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Ask Us About Palforzia – A Peanut Allergy Treatment!
Palforzia Peanut Allergy Treatment 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 allergy immunotherapy treatment program for peanut allergies.
“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
Frequently Asked Questions
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 butter
- Peanut oil
- Peanut flour
- Bread processed in a facility with peanuts
- Chocolate candy
- Baked goods
- Granola bars
- Asian, African, Mexican and other ethnic foods
Peanut Allergy Symptoms
Peanut allergy symptoms of an allergic reaction to peanuts 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
- 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 peanut allergy symptoms include:
- Eczema – itchy, flaky skin
- Eosinophilic esophagitis – difficulty swallowing food or heartburn
Current Peanut Allergy Treatment & Management
- 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 FDA Approval Information
What is Palforzia?
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.
How Does Palforzia work?
Palforzia cannot cure peanut allergies, but it can be used for severe peanut allergy treatment and to make all 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
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.
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.
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 peanut allergy treatment is administered in 3 phases: initial dose escalation, up-dosing, and maintenance.
During initial dose escalation, you will receive your first 5 Palforzia doses (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.
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 Palforzia dosing will take place at your allergist’s office for each initial dose increase, and you will continue treatment at home.
Palforzia Side Effects & Risks
The major Palforzia side effect risk 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
- Swelling or other irritation of the throat
- Runny nose
Is Palforzia covered by insurance?
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
Is there a treatment for peanut allergy?
Yes, there are peanut allergy treatments. 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?
Does Benadryl help with peanut allergies?
Yes, Benadryl can help relieve peanut allergy 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.
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 allergy treatments.
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Saturday appointments available upon request.
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