In people suffering from peanut allergies, pharmacologic inhibition of Bruton’s tyrosine kinase (BTK)  prevented or lessened clinical sensitivity to peanuts during an oral food challenge (OFC), according to an open-label clinical trial. Researchers investigated if people with peanut allergies may avoid clinical reactivity to peanuts by using the FDA-approved BTK inhibitor Acalabrutinib.

Adults with peanut allergy that had been verified by specific immunoglobulin E (IgE) and/or skin prick testing were included. The subjects undertook a baseline placebo-controlled single-blinded graded OFC to peanut to determine their baseline degree of clinical reactivity, along with skin prick testing and basophil activation testing (BAT) to peanut extract.

Volunteers underwent a repeat OFC, skin prick testing, and BAT after receiving four regular oral doses of 100 mg Acalabrutinib twice daily for a minimum of six weeks. Prior to objective clinical response, participants could tolerate a median amount of 44 mg (from 1 to 444) of peanut protein at baseline. Notably, 7/9 patients tolerated the maximum amount (4,044 mg) of peanut protein during a subsequent OFC while taking Acalabrutinib, while the tolerance levels for the last two subjects were increased from 14 to 1,044 and 3,044 mg, respectively.

The size of the average peanut skin prick testing wheal decreased from 120 to 57 mm2. In all the participants, peanut- and anti-IgE antibody-stimulated BAT were all negative on Acalabrutinib. There were no significant adverse events. When people with peanut allergies undergo OFC, pharmacologic suppression of BTK can lessen or avoid their clinical response to peanuts. BTK inhibitors may be utilized as short-term treatments for high-risk procedures encompassing medication desensitizations and allergen immunotherapy.