Families managing peanut allergies in children have received distressing news this week as the sole drug therapy designed to mitigate the risk of potentially fatal reactions is being withdrawn from pharmacy shelves worldwide. The manufacturer, Stallergenes Greer, has confirmed it will discontinue production of Palforzia, emphasising that this decision is not linked to safety issues but rather stems from commercial considerations.
A Significant Setback for Allergy Management
Anaphylaxis UK, a leading allergy charity, has characterised the move as both 'worrying' and 'upsetting' for affected families. The organisation clarified that this represents 'a commercial decision' and highlighted a critical gap in treatment availability, stating: 'At present, there are no other licensed immunotherapy treatment options for peanut allergy.' This development means that children diagnosed with peanut allergy must persist with stringent peanut avoidance measures, while consistently carrying emergency medication and adhering to their personalised allergy action plans.
The Complex Journey of Palforzia
Originally developed by Aimmune Therapeutics, Palforzia was acquired by Nestlé in 2020 for an estimated £2.1 billion. The food conglomerate subsequently sold the treatment to Stallergenes Greer in 2023, a period during which the drug was reportedly viewed as 'a commercial flop' due to lower-than-anticipated uptake among medical practitioners. The manufacturer has established a 'wind down period' allowing existing patients to continue accessing treatment, but has advised that no new patients should commence therapy after 1 April.
Understanding the Treatment and Its Mechanism
Palforzia, a powder formulation containing minute quantities of pharmaceutical-grade peanut flour, received approval for NHS use in 2021, following clearance by the US Food and Drug Administration (FDA) the previous year. The therapy operates by gradually exposing individuals with peanut allergies to increasing doses of the substance, effectively retraining the immune system to become desensitised and thereby reducing the likelihood of severe reactions.
Patients undergoing this treatment must take the medication daily to sustain its protective effects and attend regular medical appointments to monitor for any adverse responses. While individuals are still advised to avoid peanuts, the therapy can significantly diminish the risk of anaphylaxis – the most severe and life-threatening allergic reaction, which can induce airway swelling and suffocation, potentially triggered by trace amounts of peanut in food.
The Scale and Impact of Peanut Allergy
Peanut allergy affects approximately one in 50 children, equating to roughly 240,000 young people in the UK and one million in the United States, positioning it among the most prevalent food allergies. Although about one in five children may outgrow the condition, for the majority it remains a lifelong concern. The severity of reactions can vary considerably, with some cases proving rapidly fatal following exposure to minuscule peanut quantities without immediate emergency intervention.
Tragic incidents underscore these risks, including the 2020 death of 23-year-old James Atkinson from Newcastle from anaphylaxis after consuming a takeaway pizza containing peanut powder, and the 2023 passing of 19-year-old college student Hannah Glass from Wisconsin after eating a brownie made with roasted peanut flour.
Future Prospects and Current Guidance
Anaphylaxis UK acknowledged that the discontinuation represents 'a setback for the allergy community' but noted that 'extensive research into allergy treatments is ongoing.' The charity pointed to significant advancements in real-food immunotherapy, aiming to develop safer, more effective treatments that could become more widely accessible through the NHS in future years.
The organisation advises patients currently using Palforzia to maintain their current dosage and discuss any concerns with their allergy specialist team. Importantly, they strongly caution against attempting to create homemade versions of the treatment using standard peanut flour, emphasising that Palforzia is a pharmaceutical-grade product manufactured under stringent quality, purity, and consistency standards required for licensed medicines. This includes screening and treatment processes to remove natural contaminants like fungus that may be present in ordinary peanut flour.
Manufacturer's Statement and Future Directions
A spokesperson for Stallergenes Greer explained to the Daily Mail: 'Stallergenes Greer has made the decision to discontinue Palforzia worldwide after conducting a strategic review. While the product has demonstrated strong clinical efficacy and safety, the complex administrative and dosing requirements have contributed to limited adoption in clinical practice.'
The company affirmed its ongoing commitment to 'advancing innovative and practical solutions in allergen immunotherapy including food allergy,' adding that 'the experience gained from Palforzia will inform future research and development efforts focused on practical patient-centred options.'
