Low Dose Multi-OIT for Food Allergy (LoMo) (LoMO)
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|ClinicalTrials.gov Identifier: NCT03799328|
Recruitment Status : Recruiting
First Posted : January 10, 2019
Last Update Posted : January 10, 2019
Oral immunotherapy (OIT) is a food allergy treatment where small amounts of the food a child is allergic to is eaten and gradually increased over time with the aim to be able to eat a certain amount of the allergen without experiencing an allergic reaction. While this process works in many children there are concerns about safety, feasibility and drop-outs and how to adapt protocols for multiple allergies.
Many OIT trials have targeted approximately 4000mg of single food/day. In these trials up to 40% drop-out. There is evidence much lower doses can have beneficial effects.
The investigators will evaluate if low doses of foods can allow for OIT to multiple foods. This approach may have efficacy against accidental exposure and be able to demonstrate immune changes. This approach may have a low burden of treatment and a low rate of allergic reactions and
|Condition or disease||Intervention/treatment||Phase|
|Food Allergy||Other: multi-OIT||Phase 2|
This is a single-arm, open label, study of the intervention of low dose multiple-nut OIT in nut allergic children.
After meeting eligibility criteria, participants will have a food challenge to 2-5 nuts.
If the oral food challenge is positive, participants will be enrolled in the study to multiple nut OIT. A blood draw and quality of life (QOL) survey will occur at baseline.
Participants will have dose escalation visits of the multiple nut OIT every 2 months to a target dose of 30mg of each nut protein. A blood draw and QOL survey will occur at 6 months.
Participants will then continue with daily ingestion of the 30mg of each nut protein for 1 year with visits every 3 months.
After 18 months from the start of the study, another oral food challenge will be given to participants to assess the change in the maximum tolerated dose of nuts. A blood draw will assess changes in the immune parameters. A QOL survey will occur at 18 months to assess changes in QOL.
|Study Type :||Interventional (Clinical Trial)|
|Estimated Enrollment :||18 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Low Dose Multi Allergen Oral Immunotherapy for Food Allergy|
|Estimated Study Start Date :||January 2019|
|Estimated Primary Completion Date :||January 2025|
|Estimated Study Completion Date :||January 2025|
Low dose OIT with multiple allergens
low dose OIT to multiple foods
- Desensitization to allergic food as assessed by change in maximum tolerated dose in a dichotomous manner [ Time Frame: month 0, month 18 ]Change in how much nuts the participant can eat without an allergic reaction after the low dose OIT assessed as dichotomous did the participant reach 5 times the baseline eliciting dose
- Immunological change in IgG4 [ Time Frame: month 0, month 18 ]Change in allergen specific immunoglobulin G4 (IgG4) from baseline to end
- Desensitization to allergic food as assessed by change in maximum tolerated dose on a linear scale [ Time Frame: month 0, month 18 ]A continuous variable amount tolerated at baseline vs at end
- Immunological change in IgG4 [ Time Frame: pre-study, month 18 ]Change in IgG4 from measures from historical data to 18 month of study. Some patients will have historical IgG4 values to compare
- Desensitization to allergic food as assessed by maximum tolerated dose [ Time Frame: month 18 ]Did they reach 300mg (cumulative) on the 18 month exit oral food challenge
- Desensitization to allergic food as assessed by maximum tolerated dose [ Time Frame: month 0, month 18 ]Did they reach 140mg (cumulative) on the 18 month exit oral food challenge
- Feasibility analysis as assessed by can the patients achieve the maintenance dosing of the allergen mix for OIT [ Time Frame: month 18 ]Proportion who achieve maintenance doses of their allergen mix (descriptive)
- Feasibility analysis as assessed by drop-out rate [ Time Frame: month 18 ]Proportion who drop-out of the study (descriptive)
- Incidence of Treatment-Emergent Adverse Events: Safety analysis as assessed by use of epinephrine [ Time Frame: month 18 ]Administration of epinephrine; (descriptive);
- Quality of life scale [ Time Frame: month 0, month 18 ]Change in quality of life at 18m of children compared to baseline assessment (using validated questionnaire: Food allergy quality of life questionnaires (FAQLQ) FAQLQ Parental form (PF) for ages 0-12 OR the FAQLQ-teenager form (TF) using total score. The FAQLQ total and domain scores range from 1-7 with higher scores indicative of worse health related quality of life with the total score being the average of the domain scores. The domains include Emotional Impact, Social and Dietary Restrictions, Food Anxiety, Allergen Avoidance, and Risk of Accidental Exposure.
- Change in allergen specific IgE, and components [ Time Frame: month 0, month 18 ]Change in allergen specific IgE, and components via microarray
- Basophil activation test [ Time Frame: month 0, month 18 ]Basophil activation test
- Skin prick test (SPT) reactivity to the individual nut extracts [ Time Frame: month 0, month 18 ]The size of the skin prick test will be compared
- High content functional immune profiling via mass cytometry and single cell sorting [ Time Frame: pre-study, month 18 ]Compare the change in the immune pattern
- Number of participants with treatment related adverse effects [ Time Frame: month 0, month 18 ]Diaries will be analyzed for allergic symptoms and tabulated
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03799328
|Contact: Julia Upton, MD, MPHfirstname.lastname@example.org|
|Contact: Thomas Eiwegger, MDemail@example.com|
|Hospital for Sick Children||Recruiting|
|Toronto, Ontario, Canada, M5G1X8|
|Contact: Julia Upton, MD, MPH 4168138634 firstname.lastname@example.org|
|Principal Investigator:||Julia Upton||The Hospital for Sick Children|