II. Indications
- Peanut Allergy Desensitization in ages 4 to 17 years old
- Goal to reduce severity of reactions (NOT to reintroduce peanuts into diet)
- Alternative to peanut oral Immunotherapy (performed by allergists)
III. Contraindications
- Severe Asthma
- Eosinophilic Esophagitis (or other Eosinophilic gastrointestinal disease)
- Anaphylaxis for any reason within the last 60 days
IV. Efficacy
- Following 1 year of Desensitization, two thirds of children are expected to tolerate 2 peanuts without reaction
V. Precautions
- Peanut free diet must be followed regardless of Desensitization
- Keep Epinephrine Autoinjector nearby (reactions will be more common during Desensitization)
VI. Disadvantages
- Cost: $890 per month ($3000 for full one year course)
- Must be in office to start medication and at each titration up in dose
- Restart in clinic if >3 doses missed
VII. Dosing
- Risk Evaluation and Mitigation Strategy (REMS) required for prescribers
- Taken daily and gradually increasing doses
VIII. Adverse Effects
- Abdominal Pain (26%)
- Allergic symptoms
- Throat irritation (9.3%)
- Oral Pruritus (8.7%)
IX. References
- (2020) Presc Lett 27(10): 58