II. Indications

  1. Peanut Allergy Desensitization in ages 4 to 17 years old
    1. Goal to reduce severity of reactions (NOT to reintroduce peanuts into diet)
    2. Alternative to peanut oral Immunotherapy (performed by allergists)

III. Contraindications

  1. Severe Asthma
  2. Eosinophilic Esophagitis (or other Eosinophilic gastrointestinal disease)
  3. Anaphylaxis for any reason within the last 60 days

IV. Efficacy

  1. Following 1 year of Desensitization, two thirds of children are expected to tolerate 2 peanuts without reaction

V. Precautions

  1. Peanut free diet must be followed regardless of Desensitization
  2. Keep Epinephrine Autoinjector nearby (reactions will be more common during Desensitization)

VI. Disadvantages

  1. Cost: $890 per month ($3000 for full one year course)
  2. Must be in office to start medication and at each titration up in dose
  3. Restart in clinic if >3 doses missed

VII. Dosing

  1. Risk Evaluation and Mitigation Strategy (REMS) required for prescribers
  2. Taken daily and gradually increasing doses

VIII. Adverse Effects

  1. Abdominal Pain (26%)
  2. Allergic symptoms
    1. Throat irritation (9.3%)
    2. Oral Pruritus (8.7%)

IX. References

  1. (2020) Presc Lett 27(10): 58

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