Omalizumab (Xolair) and Allergy Shots For the Treatment of Seasonal Allergies

NCT ID: NCT00078195

Last Updated: 2016-10-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

168 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-04-30

Study Completion Date

2005-05-31

Brief Summary

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A series of allergy shots may reduce symptoms of seasonal ragweed allergies. This study will determine whether taking a drug called omalizumab (also known as Xolair) before getting the allergy shots is more effective than allergy shots alone or other treatments, such as prescription antihistamines.

Detailed Description

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Allergic rhinitis affects 20 to 40 million Americans annually. Allergy symptoms, which can range from mild to seriously debilitating, may affect quality of life. Left untreated, allergic rhinitis can exacerbate or trigger more serious conditions, such as asthma and sinus inflammation.

Individuals with allergies react to harmless particles such as dust or pollen. Proteins in the blood called IgE antibodies treat the harmless particles as invaders and trigger an immune system response. The immune response results in harmful inflammation of healthy tissues. In ragweed allergy, inflammation occurs in the airways and causes familiar allergy symptoms like sneezing, coughing, and general discomfort.

Omalizumab is an investigational drug that has been shown to block the effects of IgE antibodies. The blocking effect of omalizumab is temporary, but giving the drug to people before their regular allergy shots may make the shots more effective.

Participants in this study will be randomly assigned to receive injections of omalizumab or a placebo before an accelerated course of allergy shots (given over 12 weeks). The participants will return for follow-up for up to one year, and they may have as many as 27 study visits.

Conditions

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Hay Fever Hypersensitivity Allergy Rhinitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Study Groups

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Omalizumab pre-treatment, ragweed RIT, omalizumab + ragweed IT

Participants are pre-treated with omalizumab followed by ragweed rush immunotherapy (RIT) followed by dual therapy with omalizumab plus ragweed immunotherapy (IT).

Group Type EXPERIMENTAL

omalizumab

Intervention Type BIOLOGICAL

A minimum equivalent dose of 0.016 mg/kg/IgE (IU/mL) every 4 weeks will be administered. Omalizumab is administered in two separate phases. In the pre-treatment period omalizumab will be administered to condition the participants to an immune tolerance state. Omalizumab will be also administered after RIT and during the maintenance immunotherapy phase.

Ragweed rush immunotherapy (RIT)

Intervention Type BIOLOGICAL

RIT will consist of a series of injections containing ragweed extract. The series of injections will have progressively greater amounts of ragweed extract: starting from the 1:1000 dilution of the maintenance vial and progressing to the 0.3 mL of 1:10 dilution of the maintenance vial or the maximally tolerated amount.

Ragweed immunotherapy (IT)

Intervention Type BIOLOGICAL

Participants will receive weekly maintenance IT dosing for a total of 12 weeks.

Omalizumab pre-treatment, omalizumab

Participants are pre-treated with omalizumab followed by placebo rush immunotherapy (RIT), followed by dual therapy with Omalizumab plus placebo immunotherapy (IT).

Group Type EXPERIMENTAL

omalizumab

Intervention Type BIOLOGICAL

A minimum equivalent dose of 0.016 mg/kg/IgE (IU/mL) every 4 weeks will be administered. Omalizumab is administered in two separate phases. In the pre-treatment period omalizumab will be administered to condition the participants to an immune tolerance state. Omalizumab will be also administered after RIT and during the maintenance immunotherapy phase.

Placebo rush immunotherapy (RIT)

Intervention Type BIOLOGICAL

The placebo for rush immunotherapy will contain the diluents and histamine.

Placebo immunotherapy (IT)

Intervention Type BIOLOGICAL

The placebo for immunotherapy will contain the diluents and histamine.

Ragweed RIT, ragweed IT

Participants are pre-treated with placebo omalizumab followed by ragweed rush immunotherapy (RIT), followed by dual therapy with placebo omalizumab plus ragweed immunotherapy (IT).

Group Type ACTIVE_COMPARATOR

Placebo omalizumab

Intervention Type BIOLOGICAL

The placebo for omalizumab will contain the excipients and diluents of the omalizumab.

Ragweed rush immunotherapy (RIT)

Intervention Type BIOLOGICAL

RIT will consist of a series of injections containing ragweed extract. The series of injections will have progressively greater amounts of ragweed extract: starting from the 1:1000 dilution of the maintenance vial and progressing to the 0.3 mL of 1:10 dilution of the maintenance vial or the maximally tolerated amount.

Ragweed immunotherapy (IT)

Intervention Type BIOLOGICAL

Participants will receive weekly maintenance IT dosing for a total of 12 weeks.

Placebo

Participants are pre-treated with placebo omalizumab followed by placebo rush immunotherapy (RIT), followed by dual therapy with placebo omalizumab plus placebo immunotherapy (IT).

Group Type PLACEBO_COMPARATOR

Placebo omalizumab

Intervention Type BIOLOGICAL

The placebo for omalizumab will contain the excipients and diluents of the omalizumab.

Placebo rush immunotherapy (RIT)

Intervention Type BIOLOGICAL

The placebo for rush immunotherapy will contain the diluents and histamine.

Placebo immunotherapy (IT)

Intervention Type BIOLOGICAL

The placebo for immunotherapy will contain the diluents and histamine.

Interventions

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omalizumab

A minimum equivalent dose of 0.016 mg/kg/IgE (IU/mL) every 4 weeks will be administered. Omalizumab is administered in two separate phases. In the pre-treatment period omalizumab will be administered to condition the participants to an immune tolerance state. Omalizumab will be also administered after RIT and during the maintenance immunotherapy phase.

Intervention Type BIOLOGICAL

Placebo omalizumab

The placebo for omalizumab will contain the excipients and diluents of the omalizumab.

Intervention Type BIOLOGICAL

Ragweed rush immunotherapy (RIT)

RIT will consist of a series of injections containing ragweed extract. The series of injections will have progressively greater amounts of ragweed extract: starting from the 1:1000 dilution of the maintenance vial and progressing to the 0.3 mL of 1:10 dilution of the maintenance vial or the maximally tolerated amount.

Intervention Type BIOLOGICAL

Placebo rush immunotherapy (RIT)

The placebo for rush immunotherapy will contain the diluents and histamine.

Intervention Type BIOLOGICAL

Ragweed immunotherapy (IT)

Participants will receive weekly maintenance IT dosing for a total of 12 weeks.

Intervention Type BIOLOGICAL

Placebo immunotherapy (IT)

The placebo for immunotherapy will contain the diluents and histamine.

Intervention Type BIOLOGICAL

Other Intervention Names

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Xolair™ anti-Immunoglobulin E (IgE)

Eligibility Criteria

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Inclusion Criteria

* Able to comprehend and grant a witnessed, written informed consent prior to any study procedures.
* Female participants of child bearing age must have a negative urine pregnancy test at Screening Visit and subsequent visits. In addition, female participants must be using a medically acceptable form of birth control.
* History of seasonal allergic rhinitis for at least 2 years with symptoms during the ragweed pollen season requiring pharmacotherapy.
* A positive skin test by prick method to ragweed pollen at the Screening Visit. A positive skin prick test will be defined as a ragweed pollen-induced wheal greater than 3 mm larger in diameter than diluent control (measurements will be made 15-20 minutes after application).
* Must be capable of faithfully completing the diary and of attending regularly scheduled study visits.
* Must intend to remain in the ragweed pollen area during the entire ragweed season.
* Willing to avoid prohibited medications for the periods indicated in the protocol.
* Participants must meet pretrial eligibility requirements for trial enrollment (acceptable medical history, physical examination results, normal electrocardiogram and acceptable laboratory test results).
* Participants must have a baseline serum Immunoglobulin E (IgE) level greater than 10 and less than 700 IU/mL.

Exclusion Criteria

* weigh less than 30 kg or more than 120 kg.
* pregnant or lactating.
* history of severe anaphylactoid (non-IgE mediated) or anaphylactic reactions).
* history of immunotherapy within the past 10 years, if received one full year of immunotherapy, or within the past 5 years if received less than one year of immunotherapy.
* known hypersensitivity to trial rescue medication (fexofenadine HCl).
* taking beta-adrenergic antagonists in any form.
* taking allergic ophthalmologic medication.
* clinically significant perennial rhinitis that would interfere in assessment of ragweed-induced seasonal allergic rhinitis symptoms.
* Presence of a severely deviated nasal septum, septal perforation, structural nasal defect or large nasal polyps causing obstruction.
* History of an upper respiratory or sinus infection requiring treatment with an antibiotic within 2 weeks prior to Screening Visit.
* Documented evidence of acute or significant chronic sinusitis, as determined by the Investigator.
* Asthma (either history of, abnormal spirometry, \[forced expiratory volume in 1 second (FEV1) less than 80% predicted\] or use of asthma medications).
* Chronic or intermittent use of inhaled, oral, intra-muscular, or intra-venous corticosteroids; or chronic or intermittent use of topical corticosteroids within 4 weeks of Visit Screening Visit.
* Chronic use of medications (e.g., tricyclic antidepressants) that would affect assessment of the effectiveness of the study medication.
* Rhinitis medicamentosa.
* History or presence of significant renal, hepatic, neurologic, cardiovascular, hematologic, metabolic, cerebrovascular, respiratory, gastrointestinal or other significant medical condition including, autoimmune or collagen vascular disorders, aside from organ-specific autoimmune disease limited to the thyroid that in the Investigator's opinion could interfere with the study or require medical treatment that would interfere with the study.
* History of cancer other than basal cell carcinoma of the skin.
* History within the past year of excessive alcohol intake or drug addiction.
* Current smokers, greater than 10 pack year history, or participants who quit smoking less than one year prior to Screening.
* Use of any prohibited concomitant medications during the washout period (i.e., before screening) and throughout the study period.
* Participants currently undergoing immunotherapy.
* Participants with clinically significant abnormality on 12-lead Electrocardiogram (ECG) on screening visit.
* Treatment with an experimental, non-approved drug, or investigational drug within the past 30 days.
* Participants with a history of noncompliance to medical regimens and participants who are considered potentially unreliable.
* Previous treatment with a monoclonal antibody for any reason including anti-IgE in any form (e.g., omalizumab).
* Participants with known hypersensitivity to trial drug ingredients (i.e., sucrose, histidine, polysorbate 20) or related drugs (i.e., monoclonal antibody; polyclonal gamma-globulin).
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Immune Tolerance Network (ITN)

NETWORK

Sponsor Role collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas Casale, MD

Role: PRINCIPAL_INVESTIGATOR

Creighton University

Locations

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University of Iowa

Iowa City, Iowa, United States

Site Status

Creighton University

Omaha, Nebraska, United States

Site Status

University of Wisconsin

Madison, Wisconsin, United States

Site Status

Countries

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United States

References

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Nayak A, Casale T, Miller SD, Condemi J, McAlary M, Fowler-Taylor A, Della Cioppa G, Gupta N. Tolerability of retreatment with omalizumab, a recombinant humanized monoclonal anti-IgE antibody, during a second ragweed pollen season in patients with seasonal allergic rhinitis. Allergy Asthma Proc. 2003 Sep-Oct;24(5):323-9.

Reference Type RESULT
PMID: 14619332 (View on PubMed)

Casale TB, Busse WW, Kline JN, Ballas ZK, Moss MH, Townley RG, Mokhtarani M, Seyfert-Margolis V, Asare A, Bateman K, Deniz Y; Immune Tolerance Network Group. Omalizumab pretreatment decreases acute reactions after rush immunotherapy for ragweed-induced seasonal allergic rhinitis. J Allergy Clin Immunol. 2006 Jan;117(1):134-40. doi: 10.1016/j.jaci.2005.09.036. Epub 2005 Dec 2.

Reference Type RESULT
PMID: 16387596 (View on PubMed)

Klunker S, Saggar LR, Seyfert-Margolis V, Asare AL, Casale TB, Durham SR, Francis JN; Immune Tolerance Network Group. Combination treatment with omalizumab and rush immunotherapy for ragweed-induced allergic rhinitis: Inhibition of IgE-facilitated allergen binding. J Allergy Clin Immunol. 2007 Sep;120(3):688-95. doi: 10.1016/j.jaci.2007.05.034. Epub 2007 Jul 12.

Reference Type RESULT
PMID: 17631952 (View on PubMed)

Study Documents

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Document Type: Study design, -summary, -files, -interventions, participant schedule of events, -demographics, et al.

ImmPort study identifier is SDY1

View Document

Document Type: Individual Participant Data Set

TrialShare study identifier is CASALE ITN019AD

View Document

Document Type: Study protocol synopsis; -schedule of assessments; -data and reports; -specimens availability et al.

TrialShare study identifier is CASALE ITN019AD

View Document

Related Links

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https://www.niaid.nih.gov/

National Institute of Allergy and Infectious Diseases (NIAID)

https://www.niaid.nih.gov/about/dait

Division of Allergy, Immunology, and Transplantation (DAIT)

http://www.immunetolerance.org

Immune Tolerance Network (ITN)

Other Identifiers

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DAIT ITN019AD

Identifier Type: -

Identifier Source: org_study_id

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