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Child holding peanut

A peanut allergy is a type of food allergy caused by the antibody immunoglobulin E (IgE). Children who suffer from peanut allergies have an abnormal response to the proteins that are found in peanuts and peanut products (e.g., peanut butter). Today, approximately 30,000 children in metro Atlanta are affected by a peanut allergy.

What causes a peanut allergy?

While the exact cause of a peanut allergy is unclear at this time, studies have suggested a complex set of genetic, environmental and other factors may play a role.

What are symptoms of a peanut allergy?

While symptoms vary by child and can range from mild to severe, the most common symptoms of a peanut allergy include:

  • Rash, hives or swelling
  • Nausea or vomiting
  • Diarrhea or stomach cramps
  • Runny nose
  • Shortness of breath
  • Difficulty breathing or tightening of throat
  • Anaphylaxis (a serious, potentially life-threatening reaction)

How do I know if my child is allergic to peanuts?

If you think your child may be allergic to peanuts, see a pediatric allergist. At Children’s Healthcare of Atlanta, your child may be diagnosed with a peanut allergy through a process that involves a careful medical history, a physical exam by one of our providers, and allergy testing, such as a skin or blood test or an oral food challenge.

What do I do if my child is allergic to peanuts?

There is currently no cure for peanut allergies. If your child is allergic to peanuts, he should avoid peanuts and peanut products to prevent an allergic reaction. Peanuts can be found in many food items, so it is very important to read food labels to see if peanuts are included in the list of ingredients. Your child should also carry an epinephrine auto-injector device (e.g., EpiPen or AUVI-Q) at all times.

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While there is currently no cure for peanut allergies, researchers across the country and around the world, including Brian Vickery, MD, Director of the Food Allergy Program at Children’s, have been studying a variety of new therapies for peanut and other food allergies. Because of this groundbreaking research, the U.S. Food and Drug Administration (FDA) approved, for the first time, a peanut allergy treatment for eligible children and teens in January 2020.

The new treatment, called Palforzia, is an oral immunotherapy (OIT) for children ages 4 to 17 with a confirmed peanut allergy. The goal of this treatment is to desensitize children to accidental exposure to peanuts. It is not a cure.

What is OIT?

OIT involves giving someone with an allergy a specific amount of the allergen in very small amounts and gradually increasing that dose.

Is OIT a cure for food allergies?

OIT is not a cure for food allergies. While OIT could increase a child’s tolerance of an allergen like peanuts if an accidental exposure occurs, it will not cure the allergy. Children must still avoid foods containing the allergen, and an epinephrine auto-injector device (e.g., EpiPen or AUVI-Q) should be carried at all times.

What are the potential side effects of OIT?

While side effects will vary by child and can range from mild to severe, the most common side effects of OIT include:

  • Abdominal pain
  • Vomiting
  • Oral itching or discomfort
  • Eosinophilic esophagitis
  • Rash, hives or swelling
  • Anaphylaxis

What is Palforzia?

Palforzia, which comes in powder-filled capsules, is an OIT for children ages 4 to 17 with a confirmed peanut allergy.

How does this peanut allergy treatment work?

Palforzia works like other OITs by gradually exposing a child to an allergen, in this case peanuts. The goal is to increase the threshold that triggers an allergic reaction in your child. Daily exposure to peanut protein, which is the active ingredient in Palforzia, helps lessen the body’s sensitivity to peanuts. The amount of the peanut protein is increased over time as the dose of the medication is adjusted.

How long does this treatment last?

This treatment is a long-term commitment. Your child will have to take medication every day during the up-dosing and maintenance phases. These phases will take place over several months to years and may continue indefinitely. Researchers are currently studying whether some patients may be able to successfully discontinue treatment.

What are the benefits of this peanut allergy treatment?

The main benefit of Palforzia is peace of mind. This treatment can help reduce the severity of allergic reactions, including anaphylaxis, that may occur when your child is accidentally exposed to peanuts.

Will this treatment cure my child’s peanut allergy?

While this treatment could increase a child’s tolerance to peanuts if an accidental exposure occurs, it will not cure a peanut allergy. Children must still avoid foods containing peanuts, and an epinephrine auto-injector device (e.g., EpiPen or AUVI-Q) should be carried with them at all times.

Is my child eligible to receive this peanut allergy treatment?

This treatment is for children ages 4 to 17 with a confirmed peanut allergy. Children who turn 18 while taking Palforzia should continue taking it. Some factors may prohibit a child from receiving this treatment, including medical diagnoses, such as severe asthma, eosinophilic esophagitis and/or the use of certain medication.

How can I get this peanut allergy treatment for my child?

The decision to pursue an evaluation for eligibility and eventually treatment should be based on your individual and family factors. If your child meets current eligibility requirements and if your family can accommodate all considerations into your daily routine, we recommend you email our team at peanutoit@choa.org call 404-785-KIDS (5437) to start the formal clinical review process. Note, this email address is not to be used for emergencies or clinical advice.

Every candidate at Children’s will be assessed by a provider at the Center for Advanced Pediatrics before starting treatment. 

How much does this peanut allergy treatment cost? Is it covered by insurance?

Contact your insurance provider or the pharmaceutical manufacturer, Aimmune Therapeutics, for more information. Note: Children’s does not have any input or control regarding the cost of the treatment. The price is regulated by the pharmaceutical company.

How will this treatment impact our family’s daily life?

There are several considerations to take into account before starting Palforzia, including:

  • Long-term commitment: This treatment is a serious and long-term commitment. Your child will have to take medication every day during the up-dosing and maintenance phases. These phases will take place over several months to years and may continue indefinitely.
  • Time commitment: The initial dosing appointment and subsequent up-dosing appointments will take place at the Center for Advanced Pediatrics. The initial appointment will take approximately three to four hours. Up-dosing appointments will take place every other week and will last up to three hours each. Time away from work and school should be factored into your family’s decision.
  • Adherence to daily procedures: Most of the dosing will take place at a child’s home. A parent or guardian will assume the role of at-home caregiver to give dosing appropriately and on time. After dosing, there will be a home monitoring period that lasts two to four hours, when a child will have to avoid exercise, including sports, hot showers and other activities that may increase body temperature. 
  • Adverse events: Anaphylaxis is a known risk of this treatment and a potential serious adverse reaction that will require using an epinephrine auto-injector device (e.g., EpiPen or AUVI-Q) and seeking immediate medical attention. Parents or guardians administering the treatment at home must be comfortable using an epinephrine auto-injector and taking immediate action following a serious adverse reaction (e.g., how to call the emergency department or when to go to the emergency department). Our providers will review this with your family in the clinic before and during treatment.

We have entered into an exciting time when emerging research is looking to transform the lives of children living with food allergies. At Children’s, we are committed to searching for new treatments for kids, teens and young adults with peanut allergies through clinical trials and offering our patients access to new treatments as they become available through our routine clinical care.

How has Children’s contributed to peanut allergy research?

Dr. Vickery led the international Phase 3 clinical trial that studied Palforzia. This study was one of the largest clinical trials ever conducted in food immunotherapy. Children’s administered the first dose of the new FDA-approved peanut allergy OIT for pediatric patients in 2020.

What peanut allergy clinical trials are offered at Children’s?

Children’s is one of 10 centers in the country currently enrolling children, teens and young adults (ages 1 to 25) who have a peanut allergy and at least two other food allergies to milk, egg, wheat, cashew, hazelnut or walnut in the NIH-funded Omalizumab as Monotherapy and as Adjunct Therapy to Multi-Allergen OIT in Food Allergic Children and Adults (OUtMATCH) Study. In this study, our researchers are trying to determine if a medication called omalizumab—alone or combined with OIT—may help children with multiple food allergies.

More information about OUtMATCH and other current clinical trials, including trial descriptions and eligibility criteria, can be found on our research web page. You may also call 404-785-6448 or email foodallergyresearch@choa.org to learn more.

How can I sign my child up to participate in a food allergy clinical trial?

If you are interested in registering your child as a potential participant, email our team at foodallergyresearch@choa.org or complete our form. Note: This registration form only indicates your interest. It is not a binding commitment.

What other types of food allergy research activities are taking place at Children's?

  • Social and psychological burdens: Food allergies can be very stressful for families. Dr. Vickery and his team are conducting studies to better understand the social and psychological burdens caused by food allergies in order to develop better solutions to address these burdens.
  • Share your experience: As a FARE Center of Distinction, our team encourages interested families to get involved by sharing your experiences with the national FARE Patient Registry. The registry helps researchers better understand food allergies and their impact, reveals opportunities to improve the care food allergy patients receive, and powers the search for new ways to diagnose, treat and ultimately cure food allergies.

Food Allergy Patients Share Their Stories

Pediatric allergists and immunologists

Advanced practice providers

  • Chelsea Bates, PNP
  • Codi Horton, PNP

Children with peanut allergies are treated within our Food Allergy Program which is located at the Center for Advanced Pediatrics in Atlanta.

Center for Advanced Pediatrics
1400 Tullie Road NE
Atlanta, GA 30329