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Ask Us About Palforzia!

Peanut Allergy Treatment with Palforzia in New Orleans, LA

Dr. Reena Mehta is a board-certified allergist in New Orleans that can help you and your children overcome peanut allergies. Ask us about our new, FDA approved Palforzia oral immunotherapy program.

I’m the parent of a son with multiple food allergies. When our son was first diagnosed, my wife and I consulted with multiple nationally know allergists. We were frustrated with the care we received and our lack of progress. We were then referred to Dr. Mehta who has been a godsend…Since our son has been seeing Dr. Mehta, he’s overcome several of his food allergies. There really is nothing like being able to eat out at restaurants with your child after packing all of his meals for a year.

– Ravi Legha, 19-month old son Gavin, December 2018

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Peanut allergy treatment provider Dr. Reena Mehta in New Orleans, LA
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Peanut Allergy Overview

Peanut Allergies

Palforzia

Enrollment

Frequently Asked Questions

A peanut allergy occurs when exposure to peanuts triggers a person’s immune system to react to peanuts as if they were harmful to the body. The immune response causes symptoms like tongue swelling, vomiting, and diarrhea to tell your body to get rid of the peanut allergen and to stop ingesting more of it. While it is possible to outgrow a peanut allergy, most children do not. Peanut allergies typically last for life.

An allergic reaction to peanuts might occur in the below situations:

  • You have a peanut allergy and you accidentally eat a peanut or any foods that contain raw, cooked, or processed peanuts
  • You have a severe peanut allergy and share saliva with someone who ate peanuts either by kissing, sharing utensils, or sharing straws
  • You are severely allergic to peanuts and have a reaction from simply inhaling peanut dust or peanut protein when someone cooks with peanuts
  • You are allergic to peanuts and you touch peanuts or peanut butter

Types of Food

Peanut allergic reaction can occur with exposure to or ingestion of foods such as the following below:
  • Peanut butter
  • Peanut oil
  • Peanut flour
  • Bread processed in a facility with peanuts
  • Crackers
  • Chocolate candy
  • Baked goods
  • Granola bars
  • Asian, African, Mexican and other ethnic foods
Woman with peanut allergies avoiding peanuts

Peanut Allergy Reactions

Symptoms of an allergic reaction to peanut usually occur very quickly after exposure, usually within minutes. These include:
  • Skin reactions such as hives – raised, itchy, red areas of skin
  • Swelling of the face, eyes, mouth, tongue, hands, or feet
  • Difficulty breathing
  • Nausea or vomiting
  • Diarrhea
  • Dizziness or the feeling of passing out
  • Anaphylaxis – multiple organ systems produce a significant immune response causing a rapid drop in blood pressure and possible circulatory shock that is life-threatening; symptoms include difficulty breathing and/or swallowing, vomiting, dizziness, dangerously low blood pressure, swelling over different parts of the body, and loss of consciousness
Sometimes, symptoms don’t show up until hours or days after eating peanuts. These delayed symptoms include:
  • Eczema – itchy, flaky skin
  • Eosinophilic esophagitis – difficulty swallowing food or heartburn
The severity of your symptoms during an allergic reaction varies depending on how much peanut you consumed and your body’s threshold dose. Most people with peanut allergy have a reaction when eating one to three peanut kernels. One peanut kernel contains approximately 162 mg of peanut protein. For some people with severe peanut allergy, as little as 1 mg of peanut protein can trigger symptoms.

Current Management and Treatment for Peanut Allergy

  • Food avoidance – Do not eat peanuts or any peanut-containing foods.
  • Antihistamine – If you are only mildly allergic to peanuts, you may be able to manage an allergic reaction to peanuts by waiting for symptoms to subside or by taking an antihistamine like Claritin or Benadryl. Antihistamines can help relieve mild symptoms like sneezing, itchy nose or mouth, a few hives, or slight nausea.
  • Epinephrine – If you have a severe reaction, such as symptoms of anaphylaxis, you should inject yourself with epinephrine.
  • Oral immunotherapy (OIT) – Feeding an allergic person larger and larger doses of peanut allergen in a controlled fashion might get the immune system desensitized to peanuts so that the threshold required to trigger an allergic reaction is increased. Palforzia was recently approved by the FDA as an oral immunotherapy for peanut allergies. So far, OIT has not been shown to cure peanut allergies. However, OIT can help reduce the severity of future allergic reactions.

Palforzia Peanut Allergy Treatment

FDA Approval Information

On January 31, 2020, the FDA approved Palforzia for commercial use in patients as oral immunotherapy to reduce the severity of allergic reactions to peanuts, including anaphylaxis, when peanut exposure occurs. Palforzia is only approved for use in patients ages 4 to 17 years old with a confirmed peanut allergy. Patients 18 years and older can continue taking Palforzia if they started it before or at age 17. Read more about the FDA approved Palforzia here.

What is Palforzia?

Palforzia is a peanut protein powder intended to mitigate allergic reactions to peanuts. Palforzia is taken orally and is packaged in a capsule or sachet depending on the dose. While patients are on Palforzia, they should continue to follow a peanut-avoidant diet. Palforzia does not treat or cure allergic reactions to peanuts.

Palforzia should never be administered during an allergic reaction. Patients on Palforzia must carry injectable epinephrine in the event of a severe allergic reaction, such as anaphylaxis, when accidentally exposed to peanuts.

Palforzia peanut allergy treatment oral immunotherapy

How Does Palforzia work?

Palforzia cannot cure peanut allergies, but it can help make allergic reactions to peanuts less severe. This process occurs by gradually decreasing the sensitivity of the immune system to small amounts of peanuts that could be hidden in foods. The goal is to increase the threshold required to trigger an allergic reaction.

Palforzia is an oral peanut protein powder that should be mixed with food prior to consumption by a patient with confirmed peanut allergy. After handling Palforzia, you should wash your hands immediately to avoid spreading any peanut product around your home. Monitor for any potential reactions after taking Palforzia.

Safety and Effectiveness Information

Palforzia

Oral immunotherapy (OIT) with Palforzia can lead to desensitization in some children with confirmed peanut allergy. However, the ability of Palforzia to induce peanut tolerance is unclear, as is the case with other existing OITs.

US FDA approval of Palforzia was based upon the largest trial study of peanut allergen oral immunotherapy to date, which included 499 children aged 4 to 17 years and 56 adults aged 18 to 55 years. Of the children on active treatment, 77% tolerated the once daily 300 mg maintenance dose of peanut protein with no more than mild symptoms during a peanut challenge at the end of the study. Meanwhile, only 4% of the children in the placebo group passed the peanut challenge.

The rate of serious adverse events during the study was higher for the group receiving Palforzia treatment compared to the placebo group. For example, epinephrine administration for anaphylaxis was at 14% for active treatment patients compared to 6% for the placebo group. Patients on Palforzia were able to better tolerate peanut exposure during a food challenge, but they also had higher rates of anaphylaxis.

Despite the increased risk of anaphylaxis and other adverse effects, some patients may be highly motivated to take an oral immunotherapy such as Palforzia to help alleviate the anxiety of experiencing a severe allergic reaction in public upon accidental peanut ingestion. You should have a discussion with your allergist to determine if you are a good candidate for Palforzia. If a patient with confirmed peanut allergy already has a threshold high enough to make accidental ingestion reactions unlikely, he or she may be a poor candidate for Palforzia. Additionally, adverse effects, risk for anaphylaxis, and daily commitments required of oral immunotherapy may outweigh any potential benefit of Palforzia in increasing the allergic reaction threshold.

Peanut OIT

When examining the combined data of 12 clinical trials totalling 1041 patients, peanut OIT was 12 times more effective at increasing the likelihood of passing a supervised food challenge than an elimination, peanut-avoidant diet alone. However, the risk of anaphylaxis during the maintenance phase was 3 times higher for patients receiving peanut OIT treatment. Patients receiving peanut OIT also had higher frequencies of vomiting and other gastrointestinal symptoms.

Limited data suggests that OIT may be better tolerated and perhaps more effective in young children than it is in older children. In a prospective study of 40 young children (ages 9 to 36 months) treated with either high- or low-dose peanut OIT (300 mg or 3000 mg peanut protein), both groups demonstrated high rates of short-term sustained unresponsiveness (78 percent overall). Nearly all patients experienced mild or moderate adverse events, but serious adverse events were not reported.

Contraindications

Individuals with uncontrolled asthma, history of eosinophilic esophagitis, or history of other eosinophilic gastrointestinal disease should not take Palforzia. In general, Palforzia may be unsuitable for patients with conditions that reduce their ability to survive anaphylaxis. These conditions include compromised lung function, severe mast cell disorder, or cardiovascular disease. In addition, you should not start therapy with Palforzia if you had a severe or life-threatening anaphylaxis in the previous 60 days.

Palforzia Registration & Enrollment

Palforzia REMS Program

Palforzia is only available through a restricted program known as the PALFORZIA Risk Evaluation and Mitigation Strategy (REMS) due to the increased risk of anaphylaxis. Before you can receive Palforzia, you must enroll in the Palforzia REMS program with the help of a REMS certified allergist who must educate you on all the risks associated with the treatment. You must agree to be monitored in a healthcare setting during the initial phase of the treatment, attest to avoiding peanuts at all times, and fill a prescription for injectable epinephrine that should be available to you at all times.

Once you are approved to take Palforzia through the REMS program, you can start treatment. Palforzia treatment is administered in 3 phases: initial dose escalation, up-dosing, and maintenance.

Palforzia Dosing

During initial dose escalation, you will receive your first 5 doses of Palforzia (ranging from 0.5 mg to 6 mg) during a single, extended appointment at your allergist’s office. The appointment will be around 4 hours long, and during that time, you will receive five increasing doses of Palforzia.

Up-Dosing

If you successfully complete initial dose escalation, you can continue to the up-dosing phase of Palforzia treatment. During up-dosing, you will receive 11 different gradually increasing doses of Palforzia over the course of approximately six months. The dosing will take place at your allergist’s office for each initial dose increase, and you will continue treatment at home.

Maintenance

The last phase of Palforzia treatment is taking a daily dose of Palforzia at home. The maintenance dose is set at 300 mg and does not get higher.
Palforzia peanut allergy treatment dose escalation

Palforzia Side Effects & Risks

The major risk to Palforzia is anaphylaxis, which can lead to death if not treated immediately. Anaphylaxis most commonly occurs within 2 hours after a dose but can occur 10 or more hours later in some individuals. Risk of anaphylaxis increases when Palforzia is taken with intense physical activity, hot water exposure, menstruation, and fasting.

Other risks include adverse side effects, which are an expected part of treatment. These include:

  • Itchy skin or hives
  • Abdominal pain, nausea, or vomiting
  • Numbness or tingling of the mouth
  • Itchy ears
  • Cough
  • Swelling or other irritation of the throat
  • Runny nose
  • Sneezing

Frequently Asked Questions

Is Palforzia covered by insurance?

Some insurance companies cover the FDA approved peanut allergy therapy, Palforzia. If you are unsure about your insurance coverage or want more information about financial assistance options, you can ask your allergist to enroll you in the Palforzia Pathway Support Program.

Through the Palforzia Pathway Co-pay Savings Program, eligible patients may pay as little as $20 per month for Palforzia with a benefit maximum of $4,000 per calendar year. Eligibility criteria include:

  • Taking Palforzia for an FDA-approved use
  • Commercial health insurance that covers Palforzia
  • Not enrolled in a government-sponsored health insurance program
Through the Palforzia Pathway Patient Assistance Program, eligible patients can receive Palforzia at no cost if they have no insurance or if their insurance has denied coverage for Palforzia and they meet certain financial criteria.

Is there a treatment for peanut allergy?

Yes, there are treatments for peanut allergy. However, current treatments are not curative. For mild allergic reactions, you can take an antihistamine for symptom relief. However, severe allergic reactions such as anaphylaxis require autoinjection of epinephrine. Palforzia is a new peanut allergy oral immunotherapy that can help prevent severe allergic reactions.

How long does a peanut allergy reaction last?

Peanut allergy reactions usually start within minutes of peanut exposure, but some people may not develop symptoms until 2 hours later. The length of a peanut allergy reaction varies from person to person. Mild reactions typically don’t last for more than 1 day. Severe reactions, when treated with epinephrine, usually stop within minutes, but additional monitoring at a hospital may be required.

Does Benadryl help with peanut allergies?

Yes, Benadryl can help relieve symptoms associated with a mild reaction to peanuts. These symptoms include mild stomach discomfort, sneezing, itchiness of the mouth or nose, or a mild rash. However, Benadryl will not help with a severe allergic reaction such as anaphylaxis.
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Palforzia Peanut Allergy Treatment in New Orleans

If peanut allergies are complicating your life, see a peanut allergy specialist in New Orleans, LA. Doctor Mehta has a reputation for developing strong relationships with her patients and being exceptionally attentive to their needs and concerns. Now offering Palforzia for peanut allergies.

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2622 Jena St,
New Orleans, LA 70115

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