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Safety and Efficacy of Low-dose IL-2 in Birch Pollen Allergy (Rhinil-2)

Primary Purpose

Allergic Rhinoconjunctivitis to Birch Pollen, With a Positive Skin Prick Test to Birch Pollen

Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
ILT-101 ld-(IL2)
Sponsored by
Assistance Publique - Hôpitaux de Paris
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Allergic Rhinoconjunctivitis to Birch Pollen

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria

  • male or female aged between18-55 years
  • Positive clinical history of seasonal allergic rhinitis to birch pollen for at least 2 consecutive pollinic seasons before inclusion and requiring medication intake with or without GINA 1 associated asthma, with documentation of sensitivity within 12 months before enrollment by : *Positive skin prick test (SPT) and validated in vitro tests for specific Immunoglobulin E (IgE); *Positive Skin prick test (SPT): wheal for birch pollen ≥ 5 mm in diameter for histamine wheal ≥ 3 mm (positive control) and NaCl reaction < 2 mm (negative control) *Positive specific IgE to birch pollen >0.75 kUI/L;
  • Negative beta-HcG pregnancy test at screening visit for women of childbearing age;
  • Normal electrocardiogram without clinically significant abnormalities;
  • Ability to stay in the EEC for up to 4 hours, without any conditions or factors which could make this not possible
  • Positive nasal response (TNSS≥5) at baseline exposure
  • Free, informed and written consent signed by the patient and the investigator, before any specific examination required by the study;
  • Affiliation to a social security scheme (beneficiary or assignee)
  • Negative SARS-CoV-2 test less than 72 hours prior to screening visit

Exclusion Criteria:

  • Asthma: GINA 2 to 5
  • Eosinophilia > 0.6x109/mL;
  • Any history of anaphylactic reactions;
  • Specific immunotherapy treatment at the moment, including Omalizumab;
  • Specific immunotherapy for birch-pollens within 3 previous years;
  • Use of systemic corticosteroid or others immunosuppressive treatment within previous 6 months;
  • Moderate to severe allergic rhinoconjunctivitis with or without asthma due to grass pollen, if the study is performed during grass pollen season (according to ARIA)
  • Significant rhinitis, or sinusitis, due to daily contact with other allergen causing symptoms that are expected to coincide with exposures, as assessed by the investigator
  • Contraindications known to treatment with IL-2:

    • Hypersensitivity to the active substance or to any of the excipients;
    • Immunosuppressed patient;
    • Psychotropic, hepatotoxic, nephrotoxic, myelotoxic or cardiotoxic drugs;
    • Other chronic diseases not clinically controlled;
    • Signs of active infection requiring treatment;
    • Previous history of organ transplantation.
    • Heart failure (≥ grade II, class. NYHA), kidney failure (Cockroft <60 ml/min/1.73m2), liver failure (transaminase> 3N), pulmonary insufficiency (any grade);
  • Leukocytes <3000 / mm3 lymphocytes <800 / mm3, platelets <80 000 / mm3, Hemoglobin < 10.0 g/dL or 6.2 mmol/L, red cell blood < 3.5 T/L;
  • Positivity of at least one of the thyroid-specific antibodies (anti-TPO, anti-TG, or anti-TRAKS) associated with an abnormal thyroid workup (TSH, T3, or T4) at inclusion;
  • Chronic uncontrolled arterial hypertension (Systolic BP > 140 mmHg and/or Diastolic BP > 90 mmHg);
  • Poor venous capital will forbid blood samples;
  • Vaccination with attenuated live vaccine in the month before the inclusion or planned during the study;
  • Vaccination against COVID-19 during the study period or if the 2nd dose of vaccine is planned during the 15 days preceding Visit 3
  • Surgery in the previous three months or anticipated under study;
  • Participation in other interventional research with study drug in the previous month and during the study;
  • Psychiatric illness or any other concomitant chronic illness or addiction that could interfere with the ability to meet the requirements of the protocol or provide informed consent;
  • Presence or history of unhealed cancer for more than five years, presence or history of healed cancer for less than five years, except carcinoma in situ of the cervix or basal cell carcinoma;
  • Pregnant or lactating women;
  • Men and women of childbearing age without effective contraception during the treatment period;

Sites / Locations

  • CIC Paris Est GH Pitié Salpétrière

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

ILT-101 (ld-IL2)

placebo

Arm Description

Subcutaneous injections of ILT-101

Subcutaneous injections of placebo

Outcomes

Primary Outcome Measures

Change in nasal congestion expressed as area under the curve (AUC), during birch allergen exposure in ALYATEC's Environmental Exposure Chamber (EEC)
Change in nasal congestion expressed as area under the curve (AUC), during birch allergen exposure in ALYATEC's Environmental Exposure Chamber (EEC)

Secondary Outcome Measures

Change in nasal congestion expressed as area under the curve (AUC), assessed during 4 hours of exposure
TNSS, expressed as area under the curve (AUC), assessed during 4 hours of exposure: TOTAL NASAL SYMPTOM SCORE Definition of response choices (drop down menu for each of the 4 questions below) 0 = None 1 = Mild (symptom clearly present but easily tolerated) 2 = Moderate (annoying but tolerable symptom) 3 = Severe (difficult to tolerate symptom, disrupts activities)
Change in nasal response intensity
determined by Visual Analogue Scale (VAS) ranged from 0 to 10 cm where higher values correspond to more intense symptoms
Changes in Tregs expressed in percentag (%)
Changes in Tregs in percentag compared to baseline
Changes in Tregs expressed in percentag (%)
Changes in Tregs in percentag compared to baseline
Changes in Tregs expressed in percentag (%)
Changes in Tregs in percentag compared to baseline
Changes in absolute count in Tregs
Changes in absolute count in Tregs compared to baseline
Changes in absolute count in Tregs
Changes in absolute count in Tregs compared to baseline
Changes in absolute count in Tregs
Changes in absolute count in Tregs compared to baseline
Changes in eosinophils expressed in percentag (%)
Changes in eosinophils in percentag compared to baseline
Changes in eosinophils expressed in percentag (%)
Changes in eosinophils in percentag compared to baseline
Changes in eosinophils expressed in percentag (%)
Changes in eosinophils in percentag compared to baseline
Changes in absolute count in eosinophils
Changes in absolute count in eosinophils compared to baseline
Changes in absolute count in eosinophils
Changes in absolute count in eosinophils compared to baseline
Changes in absolute count in eosinophils
Changes in absolute count in eosinophils compared to baseline
Changes in Inate Lymphoid Cell type 2(ILC2) expressed in percentag (%)
Changes in Inate Lymphoid Cell type 2 in percentag compared to baseline
Changes in Inate Lymphoid Cell type 2(ILC2) expressed in percentag (%)
Changes in Inate Lymphoid Cell type 2 in percentag compared to baseline
Changes in Inate Lymphoid Cell type 2(ILC2) expressed in percentag (%)
Changes in Inate Lymphoid Cell type 2 in percentag compared to baseline
Changes in absolute count in Inate Lymphoid Cell type 2(ILC2)
Changes (in absolute count in Inate Lymphoid Cell type 2 compared to baseline
Changes in absolute count in Inate Lymphoid Cell type 2(ILC2)
Changes (in absolute count in Inate Lymphoid Cell type 2 compared to baseline
Changes in absolute count in Inate Lymphoid Cell type 2(ILC2)
Changes (in absolute count in Inate Lymphoid Cell type 2 compared to baseline
Changes of antigen-specific T-cell immune responses (cytokine IL-4 )
cytokine IL-4 at day 40
Changes of antigen-specific T-cell immune responses (cytokine IL-4 )
cytokine IL-4 at day 70
Changes of antigen-specific T-cell immune responses (cytokine IL-5)
cytokine IL-5 at day 40
Changes of antigen-specific T-cell immune responses (cytokine IL-5)
cytokine IL-5 at day 70
Changes of antigen-specific T-cell immune responses
IL-13 secretion after antigen restimulation at day 40
Changes of antigen-specific T-cell immune responses
IL-13 secretion after antigen restimulation at day 70
Changes in allergen-specific IgE dosages basophil activation test with pollen allergen
allergen-specific IgE dosages at day 40
Incidence of adverse events at day 8
Adverse events throughout the study (according to NCI-CTC AE classification)
Incidence of adverse events at day 40
Adverse events throughout the study (according to NCI-CTC AE classification)
Incidence of adverse events at 70
Adverse events throughout the study (according to NCI-CTC AE classification)

Full Information

First Posted
November 20, 2018
Last Updated
December 13, 2022
Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Iltoo Pharma
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1. Study Identification

Unique Protocol Identification Number
NCT03776643
Brief Title
Safety and Efficacy of Low-dose IL-2 in Birch Pollen Allergy
Acronym
Rhinil-2
Official Title
Safety and Efficacy of Low-dose IL-2 in Birch Pollen Allergy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
February 1, 2019 (Actual)
Primary Completion Date
August 16, 2022 (Actual)
Study Completion Date
August 16, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Assistance Publique - Hôpitaux de Paris
Collaborators
Iltoo Pharma

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Several studies have reported a deficit and/or a defect in regulatory T cells in allergic subjects, which can be correlated with the allergic responses, especially for respiratory allergies. Low-dose IL-2 (ld-IL2) specifically targets and activates regulatory T cells (Tregs), which are cells that regulate immune responses. Thus by stimulating Tregs, ld-IL2 would control allergic responses. This study is designed to evaluate the efficacy of ILT-101 (ld-IL-2), compared to placebo, on the nasal response assessed by Total Nasal Symptom Score (TNSS) during a controlled birch allergen exposure.
Detailed Description
Primary objective To evaluate the efficacy of ILT-101 (ld-IL-2), compared to placebo, on nasal response on day 40 Secondary objectives To evaluate the efficacy of ILT-101 on rhino-conjunctivitis symptoms, on inflammatory mediators, allergic specific immune responses and safety. Experimental design This is a monocentric, randomized, placebo controlled, double-blind trial in parallel-groups, evaluating a treatment by ILT-101/placebo, 1 MIU daily for 5 days and 1 MIU every week, until day 36. Population involved Male or female, aged between 18 and 55 years, with allergic rhinitis to birch pollen. Number of subjects: 24 Duration of patient participation: 3 months (treatment period: 36 days months, follow-up period: 34 days)

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Allergic Rhinoconjunctivitis to Birch Pollen, With a Positive Skin Prick Test to Birch Pollen

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Safety/Efficacy
Masking
ParticipantInvestigator
Masking Description
Double Blind
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
ILT-101 (ld-IL2)
Arm Type
Experimental
Arm Description
Subcutaneous injections of ILT-101
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
Subcutaneous injections of placebo
Intervention Type
Drug
Intervention Name(s)
ILT-101 ld-(IL2)
Other Intervention Name(s)
Placebo
Intervention Description
Subcutaneous injections of ILT-101 or Placebo starting with once-daily administration for 5 consecutive days followed by once every two weeks administration during five months
Primary Outcome Measure Information:
Title
Change in nasal congestion expressed as area under the curve (AUC), during birch allergen exposure in ALYATEC's Environmental Exposure Chamber (EEC)
Description
Change in nasal congestion expressed as area under the curve (AUC), during birch allergen exposure in ALYATEC's Environmental Exposure Chamber (EEC)
Time Frame
on day 40
Secondary Outcome Measure Information:
Title
Change in nasal congestion expressed as area under the curve (AUC), assessed during 4 hours of exposure
Description
TNSS, expressed as area under the curve (AUC), assessed during 4 hours of exposure: TOTAL NASAL SYMPTOM SCORE Definition of response choices (drop down menu for each of the 4 questions below) 0 = None 1 = Mild (symptom clearly present but easily tolerated) 2 = Moderate (annoying but tolerable symptom) 3 = Severe (difficult to tolerate symptom, disrupts activities)
Time Frame
at Day 8
Title
Change in nasal response intensity
Description
determined by Visual Analogue Scale (VAS) ranged from 0 to 10 cm where higher values correspond to more intense symptoms
Time Frame
at Day 8
Title
Changes in Tregs expressed in percentag (%)
Description
Changes in Tregs in percentag compared to baseline
Time Frame
at day 8
Title
Changes in Tregs expressed in percentag (%)
Description
Changes in Tregs in percentag compared to baseline
Time Frame
at day 40
Title
Changes in Tregs expressed in percentag (%)
Description
Changes in Tregs in percentag compared to baseline
Time Frame
at day 70
Title
Changes in absolute count in Tregs
Description
Changes in absolute count in Tregs compared to baseline
Time Frame
at day 8
Title
Changes in absolute count in Tregs
Description
Changes in absolute count in Tregs compared to baseline
Time Frame
at day 40
Title
Changes in absolute count in Tregs
Description
Changes in absolute count in Tregs compared to baseline
Time Frame
at day 70
Title
Changes in eosinophils expressed in percentag (%)
Description
Changes in eosinophils in percentag compared to baseline
Time Frame
at day 8
Title
Changes in eosinophils expressed in percentag (%)
Description
Changes in eosinophils in percentag compared to baseline
Time Frame
at day 40
Title
Changes in eosinophils expressed in percentag (%)
Description
Changes in eosinophils in percentag compared to baseline
Time Frame
at day 70
Title
Changes in absolute count in eosinophils
Description
Changes in absolute count in eosinophils compared to baseline
Time Frame
at day 8
Title
Changes in absolute count in eosinophils
Description
Changes in absolute count in eosinophils compared to baseline
Time Frame
at day 40
Title
Changes in absolute count in eosinophils
Description
Changes in absolute count in eosinophils compared to baseline
Time Frame
at day 70
Title
Changes in Inate Lymphoid Cell type 2(ILC2) expressed in percentag (%)
Description
Changes in Inate Lymphoid Cell type 2 in percentag compared to baseline
Time Frame
at day 8
Title
Changes in Inate Lymphoid Cell type 2(ILC2) expressed in percentag (%)
Description
Changes in Inate Lymphoid Cell type 2 in percentag compared to baseline
Time Frame
at day 40
Title
Changes in Inate Lymphoid Cell type 2(ILC2) expressed in percentag (%)
Description
Changes in Inate Lymphoid Cell type 2 in percentag compared to baseline
Time Frame
at day 70
Title
Changes in absolute count in Inate Lymphoid Cell type 2(ILC2)
Description
Changes (in absolute count in Inate Lymphoid Cell type 2 compared to baseline
Time Frame
at day 8
Title
Changes in absolute count in Inate Lymphoid Cell type 2(ILC2)
Description
Changes (in absolute count in Inate Lymphoid Cell type 2 compared to baseline
Time Frame
at day 40
Title
Changes in absolute count in Inate Lymphoid Cell type 2(ILC2)
Description
Changes (in absolute count in Inate Lymphoid Cell type 2 compared to baseline
Time Frame
at day 70
Title
Changes of antigen-specific T-cell immune responses (cytokine IL-4 )
Description
cytokine IL-4 at day 40
Time Frame
at day 40
Title
Changes of antigen-specific T-cell immune responses (cytokine IL-4 )
Description
cytokine IL-4 at day 70
Time Frame
at day 70
Title
Changes of antigen-specific T-cell immune responses (cytokine IL-5)
Description
cytokine IL-5 at day 40
Time Frame
at day 40
Title
Changes of antigen-specific T-cell immune responses (cytokine IL-5)
Description
cytokine IL-5 at day 70
Time Frame
at day 70
Title
Changes of antigen-specific T-cell immune responses
Description
IL-13 secretion after antigen restimulation at day 40
Time Frame
at day 40
Title
Changes of antigen-specific T-cell immune responses
Description
IL-13 secretion after antigen restimulation at day 70
Time Frame
at day 70
Title
Changes in allergen-specific IgE dosages basophil activation test with pollen allergen
Description
allergen-specific IgE dosages at day 40
Time Frame
at day 40
Title
Incidence of adverse events at day 8
Description
Adverse events throughout the study (according to NCI-CTC AE classification)
Time Frame
up to Day 8
Title
Incidence of adverse events at day 40
Description
Adverse events throughout the study (according to NCI-CTC AE classification)
Time Frame
up to Day 40
Title
Incidence of adverse events at 70
Description
Adverse events throughout the study (according to NCI-CTC AE classification)
Time Frame
up to Day 70

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria male or female aged between18-55 years Positive clinical history of seasonal allergic rhinitis to birch pollen for at least 2 consecutive pollinic seasons before inclusion and requiring medication intake with or without GINA 1 associated asthma, with documentation of sensitivity within 12 months before enrollment by : *Positive skin prick test (SPT) and validated in vitro tests for specific Immunoglobulin E (IgE); *Positive Skin prick test (SPT): wheal for birch pollen ≥ 5 mm in diameter for histamine wheal ≥ 3 mm (positive control) and NaCl reaction < 2 mm (negative control) *Positive specific IgE to birch pollen >0.75 kUI/L; Negative beta-HcG pregnancy test at screening visit for women of childbearing age; Normal electrocardiogram without clinically significant abnormalities; Ability to stay in the EEC for up to 4 hours, without any conditions or factors which could make this not possible Positive nasal response (TNSS≥5) at baseline exposure Free, informed and written consent signed by the patient and the investigator, before any specific examination required by the study; Affiliation to a social security scheme (beneficiary or assignee) Negative SARS-CoV-2 test less than 72 hours prior to screening visit Exclusion Criteria: Asthma: GINA 2 to 5 Eosinophilia > 0.6x109/mL; Any history of anaphylactic reactions; Specific immunotherapy treatment at the moment, including Omalizumab; Specific immunotherapy for birch-pollens within 3 previous years; Use of systemic corticosteroid or others immunosuppressive treatment within previous 6 months; Moderate to severe allergic rhinoconjunctivitis with or without asthma due to grass pollen, if the study is performed during grass pollen season (according to ARIA) Significant rhinitis, or sinusitis, due to daily contact with other allergen causing symptoms that are expected to coincide with exposures, as assessed by the investigator Contraindications known to treatment with IL-2: Hypersensitivity to the active substance or to any of the excipients; Immunosuppressed patient; Psychotropic, hepatotoxic, nephrotoxic, myelotoxic or cardiotoxic drugs; Other chronic diseases not clinically controlled; Signs of active infection requiring treatment; Previous history of organ transplantation. Heart failure (≥ grade II, class. NYHA), kidney failure (Cockroft <60 ml/min/1.73m2), liver failure (transaminase> 3N), pulmonary insufficiency (any grade); Leukocytes <3000 / mm3 lymphocytes <800 / mm3, platelets <80 000 / mm3, Hemoglobin < 10.0 g/dL or 6.2 mmol/L, red cell blood < 3.5 T/L; Positivity of at least one of the thyroid-specific antibodies (anti-TPO, anti-TG, or anti-TRAKS) associated with an abnormal thyroid workup (TSH, T3, or T4) at inclusion; Chronic uncontrolled arterial hypertension (Systolic BP > 140 mmHg and/or Diastolic BP > 90 mmHg); Poor venous capital will forbid blood samples; Vaccination with attenuated live vaccine in the month before the inclusion or planned during the study; Vaccination against COVID-19 during the study period or if the 2nd dose of vaccine is planned during the 15 days preceding Visit 3 Surgery in the previous three months or anticipated under study; Participation in other interventional research with study drug in the previous month and during the study; Psychiatric illness or any other concomitant chronic illness or addiction that could interfere with the ability to meet the requirements of the protocol or provide informed consent; Presence or history of unhealed cancer for more than five years, presence or history of healed cancer for less than five years, except carcinoma in situ of the cervix or basal cell carcinoma; Pregnant or lactating women; Men and women of childbearing age without effective contraception during the treatment period;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Klatzmann, Pr
Organizational Affiliation
APHP / CIC BTI / Hopital Pitie Salpétrière, Paris
Official's Role
Study Chair
Facility Information:
Facility Name
CIC Paris Est GH Pitié Salpétrière
City
Paris
ZIP/Postal Code
75013
Country
France

12. IPD Sharing Statement

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Safety and Efficacy of Low-dose IL-2 in Birch Pollen Allergy

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