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Medicine

Nestle's $6,000 Peanut Allergy Pill Has Been a Dud 94

An anonymous reader quotes a report from Bloomberg: When Nestle SA's peanut allergy medicine first hit the market in 2020, Robert Wood, the director of pediatric allergy at Johns Hopkins Hospital in Baltimore, started preparing to offer it to the children he treats. But Covid-19 soon derailed in-person treatment, so over the next year and a half Wood and his colleagues told some 1,000 patients about the new drug instead, suggesting they consider it when the pandemic abated. Their responses came as a shock. Only six people were interested in a medicine that had been billed as a game changer for life-threatening allergies -- the first of its kind to be cleared by US authorities. Three years later, Wood has yet to prescribe the drug, Palforzia, and he isn't alone. Doctors and patients from California to Germany appear to be shunning the medicine in favor of the tried-and-true prescription for sufferers: simply avoiding peanuts and carrying an adrenaline injection for emergencies.

Nestle's chief executive officer, Mark Schneider, admitted as much in November, conceding that the drug's uptake had been slow. Schneider in 2020 bought out Palforzia's developer for $2.6 billion, paying a staggering 174% premium as he sought to take "the science business to the next level," snapping up vitamin makers such as Puritan's Pride and Solgar as well. The company is looking for a buyer, and the Swiss food giant says it will have to recognize a significant impairment to the deal's original value -- likely presaging a big writedown at a time when its core grocery business faces pressure from inflation. Maybe the company known for Nespresso capsules and Kit Kat chocolate wafers was never the right owner for a complex-to-administer niche medicine, but Schneider is on the hunt to find new avenues of growth in keeping with his strategic tilt toward health and wellness. The CEO "is looking to make acquisitions in new areas, and that inherently carries risks," says Martin Deboo, an analyst at Jefferies. "Palforzia is a signal of that." Nestle reiterated its commitment to nutritional health in an email and said Palforzia is safe and effective and solves the problem of variable potency that can hobble efficacy or trigger an allergic reaction with other less stringent treatments.

The product is essentially peanut protein that's been packed in a pill, standardized and categorized as a medicine after meeting the Food and Drug Administration's exacting clinical-trial requirements on safety and efficacy. By exposing children to tiny but gradually increasing amounts of the ingredient, Palforzia slowly raises their sensitivity threshold. But the process requires commitment by parents and kids to a demanding regime that lasts more than a year. [...] Palforzia is not without risk. During the clinical trials, about 9% of children suffered potentially dangerous immune reactions when their doses were being increased. [...]
Bloomberg notes that Germany's Institute for Quality and Efficiency in Health Care concluded that Nestle's drug "doesn't offer any advantage over peanut avoidance." A UK panel that assess medicines' cost-effectiveness also found the drug to be quite expensive, costing about $6,220 per patient in England.

"As for Wood at Johns Hopkins, he says the allergy center would've lost money administering Palforzia -- something it was willing to do if there had been enough interest among patients. When asked whether some patients might've gone elsewhere for Palforzia, Wood says probably not."
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Nestle's $6,000 Peanut Allergy Pill Has Been a Dud

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  • Problem solved for free.

  • McDonald's in Canada stopped serving peanuts with their Sundays

    • by zenlessyank ( 748553 ) on Wednesday February 08, 2023 @11:45PM (#63277331)

      Did they rename it to a Saturday?

    • by markdavis ( 642305 ) on Thursday February 09, 2023 @12:05AM (#63277369)

      Yeah, ridiculous.

      I love peanuts. I have a severe nut allergy but peanuts are *not* nuts, they are legumes (nuts grow on trees). I went into anaphylaxis and almost died once (ambulance, intensive care for days, the whole thing) by accidentally eating one unidentified nut (that was in something someone made). Most nuts would just cause me a very bad reaction- like welts, swelling, itching etc, but not death, so not sure which I ate. Since I know common nuts cause me great issue, I won't eat *any* nut.

      But I am not, nor most others like me, calling for "banning" nuts in all foods. It is ridiculous how overboard the public has gone with "banning" peanuts due to a tiny number of people with severe allergies. We don't do that with nuts, seafood, sesame seeds, milk, eggs, etc. What most of us want is just clear labeling of foods that contain common allergens.

      In any case, it is hard to call what they are doing a "drug", it is just standard de-sensitization (also called allergy immunotherapy). I have had allergy injections regularly for many years as an effective way to combat my many other contact/mucosa/airborne allergies. They just increased the content of most of the stuff I am allergic to, up to a maintenance dose, to train my immune system "hey, this is always around and not dangerous." So the concept is sound, although such techniques are usually NOT effective with food allergies (and as such, allergists have not offered, or do, nut-extract injections, that I am aware of, and oral food immunotherapy is rare and unproven).

      • Similar boat as you, but flipped (can't eat peanuts, but can eat most other nuts). Generally, I don't have a problem with being around people eating peanuts. The main exception was when I was on a plane and a seatmate would finish their bag of peanuts, followed by ritual of slapping their hands together in front of them and spreading peanut dust all over. That sucked, and in that confined space, it was a problem. I don't feel too bad about peanuts going away on planes.

        As far as Nestle's $6k peanut pill

      • Standard in the EU, even restaurants have foold allergene labelling over here, but as I wrote further down below, I have the feeling that food allergies affects the USA more than it does Europeans. I have met so many people from the US with food allergies in my life, but I have not met a single European who has that, and I live in Europe and not the USA.
        I wonder if this is just a sideffect of the USA allowing tons of semi toxic substances in small doses into food, Europe has banned to keep food quality high

        • It could also be a sampling bias.

        • I spent a few years living in Asia. What I heard there was that Australians and Americans were the ones that seemed to have the peanut allergy more than anyone. My uninformed opinion is that the allergy situation (and other stuff) is caused not just by what is being consumed processed foods, but what is not eaten. People "trust" that food coming out of a box or can has been prepared to "standards" and is "safe", so they don't feed their kids actual food until much later in life, if ever. Kids grow up fa

          • Most likely food allergies are mainly influenced by genetics. And if for generations your nation has had modern medicine and lots of options for food sources (few famines) then the people with the allergies didn't die off. At this point we're invested and have to solve the problem of food allergies with science because we skipped over the cruel ways of mother nature.

            • >"And if for generations your nation has had modern medicine and lots of options for food sources (few famines) then the people with the allergies didn't die off."

              Yep, it sounds horrible to say, but humans actually are "de-evolving" due to removal of physical heath natural selection due to healthcare. I should have been dead at least three times over from genetic issues. I am glad I am not dead (my Mom and other family and friends would agree), but from an evolutionary sense, it could be retrograde. G

      • You call oral immunotherapy "rare" and "unproven".
        Rare, maybe.
        Unproven, no, it does work, at least some:

        https://www.nih.gov/news-event... [nih.gov]

        FDA approved oral immunotherapy:
        https://www.aaaai.org/tools-fo... [aaaai.org]

        I think it's also been demonstrated that pollen allergies (standard hayfever) allergies can be reduced via oral immunotherapy, perhaps more effectively than via standard injections.

        --PM

      • It is ridiculous how overboard the public has gone with "banning" peanuts due to a tiny number of people with severe allergies. We don't do that with nuts, seafood, sesame seeds, milk, eggs, etc. What most of us want is just clear labeling of foods that contain common allergens.

        I worked in the food industry for a few years. Your labelling is the reason for the banning. The issue here is the risk of contamination. Either you need to put some truly insane processes in place to control nut allergens or you end up with every product having the same generic label "may contain nuts".

        Now you have a Sunday machine at McDonalds. Got a customer with a nut allergy and they want a Sunday without? Tough, everything from that machine needs to come with a warning that it may contain nuts. In man

      • The common allergens get banned in elementary and sometimes middle school because younger kids aren't necessarily that reliable at detecting what ingredients might be present in the food they eat from the cafeteria or exchange with other students.

        The thing is, I had PB&J in my sack lunches whenever money was tight. It was nutritious and I liked it. But these days my parents would have had to come up with something else for me to eat and I doubt they could have worked out something as affordable. It's on

        • >"The thing is, I had PB&J in my sack lunches whenever money was tight. It was nutritious and I liked it. But these days my parents would have had to come up with something else for me to eat and I doubt they could have worked out something as affordable."

          That is kinda what I was saying. I know the reason peanuts are "banned" in schools for younger people. But kids with actual life-threatening peanut allergies (not just adverse reactions) are probably in the fraction of a percent range. It is a sh

    • Of course, what else where they going to pay the high school and undergraduate students with, money?

    • McDonald's in Canada stopped serving peanuts with their Sundays

      Probably the least expensive option, costing them ... I can't think of the right analogy. :-)

      • McDonald's in Canada stopped serving peanuts with their Sundays

        Probably the least expensive option, costing them ... I can't think of the right analogy. :-)

        It didn't cost McDonald's peanuts, it cost customers their peanuts! 8^)

  • by RightwingNutjob ( 1302813 ) on Thursday February 09, 2023 @12:18AM (#63277389)

    My kid's got a peanut allergy. The allergist treats it by measuring out a dose of ground up peanut powder and giving it to me to mix in a prescribed amount of apple sauce to be taken every day. Doses get upped every two weeks. No $6k pills required.

    • That's basically what the pill is. It's grounded up peanuts with the oil extracted out. They are calling it a fancy name and charging $6K for something I think people can basically make at home very carefully under supervision if you have a gram scale (the pills have to be taken under supervision too). Reference: https://www.ema.europa.eu/en/d... [europa.eu]

    • by jonadab ( 583620 )
      There are people whose allergy is so severe, that that approach is fundamentally unusable because it would be pretty much immediately fatal. The public perception is that there are *way* more such people, than is actually the case; nonetheless, they do exist.
      • by tlhIngan ( 30335 )

        There are people whose allergy is so severe, that that approach is fundamentally unusable because it would be pretty much immediately fatal. The public perception is that there are *way* more such people, than is actually the case; nonetheless, they do exist.

        No doubt, but the thing is - where are all these people as adults? We've had people with peanut allergies for over 30 years now, and while schools have locked down use of peanuts in school because yes it's a problem, most workplaces haven't. I know ther

        • by jonadab ( 583620 )
          > where are all these people as adults?

          There aren't that many of them. Really severe allergies are fairly rare, and the more severe, the more rare. For every person who would be endangered by being in the same building with a peanut, there are a thousand who would be fine with that but don't dare eat anything that might have been cross-contaminated with peanut oil; and for every one of those, there are thousands who just can't actually eat peanuts, but trace amounts are not an issue; and for every one
    • Having a peanut allergy myself, I'm curious in how things are turning out for your kid. How old? How long has the therapy been underway? Is the expectation that there will be complete de-sensitivity or just that you don't always have to run around with an epi-pen and lots of Benedryl? Thanks for sharing
      • Age less than 5. It's going good. They started with 1 mg per *week* and we're up to 16 mg/week now. The expectation is to lower the severity so that a stray candy or cookie or something fried in peanut oil doesn't cause a rash and vomiting, but I get the sense that there's not much in the way of predictive power of who will be "cured" versus still be stick with an epipen.

    • by DVK9 ( 9481479 )
      This is still prescribed as a powder, administered daily for the rest of that person's life. Basically if your child is 10 and you figure they will live til their 80 that 70 years. Now the price of the med varies from about $560 to $800+ a month for the rest of their lives. Or you avoid any place that uses nuts and you carry an auto injector that costs about $690 the prices may be a huge factor.
  • by GFS666 ( 6452674 ) on Thursday February 09, 2023 @12:20AM (#63277395)

    The main way of treating treatable allergies (like pollens and peanuts) is using a medical concept known as Allergy Immunotherapy. It involves the exposure to the body and immune system of steadily increasing exposures/dosage of the allergen into the body. The standard way of doing this is by injecting the allergen into the body using a serum with the allergen dissolved in it. This treatment is well known and has been used for a long time. So basically the only difference between using shots and using this pill is the way it is introduced into the body.

    If the two methods are interchangeable, then the over riding reason one may be used over the other is cost. The cost of the standard method is very very well defined, so I am assuming that this method of doing Immunotherapy is totally not cost effective. So the pills backers thought everyone would just love this method (because you don't have to get a shot) and were shocked that no one wanted to pay the premium for it. Idiots.

    I say all this as someone who is currently undergoing the allergy shot regime. My Insurance has paid for most all of it and willingly does so because it lessens my need for Medical interventions and treatment. I have been to urgent care for allergy related issues over 12 times in a 2 year period (I was averaging 1 urgent care visit a month when it initially hit and before I understood what was going on) so to the Insurance company treating my allergy is just good business practice which saves them money in the long term. But this pill does not do that.

    • by sg_oneill ( 159032 ) on Thursday February 09, 2023 @12:44AM (#63277449)

      Yep, desensitization shots. We've been doing this for a LONG time.

      When I was a teenager I had an absolute laundy list of allergies, and so the doc put me on weekly shots, which just had tiny amounts of the allergen in the shots. I'd get a tiny bit of redness around the injection (just a tiny shot into the leg meat) and after 3 months of that, I was good to go.

      30ish years later, none of those allergies came back. I have a cat that sleeps on my bed, and no problems [other than the usual nocturnal cat nonsense, but hey ancient egyptians taught miniature panthers to yell like babies, complications will happen], plaster mould doesnt seem to affect me, spring isnt a complete hayfever mess, etc. The only allergy that I could never beat was wool. Now THAT stuff fucks me up (Literally just touching it will cause a painful rash). Which is a shame, because wool jumpers look comfy.

      • Sorry about your allergy history and your continuing allergy to wool--but about wool--in my opinion you're not missing much! Contact with wool makes me itchy. Not rash, not allergy, just physically itchy.

        Are you allergic to alpaca or llama fur? If not, those are probably a far superior substitute--though I can't say from personal experience.

        --PM

      • Yep, desensitization shots. We've been doing this for a LONG time.

        When I was a teenager I had an absolute laundy list of allergies, and so the doc put me on weekly shots, which just had tiny amounts of the allergen in the shots. I'd get a tiny bit of redness around the injection (just a tiny shot into the leg meat) and after 3 months of that, I was good to go.

        30ish years later, none of those allergies came back. I have a cat that sleeps on my bed

        So your doctor injected you with cats!?!

      • Roasted peanuts are about 24% protein by weight. And if you are allergic you react to those 24%. Now based on studies, the starting dose for Allergen immunotherapy would be 1,5mg or 3mg.
        "Couldn't i just buy a microgram weight, weigh out 4mg of peanut, take that?" you ask. Yes, you could. But reducing the peanut down to 1/100 or 1/200 for the 7 starting dose is a huge pain. And the 7 next doses are a pain to do as well. It only starts being manageable by week 3-4 and beyond.

        Now, a bit of napkin math will tel

  • Make me a pill (Score:2, Offtopic)

    by backslashdot ( 95548 )

    so that I can eat unlimited donuts and not get fat. I have been thinking why not have some kind of a fat tube poked into the stomach that vacuums out stomach contents into an external gadget/filter that removes solids and dissolved sugars in real-time and then returns the reduced sugar/protein filtered stomach fluids back. Sort of like an aquarium water purifier, you know what I am saying? Somebody get me a patent on that while I ponder it over a donut.

    • Why don't I patent shooting a man for sport...*after* he gorges on all the donuts he can eat...to prevent him from getting fat off of donuts?

    • Wel there IS a pill that'll do that. Orlistat or something like that . Buuuuuuut as a side effect you'll basically be shitting grease all day, possibly while sitting in a meeting at work, everytime you even look at something remotely tasty.

      So you can eat unlimited donuts, but you might need to wear nappies. Kinda seems like a price I'm not willing to pay lol.

      Theres also some drug that was designed for type 2 diabetes that can be used off label as a fairly effectiev weight loss drug, except that its now almo

    • so that I can eat unlimited donuts and not get fat.

      You can do that now without a pill, they just have to be very small donuts.

    • by Xicor ( 2738029 )

      I just want a pill that temporarily increases your metabolism by 500%.(with no side effects)

  • by rta ( 559125 ) on Thursday February 09, 2023 @12:31AM (#63277425)

    As they mention the pandemic shutdown was a strong headwind for an elective in-office therapy requiring multiple visits.

    There's also a certain degree to which parents, like the mother quoted, embrace the identity of "protecting kid against the world" (the opposite of what a commenter above who takes a refreshingly pro-social view).

    So... idk, it'll probably gain acceptance over time. The cost is a bit ridiculous, but I hope they make their money back before the patent expires. Overall they've done a service by funding the clinical trials and getting to FDA approval for peanut flour protocol. Once the patent expires in 20 years the price for the pills should go to near nothing, though the office visits will still cost something.

  • commitment by parents and kids to a demanding regime that lasts more than a year

    You mean taking a pill once a day? That's a burden in exchange for alleviating a potentially deadly allergy?

    • Re:Demanding Regime (Score:4, Informative)

      by backslashdot ( 95548 ) on Thursday February 09, 2023 @01:21AM (#63277553)

      Uh, because you still have to avoid peanuts and the pill itself can cause anaphylactic shock (among other side effects) especially during dose escalation. In fact you are more likely to get anaphylaxis on the pills than if you tried to avoid peanuts. However the pills are able to desensitize people more people than the amount that become desensitized over time naturally over time. (67% vs 20%)

      References: https://www.palforzia.com/site... [palforzia.com]

      • There's also the fact that the "pill" itself is a scam, literally a home remedy patented. The pill is just grounded up/powdered peanuts and the oils removed, that's it. People have been DIY'ing that at home (see bottom reference) with powdered peanuts, oil extracting, and gram scale.

        Reference [that Palforzia is just defatted peanut powder]: https://www.ema.europa.eu/en/d... [europa.eu]
        Reference [that Palforzia is just defatted peanut powder]: https://www.palforzia.com/faq [palforzia.com]
        Reference [that Palforzia is just defatted peanu

  • "Nestle's drug "doesn't offer any advantage over peanut avoidance." "

    Duh, of course it does. You get to eat delicious peanuts.

  • I'm fairly certain I haven't eaten $6k worth of peanuts in my entire life. Never really been much of a peanut person unless they're around for free as bar snacks. My partner though, he loves his Reese's cups. I'm sure he's easily blown through $6k worth of those.

  • by kenwd0elq ( 985465 ) <kenwd0elq@engineer.com> on Thursday February 09, 2023 @02:03AM (#63277613)

    To prevent peanut allergies, infants and babies should be given SMALL amounts of creamy peanut butter. Many food "allergies" are actually immune responses to new and unknown substances. Babies' immune systems are in a "learning" mode for about a year, discovering common substances in the environment. If babies are never exposed to common allergens like peanuts, dirt, dust, dog and cat fur and all the common stuff that we and our ancestors all "discovered", then the kids MAY develop allergies when their immune systems are fully developed.

    Science fiction author L. Neil Smith once suggested that children born in sterile habitats in space or on other planets would never be able to come to Earth, becuase they'd be allergic to the whole planet!

    More personally. my son was born in Sacramento, CA. When I was transferred to Subic Bay in the Philippines, he developed MASSIVE allergic reactions to most tropical flower pollen, which manifested as continual ear infections. It didn't improve much when we moved to Hawaii, but it settled down when we returned to northern California.

    • There is also evidence that lack of exposure to common infections early on is a cause of childhood leukaemia. [bmj.com] I believe this work came about from the observation that leukaemia is a disease of rich countries, and as countries get richer their rates go up.

    • Many food "allergies" are actually immune responses to new and unknown substances.

      That is about as accurate as saying only kids who don't play in the mud get sick. Yes allergies are an immune response, but they are very much an *abnormal* immune response and early exposure isn't the factor as to whether someone develops allergies or not. It's at best a very *very* minor contributor to severity.

    • I've heard that if a child's first exposure to peanut is in food they are likely to tolerate it fine but if we keep the kids from peanuts and they are exposed to oil or dust on skin or otherwise... the body can detect that as a threat?

      It's absolutely interesting that much of the rest of the world has very little in the way of peanut allergies.. in Israel they have this peanut snack they're really into and feed it to babies all the time (its really digestible I guess, so it makes a great early first snack)

      It

  • Its been a while since I have been in the US, but I have never met so many people here in Europe with food allergies than I did in the US.
    I guess all the junk which goes often into prefabricated food and generally the junk which is allowed there (and not here in Europe for good reasons) to go into food might be the culprit there.
    Yes this is anectotal, but I wonder how many people in the US have food allergies compared to Europe, are there any statistics?

    • Most people with "allergies" to food in the US are just making it up for sympathy or to feel special or to get favored treatment or whatever.

    • by jonadab ( 583620 )
      A lot of that is just paranoia. I'm pretty sure at least 80% of the Americans who think they are "allergic" to a food, aren't.

      I'm not saying real food allergies don't exist; they certainly do, and some of them can even be life threatening (though most aren't). But I know scads of people who have concluded they are allergic to one or more foods, on absolutely no meaningful evidence whatsoever. They happened to get a stomach ache one day, thought through the list of things they'd eaten recently, selected o
  • With a spoonful of chocolate, the medicine goes down, the medicine goes down, in the most delightful way.

    https://www.lyricsondemand.com... [lyricsondemand.com]

  • KitKat (Score:4, Interesting)

    by mccalli ( 323026 ) on Thursday February 09, 2023 @07:01AM (#63277949) Homepage
    It hurts to see Nestle associated with them. They were Rowntrees, a socially conscious manufacturer in York who did great things for their community at the time. I lived in a Joseph Rowntree house at one point, built for his factory workers at the time - nice place to live in, nice place to be.

    I also knew people who worked there, and one in particular would bring a carrier bag of chocolate misshapes home every week for the shared house I was in to..well..share.

    Would love to have KitKat find a home elsewhere.
  • Is it just me, or is charging $6K for maybe $0.60 of peanut power (a 10,000x increase) a steep markup?

  • Why should anyone else worry if people with peanut allergies don't care enough to take medicine?

    Bring peanuts back to commercial air travel!

  • by ivec ( 61549 ) on Thursday February 09, 2023 @09:06AM (#63278115) Homepage

    The whole story of peanut allergies is an example of "medical science" gone wrong:

    For more than two decades, pediatricians have been recommending to avoid all peanut exposure for children below the age of 3 years. In spite of what many considered common sense:
    1. Parents have always been exposing our babies to all kinds of foods, and allergies are a recent phenomenon.
    2. Countries where some baby cookies included peanut as an ingredient (Israel) had much less allergies than the USA.
    The rate of peanut (and other) allergies has kept increasing in the USA.

    Only in 2017, after randomized controlled trials have finally brought a definitive proof that early peanut exposure was actually *reducing* the risk of allergies - even and especially in families with a high risk of allergy - has the American Academy of Pediatrics finally reversed its guidance (https://www.mana.md/peanut-allergies-may-affect-your-child/). And still today, close to a third of pediatricians still recommend peanut avoidance (https://www.sciencedaily.com/releases/2020/07/200715142338.htm).

    Simple old school advice to young parents: eat healthy yourself (avoid untraprocessed foods), and give a little taste of everything you eat to your baby, starting 3 months old (or even earlier). Just beware of choking - of course you don't give a whole peanut or pea to your child: crush, blend or, even easier, pre-chew your own food and let your child get a little taste of it. Enjoy the interaction. And as long as your baby's digestion and growth is going well, keep having fun sharing.

    Yes, there are times where trusting good old wisdom and traditional practices works better than going with the scientific consensus of the moment...
    I.V. - father of 4, MD, son of a MD.

    • Link back to a earlier slashdot article on a related part of the topic :https://science.slashdot.org/story/20/10/27/2320237/daycares-in-finland-built-a-forest-floor-and-it-changed-childrens-immune-systems
      Finns live in completely different hygiene standards than people in Russian Karelia. In terms of genetics, adaption and environment there isn't a lot of differences. But the Karelian population is healthier, where Finish population is richer.

      I hope the memetic of childhood sterility eventually dies a cold d

  • May cause swelling and or instant death, pretty standard pharma product these days.
  • doesn't offer any advantage over peanut avoidance.

    Wouldn't the point be that you don't have to avoid peanuts anymore? That seems like an advantage to me....

  • This article caught my eye mostly because just yesterday I'd seen an article that the University of Notre Dame + Indiana University School of Medicine tested an approach that prevented allergic response to peanut, and can be used as a preventative as well as a treatment (if given shortly after onset of symptoms, the inhibitor stopped the progression of the allergic reaction). Still in the very early stages, but about to progress into preclinical trials. https://news.nd.edu/news/resea... [nd.edu]

  • "costing about $6,220 per patient in England"

    The numbers I can find for immunotherapy injections are $1,000-$4,000 per year, so these pills are at least the right order of magnitude.

  • Bloomberg notes that Germany's Institute for Quality and Efficiency in Health Care concluded that Nestle's drug "doesn't offer any advantage over peanut avoidance."

    That's like saying that condoms don't offer any advantage over abstinence.

  • So I'm a parent of a 9yo who is on OIT (oral immunotherapy) for peanuts, hazelnuts, cashews and pistachios.

    By chance, we happen live nearby one of the two doctors in our state doing OIT. Still there was a several year wait, unless you were willing to pay cash ($10k) to line jump. It is not unusual for parents to take their kids out of state (monthly) for access. The success rate is really good, like over 75%. We've been fortunate to have had great results, and the therapy has been life changing for o

And it should be the law: If you use the word `paradigm' without knowing what the dictionary says it means, you go to jail. No exceptions. -- David Jones

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