Consideration of how immunotherapy may influence other allergic diseases, patient adherence options, and advancing assessment of peanut allergy options.
As previously discussed, new data from the American Academy of Allergy, Asthma & Immunology (AAAAI) 2021 Virtual Sessions showed sublingual immunotherapy (SLIT) in toddler-aged children with peanut allergy resulted in significant desensitization to the allergen and sustained unresponsiveness to allergen exposure months after ending once-daily SLIT.
The research, presented by Edwin Kim, MD, MS, of the University of North Carolina School of Medicine, evidences that even younger patients benefit more greatly and for longer.
In the second segment of an interview with HCPLive, Kim discussed the next steps of food allergy immunotherapy research and application.
HCPLive: Something that is highlighted in AAAAI discussion annually now is cross-allergic and cross-inflammatory disease risks. As you said, patients could be suffering from multiple allergies. They could also be suffering from asthma, allergies, atopic dermatitis and more.
We talk a lot about effectively treating something like asthma and what benefit that has for other conditions. But if we were to say that we're able to better treat a food allergy at this early an age, how would that influence those other frequent comorbid conditions that children face?
Kim: I mean, that's a fantastic question. And unfortunately, I don't know that we have any clue at all. I will say that for pollen allergies, your regular environmental allergies, there is a thought that starting to focus on allergy shots younger for that can prevent the onset of asthma. I don't know that we have any sense when it comes to food allergy, whether we would have that same sort of preventive effect on other diseases. We hope so. I just have not personally seen data to support that at this point.
You mentioned Stanford's peanut allergy research that comes up pretty frequently. Is there anything else that you're looking forward to, in terms of developments in the field of food allergy care?
Kim: First, with our sublingual research: PALFORZIA getting approved is humongous, right? I see this as validating food allergy as a real problem, something that requires treatment. And it also, to me, validates the concept of immunotherapy as something that does actually work and can provide protection.
At the same time, I think COVID-19 has made it clear that oral immunotherapy is hard to do. And it's not going to be for everybody. I do think that not only researching the application of these treatments to other foods and making them longer-lasting is important, but so is finding ways to make it more practical. So, I'm looking out for that. I would love to see queries around, 'Do we have to do this every day? Is this something that can be a once a week kind of treatment? Once a month?'
You know, just thinking from the patient's point of view: how do we really make this accessible to patients? We know it works now, and it's out there. But we're looking to have oral, hopefully sublingual, and epicutaneous. Is there a path forward for that? Because that would represent a simple version of immunotherapy that might be a good option for some patients.
So, I'm really looking in the future for not only improvements on the science, but also options for patients, because at this point, none of these look like they're going to be a cure. With that in mind, every administration of care that can match up to patient goals, I think will be really essential if we're going to make a real difference in food allergy.
This essentially sounds like the next steps of any novel therapy: what is its optimization? What assures patient benefit and adherence?
Kim: Absolutely. I think this is a huge time in our field right now. And I think the next couple years really are going to stand about, because I think the doors are now wide open for new treatments.