Oral Immunotherapy for Egg Allergy in Children Aged 6 to 16

NCT ID: NCT05740163

Last Updated: 2024-04-10

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-12-30

Study Completion Date

2026-12-31

Brief Summary

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The aim of the study is to determine the efficacy of a 12-month egg oral immunotherapy (OIT) protocol with a cooked whole egg product including yolk and egg white.

Study hypothesis: With this method the risk for severe allergic reaction to egg protein is reduced and the diet can partly or completely be normalized.

Detailed Description

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The prevalence of egg allergy among children varies from 0.5% to 3% and is thus the second most common food allergy in children. Until recently, the only treatment for egg allergy was in many cases a life-long avoidance of egg protein. Due to the large number of egg-allergic children, oral immunotherapy (OIT) to egg has been suggested to be of probable benefit to cure children with egg-allergy. Several studies have been conducted to evaluate the safety and clinical outcome of egg OIT. However, concerning efficacy and safety of egg OIT more data, and alternative procedures are required to gain a safe, simple and inexpensive immunotherapy protocol . Previous egg OIT studies have mainly used egg white in the immunotherapy, rather than more natural and inexpensive whole egg products.

The aim of this study is to determine the efficacy of a 12-month egg oral immunotherapy (OIT) protocol with a cooked whole egg product including yolk and egg white. Furthermore, the effects of whole egg OIT on humoral immune responses are investigated.

The investigators hypothesize that oral administration of a whole egg product with incremental dosing will increase the individual threshold for allergic reactivity to egg protein and may result in full tolerance without any reaction to egg.

Other study aims include investigating the differences in efficacy and side effects of whole-egg OIT in children with asthma and without asthma. In this study it is hypothesized that children with asthma have more symptoms than non-asthmatic children during the treatment. Furthemore, the level of asthma control during OIT is investigated.

The study is a prospective multicenter randomized open trial, investigating the efficacy, safety and immunological mechanisms of oral egg immunotherapy in children (aged 6 to 16). Children with egg allergy, egg avoidance diet, immediate reaction in a food challenge test for egg within the last six months and elevated serum egg-specific immunoglobulin E (IgE) levels, are recruited into the study. Children with uncontrolled asthma, severe cardiovascular disease and autoimmune disease or families with poor compliance are excluded from the study.

Study participants are divided into two groups: patients with asthma and without asthma. Both groups are separately randomized into immunotherapy or follow-up without the treatment. The immunotherapy and follow-up last 12 months in total. After 12 months of enrolment, participants in the follow-up group are entitled to take actively part in the egg OIT protocol.

In immunotherapy groups (asthma or no-asthma), meatball, bun or bread roll, including well-cooked whole-egg is given daily to the patients, starting from a minimal dosage (1/200 of the protein content of whole egg) and increasing the dosing every 1-2 weeks until a dosage of 1/5 of the protein content of a whole egg is reached. The initial dosage is given at the hospital outpatient clinic. The patients and their parents will be prepared for emergency treatment of severe allergic reactions and are given instructions to carry adequate medication with them. Patients in the intervention groups take levocetrizine 5 mg or cetirizine 10 mg daily until three months of maintenance dosage.

Blood samples, skin prick tests, lung function tests and exhaled nitric oxide levels are taken from all study participants. All the above-mentioned tests are taken before the therapy and at the time points of 6 and 12 months.

Conditions

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Egg 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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Egg allergy with asthma with intervention

Immunotherapy Egg product including egg white and yolk allergens

Group Type EXPERIMENTAL

Egg product including egg white and yolk allergens

Intervention Type DIETARY_SUPPLEMENT

Egg product either meatball or bread roll or bun including egg white and yolk allergens delivered orally in increasing dosages daily.

Egg allergy without asthma with intervention

Immunotherapy Egg product including egg white and yolk allergens

Group Type EXPERIMENTAL

Egg product including egg white and yolk allergens

Intervention Type DIETARY_SUPPLEMENT

Egg product either meatball or bread roll or bun including egg white and yolk allergens delivered orally in increasing dosages daily.

Egg allergy with asthma without intervention

No intervention, control

Group Type NO_INTERVENTION

No interventions assigned to this group

Egg allergy without asthma without intervention

No intervention, control

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Egg product including egg white and yolk allergens

Egg product either meatball or bread roll or bun including egg white and yolk allergens delivered orally in increasing dosages daily.

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Age 6 to 16 years
* Elevated spesific serum IgE to egg (\> 5 kU/l) and/or positive skin prick to egg allergen
* Positive oral food challenge for egg or anaphylaxis reaction to egg within the 6 months
* Diet free from egg in any form

Exclusion Criteria

* Age less than 6 years or more than 16 years
* Poor asthma control or uncontrolled asthma
* Severe/significant cardiovascular disease
* Autoimmune disease
* Malignancy
* Medication: beta bloker, angiotensin-converting-enzyme inhibitors (ACE inhibitors), Monoamine oxidase inhibitors (MAOIs)
* Poor compliance
* Fear of immunotherapy
* Desensitization to alfa-gal-protein (mammalian meat allergy)
Minimum Eligible Age

6 Years

Maximum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Oulu

OTHER

Sponsor Role collaborator

Oulu University Hospital

OTHER

Sponsor Role collaborator

Tampere University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Rudiger Schultz

Specialist in Pediatric Allergology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rüdiger Schultz, MD., PhD

Role: PRINCIPAL_INVESTIGATOR

Tampere University Hospital

Locations

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Oulu University Hospital

Oulu, , Finland

Site Status RECRUITING

Tampere University Hospital

Tampere, , Finland

Site Status RECRUITING

Countries

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Finland

Central Contacts

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Rüdiger Schultz, MD., PhD

Role: CONTACT

Facility Contacts

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Petri Kulmala, Clinical Professor

Role: primary

+35883155534

Lotta Kinnunen, MD., PhD

Role: backup

+35883155825

Rüdiger Schultz, MD., PhD

Role: primary

Other Identifiers

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Oral immunotherapy fo egg

Identifier Type: -

Identifier Source: org_study_id

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