Food Hypersensitivity Clinical Trial
Official title:
A Randomized, Double-Blind, Placebo-Controlled Pilot Study of Sublingual/Oral Immunotherapy for the Treatment of Peanut Allergy
The purpose of this study is to explore the safety and efficacy of a sublingual (under the tongue) immunotherapy (SLIT) dosing regimen and an oral immunotherapy (OIT) regimen in inducing desensitization and long term tolerance in children with persistent peanut allergy.
To effectively address the Primary Objectives of this pilot study, 30 subjects aged 6-21
years with: (1) a convincing clinical history of PA, (2) a serum IgE specific to peanut of
>0.35 kUa/L and a skin prick test (SPT) wheal >3 mm, will be enrolled. Subjects will be
recruited from the Johns Hopkins Pediatric Allergy Clinic.
Participants will undergo an initial screening visit that will include a medical history,
physical exam, skin testing, and phlebotomy. Informed consent and assent will be obtained.
At the next two visits, 20 participants will complete a double-blind placebo-controlled food
challenge (DBPCFC). Eligible subjects will be randomized in a 1:1 ratio into two groups. One
group will receive active SLIT with placebo OIT and the other group will begin active OIT
with placebo SLIT dose escalation. Over the next 16 weeks of the study, subjects will
undergo SLIT and OIT dose increases. A maintenance dose will then be taken at home daily for
12 months. A DBPCFC will be completed after 6 months and 12 months of home dosing. Those
patients who pass the DBPCFC will be taken off SLIT and OIT for 4 weeks. A final challenge
will be administered at the end of this period.
Ten additional peanut-allergic subjects age 6-21 years will be enrolled and followed as
longitudinal controls for the mechanistic studies. These subjects will follow a modified
schedule compared to those subjects receiving study treatment and will be evaluated by
phlebotomy, end point titration prick skin testing, and saliva collection. These patients
will continue strict avoidance of peanut unless otherwise advised by their personal
physician.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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