Food allergies are bad, significant, dangerous and growing in the U.S. and the rest of the world. More than 30 million people in the United States and Europe have a food allergy, and more than five million people in the United States and Europe have peanut allergy, including more than two million children.
The prevalence of peanut allergy in children in the United States has increased at a constant annual growth rate of approximately 10 percent between 1997 and 2008, and experts believe it has continued to rise since then. For people living with food allergies, certain foods can cause severe allergic reactions, including potentially life-threatening anaphylaxis.
There are no approved medical therapies to cure food allergies or prevent their effects. Currently, food-allergic patients manage their condition by strict allergen avoidance and carrying epinephrine auto-injectors for use in case of accidental exposure. Thus, in addition to the unmet medical need, food allergies can impose a significant quality of life burden. For more information, visit www.foodallergy.org and www.niaid.nih.gov/topics/foodallergy.
Is there a treatment on the horizon?
Not in the horizon, but, actually in clinical trials with results that are more than promising at most, or comforting at least, but we do believe that promising is the correct description of the trial results. The trials have been conducted by Aimmune Therapeutics (AIMT), a biopharmaceutical company developing desensitization treatments for food allergies.
Aimmune Therapeutics is developing AR101 as a potential desensitization therapy for patients with peanut allergy to provide them with protection from peanut allergens at a level believed to substantially exceed the amount typically encountered in an accidental exposure.
AR101 is a complex formulation of naturally occurring peanut proteins and pharmaceutical-grade inactive ingredients. Aimmune tests AR101 for three key allergenic proteins (Ara h1, h2 and h6), which are representative of the full range of peanut allergens. This process ensures the consistency of AR101 and enables the convenient dosing of consistent amounts of peanut protein with well-defined concentrations of peanut allergens. Patients ingest AR101 mixed into small amounts of palatable, age-appropriate food.
AR101 is part of Aimmune’s approach to treating food allergies using its characterized oral desensitization immunotherapy (CODIT™) system. The CODIT system leverages extensive independent scientific research on oral immunotherapy (OIT), demonstrating that food allergy patients can be desensitized against food allergens by being administered well-defined, gradually increasing doses of the allergen over months.
Aimmune’s CODIT system is designed to precisely control the amounts of the allergens administered in a systematic dosing regimen, beginning with very low doses of the allergens. Once a patient attains desensitization to a clinically meaningful level, the patient continues to take a daily maintenance dose of the CODIT system product in order to maintain the desensitization.
In today’s NEWS
Aimmune announced positive findings for its ARC002 clinical trials a follow-on Phase 2 study of the the firm’s lead product candidate, AR101 for the treatment of peanut allergy.
The open-label ARC002 trial, which enrolled patients 4-21 years of age who completed the ARC001 trial earlier this year, moved former placebo patients to active treatment and followed all patients through an additional 12-week maintenance period.
The efficacy results of ARC001 were confirmed in patients who rolled over from placebo,
No treatment-related serious adverse events occurred,
The drug AR101’s tolerability was supported by a low incidence of adverse events during 12 weeks of maintenance therapy and
A daily dose of 300 mg of AR101 for 12 weeks maintained the level of desensitization achieved from up-dosing.
Here is what Aimmune CEO Stephen Dilly, M.B.B.S., Ph.D. said about the trial results:
“ The data from our ARC002 trial bolster the positive findings of our ARC001 trial, in which all 23 patients who completed active treatment achieved desensitization to a cumulative amount of at least 443 mg of peanut protein, and 18 of those patients achieved desensitization to a cumulative amount of 1,043 mg of peanut protein, over a period of approximately 22 weeks of up-dosing.
Both our Phase 2 trials have now demonstrated that treatment with AR101 may confer meaningful protection against accidental exposure to peanut in just 22 weeks.”
In food allergy studies, real-world safety comes from efficacy — every day a patient is not desensitized is a day he or she is not safe from an accidental exposure triggering a potentially life-threatening reaction. As an accidental exposure to peanut would likely involve an amount less than or equal to a whole peanut kernel, which typically contains 250-300 mg of peanut protein.
In the ARC002 trial, patients from the placebo arm of the ARC001 trial repeated the same up-dosing regimen as in ARC001, but they knew they were receiving active doses of AR101.
After approximately 22 weeks of up-dosing, the patients were administered a double-blind, placebo-controlled food challenge (DBPCFC) to assess their levels of desensitization to peanut protein, with a maximum challenge dose of 600 mg (1,043 mg cumulative) of peanut protein.
The efficacy, safety, tolerability and dropout rate results for these patients were consistent with those of the patients in the active treatment arm of ARC001 trial.
Additionally, the ARC002 trial looked at the effects of AR101 after all patients completed a further 12-week maintenance period on a 300 mg daily dose of AR101. At the end of the period, patients were administered a DBPCFC with a higher maximum challenge dose of 1,000 mg (2,043 mg cumulative) of peanut protein.
The results of these DBPCFCs demonstrated that patients remained desensitized after 12 weeks on a 300 mg daily dose of AR101, and many patients were able to tolerate the higher maximum challenge dose.
Furthermore, the frequency of adverse events during the maintenance period of the ARC002 trial was markedly lower than during the active up-dosing regimens of both the ARC001 and ARC002 trials.
Given the robust efficacy seen at our ARC001 exit DBPCFCs after just two weeks at the daily maintenance dose of 300 mg of AR101, the firm became interested in analyzing the effect of a longer maintenance period as well as the potential to show desensitization at a higher challenge dose of peanut protein.
ARC002 showed that after 12 weeks of maintenance dosing, the desensitization levels patients had achieved with up-dosing were sustained and a substantial number of patients were able to tolerate a 1,000 mg challenge (2,043 mg cumulative) dose of peanut protein. We know that the exposure thresholds that trigger allergic reactions can fluctuate significantly from day to day, so achieving a higher level of desensitization could provide allergists and their patients with an increased sense of security.
Aimmune plans to initiate enrollment in the PALISADE (PEANUT ALLERGY ORAL IMMUNOTHERAPY STUDY OF AR101 FOR DESENSITIZATION IN CHILDREN AND ADULTS) Phase 3 pivotal trial for AR101 at the beginning of 2016 to support regulatory submissions in the United States and the European Union. PALISADE is an international, randomized, double-blind, placebo-controlled trial that is expected to enroll approximately 500 peanut-allergic children, adolescents and adults 4-55 years of age.
Aimmune plans to release a comprehensive review of the data from its ARC002 trial at the American Academy of Allergy, Asthma, and Immunology (AAAAI) meeting in March 2016.
Peanut allergy endangers the lives of children and adults. It is true that those who are diagnosed with peanut allergy can stop eating peanut, but the problem remains, as peanut can be found in other food and pastry and reactions happen when the allergic patients eats them without knowing that they contain peanuts.
Desensitization against food allergies, if feasible, is the safest way to go. We believe that AR101, which was granted FDA Breakthrough Therapy Designation is doing the job of desensitization against peanut and we are anxious to see the results of the upcoming PALISADE trial next year.
Aimmune Therapeutics (AIMT) focuses on developing oral desensitizing approaches for the prevention of allergic reaction against food elements. Oral administration makes it easy for the allergic patients to use the product for a sustaining protective effect.