Multi Immunotherapy to Test Tolerance and Xolair

Not Recruiting

Trial ID: NCT02626611

Purpose

This is a phase 2 randomized, double-blind, placebo controlled study which will be conducted at multiple centers in the U.S. All subjects will receive oral immunotherapy for their specific food allergies (limited to 5 of those food allergens in Investigational New Drug (IND) 14831). All subjects will receive Omalizumab for 16 weeks. The subject's allergens will be introduced in a rush desensitization day at week 8. Subjects will return to clinic to escalate the dose of their allergens until 2,000mg protein of each allergen is reached Subjects will return to clinic for a DBPCFC to each allergen at week 30. If subjects are nonreactive to 2 or more allergens during their DBPCFC at week 30 they will be randomized to one of three double blinded arms: Arm A- continue with current dose (2000 mg each food allergen protein), Arm B-300 mg of each food allergen protein, Arm C-placebo (avoiding food allergen protein), their current dose. All subjects will return to clinic for a DBPCFC to each allergen at week 36. The final challenge of week 36 will be the final end of study visit. Safety is a paramount concern in the study design and will be monitored carefully throughout the study. Study subjects and their parents/guardians will receive extensive education on food allergy reactions and medication use.

Official Title

A Phase 2 Study Multi Oral Immunotherapy in Multi Food Allergic Patients to Test Tolerance M-TAX Study

Eligibility


Inclusion Criteria:

   - Participant and/or parent guardian must be able to understand and provide informed
   consent and/or assent as applicable.

   - Age 4 to 55 years with moderate to severe allergy to milk and/or egg and/or peanut
   and/or almond and/or wheat and/or cashew and/or sesame seed and/or soy and/or pecan
   and/or walnut and/or hazelnut

   - Positive skin prick test result greater than or equal to 6 mm wheal diameter to each
   allergen OR

   - ImmunoCAP Immunoglobulin E (IgE) level >4 kilo Unit/Liter for each allergen and

   - A clinical reaction during a DBPCFC to small doses of food defined as < dose of 500 mg
   food protein

   - No clinical reaction observed during the placebo (oat) challenge and

   - If female, must have a negative urine pregnancy test on the same day (using a Clinical
   Laboratory Improvement Amendment (CLIA) approved urine test)

   - If female, of child-bearing potential, must agree to be compliant with a
   medically-approved method of contraception (please see Pregnancy section under Patient
   Disposition in this protocol)

   - Plan to remain in the study area of the research center during the trial

   - Be trained on the proper use of the Epinephrine autoinjector

   - Avoid open or blinded food challenges to other allergens outside this study

Exclusion Criteria:

   - Inability or unwillingness of a participant/parent/guardian to give written informed
   consent or comply with study protocol

   - History of cardiovascular disease

   - History of other chronic disease (other than asthma, atopic dermatitis, or rhinitis)
   requiring therapy (e.g., heart disease, diabetes) that, in the opinion of the
   Principal Investigator, would represent a risk to the participant's health or safety
   in this study or the participant's ability to comply with the study protocol

   - A total IgE at screening of >2,000 kU/L

   - Previous adverse reaction to Xolair

   - A history of severe anaphylaxis (defined as requiring intubation or admission to an
   ICU) to food allergens that will be used in this study

   - Unstable angina, significant arrhythmia, uncontrolled hypertension, current smokers,
   chronic sinusitis, or other chronic or immunological diseases that, in the judgment of
   the investigator, might interfere with the evaluation or administration of the test
   drug or pose additional risk to the participant.

   - Current use of oral, intramuscular, or intravenous corticosteroids, tricyclic
   antidepressants, or betablockers (oral or topical)

   - Routine use of medication that could induce adverse gastrointestinal reactions during
   the study

   - Refusing to sign the Epinephrine autoinjector Training Form

   - Pregnant or breast feeding women

   - A history of oat allergy (since oat is the placebo agent in the DBPCFC), or an
   objective reaction to the screening DBPCFC to oat

   - Unwilling to avoid all food allergen-containing items except those given as part of
   the Oral Immunotherapy as well as any other food allergens you are allergic to that
   are not included in the 10 foods listed in the study

   - Concurrent/prior use of immunomodulatory therapy (within 1 month) ie, omalizumab,
   nontraditional forms of allergen immunotherapy (e.g., oral or sublingual)

   - Severe asthma (2007 National Heart Lung and Blood Institute (NHLBI) Criteria Steps 5
   or 6) at time of enrollment

   - Mild or moderate asthma (2007 NHLBI Criteria Steps 1-4) at time of enrollment with any
   of the following criteria met:

   - Forced Expiratory Volume at one second (FEV1) < 80% of predicted, or FEV1/Forced Vital
   Capacity (FVC) < 75%, with or without controller medications (only for age 6 or
   greater and able to do spirometry) or

   - Inhaled Corticosteroid (ICS) dosing of > 220 mcg daily fluticasone (or equivalent
   inhaled corticosteroids based on NHLBI dosing chart) or

   - 1 hospitalization in the past year for asthma or ER visit for asthma within the past
   six months

   - Use of steroid medications (Intravenous (IV), Intramuscular (IM) or oral) in the
   following manners

   - history of daily oral steroid dosing for >1 month during the past year or

   - steroid burst course ( 5 or more days) of 1 mg/kg prednisone) course in the past 3
   months or

   - >2 steroid burst courses in the past year

   - Use of complementary and alternative medicine (CAM) treatment modalities (e.g., herbal
   remedies) for atopic and/or non-atopic disease within 90 days preceding rush
   desensitization at week 8or at any time .

   - Inability to discontinue antihistamines for the initial day of escalation, skin
   testing or Oral Food Challenges (OFCs)

   - Use of investigational drugs within 24 weeks of participation

   - Past or current medical problems or findings from physical assessment or laboratory
   testing that are not listed above, which, in the opinion of the investigator, may pose
   additional risks from participation in the study, may interfere with the participant's
   ability to comply with study requirements or that may impact the quality or
   interpretation of the data obtained from the study.

Intervention(s):

drug: Omalizumab

drug: Food Flour Buildup

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305