Peanut Sublingual Immunotherapy (SLIT)-Tablet for Treatment of Peanut Allergy
- Conditions
- Peanut Allergy
- Interventions
- Other: Placebo
- Registration Number
- NCT05440643
- Lead Sponsor
- ALK-Abelló A/S
- Brief Summary
This clinical research study investigates the safety, tolerability and efficacy of a peanut SLIT-tablet in adults, adolescents, and children with peanut allergy.
- Detailed Description
This is a phase I/II, dose-escalation, multi-site trial including subjects with peanut allergy confirmed by screening double-blind, placebo-controlled food challenge. The trial is conducted in 3 parts; part 1 will determine the entry dose of the up-dosing regimen (UDR) in adults and adolescents; part 2 will characterize the tolerability of the up-dosing regimen in adults, adolescents and children; part 3 will evaluate the efficacy of 2 maintenance doses of the SLIT-tablet primarily in adolescents and children; a small number of adults may also be included.
Peanut SLIT tablets administered as 9 doses covering a 4000-fold increase in dose will be used in the study.
In part 1, subjects will receive a peanut SLIT-tablet with one of five doses once daily for 2 weeks.
In part 2, subjects will receive a series of increasing doses of the peanut SLIT-tablet, where each dose is taken once daily for 2 weeks. The entry dose for the up-dosing regimen will be determined from part 1.
In part 3, subjects will be randomized into 3 treatment groups (UDR and Maintenance A, UDR and Maintenance B, Placebo UDR and Placebo). Subjects will receive a series of increasing doses of the peanut SLIT-tablet , where each dose is taken once daily for 2 weeks, followed by Maintenance A or B once daily for 24 weeks; or the corresponding Placebo.
The trial will consist of up to 10 cohorts (part 1 is cohort 1-5; part 2 is cohort 6-10) and 3 treatment groups in part 3.
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 192
Not provided
Not provided
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Part 1: Cohort 5 Peanut SLIT-tablet Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks Part 2: Cohort 8 Peanut SLIT-tablet Children - UDR with once daily peanut SLIT-tablet Part 3: Maintenance B Peanut SLIT-tablet UDR B + maintenance dose B Part 2: Cohort 7 Peanut SLIT-tablet Adolescents - UDR with once daily peanut SLIT-tablet Part 3: Maintenance A Peanut SLIT-tablet UDR A + maintenance dose A Part 1: Cohort 1 Peanut SLIT-tablet Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks Part 1: Cohort 2 Peanut SLIT-tablet Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks Part 1: Cohort 3 Peanut SLIT-tablet Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks Part 1: Cohort 4 Peanut SLIT-tablet Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks Part 2: Cohort 6 Peanut SLIT-tablet Adults - UDR with once daily peanut SLIT-tablet Part 2: Cohort 9 Peanut SLIT-tablet Highly sensitized Adults/Adolescents - UDR with once daily peanut SLIT-tablet Part 2: Cohort 10 Peanut SLIT-tablet Highly sensitized Children - UDR with once daily peanut SLIT-tablet Part 3: Placebo Placebo Placebo UDR + placebo maintenance
- Primary Outcome Measures
Name Time Method Part 3: TD-600 response rate After 24 weeks of maintenance treatment, up to 48 weeks. The TD (tolerated dose)-600 response rate is defined as the percentage of subjects able to consume 600 mg (1044 mg cumulative) peanut protein without dose-limiting symptoms at the exit double-blind placebo-controlled food challenge (DBPCFC) after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.
Part 1 and 2: Dose tolerability response rate 2 weeks per dose The dose tolerability response rate is defined as the percentage of subjects who experience at most moderate local application site reactions after the last peanut SLIT-tablet intake of the dose step. Local application site reactions are treatment-related adverse events occurring in close proximity to the application site of the SLIT-tablet with a temporal relationship to tablet administration.
- Secondary Outcome Measures
Name Time Method Part 3: Maximum severity of symptoms at each challenge dose of peanut protein during DBPCFC At screening, 1 - 3 weeks, and after 24 weeks of maintenance treatment, up to 48 weeks. The highest severity of any symptom experienced at any challenge dose during the DBPCFC. Possible values are 0=none, 1=mild, 2=moderate or 3=severe.
Part 3: Response rate - use of epinephrine as rescue medication during exit DBPCFC After 24 weeks of maintenance treatment, up to 48 weeks. The response rate is defined as the percentage of subjects that receive epinephrine as rescue medication during the exit DBPCFC.
Part 1, 2 and 3: Treatment-emergent adverse events Part 1 and 2: 2 weeks per dose; Part 3: from first IMP intake to 7 days after last IMP intake, up to 48 weeks. An adverse event is any untoward medical occurrence in a clinical trial subject and which does not necessarily have a causal relationship with the administered investigational medicinal product (IMP). A treatment-emergent adverse event has a start date on or after the time of first IMP intake and no later than 7 days after the last IMP intake.
Part 3: TD-300 response rate After 24 weeks of maintenance treatment, up to 48 weeks. The TD-300 response rate is defined as the percentage of subjects able to consume 300 mg (444 mg cumulative) peanut protein without dose-limiting symptoms at the exit DBPCFC after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.
Part 3: TD-1000 response rate After 24 weeks of maintenance treatment, up to 48 weeks. The TD-1000 response rate is defined as the percentage of subjects able to consume 1000 mg (2044 mg cumulative) peanut protein without dose-limiting symptoms at the exit DBPCFC after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.
Part 3: TD-2000 response rate After 24 weeks of maintenance treatment, up to 48 weeks. The TD-2000 response rate is defined as the percentage of subjects able to consume 2000 mg (4044 mg cumulative) peanut protein without dose-limiting symptoms at the exit DBPCFC after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.
Part 3: Maximum tolerated dose of peanut protein during DBPCFC At screening, 1 - 3 weeks, and after 24 weeks of maintenance treatment, up to 48 weeks. The highest single challenge dose of peanut protein that a subject can consume without experiencing dose-limiting symptoms during the DBPCFC.
Trial Locations
- Locations (40)
Arkansas Children's Hospital
🇺🇸Little Rock, Arkansas, United States
Children's Hospital of Los Angeles - USC School of Medicine
🇺🇸Los Angeles, California, United States
UCLA - Pediatrics
🇺🇸Los Angeles, California, United States
Stanford University - Lucile Packard Children's Hospital
🇺🇸Palo Alto, California, United States
Peninsula Research Associates (PRA)
🇺🇸Rolling Hills Estates, California, United States
Eastern Virginia Medical School - Children's Hospital
🇺🇸San Diego, California, United States
Allergy & Asthma Clinical Research
🇺🇸Walnut Creek, California, United States
Children's Hospital Colorado
🇺🇸Aurora, Colorado, United States
Quality Research of South Florida
🇺🇸Hialeah, Florida, United States
MOORE-PH Dermatology - Clinical Research
🇺🇸Tampa, Florida, United States
Scroll for more (30 remaining)Arkansas Children's Hospital🇺🇸Little Rock, Arkansas, United States