AR101 is a peanut-derived, investigational biologic oral immunotherapy drug. Over 500 patients (in 2 groups; 4 – 17 years olds and 18 – 55 years olds) with a confirmed peanut allergy (reaction to = 100 mg of peanut protein) received AR101 or placebo in a 1-year study. AR101 was slowly titrated from 3 mg to a 300 mg daily maintenance dose. After 24 weeks on the maintenance dose, participants underwent a peanut protein challenge. Far more participants in the younger age group who were treated with AR101 tolerated a 600 mg peanut food challenge without allergy symptoms (67% vs 4% of participants on placebo). In addition, only 10% of the 4 – 17-year old AR101 patients required epinephrine rescue after the challenge, compared with 53% of the placebo group. AR101 had no benefit in patients 18 – 55 years old.
Until a product is approved, strict dietary elimination of peanuts and administration of epinephrine upon accidental exposure are recommended measures.
• Vickery BP. N Engl J Med 2018