PEAnut Anaphylaxis Predictors

NCT ID: NCT02424136

Last Updated: 2020-01-22

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

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-07-22

Study Completion Date

2019-12-31

Brief Summary

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Peanut allergy can be life-threatening. Current diagnostic techniques for peanut allergy have high sensitivity, but not high specificity. This clinical trial will test the validity of a novel blood biomarker (compared with current testing) as a diagnostic predictor of anaphylaxis to peanut.

Detailed Description

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Children aged 2-17 years with suspected peanut allergy will be invited to participate in the study.

They will have a questionnaire, a skin prick test to peanut, 2 breathing tests (spirometry and fraction of exhaled nitric oxide (FeNO)), and a blood test (specific peanut antibodies, allergic immune responses - including the novel blood biomarker - and genetic testing to identify novel potential molecular and genetic markers of food allergy in the future. The genetic testing component will be optional). The breathing test is not required for those under 6 years.

The final step is an open label peanut food challenge with incremental doses of peanut, (routine practise) as per the Australasian Society of Clinical Immunology and Allergy (ASCIA) food challenge protocol.The endpoints in the food challenge will be signs of allergy or anaphylaxis as per PRACTicing ALLergology (PRACTALL) consensus report for oral food challenges OR completion of the ASCIA food challenge protocol.

Outcome: The primary outcome of the project is to confirm that a novel blood biomarker has a higher diagnostic accuracy as compared to current best testing in predicting anaphylaxis at open label peanut challenge.

Secondary outcome: Will be to determine the value of the biomarker, FeNO and Ara h2 specific Immunoglobulin E (sIgE) (individually and in combination) at predicting anaphylaxis or clinical allergy at open label peanut challenge.

Conditions

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Peanut Hypersensitivity Anaphylaxis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Entire group

Children aged 2-17 years with suspected peanut allergy who require peanut food challenge to confirm clinical allergy, will be recruited for the study. They will undergo a preceding questionnaire, peanut skin prick testing, spirometry, fraction of exhaled nitric oxide (FeNO) measurement, serum peanut and Ara h2 specific immunoglobulin E (sIgE) antibodies, and collection of blood biomarker prior to food challenge. The primary endpoint will be anaphylaxis at open label peanut challenge, with the primary exposure of interest will be the serum biomarker.

Group Type OTHER

Questionnaire

Intervention Type OTHER

5 minute questionnaire focused on symptoms of allergic disease

Peanut Skin prick test

Intervention Type OTHER

Skin prick testing with peanut antigen, according to ASCIA Skin Prick testing manual

Fraction of exhaled nitric oxide

Intervention Type OTHER

Measurement of exhaled nitric oxide, according to American Thoracic Society/ European Thoracic Society (ATS/ERS) standardised procedures (Not required for those age less than 6 years).

Spirometry

Intervention Type OTHER

Measurement of lung flows/volumes, according to ATS/ERS standardised procedures (Not required for those age less than 6 years).

Serum Peanut and Ara h2 specific immunoglobulin E

Intervention Type OTHER

Peanut and Ara h2 specific IgE antibodies

Collection of blood biomarker

Intervention Type OTHER

Correlation of blood biomarker levels in patients with successful or unsuccessful peanut food challenge

Peanut food challenge

Intervention Type OTHER

Open label peanut challenge conducted according to ASCIA's peanut challenge protocol and PRACTALL consensus report

Interventions

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Questionnaire

5 minute questionnaire focused on symptoms of allergic disease

Intervention Type OTHER

Peanut Skin prick test

Skin prick testing with peanut antigen, according to ASCIA Skin Prick testing manual

Intervention Type OTHER

Fraction of exhaled nitric oxide

Measurement of exhaled nitric oxide, according to American Thoracic Society/ European Thoracic Society (ATS/ERS) standardised procedures (Not required for those age less than 6 years).

Intervention Type OTHER

Spirometry

Measurement of lung flows/volumes, according to ATS/ERS standardised procedures (Not required for those age less than 6 years).

Intervention Type OTHER

Serum Peanut and Ara h2 specific immunoglobulin E

Peanut and Ara h2 specific IgE antibodies

Intervention Type OTHER

Collection of blood biomarker

Correlation of blood biomarker levels in patients with successful or unsuccessful peanut food challenge

Intervention Type OTHER

Peanut food challenge

Open label peanut challenge conducted according to ASCIA's peanut challenge protocol and PRACTALL consensus report

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Children aged 2 - 17 years with an allergy to peanut and require peanut challenge to confirm peanut allergy.

Exclusion Criteria

* Children with Peanut Skin Prick Test (SPT) wheal size greater than 10mm as these children are likely to have clinical peanut allergy (no clinical indication for food challenge).
Minimum Eligible Age

2 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hunter Medical Research Institute, Australia

UNKNOWN

Sponsor Role collaborator

University of Newcastle, Australia

OTHER

Sponsor Role collaborator

Thrasher Research Fund

OTHER

Sponsor Role collaborator

Hunter Childrens Research Foundation, Australia

UNKNOWN

Sponsor Role collaborator

Aerocrine AB

INDUSTRY

Sponsor Role collaborator

John Hunter Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joerg Mattes, MD

Role: PRINCIPAL_INVESTIGATOR

John Hunter Children's Hospital, Australia

Locations

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John Hunter Children's Hospital

New Lambton, New South Wales, Australia

Site Status

Countries

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Australia

References

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Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, Dubois AE, Beyer K, Eigenmann PA, Spergel JM, Werfel T, Chinchilli VM. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol. 2012 Dec;130(6):1260-74. doi: 10.1016/j.jaci.2012.10.017. No abstract available.

Reference Type BACKGROUND
PMID: 23195525 (View on PubMed)

Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. No abstract available.

Reference Type BACKGROUND
PMID: 16055882 (View on PubMed)

American Thoracic Society; European Respiratory Society. ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide, 2005. Am J Respir Crit Care Med. 2005 Apr 15;171(8):912-30. doi: 10.1164/rccm.200406-710ST. No abstract available.

Reference Type BACKGROUND
PMID: 15817806 (View on PubMed)

Percival E, Bhatia R, Preece K, McEvoy M, Collison A, Mattes J. Change in exhaled nitric oxide during peanut challenge is related to severity of reaction. Allergy Asthma Clin Immunol. 2020 Jul 21;16:64. doi: 10.1186/s13223-020-00464-8. eCollection 2020.

Reference Type DERIVED
PMID: 32834829 (View on PubMed)

Related Links

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https://www.allergy.org.au/images/stories/pospapers/ASCIA_SPT_Manual_March_2016.pdf

ASCIA Skin prick testing for the diagnosis of allergic disease. A manual for practitioners.

Other Identifiers

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PEAAP (14/12/12/4.12)

Identifier Type: -

Identifier Source: org_study_id

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