Trial Outcomes & Findings for Peanut Oral Immunotherapy in Children (NCT NCT01867671)

NCT ID: NCT01867671

Last Updated: 2020-03-16

Results Overview

Definition of desensitized to peanut: A participant who passed the blinded (masked) oral food challenge (OFC) to10 grams of peanut flour (=5 grams of peanut protein) without significant symptoms.\* \*Significant symptoms include hives, wheezing, vomiting, or laryngeal edema.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

146 participants

Primary outcome timeframe

Week 134

Results posted on

2020-03-16

Participant Flow

Participants ages 1 to 3 with a clinical history of peanut allergy or avoidance of peanut without ever having eaten peanut were recruited from 5 clinical centers in the United States from August 2013 to October 2015.

Individuals with a history of severe anaphylaxis (previous hypotension) to peanut were excluded.

Participant milestones

Participant milestones
Measure
Peanut Oral Immune Therapy (OIT)
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Overall Study
STARTED
96
50
Overall Study
COMPLETED
67
22
Overall Study
NOT COMPLETED
29
28

Reasons for withdrawal

Reasons for withdrawal
Measure
Peanut Oral Immune Therapy (OIT)
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Overall Study
Adverse Event
5
3
Overall Study
Anaphylaxis
0
1
Overall Study
Inability to reach 3 mg peanut/placebo
2
0
Overall Study
Lost to Follow-up
0
1
Overall Study
Non-compliance with Study Drug
1
2
Overall Study
Withdrawal by Subject
21
21

Baseline Characteristics

Peanut Oral Immunotherapy in Children

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Peanut Oral Immune Therapy (OIT)
n=96 Participants
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
n=50 Participants
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Total
n=146 Participants
Total of all reporting groups
Age, Continuous
3.1 years
STANDARD_DEVIATION 0.7 • n=5 Participants
3.0 years
STANDARD_DEVIATION 0.8 • n=7 Participants
3.1 years
STANDARD_DEVIATION 0.8 • n=5 Participants
Sex: Female, Male
Female
30 Participants
n=5 Participants
18 Participants
n=7 Participants
48 Participants
n=5 Participants
Sex: Female, Male
Male
66 Participants
n=5 Participants
32 Participants
n=7 Participants
98 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
92 Participants
n=5 Participants
45 Participants
n=7 Participants
137 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
15 Participants
n=5 Participants
3 Participants
n=7 Participants
18 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=5 Participants
5 Participants
n=7 Participants
6 Participants
n=5 Participants
Race (NIH/OMB)
White
64 Participants
n=5 Participants
31 Participants
n=7 Participants
95 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
16 Participants
n=5 Participants
11 Participants
n=7 Participants
27 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
96 participants
n=5 Participants
50 participants
n=7 Participants
146 participants
n=5 Participants

PRIMARY outcome

Timeframe: Week 134

Definition of desensitized to peanut: A participant who passed the blinded (masked) oral food challenge (OFC) to10 grams of peanut flour (=5 grams of peanut protein) without significant symptoms.\* \*Significant symptoms include hives, wheezing, vomiting, or laryngeal edema.

Outcome measures

Outcome measures
Measure
Peanut Oral Immune Therapy (OIT)
n=96 Participants
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
n=50 Participants
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Percentage of Participants Desensitized to Peanut Protein After 134 Weeks of Oral Immunotherapy (OIT)
71 Percentage of Participants
Interval 61.7 to 79.9
2 Percentage of Participants
Interval 0.0 to 5.9

SECONDARY outcome

Timeframe: Week 160

Definition of Tolerant: A participant who passed the oral food challenge (OFC) to 10 grams of peanut flour (=5 grams of peanut protein).

Outcome measures

Outcome measures
Measure
Peanut Oral Immune Therapy (OIT)
n=96 Participants
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
n=50 Participants
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Percentage of Tolerant Participants at Week 160
21 percentage of participants
Interval 12.7 to 29.0
2 percentage of participants
Interval 0.0 to 5.9

SECONDARY outcome

Timeframe: Week 134, Week 160

Population: Participants randomized to the Peanut Oral Immunotherapy (OIT) group

Definition of transient desensitization: A participant who passed the blinded (masked) oral food challenge (OFC) to 10 grams peanut flour (=5 grams peanut protein) at week 134 and failed the week 160 in the Peanut oral immunotherapy (OIT) group.

Outcome measures

Outcome measures
Measure
Peanut Oral Immune Therapy (OIT)
n=96 Participants
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Count of Participants With Transient Desensitization
Passed Week 134 and Failed Week 160
49 Participants
Count of Participants With Transient Desensitization
Passed Week 134 and Passed Week 160
19 Participants
Count of Participants With Transient Desensitization
Failed Week 134 and Failed Week 160
27 Participants
Count of Participants With Transient Desensitization
Failed Week 134 and Passed Week 160
1 Participants

SECONDARY outcome

Timeframe: Week 160

The highest tolerated cumulative dose of peanut protein during the blinded (masked) oral food challenge (OFC) at Week 160, analyzed within and between both placebo and peanut OIT groups. The highest cumulative dose of peanut protein tolerated for each participant was analyzed as a continuous outcome. Any randomized participant without an evaluable blinded (masked) OFC was imputed as not tolerant. For the continuous highest cumulative dose endpoint, this is defined as having a highest cumulative dose imputed as zero.

Outcome measures

Outcome measures
Measure
Peanut Oral Immune Therapy (OIT)
n=96 Participants
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
n=50 Participants
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Highest Tolerated Cumulative Dose
1645 mg protein
Interval 1338.0 to 1951.0
180 mg protein
Interval -244.0 to 605.0

SECONDARY outcome

Timeframe: Initial Dose Escalation through Week 160 (Tolerance Assessment)

Percentage of participants that withdrew from study participation, listed by study phase (at time of study withdrawal).

Outcome measures

Outcome measures
Measure
Peanut Oral Immune Therapy (OIT)
n=96 Participants
Peanut Oral Immune Therapy (OIT) for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of peanut oral immunotherapy were used. One form was a liquid extract derived from the peanut flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg of peanut protein. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Peanut Placebo
n=50 Participants
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. Two forms of placebo were used. One form was a liquid extract derived from oat flour source material. This was used during initial dose escalation for doses 0.1 to 0.8 mg. The second form was peanut flour, which was used for the remainder of dose escalation, build-up, and maintenance.
Percentage of Participants That Withdrew From the Study
Terminated during Initial Dose Escalation
2 percentage of participants
0 percentage of participants
Percentage of Participants That Withdrew From the Study
Terminated during Build-Up
4 percentage of participants
12 percentage of participants
Percentage of Participants That Withdrew From the Study
Terminated during Maintenance
8 percentage of participants
16 percentage of participants
Percentage of Participants That Withdrew From the Study
Terminated after Maintenance/Prior to OFC
1 percentage of participants
2 percentage of participants
Percentage of Participants That Withdrew From the Study
Terminated during Avoidance
11 percentage of participants
14 percentage of participants
Percentage of Participants That Withdrew From the Study
Terminated after Avoidance/Prior to OFC
0 percentage of participants
10 percentage of participants
Percentage of Participants That Withdrew From the Study
Terminated after Tolerance Assessment
3 percentage of participants
2 percentage of participants

Adverse Events

Peanut Oral Immunotherapy (OIT)

Serious events: 3 serious events
Other events: 96 other events
Deaths: 0 deaths

Peanut Placebo

Serious events: 4 serious events
Other events: 50 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Peanut Oral Immunotherapy (OIT)
n=96 participants at risk
Peanut OIT for 134 weeks followed by peanut avoidance for 26 weeks.
Peanut Placebo
n=50 participants at risk
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. The placebo extract was derived from oat flour source material.
Gastrointestinal disorders
Vomiting
0.00%
0/96 • 162 weeks
4.0%
2/50 • Number of events 2 • 162 weeks
Immune system disorders
Anaphylactic reaction
0.00%
0/96 • 162 weeks
2.0%
1/50 • Number of events 1 • 162 weeks
Infections and infestations
Pyelonephritis
1.0%
1/96 • Number of events 1 • 162 weeks
0.00%
0/50 • 162 weeks
Infections and infestations
Respiratory tract infection
1.0%
1/96 • Number of events 1 • 162 weeks
0.00%
0/50 • 162 weeks
Injury, poisoning and procedural complications
Vaccination complication
0.00%
0/96 • 162 weeks
2.0%
1/50 • Number of events 1 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Asthma
1.0%
1/96 • Number of events 1 • 162 weeks
2.0%
1/50 • Number of events 1 • 162 weeks

Other adverse events

Other adverse events
Measure
Peanut Oral Immunotherapy (OIT)
n=96 participants at risk
Peanut OIT for 134 weeks followed by peanut avoidance for 26 weeks.
Peanut Placebo
n=50 participants at risk
Peanut placebo for 134 weeks followed by peanut avoidance for 26 weeks. The placebo extract was derived from oat flour source material.
Ear and labyrinth disorders
Ear pain
4.2%
4/96 • Number of events 9 • 162 weeks
6.0%
3/50 • Number of events 3 • 162 weeks
Eye disorders
Conjunctivitis
6.2%
6/96 • Number of events 8 • 162 weeks
10.0%
5/50 • Number of events 9 • 162 weeks
Gastrointestinal disorders
Abdominal discomfort
18.8%
18/96 • Number of events 48 • 162 weeks
8.0%
4/50 • Number of events 6 • 162 weeks
Gastrointestinal disorders
Abdominal pain
30.2%
29/96 • Number of events 105 • 162 weeks
10.0%
5/50 • Number of events 18 • 162 weeks
Gastrointestinal disorders
Abdominal pain upper
10.4%
10/96 • Number of events 26 • 162 weeks
4.0%
2/50 • Number of events 4 • 162 weeks
Gastrointestinal disorders
Constipation
8.3%
8/96 • Number of events 8 • 162 weeks
14.0%
7/50 • Number of events 8 • 162 weeks
Gastrointestinal disorders
Diarrhoea
20.8%
20/96 • Number of events 26 • 162 weeks
24.0%
12/50 • Number of events 20 • 162 weeks
Gastrointestinal disorders
Gastritis
13.5%
13/96 • Number of events 19 • 162 weeks
10.0%
5/50 • Number of events 15 • 162 weeks
Gastrointestinal disorders
Lip pruritus
5.2%
5/96 • Number of events 10 • 162 weeks
0.00%
0/50 • 162 weeks
Gastrointestinal disorders
Vomiting
46.9%
45/96 • Number of events 80 • 162 weeks
38.0%
19/50 • Number of events 32 • 162 weeks
General disorders
Influenza like illness
20.8%
20/96 • Number of events 78 • 162 weeks
16.0%
8/50 • Number of events 27 • 162 weeks
General disorders
Pyrexia
67.7%
65/96 • Number of events 190 • 162 weeks
58.0%
29/50 • Number of events 108 • 162 weeks
Immune system disorders
Allergy to animal
6.2%
6/96 • Number of events 15 • 162 weeks
6.0%
3/50 • Number of events 6 • 162 weeks
Immune system disorders
Food allergy
88.5%
85/96 • Number of events 135 • 162 weeks
86.0%
43/50 • Number of events 72 • 162 weeks
Immune system disorders
Hypersensitivity
40.6%
39/96 • Number of events 77 • 162 weeks
30.0%
15/50 • Number of events 25 • 162 weeks
Immune system disorders
Type I hypersensitivity
78.1%
75/96 • Number of events 1047 • 162 weeks
62.0%
31/50 • Number of events 152 • 162 weeks
Infections and infestations
Bronchitis
3.1%
3/96 • Number of events 3 • 162 weeks
6.0%
3/50 • Number of events 4 • 162 weeks
Infections and infestations
Croup infectious
14.6%
14/96 • Number of events 27 • 162 weeks
10.0%
5/50 • Number of events 7 • 162 weeks
Infections and infestations
Ear infection
12.5%
12/96 • Number of events 14 • 162 weeks
14.0%
7/50 • Number of events 8 • 162 weeks
Infections and infestations
Gastroenteritis
36.5%
35/96 • Number of events 48 • 162 weeks
24.0%
12/50 • Number of events 19 • 162 weeks
Infections and infestations
Gastroenteritis viral
19.8%
19/96 • Number of events 27 • 162 weeks
18.0%
9/50 • Number of events 9 • 162 weeks
Infections and infestations
Hand-foot-and-mouth disease
6.2%
6/96 • Number of events 6 • 162 weeks
4.0%
2/50 • Number of events 2 • 162 weeks
Infections and infestations
Impetigo
5.2%
5/96 • Number of events 5 • 162 weeks
0.00%
0/50 • 162 weeks
Infections and infestations
Influenza
8.3%
8/96 • Number of events 9 • 162 weeks
14.0%
7/50 • Number of events 7 • 162 weeks
Infections and infestations
Molluscum contagiosum
5.2%
5/96 • Number of events 5 • 162 weeks
6.0%
3/50 • Number of events 3 • 162 weeks
Infections and infestations
Nasopharyngitis
8.3%
8/96 • Number of events 13 • 162 weeks
4.0%
2/50 • Number of events 8 • 162 weeks
Infections and infestations
Otitis media
24.0%
23/96 • Number of events 38 • 162 weeks
30.0%
15/50 • Number of events 21 • 162 weeks
Infections and infestations
Otitis media acute
5.2%
5/96 • Number of events 5 • 162 weeks
4.0%
2/50 • Number of events 2 • 162 weeks
Infections and infestations
Pharyngitis streptococcal
21.9%
21/96 • Number of events 28 • 162 weeks
6.0%
3/50 • Number of events 8 • 162 weeks
Infections and infestations
Pneumonia
9.4%
9/96 • Number of events 10 • 162 weeks
10.0%
5/50 • Number of events 6 • 162 weeks
Infections and infestations
Respiratory tract infection
1.0%
1/96 • Number of events 1 • 162 weeks
8.0%
4/50 • Number of events 4 • 162 weeks
Infections and infestations
Sinusitis
13.5%
13/96 • Number of events 19 • 162 weeks
10.0%
5/50 • Number of events 16 • 162 weeks
Infections and infestations
Upper respiratory tract infection
35.4%
34/96 • Number of events 73 • 162 weeks
36.0%
18/50 • Number of events 42 • 162 weeks
Infections and infestations
Urinary tract infection
0.00%
0/96 • 162 weeks
8.0%
4/50 • Number of events 4 • 162 weeks
Infections and infestations
Viral infection
34.4%
33/96 • Number of events 67 • 162 weeks
24.0%
12/50 • Number of events 16 • 162 weeks
Infections and infestations
Viral upper respiratory tract infection
27.1%
26/96 • Number of events 42 • 162 weeks
16.0%
8/50 • Number of events 14 • 162 weeks
Injury, poisoning and procedural complications
Excoriation
1.0%
1/96 • Number of events 2 • 162 weeks
6.0%
3/50 • Number of events 3 • 162 weeks
Injury, poisoning and procedural complications
Laceration
5.2%
5/96 • Number of events 6 • 162 weeks
4.0%
2/50 • Number of events 2 • 162 weeks
Nervous system disorders
Headache
8.3%
8/96 • Number of events 11 • 162 weeks
2.0%
1/50 • Number of events 1 • 162 weeks
Psychiatric disorders
Agitation
9.4%
9/96 • Number of events 10 • 162 weeks
6.0%
3/50 • Number of events 3 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Asthma
12.5%
12/96 • Number of events 17 • 162 weeks
16.0%
8/50 • Number of events 11 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Cough
50.0%
48/96 • Number of events 133 • 162 weeks
46.0%
23/50 • Number of events 49 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Nasal congestion
22.9%
22/96 • Number of events 39 • 162 weeks
18.0%
9/50 • Number of events 18 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Rhinitis allergic
20.8%
20/96 • Number of events 33 • 162 weeks
12.0%
6/50 • Number of events 17 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Rhinorrhoea
9.4%
9/96 • Number of events 16 • 162 weeks
4.0%
2/50 • Number of events 2 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Throat irritation
7.3%
7/96 • Number of events 9 • 162 weeks
0.00%
0/50 • 162 weeks
Respiratory, thoracic and mediastinal disorders
Wheezing
17.7%
17/96 • Number of events 33 • 162 weeks
30.0%
15/50 • Number of events 22 • 162 weeks
Skin and subcutaneous tissue disorders
Dermatitis atopic
9.4%
9/96 • Number of events 13 • 162 weeks
14.0%
7/50 • Number of events 8 • 162 weeks
Skin and subcutaneous tissue disorders
Eczema
28.1%
27/96 • Number of events 65 • 162 weeks
24.0%
12/50 • Number of events 16 • 162 weeks
Skin and subcutaneous tissue disorders
Erythema
5.2%
5/96 • Number of events 8 • 162 weeks
10.0%
5/50 • Number of events 5 • 162 weeks
Skin and subcutaneous tissue disorders
Pruritus
15.6%
15/96 • Number of events 39 • 162 weeks
20.0%
10/50 • Number of events 17 • 162 weeks
Skin and subcutaneous tissue disorders
Rash
25.0%
24/96 • Number of events 33 • 162 weeks
22.0%
11/50 • Number of events 24 • 162 weeks
Skin and subcutaneous tissue disorders
Rash maculo-papular
7.3%
7/96 • Number of events 9 • 162 weeks
2.0%
1/50 • Number of events 1 • 162 weeks
Skin and subcutaneous tissue disorders
Urticaria
25.0%
24/96 • Number of events 65 • 162 weeks
32.0%
16/50 • Number of events 29 • 162 weeks

Additional Information

Director, Clinical Research Operations Program

DAIT/NIAID

Phone: 301-594-7669

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place