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Impact of Carrier Solutions for House Dust Mite Allergen on Allergic Reactions (SIMBA)

Primary Purpose

Allergic Rhinitis

Status
Completed
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
Sodium chloride particles
Lactose particles
Clean air
Sodium chloride particles with house dust mite
Lactose particles with house dust mite
Sponsored by
Fraunhofer-Institute of Toxicology and Experimental Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Allergic Rhinitis focused on measuring Allergen Challenge Chamber, House dust mite, Sodium chloride

Eligibility Criteria

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

Inclusion Criteria:

  1. Able and willing to give written informed consent.
  2. Male and female subjects, aged 18-65 years. Women will be considered for inclusion if they are:

    • Not pregnant, as confirmed by pregnancy test (see flow chart), and not nursing.
    • Of non-child bearing potential (i.e. physiologically incapable of becoming pregnant, including any female who is pre-menarchial or post-menopausal, with documented proof of hysterectomy or tubal ligation, or meets clinical criteria for menopause and has been amenorrhoeic for more than 1 year prior to the screening visit).
    • Of childbearing potential and using a highly effective method of contraception during the entire study (vasectomised partner, sexual abstinence - the lifestyle of the female should be such that there is complete abstinence from intercourse from two weeks prior to the first allergen challenge until at least 72 hours after the last allergen challenge -, implants, injectables, combined oral contraceptives, hormonal IUDs or double-barrier methods, i.e. any double combination of IUD, condom with spermicidal gel, diaphragm, sponge, and cervical cap).
  3. Body mass index between 18 and 32 kg/m2
  4. History of HDM-induced allergic rhinitis with or without conjunctivitis of 1 year or longer in duration at screening.
  5. Positive skin prick test responses (positive wheal diameter reaction of ≥ 3 mm larger than the negative control and wheal diameter < 2 mm to the sodium chloride/diluent negative control) to D. pteronyssinus at screening or within the past 12 months (if performed and documented at the clinical unit).
  6. Serum specific IgE level (≥ 0.7 kU/L) to D. pteronyssinus at screening or within the past 12 months (if performed and documented at the clinical unit).
  7. FEV1 of 80% of predicted value or greater at screening. If subject fails to achieve this value, the assessment may be repeated 2 additional times.
  8. Total Nasal Symptom Score (TNSS) of ≤ 3 prior to entering the chamber at visit 2.
  9. Smokers or non-smokers.

Exclusion Criteria:

  1. Any clinically relevant abnormal findings in physical examination, clinical chemistry, hematology, urine analysis, vital signs, lung function or ECG at screening visit , which, in the opinion of the investigator, may either put the subject at risk because of participation in the study or may influence the results of the study, or the subject's ability to participate in the study.
  2. Diastolic blood pressure above 95 mmHg.
  3. Past or present disease, which as judged by the investigator, may affect the outcome of this study. These diseases include, but are not limited to, cardiovascular disease, malignancy, hepatic disease, renal disease, hematological disease, neurological disease, endocrine disease or pulmonary disease (including but not confined to chronic bronchitis, emphysema, tuberculosis, bronchiectasis or cystic fibrosis).
  4. History of an acute infection at screening that has not resolved four weeks prior to visit 2.
  5. Nasal condition that could confound the efficacy or safety assessments (e.g., nasal polyps).
  6. Concomitant allergies to seasonal aeroallergens which are anticipated to be or become active (i.e., grass, trees, weeds, rye; defined as IgE ≥ 3.5 kU/L [IgE samples drawn within 12 months prior to screening can be used to assess criteria as long as they are performed and documented at the clinical unit]; OR symptomatic to aeroallergens within the past 2 years or within the past 2 allergy seasons; OR both) through the completion of the study.
  7. Concomitant allergy to an animal dander who has exposure on a regular basis to the respective animal dander.
  8. History of allergic reactions such as anaphylactic shock, exanthema generalized, angioedema or hypotension caused by HDM and/or any medical products (including vaccine) in the past.
  9. Known or suspected clinically relevant intolerance to lactose .
  10. Asthma other than mild asthma which is treated with short acting beta-2-agonists only and which is controlled according to the current GINA guidelines.
  11. Participation in another clinical trial 30 days prior to enrollment.
  12. Donation of more than 400 ml of blood the preceding 2 months before screening.
  13. History of regular drug or alcohol abuse in the past 3 months.
  14. Risk of non-compliance with study procedures.
  15. Suspected inability to understand the protocol requirements, instructions and study-related restrictions, the nature, scope, and possible consequences of the study.
  16. Specific Immunotherapy (SIT) within five years prior to the study.
  17. Treatment with medication that might interfere with rescue medication for anaphylactic reactions (e.g. beta blocker).
  18. Systemic immunosuppression treatment (e.g. oral steroids, biologics, e.g. dupilumab, JAK-Inhibitors, cyclosporine, azathioprine, Mycophenolat Mofetil (MMF) within 3 months before visit 2
  19. Treatment with anti-allergic medication or topical steroids (within 2 weeks before visit 2)

Sites / Locations

  • Fraunhofer Institute for Toxicology and Experimental Medicine

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

Sodium chloride particles

Lactose particles

Clean air

Sodium chloride particles with house dust mite

Lactose particles with house dust mite

Arm Description

Patients are exposed to sodium chloride particles alone for 4 hours in the Fraunhofer Allergen Challenge Chamber.

Patients are exposed to lactose particles alone for 4 hours in the Fraunhofer Allergen Challenge Chamber.

Patients are exposed to clean air for 4 hours in the Fraunhofer Allergen Challenge Chamber.

Patients are exposed to sodium chloride particles coupled with D. pteronyssinus for 4 hours in the Fraunhofer Allergen Challenge Chamber.

Patients are exposed to lactose particles coupled with D. pteronyssinus for 4 hours in the Fraunhofer Allergen Challenge Chamber.

Outcomes

Primary Outcome Measures

Change of mean total nasal symptom score (TNSS) during challenge over 4 hours with either lactose or sodium chloride particles compared to challenges with clean air.
TNSS = Total Nasal Symptom Score (min = 0 = no symptoms; max = 12 = max symptoms)

Secondary Outcome Measures

Change of mean VAS of symptoms during challenge over 4 hours with either lactose or sodium chloride particles compared to challenges with clean air
VAS = Visual Analogue Scale (min = 0 = no symptoms; max = 10 = max symptoms)
Difference in nasal secretion weight during challenge over 4 hours with either lactose or sodium chloride particles compared to challenges with clean air
Pre-weighed handkerchief sachets used by subjects during challenge are weighed after use to determine nasal secretion amount

Full Information

First Posted
January 26, 2022
Last Updated
July 27, 2022
Sponsor
Fraunhofer-Institute of Toxicology and Experimental Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT05245175
Brief Title
Impact of Carrier Solutions for House Dust Mite Allergen on Allergic Reactions
Acronym
SIMBA
Official Title
Assessment of Impact of Different Carrier Solutions for House Dust Mite Allergen (HDM) Challenge on Allergic Reactions in Patients With HDM Allergic Rhinitis
Study Type
Interventional

2. Study Status

Record Verification Date
July 2022
Overall Recruitment Status
Completed
Study Start Date
February 22, 2022 (Actual)
Primary Completion Date
April 13, 2022 (Actual)
Study Completion Date
April 13, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Fraunhofer-Institute of Toxicology and Experimental Medicine

4. Oversight

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

5. Study Description

Brief Summary
Single-blind, within-block randomized, clean-air-controlled study to assess the effect of lactose and sodium chloride particles in patients with allergic rhinitis on nasal symptoms when challenged in the Fraunhofer Allergen Challenge Chamber
Detailed Description
Allergen Challenge Chambers (ACC) are used worldwide since many years to test anti-allergic treatment in early clinical development. ACCs provide the advantage of controlled atmospheres with stable allergen load and highly reproducible symptoms during challenges. The Fraunhofer ACC has been used since more than 20 years to test a range of different anti-allergic treatments, mostly using pollen challenges. For house dust mite (HDM) challenges, a carrier solution containing lactose or sodium chloride is reconstituted with commercially available HDM allergen. The solution is spray-dried to create allergen loaded lactose or sodium chloride particles of a determined size. Those particles are distributed in the ACC. Whether lactose or sodium chloride particles alone could induce nasal irritation during allergen challenges, has not been examined. Should allergen-free carrier solutions contribute to nasal symptoms, study results might be confounded. Even more so, if one carrier solution caused more nasal irritation than the other. To determine if allergen-free carrier solutions alone irritate the nasal mucosa, we expose subjects with allergic rhinitis and house dust mite allergy to three different atmospheres: (1) lactose particles alone, (2) sodium chloride particles alone, and (3) clean air. Also, we aim to document nasal symptoms during challenges with HDM-containing carrier solutions to decide on the best carrier option for future clinical trials.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Allergic Rhinitis
Keywords
Allergen Challenge Chamber, House dust mite, Sodium chloride

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
18 patients will be exposed 5 times in the Allergen Challenge Chamber. The 5 exposures are divided into 2 blocks. The first block consists of 3 challenges with sodium chloride particles, lactose particles, and clean air to address the primary and secondary objectives. The second block consists of 2 further challenges with D. pteronyssinus coupled with either sodium chloride particles or lactose particles to address exploratory objectives.
Masking
Participant
Masking Description
Patients are blinded to the sequence of exposures. Within the 2 blocks, the order of challenge atmospheres will be randomized.
Allocation
Randomized
Enrollment
19 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sodium chloride particles
Arm Type
Experimental
Arm Description
Patients are exposed to sodium chloride particles alone for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Arm Title
Lactose particles
Arm Type
Experimental
Arm Description
Patients are exposed to lactose particles alone for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Arm Title
Clean air
Arm Type
Placebo Comparator
Arm Description
Patients are exposed to clean air for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Arm Title
Sodium chloride particles with house dust mite
Arm Type
Experimental
Arm Description
Patients are exposed to sodium chloride particles coupled with D. pteronyssinus for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Arm Title
Lactose particles with house dust mite
Arm Type
Experimental
Arm Description
Patients are exposed to lactose particles coupled with D. pteronyssinus for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Intervention Type
Other
Intervention Name(s)
Sodium chloride particles
Intervention Description
Patients are exposed to sodium chloride particles alone for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Intervention Type
Other
Intervention Name(s)
Lactose particles
Intervention Description
Patients are exposed to lactose particles alone for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Intervention Type
Other
Intervention Name(s)
Clean air
Intervention Description
Patients are exposed to clean air for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Intervention Type
Other
Intervention Name(s)
Sodium chloride particles with house dust mite
Intervention Description
Patients are exposed to sodium chloride particles coupled with D. pteronyssinus for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Intervention Type
Other
Intervention Name(s)
Lactose particles with house dust mite
Intervention Description
Patients are exposed to lactose particles coupled with D. pteronyssinus for 4 hours in the Fraunhofer Allergen Challenge Chamber.
Primary Outcome Measure Information:
Title
Change of mean total nasal symptom score (TNSS) during challenge over 4 hours with either lactose or sodium chloride particles compared to challenges with clean air.
Description
TNSS = Total Nasal Symptom Score (min = 0 = no symptoms; max = 12 = max symptoms)
Time Frame
Day 1, Day 2, Day 3
Secondary Outcome Measure Information:
Title
Change of mean VAS of symptoms during challenge over 4 hours with either lactose or sodium chloride particles compared to challenges with clean air
Description
VAS = Visual Analogue Scale (min = 0 = no symptoms; max = 10 = max symptoms)
Time Frame
Day 1, Day 2, Day 3
Title
Difference in nasal secretion weight during challenge over 4 hours with either lactose or sodium chloride particles compared to challenges with clean air
Description
Pre-weighed handkerchief sachets used by subjects during challenge are weighed after use to determine nasal secretion amount
Time Frame
Day 1, Day 2, Day 3
Other Pre-specified Outcome Measures:
Title
Change of mean total nasal symptom score (TNSS) during challenge over 4 hours with either HDM allergen with lactose particles compared to challenges with HDM allergen with sodium chloride particles.
Description
TNSS = Total Nasal Symptom Score
Time Frame
Day 4, Day 11
Title
Change of nasal secretion weight during challenge over 4 hours with either HDM allergen with lactose particles compared to challenges with HDM allergen with sodium chloride particles
Description
Pre-weighed handkerchief sachets used by subjects during challenge are weighed after use to determine nasal secretion amount
Time Frame
Day 4, Day 11

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: Able and willing to give written informed consent. Male and female subjects, aged 18-65 years. Women will be considered for inclusion if they are: Not pregnant, as confirmed by pregnancy test (see flow chart), and not nursing. Of non-child bearing potential (i.e. physiologically incapable of becoming pregnant, including any female who is pre-menarchial or post-menopausal, with documented proof of hysterectomy or tubal ligation, or meets clinical criteria for menopause and has been amenorrhoeic for more than 1 year prior to the screening visit). Of childbearing potential and using a highly effective method of contraception during the entire study (vasectomised partner, sexual abstinence - the lifestyle of the female should be such that there is complete abstinence from intercourse from two weeks prior to the first allergen challenge until at least 72 hours after the last allergen challenge -, implants, injectables, combined oral contraceptives, hormonal IUDs or double-barrier methods, i.e. any double combination of IUD, condom with spermicidal gel, diaphragm, sponge, and cervical cap). Body mass index between 18 and 32 kg/m2 History of HDM-induced allergic rhinitis with or without conjunctivitis of 1 year or longer in duration at screening. Positive skin prick test responses (positive wheal diameter reaction of ≥ 3 mm larger than the negative control and wheal diameter < 2 mm to the sodium chloride/diluent negative control) to D. pteronyssinus at screening or within the past 12 months (if performed and documented at the clinical unit). Serum specific IgE level (≥ 0.7 kU/L) to D. pteronyssinus at screening or within the past 12 months (if performed and documented at the clinical unit). FEV1 of 80% of predicted value or greater at screening. If subject fails to achieve this value, the assessment may be repeated 2 additional times. Total Nasal Symptom Score (TNSS) of ≤ 3 prior to entering the chamber at visit 2. Smokers or non-smokers. Exclusion Criteria: Any clinically relevant abnormal findings in physical examination, clinical chemistry, hematology, urine analysis, vital signs, lung function or ECG at screening visit , which, in the opinion of the investigator, may either put the subject at risk because of participation in the study or may influence the results of the study, or the subject's ability to participate in the study. Diastolic blood pressure above 95 mmHg. Past or present disease, which as judged by the investigator, may affect the outcome of this study. These diseases include, but are not limited to, cardiovascular disease, malignancy, hepatic disease, renal disease, hematological disease, neurological disease, endocrine disease or pulmonary disease (including but not confined to chronic bronchitis, emphysema, tuberculosis, bronchiectasis or cystic fibrosis). History of an acute infection at screening that has not resolved four weeks prior to visit 2. Nasal condition that could confound the efficacy or safety assessments (e.g., nasal polyps). Concomitant allergies to seasonal aeroallergens which are anticipated to be or become active (i.e., grass, trees, weeds, rye; defined as IgE ≥ 3.5 kU/L [IgE samples drawn within 12 months prior to screening can be used to assess criteria as long as they are performed and documented at the clinical unit]; OR symptomatic to aeroallergens within the past 2 years or within the past 2 allergy seasons; OR both) through the completion of the study. Concomitant allergy to an animal dander who has exposure on a regular basis to the respective animal dander. History of allergic reactions such as anaphylactic shock, exanthema generalized, angioedema or hypotension caused by HDM and/or any medical products (including vaccine) in the past. Known or suspected clinically relevant intolerance to lactose . Asthma other than mild asthma which is treated with short acting beta-2-agonists only and which is controlled according to the current GINA guidelines. Participation in another clinical trial 30 days prior to enrollment. Donation of more than 400 ml of blood the preceding 2 months before screening. History of regular drug or alcohol abuse in the past 3 months. Risk of non-compliance with study procedures. Suspected inability to understand the protocol requirements, instructions and study-related restrictions, the nature, scope, and possible consequences of the study. Specific Immunotherapy (SIT) within five years prior to the study. Treatment with medication that might interfere with rescue medication for anaphylactic reactions (e.g. beta blocker). Systemic immunosuppression treatment (e.g. oral steroids, biologics, e.g. dupilumab, JAK-Inhibitors, cyclosporine, azathioprine, Mycophenolat Mofetil (MMF) within 3 months before visit 2 Treatment with anti-allergic medication or topical steroids (within 2 weeks before visit 2)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jens M Hohlfeld, Prof. Dr.
Organizational Affiliation
Fraunhofer Institute for Toxicology and Experimental Medicine ITEM
Official's Role
Principal Investigator
Facility Information:
Facility Name
Fraunhofer Institute for Toxicology and Experimental Medicine
City
Hannover
State/Province
Lower Saxony
ZIP/Postal Code
30625
Country
Germany

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
27255590
Citation
Lueer K, Biller H, Casper A, Windt H, Mueller M, Badorrek P, Haefner D, Framke T, Koch A, Ziehr H, Krug N, Koch W, Hohlfeld JM. Safety, efficacy and repeatability of a novel house dust mite allergen challenge technique in the Fraunhofer allergen challenge chamber. Allergy. 2016 Dec;71(12):1693-1700. doi: 10.1111/all.12947. Epub 2016 Jun 23.
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Impact of Carrier Solutions for House Dust Mite Allergen on Allergic Reactions

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