FAS has upgraded our forum security. Some members may need to log in again. If you are unable to remember your login information, please email food.allergy.supt@flash.net and we will help you get back in. Thanks for your patience!

Author Topic: peanut allergy cure in uk dr clarke.  (Read 3351 times)

Description:

Offline eragon

  • Member
  • ***
  • Posts: 2,550
peanut allergy cure in uk dr clarke.
« on: January 30, 2014, 02:05:11 AM »
Its OK to have dreams:one day my kids will be legal adults & have the skills to pick up a bath towel.

Offline eragon

  • Member
  • ***
  • Posts: 2,550
Its OK to have dreams:one day my kids will be legal adults & have the skills to pick up a bath towel.

twinturbo

  • Guest
Re: peanut allergy cure in uk dr clarke.
« Reply #2 on: January 30, 2014, 03:51:43 AM »
The titles news articles attach to these individual clinical trials are extremely inaccurate wrt to data presented. All that happens is one more initial OIT trial gets added to the data pile. I'm sure there was some sort of oral challenge to participate the initial dose of 1/70th of a peanut that was "far below" eliciting dose for reaction.

The logic doesn't bear out eliminating cherry-picking a population for early (or at least initial) OIT success. I'm not sure why this is hailed as a breakthrough when we've mounting data that long term success is at best unpredictable.

No OIT is a cure for allergic disease, it is an experimental treatment.
« Last Edit: January 30, 2014, 03:54:36 AM by twinturbo »

Offline Macabre

  • Global Moderator
  • Member
  • ****
  • Posts: 29,977
  • Don't Blink!
Re: peanut allergy cure in uk dr clarke.
« Reply #3 on: January 30, 2014, 05:44:38 AM »
Yes-- what I read what "another OIT study, different time zone."  What I did not see was the percentage that developed another food allergy or even EE.

OIT will totally work for some, won't work for some, and will cause other stuff for a few. It would be nice to predict who.


An aside: my DS is doing long-term, low-dose SLIT. I am worrying less about side effects with it. 
Me: Sesame, shellfish, chamomile, sage
DS: Peanuts

Offline eragon

  • Member
  • ***
  • Posts: 2,550
Its OK to have dreams:one day my kids will be legal adults & have the skills to pick up a bath towel.

twinturbo

  • Guest
Re: peanut allergy cure in uk dr clarke.
« Reply #5 on: January 30, 2014, 09:34:57 AM »
Are we to compare the published data on its own and within the standing body? The news articles don't do it for me.

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: peanut allergy cure in uk dr clarke.
« Reply #6 on: January 30, 2014, 10:09:54 AM »
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2962301-6/abstract


This is the study referenced in the BBC features.


Quote
Eligible participants were aged 7—16 years with an immediate hypersensitivity reaction after peanut ingestion, positive skin prick test to peanuts, and positive by double-blind placebo-controlled food challenge (DBPCFC). We excluded participants if they had a major chronic illness, if the care provider or a present household member had suspected or diagnosed allergy to peanuts, or if there was an unwillingness or inability to comply with study procedures. Our primary outcome was desensitisation, defined as negative peanut challenge (1400 mg protein in DBPCFC) at 6 months (first phase).



(emphasis mine)-- So the bottom line is that it's unclear (at least from the abstract) whether or not exclusion includes those who dropped out due to side effects of treatment.  You know, if participants became "unwilling" via asthma or other allergic reactivity.


Quote
The primary outcome, desensitisation, was recorded for 62% (24 of 39 participants; 95% CI 45—78) in the active group and none of the control group after the first phase (0 of 46; 95% CI 0—9; p<0·001). 84% (95% CI 70—93) of the active group tolerated daily ingestion of 800 mg protein (equivalent to roughly five peanuts).


84% is roughly in line with what US researchers have found, too, using similar treatment protocols.

That part is comforting, at least-- it suggests that UK peanut allergy is the same beast as in N. America, and that treatments work the same way there as here. 

Same short-term study, though-- six months isn't a long enough follow-up, which is what US researchers have been saying for a year or two now.

Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

twinturbo

  • Guest
Re: peanut allergy cure in uk dr clarke.
« Reply #7 on: January 30, 2014, 10:50:06 AM »
The exact starting point I was heading for was exclusion criteria. I'm not seeing anything about excluding subjects who can't pass the initial double blind, and I do not mean slight positive past the 1/70th marker. Of course I can infer if one couldn't take the initial dose without serious reactivity up to anaphylaxis that individual was excluded at that time or not even up for consideration. Details, details.

From another link eragon posted, a very excellent one and ever so glad to have brought to my attention http://www.jaci-inpractice.org/article/S2213-2198(13)00457-1/fulltext.
« Last Edit: January 30, 2014, 11:28:31 AM by twinturbo »

Offline Macabre

  • Global Moderator
  • Member
  • ****
  • Posts: 29,977
  • Don't Blink!
Re: peanut allergy cure in uk dr clarke.
« Reply #8 on: January 30, 2014, 03:41:34 PM »
Okay, but you have to be wiling/compliant to do any of these.
Me: Sesame, shellfish, chamomile, sage
DS: Peanuts

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: peanut allergy cure in uk dr clarke.
« Reply #9 on: January 30, 2014, 03:43:48 PM »
Exactly-- I don't like the fact that so many of the studies with OIT don't break out the REASONS why people don't finish the study protocol.

We know (because of a member here) that at least sometimes, it's because of repeated anaphylaxis with home-dosing.  Scary thought that this is something that is a "failure to be willing to comply with treatment protocol," isn't it?

Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline Macabre

  • Global Moderator
  • Member
  • ****
  • Posts: 29,977
  • Don't Blink!
Re: peanut allergy cure in uk dr clarke.
« Reply #10 on: January 31, 2014, 12:13:39 AM »
Hmmmm.  I don't know that we know that. I thought it was the challenges that caused issues. I'll have to go baCk to look. But yes, it would be nice if they categorized things differently.
Me: Sesame, shellfish, chamomile, sage
DS: Peanuts

Offline eragon

  • Member
  • ***
  • Posts: 2,550
Its OK to have dreams:one day my kids will be legal adults & have the skills to pick up a bath towel.

Offline CMdeux

  • Global Moderator
  • Member
  • ****
  • Posts: 31,861
  • -- but sometimes the voices have good ideas!
Re: peanut allergy cure in uk dr clarke.
« Reply #12 on: January 30, 2015, 12:07:29 AM »
This seems to be the direct institutional press on the subject--

http://www.mcri.edu.au/news/2015/january/peanut-allergy/

and here's the abstract:

http://www.ncbi.nlm.nih.gov/pubmed/25592987


If anyone has institutional access, I'd love to actually see the study.  But as noted above, I have a pretty good idea on the basis of the few statements that made it into news stories from press releases.

NOT good experimental design, if I've come even close to correct about those features.


Quote
Further work is required to confirm sustained unresponsiveness after a longer period of secondary peanut elimination and to clarify the relative contributions of probiotics versus OIT.



Massive understatement.


Oh yay-- Australia and probiotics, which apparently elevate the success rate to....


(wait for it.... wait for it)



84%.


Wait.  Um--


where have I seen that value before??  (Right-- see my post from 1 year ago.)

Only this time, ONCE MORE, with feeling. probiotics!!

 ;D
« Last Edit: January 30, 2015, 12:18:51 AM by CMdeux »
Resistance isn't futile.  It's voltage divided by current. 

Western U.S.

Offline LinksEtc

  • Member
  • ***
  • Posts: 2,746
Re: peanut allergy cure in uk dr clarke.
« Reply #13 on: January 30, 2015, 06:51:12 AM »

Oh yay-- Australia and probiotics, which apparently elevate the success rate to....


(wait for it.... wait for it)



84%.


Wait.  Um--


where have I seen that value before??  (Right-- see my post from 1 year ago.)

Only this time, ONCE MORE, with feeling. probiotics!!

 ;D




 ;D



Offline LinksEtc

  • Member
  • ***
  • Posts: 2,746
Re: peanut allergy cure in uk dr clarke.
« Reply #14 on: February 11, 2015, 08:46:51 AM »
"Headline hyperbole - probiotics cure peanut allergy?"
http://foodallergysleuth.blogspot.com/2015/02/headline-hyperbole-probiotics-cure.html#more


Quote
In the latest edition of medical headline hyperbole, many of us learned last week that “Fatal peanut allergies could be cured by probiotic bacteria, say Australian doctors” and “This Breakthrough Treatment Helped Over 80 Percent of Allergic Kids Tolerate Peanuts.”
Sigh