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A Dose-response Evaluation of the SQ Tree SLIT-tablet Using an Environmental Exposure Chamber

Primary Purpose

Allergic Rhinoconjunctivitis

Status
Completed
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
SQ tree SLIT-tablet
Placebo
Sponsored by
ALK-Abelló A/S
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Allergic Rhinoconjunctivitis

Eligibility Criteria

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

Inclusion Criteria:

  • Written informed consent obtained before any trial related procedures are performed
  • Male or female aged 18 to 65 years
  • Female subjects of child-bearing potential must have a negative urine pregnancy test and be willing to practise contraceptive methods
  • History of moderate-to-severe rhinoconjunctivitis induced by pollens from the birch group with or without asthma despite having received treatment with symptom relieving medication during the previous 2 tree pollen seasons
  • Positive SPT response (wheal diameter ≥ 3 mm) to Betula verrucosa
  • Positive specific IgE against Bet v1 (≥ IgE Class 2; ≥0.70 kU/L)
  • Willing and able to comply with the trial protocol
  • Minimum level of rhinoconjunctivitis symptoms, defined as a TSS of at least 7 (of 18), at one timepoint during birch baseline EEC session.

Exclusion Criteria:

  • Symptoms induced by interfering allergens that are expected to be present during the periods where the subject attends the EEC sessions
  • Rhinoconjunctivitis caused by animal hair and dander to which the subject is regularly exposed.
  • Allergic symptoms induced by perennial allergens such as house dust mites, and moulds
  • A clinical history of uncontrolled asthma within 3 months prior to screening
  • Reduced lung function FEV1 (< 70% of predicted value after adequate pharmacological treatment)
  • Asthma requiring treatment with inhaled corticosteroid within the past 3 months prior to screening
  • Previous treatment with any allergy immunotherapy product with tree pollen allergens or a cross-reacting allergen within the past 5 years
  • Ongoing treatment with any allergy immunotherapy product
  • Immunosuppressive treatment within 3 months prior to the screening visit
  • Treatment with tricyclic antidepressants, catecholamine-O-methyltransferase inhibitors, mono amine oxidase inhibitors and beta-blockers
  • Treatment with antidepressant medication with antihistaminic effect
  • Treatment with antipsychotic medications with antihistaminic effect
  • Treatment with anti-IgE drugs within 130 days/5 half-lives of the drug (which ever longest)
  • Treatment with an investigational drug within 30 days/5 half-lives of the drug (which ever longest) prior to screening
  • Severe oral inflammation or oral wounds at randomisation
  • Symptoms of or treatment for upper respiratory tract infection, acute sinusitis, acute otitis media or other relevant infections that have not resolved 1-week prior to the baseline birch and oak Environmental Exposure Chamber sessions and at the randomisation visit
  • Clinically relevant nasal polyps
  • A history of paranasal sinus surgery
  • A history of surgery of nasal turbinates
  • A history of anaphylaxis with cardiorespiratory symptoms
  • A history of recurrent (defined as two or more episodes) generalised urticaria during the last 2 years
  • A history of drug-induced (incl. Allergy Immunotherapy) facial angioedema or a family (parents and siblings) history of hereditary angioedema
  • Any clinically relevant chronic disease (≥3 months duration) that in the opinion of the investigator would interfere with the trial assessments or the safety of the subject
  • An uncontrolled systemic disease affecting the immune system (e.g. insulin-dependent diabetes, autoimmune disease, immune complex disease, or immune deficiency disease whether acquired or not)
  • A history of allergy, hypersensitivity or intolerance to the investigational medicinal product (except Betula verrucosa) or any of the symptomatic medications provided in this trial
  • Being immediate family of the investigator or trial staff, defined as the investigator's/staff's spouse, parent, child, grandparent or grandchild.

Sites / Locations

  • Inflamax Research Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

12 DU SQ tree SLIT-tablet

7 DU SQ tree SLIT-tablet

2 DU SQ tree SLIT-tablet

Placebo

Arm Description

Betula verrucosa, allergen extract, Oral lyophilisate

Betula verrucosa, allergen extract, Oral lyophilisate

Betula verrucosa, allergen extract, Oral lyophilisate

No active ingredient, Oral lyophilisate

Outcomes

Primary Outcome Measures

Average total rhinoconjunctivitis symptom score
The total rhinoconjunctivitis symptom score will measured during a birch pollen challenge in the Inflamax Environmental Exposure Chamber

Secondary Outcome Measures

Average total rhinoconjunctivitis symptom score
The total rhinoconjunctivitis symptom score will measured during a birch pollen challenge in the Inflamax Environmental Exposure Chamber
Average total rhinoconjunctivitis symptom score
The total rhinoconjunctivitis symptom score will measured during an oak pollen challenge in the Inflamax Environmental Exposure Chamber
Adverse events
Adverse events will be grouped by number of treatment-emergent AEs and IMP-related AEs and will further summarised by treatment group and MedDRA SOC, MedDRA PT and broken down by severity, seriousness, action taken, time from first intake to AE and re-occurence after IMP administration
Vital signs
Lung function measures
Forced expiratory volume in 1 second and peak flow measurements will be performed.
Changes in significant clinical safety laboratory values
Standard haematology, biochemistry, urinalysis analysis will be performed for each subject before and after the 24-weeks treatment period.

Full Information

First Posted
April 30, 2015
Last Updated
January 18, 2017
Sponsor
ALK-Abelló A/S
Collaborators
Inflamax Research Incorporated
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1. Study Identification

Unique Protocol Identification Number
NCT02481856
Brief Title
A Dose-response Evaluation of the SQ Tree SLIT-tablet Using an Environmental Exposure Chamber
Official Title
A Dose-response Evaluation of the SQ Tree SLIT-tablet in Subjects With Moderate to Severe Allergic Rhinoconjunctivitis Induced by Pollens From the Birch Group During Controlled Exposure in an Environmental Exposure Chamber
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
April 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ALK-Abelló A/S
Collaborators
Inflamax Research Incorporated

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The trial is a phase II, randomised, parallel-group, double-blind, placebo-controlled multi-site trial conducted in Canada. Before the start of treatment, the subjects will undergo baseline birch and oak Environmental Exposure Chamber sessions. The treatment duration is 24 weeks. The subjects will undergo birch Environmental Exposure Chamber sessions after 8, 16 and 24 weeks of treatment and an oak Environmental Exposure Chamber session after 24 weeks of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Allergic Rhinoconjunctivitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
219 (Actual)

8. Arms, Groups, and Interventions

Arm Title
12 DU SQ tree SLIT-tablet
Arm Type
Experimental
Arm Description
Betula verrucosa, allergen extract, Oral lyophilisate
Arm Title
7 DU SQ tree SLIT-tablet
Arm Type
Experimental
Arm Description
Betula verrucosa, allergen extract, Oral lyophilisate
Arm Title
2 DU SQ tree SLIT-tablet
Arm Type
Experimental
Arm Description
Betula verrucosa, allergen extract, Oral lyophilisate
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
No active ingredient, Oral lyophilisate
Intervention Type
Drug
Intervention Name(s)
SQ tree SLIT-tablet
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Average total rhinoconjunctivitis symptom score
Description
The total rhinoconjunctivitis symptom score will measured during a birch pollen challenge in the Inflamax Environmental Exposure Chamber
Time Frame
After 24 weeks of treatment
Secondary Outcome Measure Information:
Title
Average total rhinoconjunctivitis symptom score
Description
The total rhinoconjunctivitis symptom score will measured during a birch pollen challenge in the Inflamax Environmental Exposure Chamber
Time Frame
After 8 and 16 weeks of treatment
Title
Average total rhinoconjunctivitis symptom score
Description
The total rhinoconjunctivitis symptom score will measured during an oak pollen challenge in the Inflamax Environmental Exposure Chamber
Time Frame
After 24 weeks of treatment
Title
Adverse events
Description
Adverse events will be grouped by number of treatment-emergent AEs and IMP-related AEs and will further summarised by treatment group and MedDRA SOC, MedDRA PT and broken down by severity, seriousness, action taken, time from first intake to AE and re-occurence after IMP administration
Time Frame
During the 24-weeks treatment period
Title
Vital signs
Time Frame
During the 24-weeks treatment period
Title
Lung function measures
Description
Forced expiratory volume in 1 second and peak flow measurements will be performed.
Time Frame
During the 24-weeks treatment period
Title
Changes in significant clinical safety laboratory values
Description
Standard haematology, biochemistry, urinalysis analysis will be performed for each subject before and after the 24-weeks treatment period.
Time Frame
Before and after the 24-weeks treatment period

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: Written informed consent obtained before any trial related procedures are performed Male or female aged 18 to 65 years Female subjects of child-bearing potential must have a negative urine pregnancy test and be willing to practise contraceptive methods History of moderate-to-severe rhinoconjunctivitis induced by pollens from the birch group with or without asthma despite having received treatment with symptom relieving medication during the previous 2 tree pollen seasons Positive SPT response (wheal diameter ≥ 3 mm) to Betula verrucosa Positive specific IgE against Bet v1 (≥ IgE Class 2; ≥0.70 kU/L) Willing and able to comply with the trial protocol Minimum level of rhinoconjunctivitis symptoms, defined as a TSS of at least 7 (of 18), at one timepoint during birch baseline EEC session. Exclusion Criteria: Symptoms induced by interfering allergens that are expected to be present during the periods where the subject attends the EEC sessions Rhinoconjunctivitis caused by animal hair and dander to which the subject is regularly exposed. Allergic symptoms induced by perennial allergens such as house dust mites, and moulds A clinical history of uncontrolled asthma within 3 months prior to screening Reduced lung function FEV1 (< 70% of predicted value after adequate pharmacological treatment) Asthma requiring treatment with inhaled corticosteroid within the past 3 months prior to screening Previous treatment with any allergy immunotherapy product with tree pollen allergens or a cross-reacting allergen within the past 5 years Ongoing treatment with any allergy immunotherapy product Immunosuppressive treatment within 3 months prior to the screening visit Treatment with tricyclic antidepressants, catecholamine-O-methyltransferase inhibitors, mono amine oxidase inhibitors and beta-blockers Treatment with antidepressant medication with antihistaminic effect Treatment with antipsychotic medications with antihistaminic effect Treatment with anti-IgE drugs within 130 days/5 half-lives of the drug (which ever longest) Treatment with an investigational drug within 30 days/5 half-lives of the drug (which ever longest) prior to screening Severe oral inflammation or oral wounds at randomisation Symptoms of or treatment for upper respiratory tract infection, acute sinusitis, acute otitis media or other relevant infections that have not resolved 1-week prior to the baseline birch and oak Environmental Exposure Chamber sessions and at the randomisation visit Clinically relevant nasal polyps A history of paranasal sinus surgery A history of surgery of nasal turbinates A history of anaphylaxis with cardiorespiratory symptoms A history of recurrent (defined as two or more episodes) generalised urticaria during the last 2 years A history of drug-induced (incl. Allergy Immunotherapy) facial angioedema or a family (parents and siblings) history of hereditary angioedema Any clinically relevant chronic disease (≥3 months duration) that in the opinion of the investigator would interfere with the trial assessments or the safety of the subject An uncontrolled systemic disease affecting the immune system (e.g. insulin-dependent diabetes, autoimmune disease, immune complex disease, or immune deficiency disease whether acquired or not) A history of allergy, hypersensitivity or intolerance to the investigational medicinal product (except Betula verrucosa) or any of the symptomatic medications provided in this trial Being immediate family of the investigator or trial staff, defined as the investigator's/staff's spouse, parent, child, grandparent or grandchild.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Couroux, MD
Organizational Affiliation
Inflamax Research Incorporated
Official's Role
Principal Investigator
Facility Information:
Facility Name
Inflamax Research Inc.
City
Mississauga
State/Province
Ontario
ZIP/Postal Code
ON, L4W 1A4
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
33905129
Citation
Biedermann T, Couroux P, Greve TM, Makela M. Safety of the standardized quality tree sublingual immunotherapy tablet: Pooled safety analysis of clinical trials. Allergy. 2021 Dec;76(12):3733-3742. doi: 10.1111/all.14882. Epub 2021 May 15.
Results Reference
derived

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A Dose-response Evaluation of the SQ Tree SLIT-tablet Using an Environmental Exposure Chamber

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