Palforzia, the first drug approved by the FDA to treat peanut allergies, isn't a cure, but it's a breakthrough when it comes to caring for kids with severe food allergies. Here's how it works, the side effects, and how much it costs.

By Sally Kuzemchak, MS, RD
February 04, 2020
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If your child has a food allergy, you know what it's like to live with worry about accidental exposure and life-threatening reactions. Now the U.S. Food and Drug Administration (FDA) has approved the first drug for peanut allergies in children—and while it's not a cure, it can definitely help a lot of families rest easier.

The drug, called Palforzia, is approved for kids ages 4-17 who have been diagnosed with a peanut allergy. It's a powder made from peanuts that's given in increasing doses over a period of time. The goal of the drug is to boost kids' tolerance, reducing the severity of allergic reactions if they accidentally eat or come into contact with peanut protein. In research, 67 percent of people who completed the dosing (and were on a maintenance dose for six months) could withstand the equivalent of two peanuts in an oral challenge with no more than mild allergic symptoms.

"It's extremely exciting," says Scott Sicherer, M.D., a professor of pediatrics and director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York. "It's hopefully the first in a long line of options for people with food allergies."

Dr. Sicherer cautions that this drug does not mean kids with peanut allergies can start eating peanuts, be less careful about coming into contact with peanuts, or stop carrying their EpiPen. Kids must still eat a peanut-free diet and families still need to take all the usual precautions. But for kids who are sensitive to even tiny amounts, the drug can help lessen daily stress and fear. "This drug provides an extra level of safety day to day," says Dr. Sicherer.

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Here's how Palforzia works: The powder is mixed and eaten with foods such as applesauce, yogurt, or pudding, and given in increasing doses over the course of several months. Kids get the first dose of the drug under medical supervision, as well as each time the dose is increased. If they're tolerating a certain dose, they can take it at home, returning to the health care setting every two weeks to get the next level. Once they've reached the maximum dose—the equivalent of one peanut—they'll need to continue a daily maintenance dose indefinitely.

Since the drug is made from peanuts, there are risks to taking it. According to the FDA, common side effects include things like abdominal pain, vomiting, nausea, tingling in the mouth, itching, cough, and runny nose. Hives, throat irritation and tightness, wheezing, shortness of breath, and anaphylaxis (a potentially life-threatening reaction) can happen too. That's why kids take many of the doses under medical supervision—and why families must have an epinephrine auto-injector on hand when giving it at home.

The cost of the drug is set at $890 per month, but there will be a patient co-pay assistance program that could drop the out-of-pocket cost to as low as $20 per month, according to Aimmune Therapeutics, the company that makes Palforzia. The FDA says the drug will only be available through specially certified health care settings.

Peanut allergy, one of the most common food allergies, affects about 1 million kids in the U.S. Unlike with some food allergies, very few kids will ever outgrow it.

Sally Kuzemchak, M.S., R.D., is a registered dietitian, Parents Contributing Editor, and mom of two who blogs at Real Mom Nutrition, a no-judgements zone about feeding a family. She is the author of The 101 Healthiest Foods For Kids and Cooking Light Dinnertime Survival Guide. You can follow her on Facebook, Pinterest, and Instagram. In her spare time, she loads and unloads the dishwasher. Then loads it again.

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