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Real-World AR101 Market-Supporting Experience Study in Peanut-Allergic Children (RAMSES)

Phase 3
Completed
Conditions
Peanut Allergy
Interventions
Biological: Placebo
Biological: AR101
Registration Number
NCT03126227
Lead Sponsor
Aimmune Therapeutics, Inc.
Brief Summary

This is a multicenter, randomized, double-blind, placebo-controlled safety study of AR101 using the characterized oral desensitization immunotherapy (CODIT™) regimen in peanut-allergic children.

Detailed Description

The primary objective is to assess the safety and tolerability of AR101 when used in a CODIT™ regimen for approximately 6 months in peanut-allergic children children aged 4 to 17 years, inclusive.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
506
Inclusion Criteria
  • Ages 4 to 17 years, inclusive
  • History of physician-diagnosed peanut allergy that includes allergic signs and symptoms within two hours of known oral exposure to peanut
  • Mean peanut wheal diameter on SPT of at least 8mm and elevated psIgE of at least 14 kUA/L at screening
  • Written informed consent from the subject's parent/guardian
  • Written assent from the subject as appropriate (per local regulatory requirements)
  • Use of effective birth control by sexually active female subjects of childbearing potential

Key

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Exclusion Criteria
  • Subjects in whom the clinical diagnosis of peanut allergy is uncertain
  • Severe or uncontrolled asthma
  • History of cardiovascular disease, including uncontrolled or inadequately controlled hypertension
  • History of severe or life-threatening episode of anaphylaxis or anaphylactic shock within 60 days of screening
  • History of eosinophilic esophagitis (EoE), other eosinophilic gastrointestinal disease, chronic, recurrent, or severe gastroesophageal reflux disease (GERD), symptoms of dysphagia or recurrent gastrointestinal symptoms of undiagnosed etiology
  • History of a mast cell disorder, including mastocytosis, urticaria pigmentosa, chronic idiopathic or chronic physical urticaria beyond simple dermatographism (e.g., cold urticaria, cholinergic urticaria), and hereditary or idiopathic angioedema
  • Any other condition that, in the opinion of the Investigator, precludes participation for reasons of safety
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo powderPlaceboPlacebo formulation in pull-apart capsules containing only excipients color-matched to AR101 study product.
AR101 Powder Provided in CapsulesAR101Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol
Primary Outcome Measures
NameTimeMethod
Frequency of Treatment Emergent Adverse Events, Including Serious Adverse EventsApproximately 6 months

Frequency of Treatment Emergent Adverse Events, including Serious Adverse Events, during the overall study period.

Treatment-emergent adverse events were defined as adverse events with onset after the first dose of study product.

Secondary Outcome Measures
NameTimeMethod
Frequency of Allergic Hypersensitivity Adverse Events Normalized for Duration of TreatmentApproximately 6 months
Frequency of Premature Discontinuation of Dosing Due to Adverse EventsApproximately 6 months
Frequency of Premature Discontinuation of Dosing Due to Chronic/Recurrent Gastrointestinal Adverse EventsApproximately 6 months
Proportion of Chronic/Recurrent Gastrointestinal Adverse Events Resolving <2, Between 2-4, Between 4-12, and ≥ 12 Weeks Following Discontinuation of DosingApproximately 6 months
Frequency of Anaphylaxis as Defined in the ProtocolApproximately 6 months

Anaphylaxis is likely when any 1 of the 3 following sets of criteria is fulfilled:

1. Acute onset of an illness (minutes to hours) with involvement of: (a) Skin/mucosal tissue (eg, generalized hives, itch/flush, swollen lips/tongue/uvula); AND (b) Airway compromise (eg, dyspnea, stridor, wheeze/bronchospasm, hypoxia, reduced PEFR); AND/OR (c) Reduced BP or associated symptoms (eg, hypotonia, syncope, incontinence).

2. Two or more of the following that occur rapidly after exposure to the allergen (minutes to hours): (a) Skin/mucosal tissue; (b) Airway compromise; (c) Reduced BP or associated symptoms; (d) Persistent GI symptoms (eg, nausea, vomiting, crampy abdominal pain).

3. Reduced BP after exposure to the allergen (minutes to hours). Infants and children: low systolic BP (age-specific) or \> 30% drop in systolic BP; Adults: systolic BP \< 90 mm Hg or \> 30% drop from their baseline.

Frequency of Epinephrine Use as Rescue MedicationApproximately 6 months
Frequency of Accidental Ingestion of Peanut and Other Allergenic FoodsApproximately 6 months
Change of Asthma Control Using the Asthma Control Test (ACT) Questionnaire Total Score From Baseline to Interim (80 mg), End of Up-Dosing (300 mg) and Study Exit, Ages 4-11Baseline, Interim dose (approx. 10 weeks), End of Up-Dosing (20 to 40 weeks), Study Exit (14 days after End of Up-Dosing, usually approx. 6 months)

The Asthma Control Test (ACT) Questionnaire ACT for subjects aged 4-11 years included 4 questions for the subject and 3 questions for the parent; the total score (sum of 7 questions) ranged from 0 (worst control) to 27 (total control)

Change of Asthma Control Using the Asthma Control Test (ACT) Questionnaire Total Score From Baseline to Interim (80 mg), End of Up-Dosing (300 mg) and Study Exit, Ages 12-17Baseline, Interim dose (approx. 10 weeks), End of Up-Dosing (20 to 40 weeks), Study Exit (14 days after End of Up-Dosing, usually approx. 6 months)

The Asthma Control Test (ACT) Questionnaire ACT for subjects aged 12-17 years consisted of 5 questions, and the total score (sum of 5 questions) ranged from 5 (worst control) to 25 (total control).

Frequency of Adverse Events That Led to Early WithdrawalApproximately 6 months

Trial Locations

Locations (67)

Children's Hospital Los Angeles, Division of Clinical Immunology and Allergy

🇺🇸

Los Angeles, California, United States

Sean N. Parker Center for Allergy Research, LPCH at El Camino Hospital

🇺🇸

Mountain View, California, United States

UCLA Medical Center, Santa Monica

🇺🇸

Santa Monica, California, United States

Atlanta Allergy & Asthma Clinic, PA

🇺🇸

Marietta, Georgia, United States

Ann & Robert H. Lurie's Children's Hospital of Chicago

🇺🇸

Chicago, Illinois, United States

Chesapeake Clinical Research, Inc.

🇺🇸

Baltimore, Maryland, United States

Johns Hopkins Hospital, Pediatric Clinical Research Unit

🇺🇸

Baltimore, Maryland, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

Children's Hospital of Philadelphia: Allergy/Immunology

🇺🇸

Philadelphia, Pennsylvania, United States

Children's Health

🇺🇸

Dallas, Texas, United States

Cheema Research Inc. (CRI)

🇨🇦

Mississauga, Ontario, Canada

Medical Research of Arizona

🇺🇸

Scottsdale, Arizona, United States

Banner University of Arizona Medical Center

🇺🇸

Tucson, Arizona, United States

Jonathan Corren, M.D., Inc.

🇺🇸

Los Angeles, California, United States

Allergy & Asthma Associates of Southern California

🇺🇸

Mission Viejo, California, United States

Peninsula Research Associates, Inc.

🇺🇸

Rolling Hills Estates, California, United States

Allergy & Asthma Associates of Santa Clara Valley Research Center

🇺🇸

San Jose, California, United States

Allergy and Asthma Clinical Research, Inc.

🇺🇸

Walnut Creek, California, United States

Asthma & Allergy Associates, PC

🇺🇸

Colorado Springs, Colorado, United States

Sher Allergy Specialists - Center for Cough

🇺🇸

Largo, Florida, United States

Children's National Health System

🇺🇸

Washington, District of Columbia, United States

Allergy Associates of the Palm Beaches

🇺🇸

North Palm Beach, Florida, United States

Sarasota Clinical Research

🇺🇸

Sarasota, Florida, United States

The University of Chicago Medicine, Comer Children's Hospital

🇺🇸

Chicago, Illinois, United States

Sneeze, Wheeze, & Itch Associates, LLC

🇺🇸

Normal, Illinois, United States

Idaho Allergy and Research

🇺🇸

Eagle, Idaho, United States

Deaconess Clinic Downtown

🇺🇸

Evansville, Indiana, United States

University of Iowa

🇺🇸

Iowa City, Iowa, United States

Family Allergy & Asthma Research Institute

🇺🇸

Louisville, Kentucky, United States

University of Michigan Health System / Michigan Medicine

🇺🇸

Ann Arbor, Michigan, United States

Children's Mercy on Broadway

🇺🇸

Kansas City, Missouri, United States

Clinical Research Institute, Inc.

🇺🇸

Plymouth, Minnesota, United States

Nebraska Medical Research Institute, Inc.

🇺🇸

Bellevue, Nebraska, United States

Atlantic Research Center, LLC

🇺🇸

Ocean City, New Jersey, United States

Northwell Health System

🇺🇸

Great Neck, New York, United States

Princeton Center for Clinical Research

🇺🇸

Skillman, New Jersey, United States

University of North Carolina at Chapel Hill, Clinical & Translational Research Center (CTRC)

🇺🇸

Chapel Hill, North Carolina, United States

Clinical Research of Charlotte

🇺🇸

Charlotte, North Carolina, United States

National Allergy and Asthma Research, LLC

🇺🇸

Charleston, North Carolina, United States

Columbia Asthma & Allergy Clinic

🇺🇸

Clackamas, Oregon, United States

Dell Children's Medical Group / Allergy, Asthma & Immunology Clinic

🇺🇸

Austin, Texas, United States

Western Sky Medical Research

🇺🇸

El Paso, Texas, United States

Triple A Lab (Hamilton Allergy)

🇨🇦

Hamilton, Ontario, Canada

Central Texas Health Research

🇺🇸

New Braunfels, Texas, United States

McMaster University Medical Center

🇨🇦

Hamilton, Ontario, Canada

Gordon Sussman Clinical Research

🇨🇦

Toronto, Ontario, Canada

Ottawa Allergy Research Corp.

🇨🇦

Ottawa, Ontario, Canada

Allergy & Asthma Medical Group and Research Center, A.P.C

🇺🇸

San Diego, California, United States

Rady Children's Hospital San Diego

🇺🇸

San Diego, California, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Bernstein Clinical Research Center

🇺🇸

Cincinnati, Ohio, United States

Texas Children's Hospital / Baylor College of Medicine

🇺🇸

Houston, Texas, United States

Biogenics Research Institute

🇺🇸

San Antonio, Texas, United States

Sylvana Research Associates

🇺🇸

San Antonio, Texas, United States

Virginia Mason Medical Center

🇺🇸

Seattle, Washington, United States

ASTHMA Inc. Clinical Research Center

🇺🇸

Seattle, Washington, United States

University of California, San Francisco

🇺🇸

San Francisco, California, United States

Clinical Research Center of Alabama

🇺🇸

Birmingham, Alabama, United States

National Jewish Health

🇺🇸

Denver, Colorado, United States

Colorado Allergy & Asthma Centers

🇺🇸

Denver, Colorado, United States

Oklahoma Institute of Allergy and Asthma Clinical Research, LLC

🇺🇸

Oklahoma City, Oklahoma, United States

Baker Allergy, Asthma and Dermatology Research Center

🇺🇸

Portland, Oregon, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Children's Hospital Colorado

🇺🇸

Aurora, Colorado, United States

University of South Florida Asthma, Allergy, and Immunology Clinical Research Unit

🇺🇸

Tampa, Florida, United States

Arkansas Children's Hospital

🇺🇸

Little Rock, Arkansas, United States

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