Peanut allergy study reveals psychosocial burden on allergic individuals

Aimmune Therapeutics, Inc, a biopharmaceutical company developing and commercialising treatments for life-threatening food allergies, has announced findings from APPEAL-1 (Allergy to Peanuts ImPacting Emotions And Life-1), a pan-European study assessing the psychosocial effect and impact of living with peanut allergy.

The study highlighted the substantial impact peanut allergy has on every aspect of allergic individuals’ and their caregivers’ lives, including the uncertainty they feel around how to manage frightening and debilitating reactions and concerns about the feasibility of ongoing avoidance.

Peanut allergy is one of the most common food allergies, which affects over 17 million people in Europe. The prevalence of peanut allergy in Europe has doubled between 2005 and 2015, and around two-thirds of schools in Europe currently have at least one child at risk of anaphylaxis. 

APPEAL-1 is said to be the first and largest quantitative study to validate and bring attention to the significant burden and psychosocial impact with which allergic individuals and their caregivers are challenged in their daily lives. The findings illustrated the impact of living with the condition, and how attempting to avoid peanuts every day can be a major source of stress, fear and anxiety, clouded by the persistent worry of accidental exposure for both the allergic individual and their caregiver.

The data also reportedly demonstrated that, across Europe, there is insufficient education for coping and living with the disease and the management of reactions.

Of the 1,300 survey participants:

• 45 percent rated their worst allergy reactions as severe, and 31 percent require the use of rescue medicine (adrenaline auto-injector; AAI) and hospitalisation for their worst reaction. Of this latter group, percentages are higher in younger age groups; 35 percent in children and 42 percent in teenagers, compared with 26 percent in adults
• Despite this, more than a quarter had never been prescribed an adrenaline auto-injector (AAI), and only 24 percent of all respondents received training on what to do in an emergency. Of those that had been prescribed an AAI, only a third had received training on how to use it
• 87.4 percent reported multiple symptoms during their worst allergic reactions; the most common symptoms included swelling (lips, eyes, tongue), breathing difficulties/wheezing and itching mouth or throat tightness. Almost one third report gastrointestinal symptoms (vomiting 30 percent, nausea 27 percent, stomach pain/cramps 24 percent)
• Comorbidities are common, with 42, 50 and 79 percent reporting comorbid allergic rhinitis, asthma, and other food allergy, respectively
• Nearly half of all respondents (46 percent) described living with the disease as “more” or “much more” expensive than living without the disease, pointing to a financial burden associated with managing peanut allergy. Most respondents noted “significant” indirect costs associated with the extra time needed for planning day-to-day activities (85 percent) and special events (91 percent)
• 90 percent reported feeling frustrated and stressed, with over a third having frequent feelings of anxiety
• 65 percent reported feelings of isolation and 43 percent reported experiencing bullying
• 89 percent reported feeling restricted on where to eat out and 84 percent feel limited on buying food.

“The study provides essential insight and data on peanut allergy comorbidities, severity of reactions, management, and suggests a widespread need in Europe for improved quality of peanut allergy health management and education”, said Daniel Adelman, Chief Medical Officer of Aimmune. “These findings represent the largest quantitative data set to date and, importantly, deepen our knowledge and understanding of the impact of peanut allergy on everyday lives, further providing some signposts for clinicians and policymakers on significant needs among these patients that need to be addressed.”