Posted: 31 July 2024
Babies with peanut allergies in Australia will be offered a treatment program under a world-first model aiming to transform allergy care.
Ten paediatric hospitals across five states have partnered with the National Allergy Centre of Excellence (NACE), hosted at Murdoch Children’s Research Institute (MCRI), to be the first globally to introduce a nation-wide peanut oral immunotherapy (OIT) program into mainstream care.
The ADAPT OIT Program aims to change the way the most common food allergy among Australian school-aged children is treated from strictly avoiding peanut in diets to safely building a tolerance to the allergen and hopefully achieving remission.
The free program is only available to children under 12 months, diagnosed with peanut allergy, and who are receiving care by an allergist at one of the participating hospitals. The program capacity at each hospital will depend on demand and resources. Those eligible will follow a carefully planned daily dosing schedule of peanut powder, taken at home, over two years.
Professor Kirsten Perrett, Director of the NACE, Paediatric Allergist and Leader of MCRI’s Population Allergy Group, said unlike OIT clinical trials, the treatment would be offered as a new standardised model of care. This will be the first peanut allergy treatment program offered in Australian hospitals outside of a clinical trial setting.
“Oral immunotherapy is being variably implemented around the world using different approaches making it difficult to assess the results, including the long-term outcomes for children, their families and the health system,” Professor Perrett, Head of the ADAPT OIT Program, said.
“Under this Australia-wide model, a food allergy test at the end of the treatment will help determine if remission was achieved. These children will then be followed in routine clinical care for at least 12 months to help us evaluate the acceptability, safety and effectiveness, quality of life and long-term outcomes.
“Ultimately, we want to change the trajectory of allergic disease in Australia so that more children can go to school without the risk of a life-threatening peanut reaction.”
The NACE, which is funded by the Federal Government, will lead an evaluation study to analyse the program’s results. If successful, it’s hoped more hospitals and private allergy clinics will then adopt the program, including in regional and remote areas.
Assistant Minister for Health Ged Kearney said: “The Albanese Labor Government is funding life changing medical research to save lives while building capacity and capability, which is so critical in allergy research.
“Today’s announcement is a big step forward towards combating life threatening peanut allergies in babies.
“This new model of care might be the game changer we have all wanted to stop this terrible allergy in its tracks.”
Dr Michael O’Sullivan, Allergist and Program Lead at Perth Children’s Hospital and Fiona Stanley Hospital in Western Australia, encouraged families who suspect their baby had a peanut allergy to first visit their GP.
“Australian guidelines recommend infants are introduced to common allergens, such as peanut in the form of peanut butter, in the first year of life,” he said.
“If you think your baby has had an allergic reaction to peanut, avoid that food and talk to your GP, who may refer your child to an allergist at one of the participating hospitals.”
Peanut allergy affects 3.1 per cent of 12 month olds in Australia and over two thirds of children with a peanut allergy remain allergic by age 10, according to MCRI-led research.
Dr Lara Ford, Allergist and Program Lead at the Children’s Hospital at Westmead in NSW, said: “One of the biggest concerns for families living with peanut allergy is the fear of accidental exposure. This program has the potential to remove that burden.”
The Chatwin family, of Mickleham, Victoria, first noticed their son, Hunter, showing signs of being allergic to peanuts when he ate peanut butter and developed hives at the age of six months.
Hunter, now nine months old, has been referred into the ADAPT OIT Program at The Royal Children’s Hospital in Melbourne.
“We are taking part in the program to try and improve his chance of being able to safely eat peanut in the future,” Hunter’s mother Kirsten said.
“Many families are desperate to protect their children from allergic reactions and anaphylaxis. Some are travelling interstate or even overseas for OIT treatment at private clinics, so to have this program available and free at public hospitals is a game-changer.”
Dr Tim Brettig, ADAPT OIT Program Medical Lead, said like all treatments, OIT may not be suitable for everyone and it does not guarantee remission.
“OIT treatment takes time and this program requires a long-term commitment from families to give their child daily doses of peanut powder at home along with regular visits to their hospital allergy clinic,” he said. It is important to remember, OIT is not a cure, but by following treatment it may improve the chance of being able to safely eat a specific food allergen, such as peanut.”
While on the program, children are prescribed an Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plan for Anaphylaxis and adrenaline injector, families receive a comprehensive education pack and have access to an allergist on-call.
Eligible babies will be referred into the program by their allergist from either The Royal Children’s Hospital in Victoria, Perth Children’s Hospital and Fiona Stanley Hospital in Western Australia, Queensland Children’s Hospital, Women’s and Children’s Health Network in South Australia, and Sydney Children’s Hospital, Randwick, The Children’s Hospital at Westmead, John Hunter Children’s Hospital Newcastle, Campbelltown Hospital and Royal Prince Alfred Hospital in NSW.
