Allergic Rhinitis, Allergic Rhinoconjunctivitis
Conditions
Keywords
non-seasonal allergy, house dust mite, immunotherapy, dose response
Brief summary
The objective of the present study is to characterize the dose-response relationship of PURETHAL® Mites with a nasal provocation test in order to support the optimal dose in terms of clinical efficacy and safety. For this purpose 5 groups of 50 patients, suffering from rhinitis or rhinoconjunctivitis due to House Dust Mite Allergy will be treated during 1 year. Before start, after 6 months of treatment and at the end of the study patients will be subjected to a nasal provocation test.
Interventions
Increasing volumes of placebo, will be administered by subcutaneous injection (starting with 0.05 ml) at weekly intervals till the maintenance dose (0.5 ml) is reached. Subsequently, maintenance dosages, corresponding to 0.5 ml of placebo, are given at 4-weekly intervals.
Increasing dosages, corresponding to increasing volumes of drug solution (starting with 0.05 ml), will be administered by subcutaneous injection at weekly intervals till the maintenance dose (0.5 ml) is reached. Subsequently, maintenance dosages, corresponding to 0.5 ml of drug solution, are given at 4-weekly intervals.
Increasing dosages, corresponding to increasing volumes of drug solution (starting with 0.05 ml), will be administered by subcutaneous injection at weekly intervals till the maintenance dose (0.5 ml) is reached. Subsequently, maintenance dosages, corresponding to 0.5 ml of drug solution, are given at 4-weekly intervals.
Increasing dosages, corresponding to increasing volumes of drug solution (starting with 0.05 ml), will be administered by subcutaneous injection at weekly intervals till the maintenance dose (0.5 ml) is reached. Subsequently, maintenance dosages, corresponding to 0.5 ml of drug solution, are given at 4-weekly intervals.
Increasing dosages, corresponding to increasing volumes of drug solution (starting with 0.05 ml), will be administered by subcutaneous injection at weekly intervals till the maintenance dose (0.5 ml) is reached. Subsequently, maintenance dosages, corresponding to 0.5 ml of drug solution, are given at 4-weekly intervals.
Sponsors
Study design
Eligibility
Inclusion criteria
* Signed informed consent * Patients (male or female) must be ≥ 18 and ≤ 60 years at screening * Patients with allergic rhinitis or rhinoconjunctivitis for at least 1 year; allergic symptoms related to HDM, with or without concomitant clinically stable controlled mild to moderate asthma (according to GINA classification) * Patients with a history of concomitant asthma should have a FEV1 \> 70% at inclusion. Patients without a history of asthma should have a FEV1 \> 70% or a PEF \> 80%. * Positive SPT to HDM D. pter and/or D. far * Serum specific IgE-test (ssIgE) level for HDM D. pter or D. far at screening * Positive nasal provocation test for HDM extract at screening
Exclusion criteria
* Current clinically relevant symptoms of seasonal rhinitis/rhinoconjunctivitis caused by other allergen(s) than HDM (with a demonstrated positive SPT for this allergen) at the time of inclusion * Patients sensitized to animals should not be included if they are symptomatic upon exposure and regularly exposed to animals * Completed allergen-specific immunotherapy (SCIT or SLIT) with HDM within the last 5 years * Completed unsuccessful allergen-specific immunotherapy (SCIT or SLIT) within the past 5 years * Allergen-specific immunotherapy (SCIT or SLIT) with other allergens than HDM during the study period * Any vaccination one week before start of therapy and during the up-dosing phase * Any anti-IgE therapy within the last 6 months prior to inclusion and during study * Severe immune disorders (including auto-immune diseases) and/or diseases requiring immunosuppressive drugs * Active malignancies or any malignant disease in the past 5 years * A chronic or acute disease that in the opinion of the investigator might place the patient at an additional risk, including but not limited to the following: cardiovascular insufficiency, any severe or unstable lung diseases, endocrine disorders, clinically significant renal or hepatic diseases, or haematological disorders * Moderate to severe nasal obstructive diseases such as polyps, septal deviations etc. * Clinically significant chronic sinusitis or ocular infection * Diseases with a contra-indication for the use of adrenaline (e.g. hyperthyroidism, glaucoma) * Use of systemic corticosteroids within 4 weeks of screening * Treatment with systemic or local b-blockers * Participation in a clinical study with a new investigational drug within the last 3 months or a biological within the last 6 months prior to the study or during the study * Pregnancy, lactation or inadequate contraceptive measures (contraceptive measures considered as adequate include appropriate use of oral contraception, i.m. contraception or a contraceptive device) * Alcohol, drug, or medication abuse within the past year and during study * Any abnormal laboratory parameter at screening that in the opinion of the investigator is considered clinically relevant * Lack of co-operation or compliance * Severe psychiatric, psychological, or neurological disorders * Patients who are employees of the department, 1st grade relatives, or partners of the investigator * Expected changes in HDM exposure during the study (avoidance measures, move, etc.)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Sensitivity to House Dust Mite (HDM) allergen assessed by a Nasal Provocation Test | 12 months |
Secondary
| Measure | Time frame |
|---|---|
| Sensitivity to HDM allergen assessed by a Nasal Provocation Test | 6 months |
| Average Adjusted daily Symptom Score (AAdSS) | last 2 months of treatment |
| Peak Nasal Inspiratory Flow (PNIF) | at each visit during 1 year treatment |
| Specific serum IgE, IgG, and IgG4 immunoglobulin concentrations to house dust mite | 6 and 12 months treatment |
| Local and systemic reactions after injection as a measure of Safety and Tolerability | 24 hours after each injection during 1 year treatment |
Countries
Austria, Belgium, Germany, Netherlands, Spain