- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04027465
Egg Allergy Oral Desensitization
Egg Desensitization and Induction of Tolerance in Children
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The investigators are proposing to initiate a study assessing a common desensitization protocol for egg allergy. This study would enable the investigators to better determine the potential benefit of desensitization in individuals with egg allergy.
More specifically, the investigators will address the following research objectives:
Objectives A. To develop a protocols for egg desensitization
B. To determine the rate of desensitization to egg.
C. To characterize predictors of successful desensitization.
D. To characterize molecular mechanisms involved in the process of desensitization
These objectives will be evaluated through a randomized controlled trial
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Quebec
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Montreal, Quebec, Canada, H4A 3J1
- Montreal Children's Hospital
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Montreal, Quebec, Canada, H4A3J1
- Duncan Lejtenyi
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Children 6 years and older
- Informed consent form signed by the parents or legal guardian (appendix B).
- A history suggestive of immediate allergy to egg. A convincing clinical history of an IgE mediated reaction to a specific food will be defined as a minimum of 2 mild signs/symptoms or 1 moderate or 1 severe sign/symptom that was likely IgE mediated and occurred within 120 minutes after ingestion or contact (or inhalation in the case of fish and shellfish). Reactions will be considered mild if they involve pruritus, urticaria, flushing, or rhinoconjunctivitis; moderate if they involve angioedema, throat tightness, gastrointestinal complaints, or breathing difficulties (other than wheeze); and severe if they involve wheeze, cyanosis, or circulatory collapse
- Positive oral challenge test to egg. Oral challenges will be performed with Meringue Powder according to the recommendations of the position paper of the European Academy of Allergology and Clinical Immunology (68)and in an open manner (appendix C). When subjective symptoms will appear (oral pruritus, abdominal discomfort), the challenge tests will be blinded.
The presence of at least one of the following confirmatory tests:
i) Positive SPT to egg or its proteins (weal diameter 3 mm larger than that of the normal saline control). The allergens used will be commercial extracts of egg (Omega Labs, Toronto, Ontario). OR ii) Detection of serum specific IgE (>0.35 kU/L) to egg or any of its proteins (ovalbumin, ovomucoid, lysozyme and conalbumin), measured by fluorescence enzyme immunoassay (Phadia, CAP System, Uppsala, Sweden).
Exclusion criteria.
- Patients who are unstable from a respiratory point of view ..
- Patients who present with intercurrent disease at the time of starting desensitization.
- Non-IgE-mediated or non-immunological adverse reactions to nuts.
- Malignant or immunopathological diseases and/or severe primary or secondary immune deficiencies.
- Patients receiving immunosuppressor therapy
- Patients receiving β-blockers (including topical formulations).
- Associated diseases contraindicating the use of epinephrine: cardiovascular disease or severe hypertension.
- Patients diagnosed with eosinophilic gastrointestinal disorder .
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
NO_INTERVENTION: Control
Following randomization, this arm will receive no intervention.
After twelve months, participants in this group will undergo a singe-blind, placebo-controlled oral food challenge
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EXPERIMENTAL: Treatment
Following randomization, participants in this group will receive escalating doses of egg protein, up to a dose of 300 mg.
Once they attain that dose, they will maintain it for six months.
At the end of this maintenance period, they will undergo a singe-blind, placebo-controlled oral food challenge
|
Subjects in the treatment will begin treatment by undergoing an egg oral challenge.
This will confirm that the subject is still allergic to egg and establish the dose of egg the subject can tolerate.
The last dose of egg tolerated during the challenge will serve as the first desensitization dose Subjects will then come to the research center every two weeks to receive their dose increases until they reach the maintenance dose of 300 mg.
Subjects will then enter the maintenance phase for one year.
During this period they will undergo another oral food challenge one month after attaining the maintenance dose
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Efficacy of desensitization in egg allergic patients as assessed by presence or absence of allergic symptoms during a blinded, placebo controlled oral food challenge
Time Frame: 18 months
|
Comparison of participants randomized to treatments arms who egg desensitization compared to participants randomized to the control group.
This is measured by whether a participant is able to tolerate a total dose of 6043 mg powdered egg during an oral food challenge
|
18 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from baseline over the immunotherapy process of Regulatory T cell levels
Time Frame: 18 months
|
Measurement of Regulatory T cell levels, before, during and after the desensitization process
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18 months
|
Change from baseline over the immunotherapy process of egg specigic IgE levels
Time Frame: 18 months
|
Measurement of egg specigic IgE before, during and after the desensitization process
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18 months
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Change from baseline over the immunotherapy process of egg specigic IgA levels
Time Frame: 18 months
|
Measurement of egg specigic IgA before, during and after the desensitization process
|
18 months
|
Change from baseline over the immunotherapy process of egg specigic IgG4 levels
Time Frame: 18 months
|
Measurement of egg specigic IgG4 before, during and after the desensitization process
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18 months
|
Change from baseline over the immunotherapy process of mast cell activation, as measured by CD63 levels
Time Frame: 18 months
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Measurement of mast cell activation before, during and after the desensitization process as measured by CD63 expression
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18 months
|
Change from baseline over the immunotherapy process of of DNA methylation levels
Time Frame: 18 months
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Measurement of DNA methylation levels before, during and after the desensitization process
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18 months
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2017-3182
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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