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Predicting Peanut Anaphylaxis and Reducing Epinephrine

Not Applicable
Recruiting
Conditions
Anaphylaxis Food
Interventions
Device: Transepidermal water loss (TEWL) monitor and stopping rules
Device: Monitor (TEWL) without stopping rules
Registration Number
NCT05696236
Lead Sponsor
University of Michigan
Brief Summary

This research study is testing a new way to look for the early stages of anaphylaxis. Eligible participants will have a small monitor (transepidermal water loss) placed on the forearm during a food challenge (for peanut allergies). This monitor continuously records the amount of water lost through the skin.

In a previous study the team learned what values are associated with an anaphylactic reaction. These values are called "stopping rules." This study is looking at whether it can use these new stopping rules to end the oral food challenge before a person may show any symptoms.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Have a known history of food anaphylaxis to peanut confirmed by an allergist
  • Have had skin and blood food allergy testing to peanut within the past 12 months. Meet the 80% likelihood positive predictive value threshold for peanut allergy based on at least 1 of either the skin or blood immunoglobulin E (IgE) tests per current literature corrected for age.
  • Meet all clinical oral food challenge (OFC) requirements. This includes no asthma or atopic dermatitis exacerbations, no recent viral infections, no recent antibiotics, and no food allergy reactions in the past month.
Exclusion Criteria
  • Any known cardiovascular disease, cancer, pulmonary disease except well-controlled asthma, or other condition that would preclude an OFC otherwise.
  • Any medication use that would interfere with an OFC result. Medications in this category include antihistamines (first or second generation) within 1 week, omalizumab within 3 months, and others listed in the protocol appendix.
  • Any skin condition aside from well-controlled eczema that might impact TEWL measurement, including such conditions as autoimmune skin conditions (such as psoriasis), congenital ichthyoses, hyper-IgE syndromes.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Monitor (TEWL) and stopping rulesTransepidermal water loss (TEWL) monitor and stopping rulesWears the monitor, and the food challenge will be done using the new stopping rules to end the test.
Monitor (TWLG) without stopping rulesMonitor (TEWL) without stopping rulesWears the monitor, but the stopping rules will not be used to end the food challenge. The food challenge will be done following standard oral food challenge procedures.
Primary Outcome Measures
NameTimeMethod
Anaphylaxis occurrence rates in each groupApproximately 4-6 hours (Day 1 during the food challenge)

Any Brighton Level 1, 2, or 3 anaphylaxis.

Secondary Outcome Measures
NameTimeMethod
Reaction rates in each groupApproximately 4-6 hours (Day 1 during the food challenge)

Any objective symptom of allergic reaction occurs (e.g., hives, angioedema, vomiting, wheeze, etc) not rising to the definition of anaphylaxis.

Anaphylaxis severity in each groupApproximately 4-6 hours (Day 1 during the food challenge)

This will be graded on a scale of 1 to 5 (where 1 = mild, 5 = death)) according to criteria set forth in the Consortium for Food Allergy Research (CoFAR) Grading Scale.

Anaphylaxis likelihood in each group based on the Brighton scoreApproximately 4-6 hours (Day 1 during the food challenge)

The Brighton score gives a 0-3 score of anaphylaxis likelihood (0 = no anaphylaxis, 3 = highly likely).

Trial Locations

Locations (1)

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

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