I am sharing this post to raise awareness about a peanut allergy treatment and to encourage you to talk to your child’s allergist to learn more. This post is sponsored by Aimmune Therapeutics, the manufacturer of PALFORZIA® [Peanut (Arachis hypogaea) Allergen Powder-dnfp], and does not constitute medical advice. No one in my family is a PALFORZIA patient, and my personal story and opinions are my own. Some of the content in this post was provided by the manufacturer of PALFORZIA. I am not a medical professional and am not qualified to give medical advice.
Please talk with your child’s allergist about whether PALFORZIA might be right for your child.
On January 31, 2020, PALFORZIA became the first and only FDA-approved treatment for peanut allergy.
PALFORZIA is a treatment for people who are allergic to peanuts. PALFORZIA can help reduce the severity of allergic reactions that may occur with accidental exposure to peanuts. PALFORZIA may be started in patients aged 4 through 17 years old. If a child turns 18 years of age while on PALFORZIA treatment, they should continue taking PALFORZIA unless otherwise instructed by their doctor.
PALFORZIA does NOT treat allergic reactions and should not be given during an allergic reaction.
Children must maintain a strict peanut-free diet while taking PALFORZIA.
Before I talk about why PALFORZIA is an exciting development for peanut allergy, I want to share some important safety information here and throughout this post. Keep reading!
IMPORTANT SAFETY INFORMATION
It is important to note that PALFORZIA can cause severe allergic reactions called anaphylaxis that may be life-threatening.
- You will receive your first dose in a healthcare setting under the observation of trained healthcare staff.
- You will receive the first dose of all dose increases in a healthcare setting.
- In the healthcare setting, you will be observed for at least 1 hour for signs and symptoms of a severe allergic reaction.
- If you have a severe reaction during treatment, you will need to receive an injection of epinephrine immediately and get emergency medical help right away.
- You will return to the healthcare setting for any trouble tolerating your home doses.
Stop taking PALFORZIA and get emergency medical treatment right away if you have any of the following symptoms after taking PALFORZIA: trouble breathing or wheezing, chest discomfort or tightness, throat tightness, trouble swallowing or speaking, swelling of your face, lips, eyes, or tongue, dizziness or fainting, severe stomach cramps or pain, vomiting, or diarrhea, hives (itchy, raised bumps on skin), or severe flushing of the skin.
Because of the risk of severe allergic reactions, PALFORZIA is only available through a restricted program called the PALFORZIA Risk Evaluation and Mitigation Strategy (REMS) Program. Talk to your healthcare provider for more information about the PALFORZIA REMS program and how to enroll.
You should NOT take PALFORZIA if you have uncontrolled asthma, or if you ever had eosinophilic esophagitis (EoE) or other eosinophilic gastrointestinal disease.
Please refer to additional Important Safety Information below.
PALFORZIA is intended to gradually decrease your child’s sensitivity to small amounts of peanuts that may be hidden in foods through a process called oral immunotherapy, or OIT. PALFORZIA is not a cure for peanut allergy, but it may help make your child’s reaction to accidental exposure less severe.
I am sharing this post to raise awareness about PALFORZIA and to encourage you to find out more information from your allergist to help you decide whether it may be the right treatment for your child. You can also take this quiz and talk to your child’s doctor to see if PALFORZIA, along with practicing a strict peanut-free diet, could be right for your child’s specific situation.
Our Peanut Allergy Life
My younger son was diagnosed with severe peanut allergy 15 years ago. We realized from the first reaction that very small amounts of peanut could cause a severe reaction and we found accidental exposure to peanuts hard to prevent.
About 9 years ago, he had an unexpected allergic reaction and he needed an epinephrine injection. I later found out that he sat near someone who had eaten peanuts hours earlier in their own home. I felt devastated by his reaction to mere “specks” of peanuts and helpless to prevent it. I ugly cried for weeks at the most awkward moments because I didn’t know how I could keep him safe.
Over time, we had some peanut-allergy related moments that would make any peanut-allergic kid (or mom) cry, such as giving up fun activities to be safe, dealing with bullying and discrimination, and allergic reactions to random peanut cross contact. I had my share of worries through the years.
- I anticipated and prepared for any random thing that could happen at school.
- My son was limited to playdates only with children whose families were careful about serving peanut free snacks and willing to use epinephrine.
- I have had to console my son after other children told him that they wanted to give him peanuts so they could see a reaction and then I had to address the bullying with the adults in charge so that it doesn’t happen again.
- We said no to sleep-away camps because we weren’t confident about peanut-free meals and access to emergency medical services.
- Our family opted for road trips and meals prepared in hotel kitchenettes.
- We tried not to worry about the future even though we knew that the teen years could be the riskiest, as children become more independent and eat out with friends or go off to college.
We did all of those things and more because accidental exposure to “specks” of peanuts could cause potentially life-threatening allergic reactions.
I wished that we could have considered a treatment option like PALFORZIA which is an FDA-approved peanut allergy treatment for children 4 through 17 years old. It can help reduce the severity of allergic reactions, including anaphylaxis, that may occur with accidental exposure to peanut.
What Families Should Know About PALFORZIA® [Peanut (Arachis hypogaea) Allergen Powder-dnfp]
I have talked with many friends, family, and acquaintances about peanut allergy and PALFORZIA to understand what key information families need in order to discuss with their healthcare provider if the treatment is right for their child. Of course, none of the information here is a substitute for speaking to your allergist about your child’s peanut allergy diagnosis and appropriate treatment options.
PALFORZIA wasn’t an available option for us 9 years ago and it’s too late now because my son is older than the approved age range of 4 through 17 years old. Given that PALFORZIA is FDA-approved and we know about the risks and potential benefits from clinical trials, it’s an option worthy of consideration by peanut allergy families in addition to practicing a strict peanut-free diet. It’s also important to remember that PALFORZIA does not treat allergic reactions and should not be given during an allergic reaction.
PALFORZIA is an oral powder that is mixed with a few spoonfuls of refrigerated or room temperature soft food such as applesauce, yogurt, or pudding. The powder has a well-defined allergen profile and has been prepared and quality tested for consistency. The treatment objective is to help reduce the severity of allergic reactions to accidental peanut exposure.
It’s important throughout treatment to follow all dosing instructions, have access to injectable epinephrine at all times, and avoid peanuts in the daily diet.
If you and your child’s allergist have determined that PALFORZIA is the right choice for your child, the next step is to enroll into the PALFORZIA Risk Evaluation and Mitigation Strategy Program.
Once enrolled into the PALFORZIA REMS Program, the treatment process consists of three phases:
- The first phase of the process, called Initial Dose Escalation, takes place in the allergist’s office and lasts about 4 hours. Your child will be given small doses of PALFORZIA from 0.5 mg to 6 mg. If they can tolerate at least 3 mg, they can move to the next step.
- The next phase of the process, called Up-Dosing, takes about 6 months, with consistent, precise amounts of peanut protein given every day. You will mix the contents of one or more capsules or sachets that contain each day’s pre-measured dose of PALFORZIA into a few spoonfuls of refrigerated or room temperature soft food such as applesauce, yogurt, pudding or other food. If the dose is tolerated, it will slowly be increased according to your doctor’s instructions every couple of weeks during visits to the allergist’s office.
- After completing the Up-Dosing phase, your child will start taking a Maintenance dose every day; this dose is in a single small sachet that you open and administer in soft food, as usual. The Maintenance phase continues over time to help your child maintain their decreased sensitivity to small amounts of peanuts that may be hidden in foods. The Maintenance dose must be taken every day for PALFORZIA to be effective.
Because PALFORZIA is not a cure, kids who use it still need to carry injectable epinephrine and avoid eating peanuts.
When Is It a Good Time to Start PALFORZIA?
Talk to your child’s doctor about when it is appropriate to start PALFORZIA and consider whether elementary school aged children may have more flexibility in their schedule than older students. If your child is in high school and interested in PALFORZIA, it’s still worthwhile to plan around appointments and dosing times so that they have the most support from their family while they are still living at home.
Courage, Commitment, Compassion are Required
Deciding whether to start PALFORZIA is a deeply personal and complicated decision and my best advice is to first talk with your child, then decide together with your child’s allergist. Understand your child’s concerns and goals first. Your child’s allergist can provide context based on your child’s health history and inform you about potential benefits and risks of oral immunotherapy with PALFORZIA.
Whatever your family chooses to do will require courage, commitment, and compassion when it comes to managing food allergies. I am in full support of families who take the time to be informed and to make decisions together with their medical care team. No matter what your child decides, I wish your kids the best health and much happiness in their peanut allergy journey.
If you think PALFORZIA could be right for your child, visit PALFORZIA.com to learn more about how to get started and speak to your child’s allergist.
IMPORTANT SAFETY INFORMATION (CONTINUED)
Tell your doctor if you are not feeling well prior to starting treatment with PALFORZIA. Your doctor may decide to delay treatment until you are feeling better. Also tell your doctor about any medical conditions you have and if you are taking or have recently taken any other medicines, including medicines obtained without a prescription and herbal supplements.
Your doctor may decide that PALFORZIA is not the best treatment if:
- You are unwilling or unable to receive (or self-administer) injectable epinephrine.
- You have a condition or are taking a medication that reduces the ability to survive a severe allergic reaction.
What are the possible side effects of PALFORZIA?
The most commonly reported side effects of PALFORZIA were: stomach pain, vomiting, feeling sick, itching or burning in the mouth, throat irritation, cough, runny nose, sneezing, throat tightness, wheezing, shortness of breath, itchy skin, hives, and/or itchy ears.
PALFORZIA can cause severe allergic reactions called anaphylaxis that may be life threatening.
PALFORZIA can cause stomach or gut symptoms including inflammation of the esophagus (called eosinophilic esophagitis). Symptoms of eosinophilic esophagitis can include:
- Trouble swallowing
- Food stuck in throat
- Burning in chest, mouth, or throat
- Regurgitation of undigested food
- Feeling sick
For additional information on the possible side effects of PALFORZIA, talk with your doctor or pharmacist.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
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