Development of Cockroach Immunotherapy by the Inner-City Asthma Consortium
A Biomarker-Based Pilot Study of Cockroach Subcutaneous Immunotherapy in Cockroach Sensitive Adults With Asthma and/or Perennial Allergic Rhinitis (ICAC-18)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Locations
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Maryland
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Baltimore, Maryland, United States, 21287
- Johns Hopkins University School Of Medicine
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Have a history of perennial allergic rhinitis, asthma, or both, for a minimum of 1 year before study entry. For those with asthma:
- a diagnosis of asthma will be defined as a report by the participant that they have had a clinical diagnosis of asthma made by a physician over a year ago
- the participant's asthma must be well controlled as defined by:
- a forced expiratory volume at one second (FEV1) greater than or equal to 80% predicted value with or without controller medication
- albuterol use for no more than 3 days per week in each of the previous 2 weeks for asthma symptoms (not including exercise prophylaxis)
- Are sensitive to German cockroach (Blattella germanica) as documented by a positive (>= 3 mm greater than negative control) skin prick test result and detectable German cockroach specific IgE (>=0.35 kUA/L)
- Have no known contraindications to therapy with glycerinated German (Blattella germanica) cockroach allergenic extract
- Are willing to sign the written Informed Consent prior to initiation of any study procedure
Exclusion Criteria:
- Are pregnant or lactating. Females must be abstinent or use a medically acceptable birth control method throughout the study (e.g. oral, subcutaneous, mechanical, or surgical contraception)
- Are unable to perform spirometry at screening
Have an asthma severity classification at recruitment of severe persistent, using the National Asthma Education and Prevention Program (NAEPP) classification, as evidenced by at least one of the following:
- requires a dose of greater than 500 mcg of fluticasone per day or the equivalent of another inhaled corticosteroid
- have received more than 2 courses of oral or parenteral corticosteroids within the last 12 months
- have been treated with depot steroids within the last 12 months
- have been hospitalized for asthma within the 6 months prior to recruitment
- have had a life-threatening asthma exacerbation that required intubation, mechanical ventilation, or that resulted in a hypoxic seizure within 2 years prior to recruitment
- Do not have access to a phone (needed for scheduling appointments)
- Have received allergen immunotherapy (SLIT or SCIT) in the last 12 months prior to recruitment or who plan to initiate or resume allergen immunotherapy during the study. Subjects who only received placebo therapy in the BioCSI protocol (A Biomarker-based Pilot Study of Cockroach Sublingual Immunotherapy in Cockroach Sensitive Adults With Asthma and/or Perennial Allergic Rhinitis, ICAC-12, NCT00829985) are eligible to participate in this study
- Have previously been treated with anti-IgE therapy within 1 year of recruitment
- Have received an investigational drug in the 30 days prior to recruitment or who plan to use an investigational drug during the study
- Refuse to sign the Epinephrine Auto-injector Training Form
- Do not primarily speak English
- Plan to move from the area during the study period
- Have a history of idiopathic anaphylaxis or anaphylaxis grade 2 or higher as defined in the protocol
- Have unstable angina, significant arrhythmia, uncontrolled hypertension, history of autoimmune disease, or other chronic or immunological diseases that in the opinion of the investigator might interfere with the evaluation of the investigational agent or pose additional risk to the participant
- Are using tricyclic antidepressants or beta-adrenergic blocker drugs (either oral or topical route[s] of administration)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: German cockroach allergenic extract
Participants will receive weekly escalating doses of glycerinated German cockroach allergenic extract administered via the subcutaneous route up to a Maximum Study Dose of 0.6 mL of extract at a concentration of 1:20 wt/vol.
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Participants received weekly escalating doses of glycerinated German cockroach allergenic extract administered via the subcutaneous route up to a Maximum Study Dose of 0.6 mL of extract at a concentration of 1:20 wt/vol.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Reported Treatment-related Adverse Events (AEs)
Time Frame: Baseline through 6-months of treatment
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Number of non-serious adverse events reported as possibly related, probably related, or definitely related to study participation.
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Baseline through 6-months of treatment
|
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Number of Reported Treatment-related Serious Adverse Events (SAEs)
Time Frame: Baseline through 6-months of treatment
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Number of SAEs reported as possibly related, probably related, or definitely related to study participation.
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Baseline through 6-months of treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in German Cockroach-Specific Serum IgE Over Time
Time Frame: Baseline through 6-months of treatment
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Outcome is the ratio of geometric means for baseline German cockroach-specific serum Immunoglobulin E (IgE) vs. post-baseline German cockroach-specific serum IgE.
Numerator is geometric mean post-baseline IgE; denominator is baseline IgE.
This result is an indicator of immune modulation over time, however its clinical significance is unclear.
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Baseline through 6-months of treatment
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Change in German Cockroach-Specific Serum IgG Over Time
Time Frame: Baseline through 6-months of treatment
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Outcome is the ratio of geometric means for baseline German cockroach-specific serum Immunoglobulin G (IgG) vs. post-baseline German cockroach-specific serum IgG.
Numerator is geometric mean post-baseline IgG; denominator is baseline IgG.This result is an indicator of immune modulation over time, however its clinical significance is unclear.
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Baseline through 6-months of treatment
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Change in German Cockroach-Specific Serum IgG4 Over Time
Time Frame: Baseline through 6-months of treatment
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Outcome is the ratio of geometric means for baseline German cockroach-specific serum Immunoglobulin subclass 4 (IgG4) vs. post-baseline German cockroach-specific serum IgG4.
Numerator is geometric mean post-baseline IgG4; denominator is baseline IgG4.
This result is an indicator of immune modulation over time, however its clinical significance is unclear.
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Baseline through 6-months of treatment
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Change in IgE Fragment Antibody Binding (FAB) Activity (10 Micrograms/mL Cockroach Allergen Extract)
Time Frame: Baseline through 6-months of treatment
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Outcome is the change in mean IgE fragment antibody binding (FAB) activity, baseline to post-baseline.
Serum from cockroach subcutaneous immunotherapy (SCIT)-treated participants were analyzed to determine if treatment inhibits the in-vitro cockroach antigen binding to B-cells after 6-months of treatment with cockroach SCIT, using the per protocol allergenic extract doses.
This result is an indicator of immune modulation over time, however its clinical significance is unclear.
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Baseline through 6-months of treatment
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Respiratory Tract Infections
- Respiratory Tract Diseases
- Immune System Diseases
- Lung Diseases
- Hypersensitivity, Immediate
- Bronchial Diseases
- Otorhinolaryngologic Diseases
- Lung Diseases, Obstructive
- Respiratory Hypersensitivity
- Hypersensitivity
- Nose Diseases
- Asthma
- Rhinitis
- Rhinitis, Allergic
- Rhinitis, Allergic, Perennial
Other Study ID Numbers
Other Study ID Numbers
- DAIT ICAC-18
- SCITCO (Other Identifier: NIAID)
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