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Efficacy and Safety Study of a Sublingual Immunotherapy Solution to Treat Patients Suffering From Birch Pollen Allergic Rhinoconjunctivitis

Primary Purpose

Hypersensitivity, Allergic Rhinitis, Allergic Conjunctivitis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Placebo
Birch pollen allergen extract
Sponsored by
Stallergenes Greer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypersensitivity focused on measuring Sublingual immunotherapy, Birch pollen extract solution, Allergic rhinoconjunctivitis

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Symptomatic birch pollen-related allergic rhinoconjunctivitis for at least the previous 2 pollen seasons requiring intake of symptomatic treatment.
  • Sensitization to birch pollen demonstrated by a positive Skin Prick Test to birch pollen with wheal diameter > 3 mm and birch pollen allergens specific IgE levels ≥ 0.70 kU/L.
  • RRTSS based on the previous or on the penultimate birch pollen season ≥ 12 out of a maximum possible score of 18.
  • Patients with an FEV1 (Forced Expiratory Volume at one second) ≥ 80% of the predicted value.
  • Patients who are willing to comply with the protocol.
  • Patients having given a signed informed consent before completing any study related procedure.

Exclusion Criteria:

  • Patients with symptoms of rhinitis/rhinoconjunctivitis during the birch pollen season due to any other allergens (except alder and hazel). This includes patients with symptomatic allergic rhinitis/rhinoconjunctivitis due to cat or dog allergens, and living with these animals at home or at risk of frequent contacts with these animals (family, friends etc.) during the course of the study.
  • Patient who previously received desensitization treatment to birch pollen and/or another Betulaceae sp. (for example hazel or alder) within the previous 5 years.
  • Patients with ongoing treatment by immunotherapy with another allergen.
  • Pregnancy (positive pregnancy test), breast-feeding.
  • Female patients of childbearing potential planning a pregnancy during this study or not using a medically accepted contraceptive method (hormonal birth control [orally, injectable or by implant, for at least 2 months before enrolment], intrauterine device, spermicide used with a male condom, bilateral tubal ligation, diaphragm with spermicide, female condom, monogamous relationship with a vasectomised partner).
  • Patients planning to move during the study or planning to leave the area during the birch pollen season for more than 1 week (7 consecutive days).
  • Patients with moderate or severe persistent asthma (GINA 3 or 4).
  • Patients with seasonal mild persistent asthma (GINA 2) necessitating treatment with inhaled glucocorticosteroids at a dose level greater than 400 mcg budesonide dose-equivalents.
  • Patients with any nasal or oral condition that could interfere with the efficacy or safety assessments (such as nasal polyposis or oral inflammation).
  • Patients with severe immune deficiency.
  • Patients with a past or current disease, which as judged by the Investigator, may affect the patient's participation in or outcome of this study.
  • Any other disease or condition which would place a patient at undue risk by being included in the study (according to the Investigator's opinion).
  • Usual contra-indications of immunotherapy such as concomitant beta-blocker therapy whatever the route and/or immunosuppressive drugs.
  • Patients treated with inhaled/systemic steroids (whatever the indication) within 4 weeks prior to Visit 1 (Screening), or with long acting systemic corticosteroids 12 weeks before Visit 1 (Screening).
  • Patients under continuous corticotherapy (inhaled or systemic drugs).
  • Patients following a strict low sodium diet as the study treatment contains 590 mg of sodium chloride per vial in a 10 mL solution.
  • Investigators, co-Investigators, as well as their children or spouses and all study collaborators.

Sites / Locations

  • Alergologicka ordinace
  • National University Hospital - Allergy Unit 4222
  • Merekivi Perearstid OÜ
  • Helsingin yliopistollinen keskussairaala
  • NHC, Hôpitaux Universitaires de Strasbourg
  • Universitätsmedizin Berlin - Allergie-Centrum-Charité
  • Centre of Investigations and Treatment of Allergic Diseases
  • Allergic Diseases Diagnostics and Treatment Centre
  • SPZOZ Uniwersytecki Szpital Kliniczny Nr 1im.N.Barlickiego w Uniwersystetu Medycznego w Łodzi
  • Imunologicko-alergologicka amb.
  • Sahlgrenska Universitetssjukhuset - Avd för Lungmedicin och Allergi

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Birch pollen allergen extract

Arm Description

Placebo sublingual solution

Sublingual Solution of Birch pollen allergen extract 300IR once daily 5 months per year and during 2 years

Outcomes

Primary Outcome Measures

Average Adjusted Symptom Score
Symptom score adjusted on patient's rescue medication usage

Secondary Outcome Measures

Average Rhinoconjunctivitis Total Symptom Score
Average Rescue Medication Score
Each of Six Individual Average Rhinoconjunctivitis Symptom Scores
Average Combined Score
Average Rhinoconjunctivitis Visual Analogue Scale Score
Average Adjusted Visual Analogue Scale Score
Rescue Medication Usage
Proportion of Symptom-controlled Days
Rhinoconjunctivitis Quality of Life Questionnaire
Global evaluation of the efficacy by the patient
Sensitization profile
sensitization profile (mono- vs poly-sensitized) is derived from the skin prick test results
Asthma
Immunological markers specific for birch pollen
Economical Evaluation
Proportion of days-off due to birch pollen-induced symptoms
Wheal diameter of the birch allergen Skin prick test
Oral Provocation Test
Analysis on a subset of patients presenting an Oral Allergy Syndrome at study entry
Mucosa Local Inflammation
Analysis on a subset of patients
Safety assessments
adverse events, physical examination including vital signs and laboratory data described by number of patients in each treatment group
Average adjusted Symptom score analysis by tertiles

Full Information

First Posted
November 15, 2012
Last Updated
November 22, 2012
Sponsor
Stallergenes Greer
Collaborators
Quintiles, Inc., Aptuit, Cenduit LLC, PHT Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01731249
Brief Title
Efficacy and Safety Study of a Sublingual Immunotherapy Solution to Treat Patients Suffering From Birch Pollen Allergic Rhinoconjunctivitis
Official Title
A Randomised, Double-blind, Placebo-controlled, Multi-national, Phase IIIb Study to Assess the Sustained Clinical Effect and Safety of Sublingual Immunotherapy Administered as Birch Pollen Extract Solution at a Dose of 300 IR Once Daily to Patients Suffering From Birch Pollen-induced Rhinoconjunctivitis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2012
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
July 2012 (Actual)
Study Completion Date
October 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stallergenes Greer
Collaborators
Quintiles, Inc., Aptuit, Cenduit LLC, PHT Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this 2-year study is to assess the sustained clinical efficacy and safety of 300 IR/day of a sublingual solution of birch pollen allergen extract starting 4 months prior to the birch pollen season and continuing over the birch pollen season compared with placebo for reduction of rhinoconjunctivitis-related symptoms and anti-allergy medication usage.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypersensitivity, Allergic Rhinitis, Allergic Conjunctivitis, Seasonal Allergy
Keywords
Sublingual immunotherapy, Birch pollen extract solution, Allergic rhinoconjunctivitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
574 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo sublingual solution
Arm Title
Birch pollen allergen extract
Arm Type
Experimental
Arm Description
Sublingual Solution of Birch pollen allergen extract 300IR once daily 5 months per year and during 2 years
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
10 actuations of placebo sublingual solution once daily 5 months a year and during 2 years
Intervention Type
Biological
Intervention Name(s)
Birch pollen allergen extract
Other Intervention Name(s)
Staloral Birch
Intervention Description
Sublingual solution of Birch pollen allergen extract 300IR (10 actuations) once daily 5 months per year and during 2 years
Primary Outcome Measure Information:
Title
Average Adjusted Symptom Score
Description
Symptom score adjusted on patient's rescue medication usage
Time Frame
Year 2 of treatment
Secondary Outcome Measure Information:
Title
Average Rhinoconjunctivitis Total Symptom Score
Time Frame
Year 2 of treatment
Title
Average Rescue Medication Score
Time Frame
Year 2 of treatment
Title
Each of Six Individual Average Rhinoconjunctivitis Symptom Scores
Time Frame
Year 2 of treatment
Title
Average Combined Score
Time Frame
Year 2 of treatment
Title
Average Rhinoconjunctivitis Visual Analogue Scale Score
Time Frame
Year 2 of treatment
Title
Average Adjusted Visual Analogue Scale Score
Time Frame
Year 2 of treatment
Title
Rescue Medication Usage
Time Frame
Year 2 of treatment
Title
Proportion of Symptom-controlled Days
Time Frame
Year 2 of treatment
Title
Rhinoconjunctivitis Quality of Life Questionnaire
Time Frame
Year 2 of treatment
Title
Global evaluation of the efficacy by the patient
Time Frame
Year 2 of treatment
Title
Sensitization profile
Description
sensitization profile (mono- vs poly-sensitized) is derived from the skin prick test results
Time Frame
Before and after each treatment period (over 2 years)
Title
Asthma
Time Frame
Before, during and after each pollen season (over 2 years)
Title
Immunological markers specific for birch pollen
Time Frame
Before and after each treatment period (over 2 years)
Title
Economical Evaluation
Description
Proportion of days-off due to birch pollen-induced symptoms
Time Frame
Year 2 of treatment
Title
Wheal diameter of the birch allergen Skin prick test
Time Frame
Before and after each treatment period (over 2 years)
Title
Oral Provocation Test
Description
Analysis on a subset of patients presenting an Oral Allergy Syndrome at study entry
Time Frame
Year 2 of treatment
Title
Mucosa Local Inflammation
Description
Analysis on a subset of patients
Time Frame
Year 1 of treatment
Title
Safety assessments
Description
adverse events, physical examination including vital signs and laboratory data described by number of patients in each treatment group
Time Frame
~20 months
Title
Average adjusted Symptom score analysis by tertiles
Time Frame
Year 2 of treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Symptomatic birch pollen-related allergic rhinoconjunctivitis for at least the previous 2 pollen seasons requiring intake of symptomatic treatment. Sensitization to birch pollen demonstrated by a positive Skin Prick Test to birch pollen with wheal diameter > 3 mm and birch pollen allergens specific IgE levels ≥ 0.70 kU/L. RRTSS based on the previous or on the penultimate birch pollen season ≥ 12 out of a maximum possible score of 18. Patients with an FEV1 (Forced Expiratory Volume at one second) ≥ 80% of the predicted value. Patients who are willing to comply with the protocol. Patients having given a signed informed consent before completing any study related procedure. Exclusion Criteria: Patients with symptoms of rhinitis/rhinoconjunctivitis during the birch pollen season due to any other allergens (except alder and hazel). This includes patients with symptomatic allergic rhinitis/rhinoconjunctivitis due to cat or dog allergens, and living with these animals at home or at risk of frequent contacts with these animals (family, friends etc.) during the course of the study. Patient who previously received desensitization treatment to birch pollen and/or another Betulaceae sp. (for example hazel or alder) within the previous 5 years. Patients with ongoing treatment by immunotherapy with another allergen. Pregnancy (positive pregnancy test), breast-feeding. Female patients of childbearing potential planning a pregnancy during this study or not using a medically accepted contraceptive method (hormonal birth control [orally, injectable or by implant, for at least 2 months before enrolment], intrauterine device, spermicide used with a male condom, bilateral tubal ligation, diaphragm with spermicide, female condom, monogamous relationship with a vasectomised partner). Patients planning to move during the study or planning to leave the area during the birch pollen season for more than 1 week (7 consecutive days). Patients with moderate or severe persistent asthma (GINA 3 or 4). Patients with seasonal mild persistent asthma (GINA 2) necessitating treatment with inhaled glucocorticosteroids at a dose level greater than 400 mcg budesonide dose-equivalents. Patients with any nasal or oral condition that could interfere with the efficacy or safety assessments (such as nasal polyposis or oral inflammation). Patients with severe immune deficiency. Patients with a past or current disease, which as judged by the Investigator, may affect the patient's participation in or outcome of this study. Any other disease or condition which would place a patient at undue risk by being included in the study (according to the Investigator's opinion). Usual contra-indications of immunotherapy such as concomitant beta-blocker therapy whatever the route and/or immunosuppressive drugs. Patients treated with inhaled/systemic steroids (whatever the indication) within 4 weeks prior to Visit 1 (Screening), or with long acting systemic corticosteroids 12 weeks before Visit 1 (Screening). Patients under continuous corticotherapy (inhaled or systemic drugs). Patients following a strict low sodium diet as the study treatment contains 590 mg of sodium chloride per vial in a 10 mL solution. Investigators, co-Investigators, as well as their children or spouses and all study collaborators.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Margitta WORM, MD, PR
Organizational Affiliation
Allergie-Centrum-Charité, Klinik für Dermatologie, Venerologie und Allergologie, Charité Campus Mitte, Universitätsmedizin, Charitéplatz 1, 10117 Berlin, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Alergologicka ordinace
City
Plzen
ZIP/Postal Code
30100
Country
Czech Republic
Facility Name
National University Hospital - Allergy Unit 4222
City
Copenhagen
ZIP/Postal Code
2100
Country
Denmark
Facility Name
Merekivi Perearstid OÜ
City
Tallinn
ZIP/Postal Code
10617
Country
Estonia
Facility Name
Helsingin yliopistollinen keskussairaala
City
Helsinki
ZIP/Postal Code
00029
Country
Finland
Facility Name
NHC, Hôpitaux Universitaires de Strasbourg
City
Strasbourg
ZIP/Postal Code
67091
Country
France
Facility Name
Universitätsmedizin Berlin - Allergie-Centrum-Charité
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Centre of Investigations and Treatment of Allergic Diseases
City
Riga
ZIP/Postal Code
1003
Country
Latvia
Facility Name
Allergic Diseases Diagnostics and Treatment Centre
City
Vilnius
ZIP/Postal Code
08109
Country
Lithuania
Facility Name
SPZOZ Uniwersytecki Szpital Kliniczny Nr 1im.N.Barlickiego w Uniwersystetu Medycznego w Łodzi
City
Lodz
ZIP/Postal Code
90-153
Country
Poland
Facility Name
Imunologicko-alergologicka amb.
City
Banska Bystrica
ZIP/Postal Code
975 17
Country
Slovakia
Facility Name
Sahlgrenska Universitetssjukhuset - Avd för Lungmedicin och Allergi
City
Göteborg
ZIP/Postal Code
413 45
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
24517417
Citation
Worm M, Rak S, de Blay F, Malling HJ, Melac M, Cadic V, Zeldin RK. Sustained efficacy and safety of a 300IR daily dose of a sublingual solution of birch pollen allergen extract in adults with allergic rhinoconjunctivitis: results of a double-blind, placebo-controlled study. Clin Transl Allergy. 2014 Feb 11;4(1):7. doi: 10.1186/2045-7022-4-7.
Results Reference
derived

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Efficacy and Safety Study of a Sublingual Immunotherapy Solution to Treat Patients Suffering From Birch Pollen Allergic Rhinoconjunctivitis

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