The Pharmacy Read List: March 9th Edition

Last week our guest contributor Timothy did a great job at explaining a meta-analysis that used the technically-difficult concept of Bayesian statistics. I hope that you read it carefully since it might be important in another few weeks (hint, hint). This week we have a regular contribution from our wonderful team member, Harpreet! Food allergy rates in western countries have risen considerably in the last ten years. Previous guidelines advise pregnant women to avoid allergenic foods such as peanuts, but a new trial says otherwise. Have a read below and have a good start to the week (and what nice weather we had all weekend in Vancouver!)

The Read List is (usually) a biweekly update on pharmaceutical literature. Every two weeks we handpick one of the most relevant and interesting pharmacy-related publications and summarize it for your convenience. At the end of every month, a quiz on that month’s content will be released. Simply take the quiz, and you’ll be automatically entered into a draw for a gift card prize!

Instructions to access: Copy and paste the article title into UBC Summons to read the full article, or click on the link below to access the article when on the campus network.

Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy

Peanut allergy is the leading cause of food allergy related anaphylaxis and death in children. It develops early in life and is usually present life long. Its prevalence in Western countries has doubled in the past ten years and it is becoming increasingly apparent in Africa and Asia. For years, health professionals have been seeking answer to the question around early vs. late introduction of peanuts in diet of an infant and which approach will be better to avoid the development of a peanut allergy. Although earlier guidelines have recommended exclusion of allergenic foods from diets of infants and from the diets of their mothers during pregnancy and lactation, new research suggests otherwise. This study randomly assigned 640 infants, older than 4 months and younger than 11 months with high predisposition to developing peanut allergy, to consume or avoid peanuts until 5 years (60 months) of age. These infants had severe eczema, egg allergy, or both. One group had no reaction in the skin prick test, whereas the other developed a wheal 1 to 4mm in diameter. The primary outcome was the proportion of infants who developed peanut allergy at 60 months of age. The study found that in 530 infants who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001). Among the 98 participants who initially had positive test results, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group (P=0.004). There were no significant differences in the incidence of serious adverse events between the two groups. Therefore, in the study population, sustained peanut consumption beginning in the first 11 months of life, as compared with peanut avoidance was shown to result in a significantly smaller proportion of children with peanut allergy at the age of 60 months. Nevertheless, many children have very severe peanut allergy and respond with wheals larger than 4mm on the skin-prick test. They were not included in this study due to safety concerns. The study lacked a placebo regimen and the question of whether the participants who consumed peanut would continue to remain protected against the development of peanut allergy even after prolonged cessation of peanut consumption is being studied further.

– Harpreet Bahniwal
B.Sc. (Pharm) Candidate 2016

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