- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01822353
The Effect of Per Oral Immunotherapy in Severe IgE Mediated Egg, Milk, and Nut Allergy in Adults
The Effect of Per Oral Immunotherapy in Severe IgE Mediated Egg, Milk and Nut Allergy in Adults
In Finland, the estimated prevalence of physician-diagnosed food allergy in 1-4 year old children is 9%, and the most common allergen is milk. The overall food allergy has been reported to be 3.7%. Hen's egg allergy is among the most common food allergies in childhood. In addition, it predicts later development of allergic disease such as asthma. Most of the egg and milk allergy is transient and disappears in childhood. Currently, the standard of care for food allergy includes strict allergen avoidance. However, oral immunotherapy has been under investigation in children milk, egg, and wheat allergy. Previously, induction of clinical egg tolerance has been reported with egg oral immunotherapy in children aged from 3 to 13 years. In adults, strict avoidance is still the standard care but there is also growing interest in treatment of severe food allergy with oral immunotherapy or anti-IgE.
The investigators aim to analyse the results of per oral immunotherapy treatment in severe IgE-mediated egg, milk, and nut allergy in adults.
Could severe egg, milk and nut allergy be treated with oral immunotherapy treatment in stead of total allergen avoidance and could desensitization thus be achieved?
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Up to 100 subjects are studied. All subjects are adults having no other severe chronic diseases. The subjects belong to four different groups:
- 30 18-50 year olds who start per oral immunotherapy treatment in severe egg allergy.
- 30 18-50 year olds who start per oral immunotherapy treatment in severe milk allergy.
- 30 18-50 year olds who start per oral immunotherapy treatment in severe nut allergy.
- 10 milk allergic 18-50 year olds that have been treated as pilot patients with milk hyposensitisation treatment.
The diagnosis of milk or egg allergy is verified with positive history, skin prick test, egg, milk and nut allergen specific IgE antibodies. In addition, food allergy is verified with an allergen specific challenge test.
Atopic subjects may have simultaneously other allergies. Intermittent mild asthma, and mild and moderate persistent asthma are tolerated and treatment with inhaled steroids and other asthma medication is allowed. Atopic subjects may have additional skin symptoms. Quality of life, anxiety and patient history data is collected by questionnaires. All patients undergo a spirometry with a bronchodilatation test, fractional exhaled nitric oxide and a methacholine challenge before and a year after oral immunotherapy. Those with test results diagnostic for asthma are treated with asthma medication before hyposensitisation treatment is started.
Exclusion criteria: adults with instable cerebrovascular or heart disease, active autoimmune disease or cancer, or use of betablocker agents. In addition, poorly controlled asthma or FEV1 < 70% are not tolerated.
In oral immunotherapy, increasing doses are given first observed, and then daily at home. If the subject does not tolerate a given dose and symptoms are mild, then that dose or the previously tolerated one is repeated, and the protocol proceeds as outlined. If the subject experiences significant symptoms, then the protocol is stopped, and the highest tolerated dose is used as the starting daily one.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Helsinki, Finland, 00029
- Helsinki University Central Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- severe IgE-mediated milk allergy or
- severe IgE-mediated egg allergy or
- severe IgE-mediated nut allergy or
- 18-50 years
Exclusion Criteria:
- instable cerebrovascular or heart disease
- active autoimmune disease or cancer
- use of betablocker agents
- poorly controlled asthma
- FEV1 < 70% of the predicted
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Milk allergy
Dietary supplement, milk in increasing dosages, delivered daily and orally.
|
Milk, egg or nut oral immunotherapy
Other Names:
|
EXPERIMENTAL: Egg allergy
Dietary supplement, egg protein given in increasing dosages, delivered daily and orally.
|
Milk, egg or nut oral immunotherapy
Other Names:
|
EXPERIMENTAL: Nut allergy
Dietary supplement, nut cream including nut allergens, delivered in increasing dosages, daily and orally.
|
Milk, egg or nut oral immunotherapy
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of the Patients That Achieve Higher Tolerance of Allergen With Immunotherapy
Time Frame: One year
|
Number of the patients that achieve higher tolerance of allergen with immunotherapy in one year than the measured baseline allergen challenge shows.
|
One year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Effect of Therapy on Lung Function.
Time Frame: One year
|
Does hyposensitisation change lung function (do spirometry tests show difference from the baseline values (= before immunotherapy) after the immunotherapy) ?
|
One year
|
Does Oral Immunotherapy Change Bronchial Hyperreactivity?
Time Frame: One year
|
Does bronchial hyperreactivity (measured with methacholine bronchial challenge test) show change from the baseline level after the immunotherapy?
|
One year
|
Does the Oral Immunotherapy Have en Effect on Airway Inflammation?
Time Frame: One year
|
Does the oral immunotherapy change exhaled nitric oxide levels (measured before and after immunotherapy)
|
One year
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Safety of Oral Immunotherapy in Severe IgE Mediated Food Allergy in Adults.
Time Frame: One year
|
How many of the patients have side effects (categorized as mild, moderate or severe)of the hyposensitisation and how many of the patients discontinue the therapy because of side effects?
|
One year
|
Effect of Treatment on Quality of Life
Time Frame: one year
|
Quality of life is assessed by a questionnaire before and after immunotherapy (VAS scale on worries on allergy 0-100, 0 no worries, 100 maximal worries).
|
one year
|
Collaborators and Investigators
Investigators
- Study Director: Mika J Mäkelä, MD, PhD, Helsinki University Central Hospital
Study record dates
Study Major Dates
Study Start (ACTUAL)
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
Other Study ID Numbers
- HUS21813030112
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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