- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00829985
Biomarker-based Cockroach Sublingual Immunotherapy Study (BioCSI)
A Biomarker-based Pilot Study of Cockroach Sublingual Immunotherapy in Cockroach Sensitive Adults With Asthma and/or Perennial Allergic Rhinitis (ICAC-12)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Over the last two decades, the prevalence of asthma has dramatically increased in many parts of the world. Currently, there are no effective ways to prevent the development of nasal allergies and asthma, and there are no cures for these diseases. Sublingual immunotherapy (SLIT) may help reduce symptoms of allergy and asthma. The purpose of this study is to evaluate the safety and efficacy of a cockroach extract given sublingually to adults with perennial (year-round) nasal allergies, asthma, or both.
At study entry, participants will receive a dose of placebo and then up to five incremental doses of cockroach extract or placebo at 15-minute intervals while observed by the clinical research staff. Doses will continue to be given until a sign or symptom occurs that indicates the participant is having difficulty tolerating the drug, or until the maximum study dose is reached.
For the next 6 months, participants will take the maximum study dose of cockroach extract or placebo daily at home.
This study will consist of 8 study visits. Skin tests, breathing tests, and blood collection will occur at study screening and other visits during the study. At study entry, participants will be taught to use an EpiPen in the event of a severe allergic reaction at any time during the study. A physical and oral exam, breathing test, and blood collection will occur at study entry and all follow-up visits.
Study Type
Enrollment (Actual)
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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Colorado
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Denver, Colorado, United States, 80206
- National Jewish Center
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Illinois
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Chicago, Illinois, United States, 60614
- Childrens Memorial Hospital
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Maryland
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Baltimore, Maryland, United States, 21287
- Johns Hopkins University School of Medicine
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Massachusetts
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Boston, Massachusetts, United States, 02118
- Boston University School Of Medicine
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- History of perennial allergic rhinitis, asthma, or both for a minimum of 1 year prior to study entry;
- Positive skin prick test to German cockroach;
- No known contraindications to therapy with glycerinated German cockroach allergenic extract or placebo; and
- Willing to sign the written Informed Consent prior to initiation of any study procedures.
Exclusion Criteria:
- Cannot perform spirometry at screening;
- Have clinically significant abnormal laboratory values;
- Have an Asthma classification of severe persistent at screening;
- Hospitalized for asthma within the 6 months prior to study entry;
- Life-threatening asthma exacerbation that required intubation, mechanical ventilation, or that resulted in a hypoxic seizure within the 2 years prior to study entry;
- No access to a telephone;
- Received allergen immunotherapy within the last 12 months prior to study entry and plan on initiating or resuming immunotherapy during the study;
- Treatment with anti-immunoglobulin E (anti-IgE) therapy within 1 year of study entry;
- Received an investigational drug within the 30 days prior to study entry and plan on using an investigational drug during the study;
- Experienced nausea, vomiting, abdominal pain or cramps, or diarrhea within the 3 months prior to study entry;
- Refuse to sign the Epinephrine Auto-injector Training Form;
- Does not primarily speak English;
- Plan to move from the area during the study period;
- History of idiopathic anaphylaxis or anaphylaxis grade 3;
- Using tricyclic antidepressants or beta-adrenergic blocker drugs;
- Clinically unacceptable complete blood count (CBC) and liver function tests, as defined by a hemoglobin less than 11.5 in males and 10.0 in females, or platelet counts less than 150,000 and an Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT) greater than twice the upper limit of normal;
- Any condition that, in the opinion of the investigator, would interfere with the study; or
- Pregnant or breastfeeding.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Glycerinated German Cockroach Allergenic Extract
Participants with German cockroach allergy and mild to moderate asthma, rhinitis, or both self-administered concentrated (1:20 weight per volume [w/v]) daily doses of glycerinated German cockroach allergenic extract (50% glycerin) placed under the tongue (sublingually) to dissolve.
The treatment course and study duration was 6 months.
Note: The extract was also administered during the preliminary dosing visits, up to five escalating doses, or until the maximum study dose (420 microliters, 1:20 w/v) was achieved.
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Concentrated (1:20 w/v) daily doses of glycerinated German cockroach allergenic extract placed under the tongue to dissolve.
The extract is also administered during the preliminary dosing visits in up to five escalating doses or until the maximum study dose (420 microliters, 1:20 w/v) is achieved.
|
Placebo Comparator: Placebo
Participants with German cockroach allergy and mild to moderate asthma, rhinitis, or both self-administered daily doses of placebo placed under the tongue (sublingually) to dissolve.
The treatment course and study duration was 6 months.
Note: The placebo was also administered during the preliminary dosing visits, up to five escalating doses, or until the maximum study dose (420 microliters, 1:20 weight per volume [w/v]) was achieved.
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Daily doses of cockroach allergenic extract placebo placed under the tongue to dissolve
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference 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.
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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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Difference 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.
This ratio is an indicator of immune modulation, 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 (30 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 sensitized donor incubated with 30 micrograms/mL of cockroach allergen extract in presence or absence of equal volume of sera from study participants to assess allergen-IgE binding.
(Presence of sera from those who previously received allergen-specific immunotherapy, viz., study participants post-baseline, expected to inhibit allergen-IgE complex binding.)
This change is an indicator of immune modulation, 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 (60 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 sensitized donor incubated with 60 micrograms/mL of cockroach allergen extract in presence or absence of equal volume of sera from study participants to assess allergen-IgE binding.
(Presence of sera from those who previously received allergen-specific immunotherapy, viz., study participants post-baseline, expected to inhibit allergen-IgE complex binding.)
This change is an indicator of immune modulation, however its clinical significance is unclear.
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Baseline through 6-months of treatment
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Percent of Participants With the Occurrence of Adverse Events (AE)
Time Frame: Participant enrollment to end of study (up to 6 months post-baseline)
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Percent of participants who experienced at least one adverse event
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Participant enrollment to end of study (up to 6 months post-baseline)
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Collaborators and Investigators
Collaborators
Publications and helpful links
General Publications
- Wood RA, Togias A, Wildfire J, Visness CM, Matsui EC, Gruchalla R, Hershey G, Liu AH, O'Connor GT, Pongracic JA, Zoratti E, Little F, Granada M, Kennedy S, Durham SR, Shamji MH, Busse WW. Development of cockroach immunotherapy by the Inner-City Asthma Consortium. J Allergy Clin Immunol. 2014 Mar;133(3):846-52.e6. doi: 10.1016/j.jaci.2013.08.047. Epub 2013 Nov 1.
- Ciprandi G, Contini P, Pistorio A, Murdaca G, Puppo F. Sublingual immunotherapy reduces soluble HLA-G and HLA-A,-B,-C serum levels in patients with allergic rhinitis. Int Immunopharmacol. 2009 Feb;9(2):253-7. doi: 10.1016/j.intimp.2008.11.009. Epub 2008 Dec 17.
- Passalacqua G, Pawankar R, Baena-Cagnani CE, Canonica GW. Sublingual immunotherapy: where do we stand? Present and future. Curr Opin Allergy Clin Immunol. 2009 Feb;9(1):1-3. doi: 10.1097/ACI.0b013e3283196a9b. No abstract available.
- Rolland JM, Gardner LM, O'Hehir RE. Allergen-related approaches to immunotherapy. Pharmacol Ther. 2009 Mar;121(3):273-84. doi: 10.1016/j.pharmthera.2008.11.007. Epub 2008 Dec 7.
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
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
- DAIT ICAC-12
- BioCSI (Other Identifier: NIAID)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Study Data/Documents
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Individual Participant Data Set
Information identifier: SDY223Information comments: ImmPort study identifier is SDY223.
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Study Protocol
Information identifier: SDY223Information comments: ImmPort study identifier is SDY223.
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Study summary, -design, -adverse event(s), -interventions, -medications, -demographics, -study files.
Information identifier: SDY223Information comments: ImmPort study identifier is SDY223.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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