Efficacy of Tezepelumab in Peanut Oral Immunotherapy

NCT ID: NCT07015996

Last Updated: 2025-10-30

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: PHASE2
• Total Enrollment: 62 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-02-18
• Study Completion Date: 2028-09-16

Brief Summary

The proposed study is a proof-of-concept Phase 2, double-blind, randomized placebo-controlled clinical trial evaluating the safety and efficacy of tezepelumab and peanut Oral Immunotherapy (OIT) for the treatment of peanut allergy. Study participation is divided into 3 periods: (i) a monotherapy period comprised of injections of either Tezepelumab or placebo from week 0 to week 8, (ii) followed by a combination therapy period comprised of 56 weeks during which peanut OIT is built up and maintained, and (iii) a treatment withdrawal period comprised of 12 weeks. This study will enroll 62 peanut-allergic individuals from 12 to 55 years of age who experience dose-limiting symptoms to <=100 mg of peanut protein in a single dose (<= 144 mg cumulative dose) as assessed by DBPCFC.

The primary objective is to determine whether 56 weeks of tezepelumab plus peanut OIT as compared to 56 weeks of placebo plus peanut OIT induces sustained unresponsiveness to peanut 12 weeks after stopping combination therapy.

Conditions

Peanut Allergy

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Tezepelumab plus Peanut Oral Immunotherapy (OIT) Group

Eligible participants will be randomized in a 1:1 fashion to receive Tezepelumab during the monotherapy period of the trial. Throughout the combination therapy period, which also includes an OIT build-up and maintenance period, participants will remain on tezepelumab 210 mg every 4 weeks until reaching the final period of the trial, the withdrawal period.

Group Type: EXPERIMENTAL

Tezepelumab

Intervention Type: BIOLOGICAL

Monotherapy Period: Participants randomized to tezepelumab will receive two subcutaneous (SQ) injections of tezepelumab 210 mg during the monotherapy period.

Combination Therapy Period: Participants randomized to Tezepelumab will continue to receive Tezepelumab 210 mg every 4 weeks.

Withdrawal Period: Participants will stop receiving Tezepelumab injections.

Peanut Oral Immunotherapy (OIT)

Intervention Type: DRUG

Monotherapy Period: Not Applicable. Combination Therapy Period: During combination therapy period, each participant will start peanut OIT. Participants will start on a minimum of 0.1 mg peanut OIT, with starting dose depending on last tolerated dose from screening double-blind placebo-controlled food challenge (DBPCFC) and build to a maximum of 6 mg peanut OIT on the initial dose escalation (IDE) day. Participants will return every 2 weeks for dose escalation to a goal maintenance dose of 2000 mg peanut protein.

Withdrawal Period: Participants will stop peanut OIT.

Placebo for Tezepelumab plus peanut Oral Immunotherapy (OIT) Group

Eligible participants will be randomized in a 1:1 fashion to receive placebo for Tezepelumab during the monotherapy period of the trial. Throughout the combination therapy period, which also includes an OIT build-up and maintenance period, participants will remain on placebo for tezepelumab every 4 weeks until reaching the final period of the trial, the withdrawal period.

Group Type: PLACEBO_COMPARATOR

Peanut Oral Immunotherapy (OIT)

Intervention Type: DRUG

Monotherapy Period: Not Applicable. Combination Therapy Period: During combination therapy period, each participant will start peanut OIT. Participants will start on a minimum of 0.1 mg peanut OIT, with starting dose depending on last tolerated dose from screening double-blind placebo-controlled food challenge (DBPCFC) and build to a maximum of 6 mg peanut OIT on the initial dose escalation (IDE) day. Participants will return every 2 weeks for dose escalation to a goal maintenance dose of 2000 mg peanut protein.

Withdrawal Period: Participants will stop peanut OIT.

Placebo for Tezepelumab

Intervention Type: BIOLOGICAL

Monotherapy Period: Participants randomized to placebo for tezepelumab will receive two subcutaneous (SQ) injections of placebo 210 mg during the monotherapy period.

Combination Therapy Period: Participants randomized to placebo will continue to receive placebo for Tezepelumab every 4 weeks.

Withdrawal Period: Participants will stop receiving placebo injections.

Interventions

Tezepelumab

Monotherapy Period: Participants randomized to tezepelumab will receive two subcutaneous (SQ) injections of tezepelumab 210 mg during the monotherapy period.

Combination Therapy Period: Participants randomized to Tezepelumab will continue to receive Tezepelumab 210 mg every 4 weeks.

Withdrawal Period: Participants will stop receiving Tezepelumab injections.

Intervention Type: BIOLOGICAL

Peanut Oral Immunotherapy (OIT)

Monotherapy Period: Not Applicable. Combination Therapy Period: During combination therapy period, each participant will start peanut OIT. Participants will start on a minimum of 0.1 mg peanut OIT, with starting dose depending on last tolerated dose from screening double-blind placebo-controlled food challenge (DBPCFC) and build to a maximum of 6 mg peanut OIT on the initial dose escalation (IDE) day. Participants will return every 2 weeks for dose escalation to a goal maintenance dose of 2000 mg peanut protein.

Withdrawal Period: Participants will stop peanut OIT.

Intervention Type: DRUG

Placebo for Tezepelumab

Monotherapy Period: Participants randomized to placebo for tezepelumab will receive two subcutaneous (SQ) injections of placebo 210 mg during the monotherapy period.

Combination Therapy Period: Participants randomized to placebo will continue to receive placebo for Tezepelumab every 4 weeks.

Withdrawal Period: Participants will stop receiving placebo injections.

Intervention Type: BIOLOGICAL

Eligibility Criteria

Inclusion Criteria

1. Participant and/or parent/legal guardian must be able to understand and provide informed consent (parental permission and informed assent of minor, if applicable)

2. A personal history of an allergic reaction to peanut ingestion

3. A positive reaction at or below ingestion of 100 mg of peanut protein in a single dose (<= 144 milligram cumulative dose) during the screening Double-Blind Placebo-Controlled Food Challenge (DBPCFC)

4. A negative challenge to the placebo (oat) during the Screening DBPCFC

5. Sensitization to peanut as evidenced by either one of the following:

1. positive sIgE to Ara h2 >= 0.35 kilounit per liter by ImmunoCAP (TM) testing, or

2. wheal >= 3 mm on skin prick test to peanut extract compared to a negative control

6. Female participants of childbearing potential must have a negative pregnancy test upon study entry

7. Female participants with reproductive potential must agree to use an FDA approved method of contraception for the duration of the study

8. Willing and able to comply with the study protocol requirements

9. Participants with other food allergies must agree to continue avoidance of these food items from their diet to avoid confounding the safety and efficacy data of the study

Exclusion Criteria

1. Currently in build-up phase of aeroallergen immunotherapy

2. Current food allergen immunotherapy or use of any food allergen immunotherapy within the past 12 months

3. Pregnant, planning a pregnancy during the study, or breast-feeding

4. History of intolerance, hypersensitivity, or allergic reactions to tezepelumab, or the inactive ingredients (excipients) of tezepelumab, other IgG biologics, or rescue medications and their excipients

5. Allergy to oat (participant reported)

6. History of severe systemic allergic reaction to peanut with symptoms including the need for mechanical ventilation and/or severe hypotension requiring intensive care unit admission

7. Asthma requiring high dose inhaled corticosteroid therapy for control (2007 NHLBI Criteria Steps 5 or 6 in adults and adolescents)

8. History of a life-threatening asthma attack within 1 year before screening (e.g., requiring an ICU admission or intubation with mechanical ventilation), need for oral corticosteroids for asthma management within the last 6 months, or current Asthma Control Test score less than 19 at screening

9. History of ischemic cardiovascular disease or other cardiac disease, where, in the opinion of the site investigator, participation in the trial would pose a risk from participation in the study

10. History of eosinophilic gastrointestinal disease at screening

11. History of disease affecting the immune system such as autoimmune disease (e.g., systemic lupus erythematosus), immune complex disease (e.g., serum sickness), or immunodeficiency, where, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study

12. History of malignancy of any type, excluding basal cell and squamous cell cancers of the skin that only required surgical excision or in situ carcinoma of the cervix study provided that curative therapy was completed at least 12 months prior to informed consent

13. Current known helminth infection

14. Positive QuantiFERON - TB Gold test or TB Gold Plus, or T-SPOT(R) TB test unless the potential participant has been treated with appropriate chemoprophylaxis. In the case of an indeterminate or borderline Interferon Gamma Release Assay (IGRA), an IGRA may be repeated

15. Any of the following:

1. HIV

2. current or prior infection with hepatitis B virus (HBV)

3. current or prior infection with hepatitis C virus (HCV), except adequately treated HCV with sustained virologic response >= 12 weeks

16. Active liver disease, defined as either:

1. AST, ALT, and/or Alk phos >2x ULN, or

2. other active liver disease which, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study

17. Any of the following:

1. Current use of beta-blockers, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers

2. Received any investigational product within the past 4 months or 5 half-lives (whichever is longer) prior to screening

3. Received systemic corticosteroids within 14 days prior to screening

4. Receipt of immunoglobulin or other blood product within 30 days of screening

5. Receipt of live attenuated vaccine within 30 days of informed consent

6. Use of an immunosuppressant or immunomodulating drug within 30 days prior to screening

7. Use of biologics targeting the human immune system within the past 12 months prior to screening

8. Use of any herbal medications, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study

18. Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study

• Minimum Eligible Age: 12 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Immune Tolerance Network (ITN)

NETWORK

Sponsor Role: collaborator

PPD Development, LP

INDUSTRY

Sponsor Role: collaborator

Rho Federal Systems Division, Inc.

INDUSTRY

Sponsor Role: collaborator

National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Edwin H Kim, M.D., M.S.

Role: STUDY_CHAIR

North Carolina Children's Hospital: Department of Pediatrics, Division of Allergy, Immunology and Rheumatology

Sarita Patil, M.D.

Role: STUDY_CHAIR

Massachusetts General Hospital: Department of Medicine: Allergy & Clinical Immunology Unit

Locations

Arkansas Children's Hospital Research Institute: Department of Pediatrics, Allergy & Immunology

Little Rock, Arkansas, United States

University of California, Los Angeles: Department of Medicine, Division of Clinical Immunology and Allergy

Los Angeles, California, United States

Johns Hopkins Children's Center: Department of Allergy & Immunology

Baltimore, Maryland, United States

Massachusetts General Hospital: Department of Medicine: Allergy & Clinical Immunology Unit

Boston, Massachusetts, United States

Boston Children's Hospital: Allergy and Asthma Program

Boston, Massachusetts, United States

The University of Michigan: Division of Allergy and Clinical Immunology

Ann Arbor, Michigan, United States

Icahn School of Medicine at Mount Sinai: Department of Pediatrics Allergy & Immunology

New York, New York, United States

North Carolina Children's Hospital: Department of Pediatrics, Division of Allergy, Immunology and Rheumatology

Chapel Hill, North Carolina, United States

Cincinnati Children's Hospital Medical Center: Division of Allergy and Immunology

Cincinnati, Ohio, United States

University of Texas Southwestern Medical Center: Division of Allergy and Immunology

Dallas, Texas, United States

Countries

United States

Related Links

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

National Institute of Allergy and Infectious Diseases (NIAID)

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

Division of Allergy, Immunology, and Transplantation (DAIT)

Other Identifiers

DAIT ITN097AD

Identifier Type: -

Identifier Source: org_study_id