12 October 2016

Safety first trial for baby's first peanuts

Perth researchers are to trial medically-supervised “peanut clinics” in an attempt to cut rising rates of peanut allergy.

The researchers want to know whether providing a setting where parents can feel safe introducing their children to peanuts, can lead to greater numbers of children receiving timely exposure to peanut products.

Michael O’Sullivan, a consultant immunologist with Princess Margaret and Fiona Stanley hospitals who is heading the study, said early exposure to peanut products was known to reduce the risk of developing peanut allergy, with current guidelines recommending that children at high risk of developing peanut allergy be exposed from as early as four months.

Dr O’Sullivan said that parental apprehension at introducing peanuts – while understandable – was delaying exposure, with only 20 per cent of children at high risk of developing peanut allergy being exposed within the optimal timeframe.

“Severe allergic reactions are extremely rare – even among high-risk children – but this doesn’t stop parents from worrying that their child will have a reaction with their first exposure,” he said.

“The number of ‘peanut picnics’ we see being held outside hospital emergency departments demonstrates the level of anxiety.”

Dr O’Sullivan said the peanut clinics would enable small groups of parents at a time to introduce their children to peanut products in a clinically supported setting.

He said children needed continued exposure to peanut products to prevent the development of peanut allergy.  A child who did not react on initial exposure was unlikely to react on subsequent exposures provided they continued to eat peanut products regularly at home (two to three times per week).

Dr O’Sullivan and his co-researchers hope to recruit about 400 infants, identified as being at high risk of developing a peanut allergy, for their intervention which will be part of a controlled trial.

The researchers will compare the proportion of infants regularly eating peanut by 12 months of age in the intervention group (those invited to the peanut clinics) with rates of regular peanut consumption among infants of similar high risk, but not offered the intervention.  They will also compare the incidence of peanut allergy in the two groups.

Infants will be invited to attend a “peanut clinic” if they have an increased risk of developing peanut allergy, such as if he or she:

  • has eczema
  • is allergic to eggs
  • has a strong family history of allergies.

Dr O’Sullivan said that if the intervention was found to be effective, peanut clinics could be introduced across a variety of settings such as GP practices and child health clinics, leading to significant health benefits and cost savings.

Dr O’Sullivan’s study is one of nine projects awarded grants in the latest round of the Department of Health-funded Research Translation Project (RTP) program. The program, which is now in its tenth year, encourages research and the translation of research outcomes into effective health care policy and practice.

Western Australia’s acting Chief Medical Officer Dr Audrey Koay said Dr O’Sullivan’s project was an example of the important and innovative research taking place in WA’s public health system.

Dr Koay said peanut allergy was the most common cause of severe food allergy in children and that with rates of peanut allergy rising steadily over the past 20 years, Dr O’Sullivan’s project had the potential to create both patient and health-cost benefits.

The full list of list of RTP recipients for 2016 is:  

Coordinating Principal Investigator (CPI)

CPI Institution

Project Title

Benhur Amanuel

PathWest

Clinical implementation of personalised medicine for five high-priority WA cancers

Camile Farah

University of Western Australia

Image-guided oncological surgery improves patient outcomes in management of head and neck cancer

Graham Hillis

Royal Perth Hospital

The RoyAl Perth evidence-based accelerated chest pain pathway (RAPID) Study

Edward Litton

Fiona Stanley Hospital

Restoration Of the microbiome in CrITical illness: The ROCIT Study

Jenny McClosky

King Edward Memorial Hospital

Proof of concept cervical human papillomavirus treatment trial

Michael O’Sullivan

Child and Adolescent Health Service

The Promoting Introduction to Prevent Peanut Allergy (PIPPA) project

Thomas Snelling

Telethon Kids Institute

Evaluation of PLATINUM C: PLATform IN the Use of Medicines to treat chronic hepatitis C

Teresa Williams

Curtin University

A randomised controlled trial of Continuous Positive Airway Pressure (CPAP) for the treatment of severe respiratory distress by ambulance paramedics in the pre-hospitals setting

Dao-Yi Yu

Lions Eye Institute

A novel approach to significantly improve clinical management of glaucoma

Mel Ziman

Edith Cowan University

A blood-based ‘liquid biopsy” to improve healthcare for metastatic melanoma patients

ENDS

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