Promoting Tolerance to Peanut in High-Risk Children

NCT ID: NCT00329784

Last Updated: 2019-04-17

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

640 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2014-05-31

Brief Summary

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This study will evaluate whether early exposure to peanuts promotes tolerance and provides protection from developing peanut allergy in children who are allergic to eggs or who have severe eczema.

This study has been continued into the ITN049AD (LEAP-On) Study (NCT01366846).

Detailed Description

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Allergic reactions to peanuts are potentially life-threatening and, in some children, can result from ingestion of only trace quantities of peanuts. At highest risk are children with eczema or who are allergic to eggs; these children have a 20% chance of developing peanut allergy by the age of five. The majority of children allergic to peanuts have their first reaction between the ages of 14 and 24 months, often at the time of their first exposure to peanut. Currently, there is no cure for peanut allergy.

Peanut allergy has become an increasingly common problem in early childhood in the United States and the United Kingdom. Despite current public health guidelines in both countries recommending the avoidance of peanut consumption in the first years of life, the proportion of children with peanut allergy doubled in these countries over the period from 1998 to 2003. In contrast, peanuts are commonly consumed by infants in relatively high amounts in Africa, Southeast Asia and Israel, yet the rate of peanut allergy is quite low and does not appear to be increasing. Peanut consumption by infants in these parts of the world may actually protect children from developing peanut allergy by promoting oral tolerance to peanuts.

Participants in this study will be randomly assigned to either follow a peanut consumption regimen or a strict peanut avoidance regimen. Those assigned to the peanut consumption group will be asked to consume an age-appropriate snack three times a week for the duration of the study and will be monitored closely during their first introduction to peanut.

Those assigned to the peanut avoidance group will be asked to avoid ingestion of peanut for the first three years of life. A physical exam, allergy testing, and other immune system tests requiring blood collection will occur at Years 1, 3, and 5 following study entry. During the study, parents will maintain regular contact with study dietitians.

Conditions

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Eczema Egg Allergy Food Allergy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Peanut Consumption Group

Participants on this arm will consume peanut protein.

Group Type EXPERIMENTAL

Peanut Consumption Group

Intervention Type BIOLOGICAL

Peanut-containing snack. Children are to consume 2 g of peanut protein in three servings per week (total of 6 g) over 3 servings.

Peanut Avoidance Group

Participants on this arm will avoid peanut as per United Kingdom (UK) public health recommendations.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Peanut Consumption Group

Peanut-containing snack. Children are to consume 2 g of peanut protein in three servings per week (total of 6 g) over 3 servings.

Intervention Type BIOLOGICAL

Other Intervention Names

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Bamba

Eligibility Criteria

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Inclusion Criteria

* Able to consume solid food
* Allergy to eggs and/or severe eczema
* Informed consent obtained from parent or guardian.

Exclusion Criteria

* Clinically significant chronic illness. Participants with eczema or recurrent wheeze are not excluded.
* Positive skin prick test for peanut allergen with a wheel diameter greater than 4 mm in the presence of a negative saline control
* Previous or current consumption of peanut protein that exceeds 0.2 g of peanut protein on at least one occasion or 0.5 g over a single week
* Investigator-suspected allergy to peanut protein
* Investigator-suspected allergy to peanut protein in care provider or current household member.
* Diagnosis of persistent asthma
* ALT (SGPT) or bilirubin greater than 2 times the upper limit of age-related normal value
* BUN or creatinine greater than 1.25 times the upper limit of age-related normal value
* Platelet count less than 100,000/mL, hemoglobin less than 9 g/dL, or investigator-suspected immunocompromise
* Unwillingness or inability to comply with study requirements and procedures
Minimum Eligible Age

4 Months

Maximum Eligible Age

10 Months

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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Gideon Lack, MD

Role: PRINCIPAL_INVESTIGATOR

Imperial College, St. Mary's Hospital

Locations

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Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust

London, England, United Kingdom

Site Status

Countries

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United Kingdom

References

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Palmer K, Burks W. Current developments in peanut allergy. Curr Opin Allergy Clin Immunol. 2006 Jun;6(3):202-6. doi: 10.1097/01.all.0000225161.60274.31.

Reference Type BACKGROUND
PMID: 16670515 (View on PubMed)

Santos AF, Du Toit G, Lack G. Is the use of epinephrine a good marker of severity of allergic reactions during oral food challenges? J Allergy Clin Immunol Pract. 2015 May-Jun;3(3):429-30. doi: 10.1016/j.jaip.2014.12.009. No abstract available.

Reference Type BACKGROUND
PMID: 25956314 (View on PubMed)

Du Toit G, Sayre PH, Roberts G, Sever ML, Lawson K, Bahnson HT, Brough HA, Santos AF, Harris KM, Radulovic S, Basting M, Turcanu V, Plaut M, Lack G; Immune Tolerance Network LEAP-On Study Team. Effect of Avoidance on Peanut Allergy after Early Peanut Consumption. N Engl J Med. 2016 Apr 14;374(15):1435-43. doi: 10.1056/NEJMoa1514209. Epub 2016 Mar 4.

Reference Type BACKGROUND
PMID: 26942922 (View on PubMed)

Du Toit G, Roberts G, Sayre PH, Bahnson HT, Radulovic S, Santos AF, Brough HA, Phippard D, Basting M, Feeney M, Turcanu V, Sever ML, Gomez Lorenzo M, Plaut M, Lack G; LEAP Study Team. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015 Feb 26;372(9):803-13. doi: 10.1056/NEJMoa1414850. Epub 2015 Feb 23.

Reference Type RESULT
PMID: 25705822 (View on PubMed)

Gruchalla RS, Sampson HA. Preventing peanut allergy through early consumption--ready for prime time? N Engl J Med. 2015 Feb 26;372(9):875-7. doi: 10.1056/NEJMe1500186. Epub 2015 Feb 23. No abstract available.

Reference Type RESULT
PMID: 25705823 (View on PubMed)

Du Toit G, Roberts G, Sayre PH, Plaut M, Bahnson HT, Mitchell H, Radulovic S, Chan S, Fox A, Turcanu V, Lack G; Learning Early About Peanut Allergy (LEAP) Study Team. Identifying infants at high risk of peanut allergy: the Learning Early About Peanut Allergy (LEAP) screening study. J Allergy Clin Immunol. 2013 Jan;131(1):135-43.e1-12. doi: 10.1016/j.jaci.2012.09.015. Epub 2012 Nov 19.

Reference Type RESULT
PMID: 23174658 (View on PubMed)

Feeney M, Du Toit G, Roberts G, Sayre PH, Lawson K, Bahnson HT, Sever ML, Radulovic S, Plaut M, Lack G; Immune Tolerance Network LEAP Study Team. Impact of peanut consumption in the LEAP Study: Feasibility, growth, and nutrition. J Allergy Clin Immunol. 2016 Oct;138(4):1108-1118. doi: 10.1016/j.jaci.2016.04.016. Epub 2016 Jun 10.

Reference Type RESULT
PMID: 27297994 (View on PubMed)

Roberts G, Bahnson HT, Du Toit G, O'Rourke C, Sever ML, Brittain E, Plaut M, Lack G. Defining the window of opportunity and target populations to prevent peanut allergy. J Allergy Clin Immunol. 2023 May;151(5):1329-1336. doi: 10.1016/j.jaci.2022.09.042. Epub 2022 Dec 12.

Reference Type DERIVED
PMID: 36521802 (View on PubMed)

Study Documents

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Document Type: Individual Participant Data Set

ImmPort study identifier is SDY660

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Document Type: Study summary, -design, -adverse event(s), -demographics, -study files

ImmPort study identifier is SDY660

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Document Type: Individual Participant Data Set

TrialShare study identifier is LEAP (ITN032AD)

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Document Type: Overview, Date & Reports, Manuscripts et al.

TrialShare study identifier is LEAP (ITN032AD)

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Related Links

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http://www.immunetolerance.org

Immune Tolerance Network website

http://www.leapstudy.co.uk

LEAP Study informational website

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

National Institute of Allergy and Infectious Diseases (NIAID)

Other Identifiers

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DAIT ITN032AD

Identifier Type: -

Identifier Source: org_study_id

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