first taste of peanut butter led to an allergic reaction at six months old.

Now, three months later, he has been referred into the ADAPT OIT Program at The Royal Children’s Hospital in Melbourne.

“We are taking part in the program to try and improve his chance of being able to safely eat peanut in the future,” his mother Kirsten said in the MCRI statement.

“Many families are desperate to protect their children from allergic reactions and anaphylaxis. Some are travelling interstate or even overseas for OIT treatment at private clinics, so to have this program available and free at public hospitals is a game-changer.” Anaphylaxis is a severe, potentially life-threatening allergic reaction.

Adam Fox is a London-based professor of paediatric allergy and chair of the National Allergy Strategy Group in the UK. He has spent many years seeing patients with peanut allergy and regularly posts on social media about it.

He welcomed the development in Australia, telling CNN: “This is a really exciting initiative and the whole allergy world will be looking closely at the outcome.”

Fox added: “By taking a large scale, public health approach to the problem with early aggressive intervention, there is a real chance of reversing Australia’s unwelcome record of the world’s highest rates of peanut allergy.”

Food allergies are also a growing public health concern in the United States, where peanut allergy is estimated to affect about 2% of children, or nearly 1.5 million people younger than 18. Peanuts are among the food types that can cause the most serious allergic reactions, including the risk of the life-threatening reaction anaphylaxis.

Earlier this year a study by experts in London revealed that feeding children smooth peanut butter during infancy and early childhood can help reduce their risk of developing a peanut allergy even years later.

The research published in the journal NEJM Evidence in May showed that, when compared with avoiding peanuts, consumption beginning early in infancy and continuing until around five years old was linked to a 71% reduced rate of peanut allergy among adolescents in the United Kingdom.

Starting in 2000, the American Academy of Pediatrics recommended delaying the introduction of peanuts until the age of 3, but it ended that recommendation in 2008.

About a decade later, in 2019, the AAP updated its guidance to say that delaying the introduction of allergenic foods doesn’t prevent disease and that “there is now evidence that early introduction of peanuts may prevent peanut allergy.”

CNN’s Jacqueline Howard contributed to this report.

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