Promoting Tolerance to Peanut in High-Risk Children (LEAP)

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborator:
Immune Tolerance Network (ITN)
Information provided by (Responsible Party):
National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier:
NCT00329784
First received: May 23, 2006
Last updated: April 23, 2014
Last verified: April 2014
  Purpose

This study will evaluate whether early exposure to peanuts promotes tolerance and provides protection from developing peanut allergy in children who are allergic to eggs or who have severe eczema.

This study has been continued into the ITN049AD (LEAP-On) Study (NCT01366846).


Condition Intervention Phase
Eczema
Egg Allergy
Food Allergy
Biological: peanut-containing snack
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Induction of Tolerance Through Early Introduction of Peanut in High-Risk Children (ITN032AD)

Resource links provided by NLM:


Further study details as provided by National Institute of Allergy and Infectious Diseases (NIAID):

Primary Outcome Measures:
  • Proportion of participants with peanut allergy at 60 months of age [ Time Frame: 60 months ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • the proportion of participants with allergic sensitization to selected ingested and inhaled allergens, and with seasonal rhinoconjunctivitis, perennial rhinoconjunctivitis, and asthma [ Time Frame: 30 and 60 months ] [ Designated as safety issue: No ]
  • The proportion of participants with type-1 immediate onset food allergy to selected ingested allergens. [ Time Frame: 60 months ] [ Designated as safety issue: Yes ]
  • Incidence of adverse events, laboratory abnormalities and nutritional evaluations [ Time Frame: 60 months ] [ Designated as safety issue: Yes ]

Enrollment: 640
Study Start Date: December 2006
Estimated Study Completion Date: July 2014
Estimated Primary Completion Date: July 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Peanut Consumption Group
Participants on this arm will consume peanut protein.
Biological: peanut-containing snack
Children are to consume 2 g of peanut protein in three servings per week (total of 6 g) over 3 servings.
Other Name: Bamba
No Intervention: Peanut Avoidance Group
Participants on this arm will avoid peanut as per UK public health recommendations.

Detailed Description:

Allergic reactions to peanuts are potentially life-threatening and, in some children, can result from ingestion of only trace quantities of peanuts. At highest risk are children with eczema or who are allergic to eggs; these children have a 20% chance of developing peanut allergy by the age of five. The majority of children allergic to peanuts have their first reaction between the ages of 14 and 24 months, often at the time of their first exposure to peanut. Currently, there is no cure for peanut allergy.

Peanut allergy has become an increasingly common problem in early childhood in the United States and the United Kingdom. Despite current public health guidelines in both countries recommending the avoidance of peanut consumption in the first years of life, the proportion of children with peanut allergy doubled in these countries over the period from 1998 to 2003. In contrast, peanuts are commonly consumed by infants in relatively high amounts in Africa, Southeast Asia and Israel, yet the rate of peanut allergy is quite low and does not appear to be increasing. Peanut consumption by infants in these parts of the world may actually protect children from developing peanut allergy by promoting oral tolerance to peanuts.

Participants in this study will be randomly assigned to either follow a peanut consumption regimen or a strict peanut avoidance regimen. Those assigned to the peanut consumption group will be asked to consume an age-appropriate snack three times a week for the duration of the study and will be monitored closely during their first introduction to peanut.

Those assigned to the peanut avoidance group will be asked to avoid ingestion of peanut for the first three years of life. A physical exam, allergy testing, and other immune system tests requiring blood collection will occur at Years 1, 3, and 5 following study entry. During the study, parents will maintain regular contact with study dietitians.

  Eligibility

Ages Eligible for Study:   4 Months to 10 Months
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Able to consume solid food
  • Allergy to eggs and/or severe eczema
  • Informed consent obtained from parent or guardian.

Exclusion Criteria:

  • Clinically significant chronic illness. Participants with eczema or recurrent wheeze are not excluded.
  • Positive skin prick test for peanut allergen with a wheel diameter greater than 4 mm in the presence of a negative saline control
  • Previous or current consumption of peanut protein that exceeds 0.2 g of peanut protein on at least one occasion or 0.5 g over a single week
  • Investigator-suspected allergy to peanut protein
  • Investigator-suspected allergy to peanut protein in care provider or current household member.
  • Diagnosis of persistent asthma
  • ALT (SGPT) or bilirubin greater than 2 times the upper limit of age-related normal value
  • BUN or creatinine greater than 1.25 times the upper limit of age-related normal value
  • Platelet count less than 100,000/mL, hemoglobin less than 9 g/dL, or investigator-suspected immunocompromise
  • Unwillingness or inability to comply with study requirements and procedures
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00329784

Locations
United Kingdom
Evelina Children's Hospital, Guy's & St Thomas' NHS Foundation Trust
London, England, United Kingdom, SE1 7EH
Sponsors and Collaborators
Immune Tolerance Network (ITN)
Investigators
Principal Investigator: Gideon Lack, MD Imperial College, St. Mary's Hospital
  More Information

Additional Information:
Publications:
Responsible Party: National Institute of Allergy and Infectious Diseases (NIAID)
ClinicalTrials.gov Identifier: NCT00329784     History of Changes
Other Study ID Numbers: DAIT ITN032AD
Study First Received: May 23, 2006
Last Updated: April 23, 2014
Health Authority: United States: Federal Government
United Kingdom: National Health Service
United Kingdom: Research Ethics Committee

Keywords provided by National Institute of Allergy and Infectious Diseases (NIAID):
peanut allergy
egg allergy
eczema
peanut
allergy
allergies
allergic reaction
anaphylaxis
infants
children

Additional relevant MeSH terms:
Hypersensitivity
Eczema
Food Hypersensitivity
Egg Hypersensitivity
Immune System Diseases
Dermatitis
Skin Diseases
Skin Diseases, Eczematous
Hypersensitivity, Immediate

ClinicalTrials.gov processed this record on July 10, 2014