Peanut Allergies - page 2
What does your district do with the kids who are severely allergic to peanuts, via inhilation? They have EpiPens at school. I heard of a school in GA that made natl. news when the banned peanut,... Read More
Mar 10, '03Occupation: Public Health Joined: Jun '01; Posts: 151; Likes: 2If this works & families follow through with treatment it would be good news for our peanut allergic students, their families.
Effect of Anti-IgE Therapy in Patients with Peanut Allergy
Donald Y.M. Leung, M.D., Ph.D., Hugh A. Sampson, M.D., John W. Yunginger, M.D., A. Wesley Burks, Jr., M.D., Lynda C. Schneider, M.D., Cornelis H. Wortel, M.D., Ph.D., Frances M. Davis, Ph.D., John D. Hyun, B.S., William R. Shanahan, Jr., M.D., for the TNX-901 Peanut Allergy Study Group ABSTRACT
Background Peanut-induced anaphylaxis is an IgE-mediated condition that is estimated to affect 1.5 million people and cause 50 to 100 deaths per year in the United States. TNX-901 is a humanized IgG1 monoclonal antibody against IgE that recognizes and masks an epitope in the CH3 region of IgE responsible for binding to the high-affinity Fc receptor on mast cells and basophils.
Methods We conducted a double-blind, randomized, dose-ranging trial in 84 patients with a history of immediate hypersensitivity to peanut. Hypersensitivity was confirmed and the threshold dose of encapsulated peanut flour established by a double-blind, placebo-controlled oral food challenge at screening. Patients were randomly assigned in a 3:1 ratio to receive either TNX-901 (150, 300, or 450 mg) or placebo subcutaneously every four weeks for four doses. The patients underwent a final oral food challenge within two to four weeks after the fourth dose.
Results From a mean base-line threshold of sensitivity of 178 to 436 mg of peanut flour in the various groups, the mean increases in the oral-food-challenge threshold were 710 mg in the placebo group, 913 mg in the group given 150 mg of TNX-901, 1650 mg in the group given 300 mg of TNX-901, and 2627 mg in the group given 450 mg of TNX-901 (P<0.001 for the comparison of the 450-mg dose with placebo, and P for trend with increasing dose <0.001). TNX-901 was well tolerated.
Conclusions A 450-mg dose of TNX-901 significantly and substantially increased the threshold of sensitivity to peanut on oral food challenge from a level equal to approximately half a peanut (178 mg) to one equal to almost nine peanuts (2805 mg), an effect that should translate into protection against most unintended ingestions of peanuts.
N Engl J Med 2003;348:986-93.
Notice: This article has been published at www.nejm.org on March 10, 2003, to coincide with a presentation at the annual meeting of the American Academy of Allergy, Asthma and Immunology. The article will appear in the March 13 issue of the Journal.
Mar 10, '03Occupation: Ob/Gyn RN Joined: Sep '01; Posts: 927; Likes: 2I am severly allergic to nuts. I have carried an epi pen with me since I was 5. My co-workers are very aware of my allergy and when they bring goodies in there is always a nut free goody for me.
Mar 10, '03Joined: Sep '01; Posts: 658I've never heard of schools in Australia or the UK providing CNAs or their equivalent - the kids carry their pens and the teachers have one too. If the school does have a nurse, it can take ages for them to get to a classroom or playing field to give the stick so it makes sense for both child and teacher to know what to do.
I have one friend who is inhalation anaphylactic with peanuts, contact allergic to eggs. Another is severely contact allergic to eggs, nuts, oranges, fish, latex and cats and dogs - and she's the worst asthmatic I've *ever* met. She was never allowed to stay over when we were kids since both of my parents smoked and we had pets. Just hanging around together was sometimes enough to make her feel ill if I'd been lying on the carpet before coming to school, due to the dog and cat hairs on my clothes.
Both friends benefited from a nurse coming to the classroom to explain why it was important for the child to avoid certain substances etc - a lot of kids stopped bringing peanut products to school altogether after seeing a video of a child having a reaction to peanuts. They weren't overly upset, just worried that this might happen to their friend. We're all grown up now - both say that having the pen on them made them more confident in their own skins (because having these allergies *really* affects confidence, self esteem and body image) yet not cocky in the face of a reaction.