Allergy, Asthma
Conditions
Brief summary
To establish efficacy and safety of HDM sublingual Immunotherapy (HDM-SLIT) by comparing Odactra and placebo, when given sublingually for 3 years to high risk infants aged between 6 to 12 months at enrollment in preventing the development of asthma, assessed 1.5 years after discontinuation of treatment.
Detailed description
Aim to prevent the development of asthma in children by intervening at a time when the developing system in still amenable to immune modulation, by using the only therapy that has proven ability to change the natural history of allergic diseases and induce clinical remission. We hypothesize that three years of HDM Immunotherapy in high-risk infants will prevent the development of asthma assessed over a period of 1.5 years after discontinuation of treatment and HDM immunotherapy will result in (a) a significant reduction in the number and pathogenic features of HDM-reactive TH2 cells, and (b) an increase in the numbers of HDM-reactive TH and TREG cells expressing the interferon-response signature. The study is a Randomized (1:1), double blinded, placebo controlled, parallel arms, multi-site, Phase II study with a 3 year treatment phase and further 1.5 year follow-up phase. The study duration for each participant is 4.5 years. Overall study duration is 84 months (7 years); which include 9 months preparation and regulatory approvals, 15 months accrual, 36 months treatment and 18 months follow-up observation period.
Interventions
DRUGHDM sublingual Immunotherapy
HDM-SLIT tablet (Odactra®/Acarizax®) is a rapidly dissolving, freeze-dried, oral lyophilizate for oromucosal treatment, which contains a 1:1 mixture of two allergen extracts derived for the cultivated house dust mites, D. pteronyssinus and D. farinae. These species are included in SLIT tablet and subcutaneous immunotherapy administered for the treatment of allergic rhinitis and asthma in the pediatric and adult populations. The tablet dissolves within seconds after contact with a wet surface such as the oral mucosa. Participants will be administered the drug sublingually for 3 years.
DRUGPlacebo
Placebo sublingual therapy
Sponsors
Children's Hospital Medical Center, Cincinnati
University of North Carolina, Chapel Hill
George Washington University
Emory University
University of Southampton
Imperial College London
Boston Children's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
double blinded
Intervention model description
Randomized (1:1), double blinded, placebo controlled, parallel arms, multi-site, Phase II study; 3 year treatment phase with further 1.5 year follow-up phase.
Eligibility
Sex/Gender
ALL
Age
6 Months to 12 Months
Healthy volunteers
Yes
Inclusion criteria
1. Aged 6 to 12 months of age 2. history of physician diagnosed atopic dermatitis OR 3. allergen sensitization OR 4. family history of asthma or allergy
Exclusion criteria
1. Evidence of sensitization to house dust mite (SPT ≥3 mm OR sIgE (\> 0.35 kU/L) 2. Prematurity (\<37 weeks) 3. Failure to thrive 4. Need for oxygen for more than 5 days in the neonatal period 5. history of intubation or mechanical ventilation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with Asthma | 1.5 years after discontinuation of 3 years of treatment | asthma diagnosis |
Outcome results
None listed