Peanut Allergy Oral Immunotherapy Desensitization
The purpose of the study is to determine how a type of treatment for peanut allergy known as oral desensitization works in the immune system.
Objectives
- To determine whether premedication with desloratidine and ranitidine results in fewer side effects during desensitization procedure.
- To assess quality of life in peanut allergic subjects before and after desensitization.
- To compare serum metabolites in peanut allergic and non peanut allergic subjects.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Allergic reactions to peanuts and tree nuts account for the majority of fatal and near fatal food allergic reactions, and the only treatment is complete avoidance of peanut. Despite avoidance, the majority of peanut allergic people will accidently ingest peanut. OIT has been shown to desensitize peanut allergic subjects (Hofmann et al. 2009). This would protect patients who have no other treatment, and may even form the basis for true tolerance to peanut in the future.
Objectives:
- To determine whether premedication with desloratidine and ranitidine results in fewer side effects during desensitization procedure.
- To assess quality of life in peanut allergic subjects before and after desensitization.
- To compare serum metabolites in peanut allergic and non peanut allergic subjects.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Ontario
-
Hamilton, Ontario, Canada, L8N 3Z5
- McMaster University
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients must be between 5 and 10 years of age.
- Patients will be confirmed to have peanut allergy based on a history of significant clinical symptoms within 60 minutes after the ingestion of peanut,the presence of specific IgE to peanut (a positive skin prick test to peanut, defined as a wheal 3 mm larger than that of the saline control; and a positive in vitro IgE [CAP-FEIA] result of >15 kU/L..
- Patients will also be accepted into the study if they have a clinical reaction to peanut ingestion within the past 6 months, a positive skin prick test to peanut as defined previously, and an in vitro peanut IgE (CAP-FEIA) result of 7 kU/L or greater.
- Subjects must be free of any clinically significant disease which may interfere with study evaluations.
Exclusion Criteria:
- Use of antihistamines or decongestant therapy 7 days prior to the clinic visit. (antihistamines eg. diphenhydramine, desloratadine etc or throughout the desensitization phase of the study.
- Patients who had an acute allergic reaction to food other than peanut, drugs, or stinging insects one month prior to the recruitment clinic visit
- Patients who have had a respiratory infection one month prior to the recruitment clinic visit.
- Patients with significant or uncontrolled asthma, (inhaled corticosteroids (fluticasone >500 mcg per day, ciclesonide >400 mcg per day or budesonide >800 mcg per day or the corresponding combination inhalers, oral prednisone in the preceding 1 month and FEV1 < 80% predicted). Nasal steroids, bronchodilators and leukotriene inhibitors will be permitted. If Prednisone is taken, it must also be stopped 1 month prior to blood being drawn if possible.
- Patients who received allergy injections (immunotherapy) to environmental allergens at any time in the past. Symptomatic atopic dermatitis or chronic urticaria which may interfere with ability to evaluate oral immunotherapy and /or requiring daily medication including antihistamines.
- Patients with problems related to compliance or following study instructions. Inability to come to hospital every 2 weeks for dose escalation.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Oral Immunotherapy with placebo antihistamines
500 mg Peanut Protein with placebo antihistamines
|
500 mg
Other Names:
|
|
Placebo Comparator: Double Placebo
Placebo (Oat flour) and placebo antihistamines
|
500 mg Oat flour
|
|
Active Comparator: Oral Immunotherapy with H1 and H2 antihistamines
500 mg Peanut Protein with Dosage of desloratidine 5 ml po od (0.5mg/ml = 2.5 mg) and ranitidine be 5ml (15mg/ml=75 mg) po bid.
|
500 mg
Other Names:
Desloratidine 5 ml po od (0.5mg/ml = 2.5 mg) Ranitidine 5ml (15mg/ml=75 mg) po bid
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Adverse effects
Time Frame: 6-12 months
|
Frequency and risk of adverse events, overall and stratified by organ system and severity
|
6-12 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Health related quality of life pre and post intervention
Time Frame: 6-12 months
|
Pre and post OIT.
|
6-12 months
|
|
Eliciting doses to oral food challenge
Time Frame: 6-12 months
|
Patients will be challenged at the end of the treatment period with peanut at the end to determine the change from threshold that they are able to tolerate.
|
6-12 months
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Immunological changes/Mechanistic outcomes
Time Frame: 6-12 months
|
Various mechanistic outcomes/biomarkers
|
6-12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Susan Waserman, MD, McMaster University
- Principal Investigator: Susan Waserman, ME, McMaster University
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 (Actual)
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
- Immune System Diseases
- Food Hypersensitivity
- Hypersensitivity, Immediate
- Nut and Peanut Hypersensitivity
- Hypersensitivity
- Peanut Hypersensitivity
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Cholinergic Antagonists
- Cholinergic Agents
- Gastrointestinal Agents
- Anti-Ulcer Agents
- Histamine Agents
- Histamine H1 Antagonists, Non-Sedating
- Histamine H2 Antagonists
- Ranitidine
- Desloratadine
- Histamine H1 Antagonists
- Histamine Antagonists
Other Study ID Numbers
Other Study ID Numbers
- REB 07-348
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