Peanut Oral Immunotherapy Study of Early Intervention for Desensitization

NCT ID: NCT03736447

Last Updated: 2023-03-02

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

146 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-12-27

Study Completion Date

2022-07-05

Brief Summary

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The purpose of this study is to determine the efficacy and safety of AR101 in peanut-allergic children aged 1 to \< 4 years.

Detailed Description

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This is a Phase 3, randomized, double-blind, placebo-controlled study conducted at 14 study sites in North America and 9 in Europe to evaluate the efficacy and safety of AR101 in a characterized oral desensitization immunotherapy (CODIT™) regimen compared with placebo in peanut-allergic children aged 1 to \< 4 years.

Conditions

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Peanut Allergy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

2:1 randomization
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
Double-Blinded

Study Groups

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AR101 powder provided in capsules & sachets

Study product provided as peanut protein in pull-apart capsules or sachets

Group Type ACTIVE_COMPARATOR

AR101 powder provided in capsules & sachets

Intervention Type BIOLOGICAL

Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol

Placebo powder provided in capsules & sachets

Placebo formulation in pull-apart capsules or sachets containing only inactive ingredients

Group Type PLACEBO_COMPARATOR

Placebo powder provided in capsules & sachets

Intervention Type BIOLOGICAL

Study product formulated to contain only inactive ingredients for use as defined in the protocol

Interventions

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AR101 powder provided in capsules & sachets

Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol

Intervention Type BIOLOGICAL

Placebo powder provided in capsules & sachets

Study product formulated to contain only inactive ingredients for use as defined in the protocol

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Aged 1 to \< 4 years at randomization.
* Written informed consent from the legal guardian/parent (or both parents where required by local authorities). Provide assent where required and as appropriate per local requirements.
* Sensitivity to peanut, defined as one of the following:

* No known history of peanut ingestion and has serum IgE to peanut ≥ 5 kUA/L within 12 months before randomization.
* Documented history of physician-diagnosed IgE-mediated peanut allergy that includes the onset of characteristic\* signs and symptoms of allergy within 2 hours of known oral exposure to peanut or peanut-containing food, and has a mean wheal diameter on skin prick test (SPT) to peanut of at least 3 mm greater than the negative control (diluent) or serum IgE to peanut ≥ 0.35 kUA/L, obtained within 12 months before randomization.
* Development of age-appropriate dose-limiting allergy symptoms after consuming single doses of peanut protein \> 3 mg to ≤ 300 mg in a screening DBPCFC.
* A palatable vehicle food to which the subject is not allergic must be available for administering study product.

Exclusion Criteria

* History of severe or life-threatening anaphylaxis anytime before the screening DBPCFC.
* History of hemodynamically significant cardiovascular or renovascular disease, including uncontrolled or inadequately controlled hypertension.
* History of biopsy-confirmed diagnosis of EoE; other eosinophilic GI disease; chronic, recurrent, or severe gastroesophageal reflux disease (GERD); or symptoms of dysphagia (eg, difficulty swallowing, food "getting stuck").
* Recurrent GI symptoms considered clinically significant in the opinion of the investigator.
* History of a mast cell disorder including mastocytosis, urticaria pigmentosa, chronic idiopathic or chronic physical urticaria beyond simple dermatographism (eg, cold urticaria, cholinergic urticaria), and hereditary or idiopathic angioedema.
* Moderate or severe persistent asthma (criteria steps 3-6; National Heart, Lung, and Blood Institute \[NHLBI\], 2007).
* Mild asthma (criteria steps 1-2; NHLBI, 2007) that is uncontrolled or difficult to control based on NHLBI 2007 criteria.
* History of high-dose corticosteroid use (eg, 1-2 mg/kg prednisone or equivalent for \> 3 days) by any route of administration as defined by any of the following:

* Steroid administered daily for \> 1 month within 1 year before screening
* One steroid course within 6 months before screening
* More than 2 steroid courses ≥ 1 week in duration within 1 year before screening
* History of food protein-induced enterocolitis syndrome (FPIES) within 12 months before screening.
* Recurrent urticaria.
* History of failure to thrive or any other form of abnormal growth, or developmental or speech delay that precludes age-appropriate communication.
* History of chronic disease (except mild intermittent asthma, mild persistent asthma that is controlled, atopic dermatitis, or allergic rhinitis) that is or is at significant risk of becoming unstable or requiring a change in a chronic therapeutic regimen.
* Unable to discontinue antihistamines and other medications that could interfere with the assessment of an allergic reaction for 5 half-lives of the medication before the screening SPT, first day of dose escalation, and DBPCFCs.
* Use or anticipated use of a prohibited medication (eg, beta blockers \[oral\], angiotensin converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, or tricyclic antidepressants), monoclonal antibody, or any other immunomodulatory therapy (including immunosuppressive medications).
* Treatment with any form of immunotherapy for any food allergy anytime before screening.
* Participation in another clinical trial within 30 days or 5 half-lives of the investigational product, whichever is longer, before screening.
* Allergy to oat or rice.
* Hypersensitivity to epinephrine or any of the excipients in the epinephrine auto-injector.
* Parent/caregiver unable or unwilling to use epinephrine auto-injectors.
* Unable to follow the protocol requirements.
* Any other condition (concurrent disease, infection, comorbidity, or psychiatric or psychological disorders) or reason that may interfere with the ability to participate in the study, cause undue risk, or complicate the interpretation of data, in the opinion of the investigator or medical monitor.
* Resides at the same place as another subject in any AR101 interventional trial.
* Lives in the same household and/or is a family member of a sponsor employee or site staff involved in conducting this study.
Minimum Eligible Age

1 Year

Maximum Eligible Age

3 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Aimmune Therapeutics, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Director of Regulatory Affairs

Role: STUDY_DIRECTOR

Aimmune Therapeutics

Locations

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Arkansas Children's Hospital

Little Rock, Arkansas, United States

Site Status

Sean N. Parker Center for Allergy & Asthma Reseach, LPCH at El Camino Hospital

Mountain View, California, United States

Site Status

Peninsula Research Associates, Inc.

Rolling Hills Estates, California, United States

Site Status

Allergy & Asthma Medical Group and Research Center

San Diego, California, United States

Site Status

Children's Center for Advanced Pediatrics Clinical Research Lab

Atlanta, Georgia, United States

Site Status

Atlanta Allergy & Asthma Clinic

Marietta, Georgia, United States

Site Status

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status

The John Hopkins Hospital

Baltimore, Maryland, United States

Site Status

University of Michigan Division of Allergy and Clinical Immunology

Ann Arbor, Michigan, United States

Site Status

Atlantic Research Center

Ocean City, New Jersey, United States

Site Status

Icahn School of Medicine at Mount Sinai

New York, New York, United States

Site Status

UNC-CH School of Medicine, Pediatric Allergy, Immunology & Rheumatology, Food Allergy

Chapel Hill, North Carolina, United States

Site Status

Clinical Research of Charlotte

Charlotte, North Carolina, United States

Site Status

Virginia Mason Medical Center

Seattle, Washington, United States

Site Status

Jeanne de Flandre Hospital

Lille, , France

Site Status

Charité Universitaetsmedizin Berlin

Berlin, , Germany

Site Status

University of Frankfurt

Frankfurt am Main, , Germany

Site Status

James Paget University Hospital

Gorleston-on-Sea, Norfolk, United Kingdom

Site Status

Leicester Royal Infirmary

Leicester, , United Kingdom

Site Status

Guy's and St. Thomas' NHS Foundation Trust, Snowy Owl, First Floor, Evelina Children's Hospital

London, , United Kingdom

Site Status

Royal Manchester Children's Hospital Central Manchester University Hospitals

Manchester, , United Kingdom

Site Status

Sheffield Children's Hospital

Sheffield, , United Kingdom

Site Status

University Hospital Southampton Foundation NHS Trust Southampton General Hospital

Southampton, , United Kingdom

Site Status

Countries

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United States France Germany United Kingdom

References

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Du Toit G, Brown KR, Vereda A, Irani AM, Tilles S, Ratnayake A, Jones SM, Vickery BP. Oral Immunotherapy for Peanut Allergy in Children 1 to Less Than 4 Years of Age. NEJM Evid. 2023 Nov;2(11):EVIDoa2300145. doi: 10.1056/EVIDoa2300145. Epub 2023 Oct 23.

Reference Type DERIVED
PMID: 38320526 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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ARC005

Identifier Type: -

Identifier Source: org_study_id

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