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A Pilot Study of the Treatment of Eosinophilic Esophagitis With Omalizumab

Primary Purpose

Esophagitis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
omalizumab
Placebo
Sponsored by
University of Utah
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Esophagitis focused on measuring eosinophilic esophagitis, omalizumab

Eligibility Criteria

12 Years - 60 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Male or female subjects aged 12-60 years of age with EE as defined above Serum IgE level 30-700 IU/mL Subjects with acceptable medical history, physical exam and laboratory test results No history of bleeding diathesis, significant cardiopulmonary disease, or other contraindication to upper endoscopy Exclusion Criteria: Need for esophageal dilation at enrollment due to food impaction or inability to pass endoscope Inability of subject to provide informed consent (if ages 18-60), or inability of children (ages 12-17) to provide assent History of esophagogastric surgery Presence of other esophageal pathology that could account for patients' symptoms including eosinophil infiltration due to gastroesophageal reflux disease (GERD) Incarceration Pregnancy Women of childbearing potential not using the contraception method(s) Patients with elevated serum IgE levels for reasons other than atopy Patients taking cromolyn sodium or nedocromil sodium within 1 month of visit 1 Patients taking oral or topical corticosteroids within one month of visit 1 Patients taking leukotriene receptor inhibitors within one month of visit 1 Patients with severe medical condition(s) that in the view of the investigator prohibits participation in the study Patients with a history of noncompliance to medical regimens or who were considered potentially unreliable Use of any other investigational agent in the last 30 days Patients with a known hypersensitivity to any ingredient of rhuMAb-E25, study rescue medication Patients with Barrett's esophagus will be excluded if found endoscopically or pathologically at biopsy Currently treated with omalizumab or treated with omalizumab within the past 6 months.

Sites / Locations

  • University of Utah HSC

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

placebo

omalizumab

Arm Description

placebo group

Xolair group

Outcomes

Primary Outcome Measures

Change in Eosinophil Numbers Per High Power Field Proximally and Distally Between Baseline and Post-treatment and Between Both Groups

Secondary Outcome Measures

Full Information

First Posted
July 21, 2005
Last Updated
May 18, 2016
Sponsor
University of Utah
Collaborators
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00123630
Brief Title
A Pilot Study of the Treatment of Eosinophilic Esophagitis With Omalizumab
Official Title
A Pilot Study of the Treatment of Eosinophilic Esophagitis With Omalizumab
Study Type
Interventional

2. Study Status

Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
November 2005 (undefined)
Primary Completion Date
January 2010 (Actual)
Study Completion Date
January 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Utah
Collaborators
Novartis Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Eosinophilic esophagitis (EE) is an increasingly recognized condition characterized by dysphagia, food impaction or other obstructive esophageal symptoms in children and young adults. The pathophysiology of EE appears to be an allergy/atopy mediated disease. A personal and family history of allergic diseases (food allergies, atopic dermatitis, asthma, allergic rhinitis or conjunctivitis) has been noted in 62-85% of patients with EE. The rising incidence of EE may be related to the worldwide allergy and asthma epidemic. Current treatment of EE is directed at decreasing esophageal allergic inflammation. Oral and topical corticosteroids, cromolyn sodium, montelukast and elemental/elimination diets have all been shown to be effective. However, none of these treatments are directed at the specific pathophysiologic mechanism of EE and some have significant side effects. The shared pathogenetic mechanisms of EE and asthma suggest that therapeutic strategies directed at asthma may also be effective for EE. Specifically those targeted at the allergic immune mechanisms involved with asthma may be effective. Omalizumab is a recently developed anti-IgE antibody that has been shown to decrease the use of inhaled and oral corticosteroids, reduce the frequency of asthma exacerbations, and improve asthma related symptoms in patients with allergic asthma. The objective of the study is to determine the efficacy of omalizumab in the treatment of eosinophilic esophagitis
Detailed Description
This is a dual-center double-blind, placebo controlled trial of omalizumab for the treatment of EE. Omalizumab will be dosed depending on the patient's body weight and baseline IgE level. Omalizumab or placebo will be administered subcutaneously every 4 weeks for 16 weeks. At study entry subjects will have EGD with biopsies performed to ensure the diagnosis and obtain tissue for histologic analysis. No dilation will be performed at this time. Baseline validated questionnaires for dysphagia, GERD, and atopy will also be administered. Blood will be drawn for baseline serum testing. Repeat questionnaires and rating of overall symptom improvement will be administered at 4 week intervals for the rest of the study period. At the end of the 16 week period, repeat endoscopy will be performed and biopsies taken. Esophageal dilation may be performed if clinically indicated at this time. Blood will also be drawn for repeat serum testing.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Esophagitis
Keywords
eosinophilic esophagitis, omalizumab

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
placebo group
Arm Title
omalizumab
Arm Type
Experimental
Arm Description
Xolair group
Intervention Type
Drug
Intervention Name(s)
omalizumab
Other Intervention Name(s)
Xolair
Intervention Description
omalizumab dosed IV based on IgE level and weight every 2 - 4 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
saline
Intervention Description
Placebo given IV once every 2-4 weeks based on weight
Primary Outcome Measure Information:
Title
Change in Eosinophil Numbers Per High Power Field Proximally and Distally Between Baseline and Post-treatment and Between Both Groups
Time Frame
16 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects aged 12-60 years of age with EE as defined above Serum IgE level 30-700 IU/mL Subjects with acceptable medical history, physical exam and laboratory test results No history of bleeding diathesis, significant cardiopulmonary disease, or other contraindication to upper endoscopy Exclusion Criteria: Need for esophageal dilation at enrollment due to food impaction or inability to pass endoscope Inability of subject to provide informed consent (if ages 18-60), or inability of children (ages 12-17) to provide assent History of esophagogastric surgery Presence of other esophageal pathology that could account for patients' symptoms including eosinophil infiltration due to gastroesophageal reflux disease (GERD) Incarceration Pregnancy Women of childbearing potential not using the contraception method(s) Patients with elevated serum IgE levels for reasons other than atopy Patients taking cromolyn sodium or nedocromil sodium within 1 month of visit 1 Patients taking oral or topical corticosteroids within one month of visit 1 Patients taking leukotriene receptor inhibitors within one month of visit 1 Patients with severe medical condition(s) that in the view of the investigator prohibits participation in the study Patients with a history of noncompliance to medical regimens or who were considered potentially unreliable Use of any other investigational agent in the last 30 days Patients with a known hypersensitivity to any ingredient of rhuMAb-E25, study rescue medication Patients with Barrett's esophagus will be excluded if found endoscopically or pathologically at biopsy Currently treated with omalizumab or treated with omalizumab within the past 6 months.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John C. Fang, M.D.
Organizational Affiliation
University of Utah HSC
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Utah HSC
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24907494
Citation
Clayton F, Fang JC, Gleich GJ, Lucendo AJ, Olalla JM, Vinson LA, Lowichik A, Chen X, Emerson L, Cox K, O'Gorman MA, Peterson KA. Eosinophilic esophagitis in adults is associated with IgG4 and not mediated by IgE. Gastroenterology. 2014 Sep;147(3):602-9. doi: 10.1053/j.gastro.2014.05.036. Epub 2014 Jun 4.
Results Reference
derived

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A Pilot Study of the Treatment of Eosinophilic Esophagitis With Omalizumab

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