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E-B-FAHF-2, Multi OIT and Xolair (Omalizumab) for Food Allergy

Primary Purpose

Food Allergy

Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Chinese Herbal Medication
Placebo
Omalizumab
Multi OIT
Sponsored by
Xiu-Min Li
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Food Allergy focused on measuring Chinese herbal therapy, Oral immunotherapy, Food allergy, Omalizumab

Eligibility Criteria

6 Years - 40 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • 6 through 40 years
  • At least one of the following for each of the 3 study allergens: serum IgE >4 kU/L or skin prick test >6mm
  • dose limiting symptoms at a cumulative dose of <=444 mg protein for 3 allergens as screening double-blind, placebo-controlled food challenge
  • use of an effective method of contraception by females of child-bearing potential
  • ability to ingest oat or corn with no allergic reaction

Exclusion Criteria:

  • If baked milk or egg are tolerated (assessed by clinical report), then milk or egg may not be included as a study allergen
  • Any disorder in which epinephrine is contraindicated such as coronary artery disease, uncontrolled hypertension, and serious ventricular arrhythmias
  • History of other chronic disease requiring therapy (other than asthma, atopic dermatitis, or rhinitis)
  • History of eosinophilic gastrointestinal disease
  • Current participation in any other interventional study
  • Investigational drug use within 90 days
  • Subject is on build-up phase of any allergen immunotherapy (prior to maintenance dosing)
  • Current uncontrolled moderate to severe asthma as defined by:

    • FEV1 value <80% predicted (or PFR if unable to perform spirometry) or any clinical features of moderate or severe persistent asthma baseline severity (as defined by the 2007 NHLBI Guidelines) and greater than high daily doses of inhaled corticosteroids (as defined for children and adults using dosing tables from the 2007 NHLBI Guidelines).
    • Use of steroid medications in the following manners: history of daily oral steroid dosing for >1 month during the past year, having 1 burst or steroid course within the past 6 months, or having >1 burst oral steroid course within the past 12 months.
    • Asthma requiring >1 hospitalization in the past year for asthma or >1 ED visit in the past 6 months for asthma.
  • Use of systemic steroid medications (IV, IM or oral) for indications other than asthma for > 3 weeks within the past 6 months
  • Inability to discontinue antihistamines for the initial day of escalation, skin testing or DBPCFC
  • Use of Xolair® (omalizumab) within the past 6 months
  • Known sensitivity to Xolair® (omalizumab) or to the class of study drugs
  • Body weight more than 90 kg, or subjects with weight-IgE combination that yields a dose requirement greater than 600 mg dosing
  • Use of beta-blockers (oral), (ACE) inhibitors, angiotensin-receptor blockers or calcium channel blockers
  • Pregnancy or lactation
  • Inability to swallow placebo capsules
  • Mental illness or history of drug or alcohol abuse that, in the opinion of the investigator, would interfere with the subject's ability to comply with study requirements

Sites / Locations

  • Johns Hopkins University
  • Icahn School of Medicine at Mount Sinai

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Chinese Herbal Medication

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Sustained unresponsiveness
Sustained unresponsiveness evaluated by the absence of dose-limiting symptoms to a cumulative dose of 4,444 protein.

Secondary Outcome Measures

Desensitizing to 4444mg
Number of participants tolerating a cumulative dose of 4,444mg of food allergen protein.
High level of desensitization to 7444mg or higher
Number of participants tolerating a cumulative dose of 7,444mg or higher (max of 10,444mg) of food allergen protein

Full Information

First Posted
August 22, 2016
Last Updated
August 10, 2020
Sponsor
Xiu-Min Li
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1. Study Identification

Unique Protocol Identification Number
NCT02879006
Brief Title
E-B-FAHF-2, Multi OIT and Xolair (Omalizumab) for Food Allergy
Official Title
Double-Blind, Placebo-Controlled Phase 2 Study to Assess Safety and Efficacy of Chinese Herbal Therapy and Multiple Food Allergen Oral Immunotherapy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
August 2016 (undefined)
Primary Completion Date
November 2020 (Anticipated)
Study Completion Date
November 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Xiu-Min Li

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is testing the use E-B-FAHF-2 Chinese herbal therapy in combination with multi-food oral immunotherapy (OIT) and Xolair® (Omalizumab) to help children and adults who are allergic to foods be able to safely tolerate food allergens. Specifically in this protocol, the food allergens are milk, egg, peanut, almond, cashew, hazelnut, walnut, sesame, and/or wheat. Omalizumab is considered an investigational drug for the treatment of food allergies in children and adults. Investigational means it has not been approved by the Food and Drug Administration (FDA) for use in the U.S. The researchers hope to learn whether the addition of Chinese herbal therapy (E-B-FAHF-2) can improve the outcome of sustained unresponsiveness (which is the ability to consume a food allergen and pass an oral food challenge after being off treatment for 3 months) as compared to placebo (i.e. subjects with OIT/Omalizumab + herbal vs. OIT/Omalizumab + placebo), and will help adults and children be able to safely ingest the foods they are allergic to.
Detailed Description
Prior studies have shown that this Chinese herbal formulation is safe and well-tolerated in food allergic individuals. While oral immunotherapy (OIT) can lead to desensitization, it remains uncertain whether this treatment can lead to lasting protection. Therefore, this study aims to use the Chinese herbal formula in combination with OIT to determine whether sustained protection can be achieved. All subjects will receive multi-allergen OIT, along with a 4 month course of omalizumab to provide added safety for the initial dose escalation and build up phases. Subjects will be randomized to receive active Chinese herbal formula or placebo. Subjects will be treated with OIT for 2 years and then food challenges will be performed to assess for desensitization. For those who achieve desensitization, all treatments will be discontinued and food challenges will be performed 3 months later to assess for sustained unresponsiveness.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Food Allergy
Keywords
Chinese herbal therapy, Oral immunotherapy, Food allergy, Omalizumab

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Chinese Herbal Medication
Arm Type
Active Comparator
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Chinese Herbal Medication
Other Intervention Name(s)
E-B-FAHF-2
Intervention Description
Capsules, 26 month course, starting 2 months pre-OIT
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Placebo Chinese Herb
Intervention Description
Placebo capsules that look identical to E-B-FAHF-2, 26 month course, starting 2 months pre-OIT
Intervention Type
Drug
Intervention Name(s)
Omalizumab
Other Intervention Name(s)
Xolair®
Intervention Description
4 months course, starting 2 months pre-OIT through the 2 month build-up phase
Intervention Type
Drug
Intervention Name(s)
Multi OIT
Intervention Description
24 months of multi OIT (maintenance dose of 1gm each food allergen)
Primary Outcome Measure Information:
Title
Sustained unresponsiveness
Description
Sustained unresponsiveness evaluated by the absence of dose-limiting symptoms to a cumulative dose of 4,444 protein.
Time Frame
month 29
Secondary Outcome Measure Information:
Title
Desensitizing to 4444mg
Description
Number of participants tolerating a cumulative dose of 4,444mg of food allergen protein.
Time Frame
month 26
Title
High level of desensitization to 7444mg or higher
Description
Number of participants tolerating a cumulative dose of 7,444mg or higher (max of 10,444mg) of food allergen protein
Time Frame
month 26

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: 6 through 40 years At least one of the following for each of the 3 study allergens: serum IgE >4 kU/L or skin prick test >6mm dose limiting symptoms at a cumulative dose of <=444 mg protein for 3 allergens as screening double-blind, placebo-controlled food challenge use of an effective method of contraception by females of child-bearing potential ability to ingest oat or corn with no allergic reaction Exclusion Criteria: If baked milk or egg are tolerated (assessed by clinical report), then milk or egg may not be included as a study allergen Any disorder in which epinephrine is contraindicated such as coronary artery disease, uncontrolled hypertension, and serious ventricular arrhythmias History of other chronic disease requiring therapy (other than asthma, atopic dermatitis, or rhinitis) History of eosinophilic gastrointestinal disease Current participation in any other interventional study Investigational drug use within 90 days Subject is on build-up phase of any allergen immunotherapy (prior to maintenance dosing) Current uncontrolled moderate to severe asthma as defined by: FEV1 value <80% predicted (or PFR if unable to perform spirometry) or any clinical features of moderate or severe persistent asthma baseline severity (as defined by the 2007 NHLBI Guidelines) and greater than high daily doses of inhaled corticosteroids (as defined for children and adults using dosing tables from the 2007 NHLBI Guidelines). Use of steroid medications in the following manners: history of daily oral steroid dosing for >1 month during the past year, having 1 burst or steroid course within the past 6 months, or having >1 burst oral steroid course within the past 12 months. Asthma requiring >1 hospitalization in the past year for asthma or >1 ED visit in the past 6 months for asthma. Use of systemic steroid medications (IV, IM or oral) for indications other than asthma for > 3 weeks within the past 6 months Inability to discontinue antihistamines for the initial day of escalation, skin testing or DBPCFC Use of Xolair® (omalizumab) within the past 6 months Known sensitivity to Xolair® (omalizumab) or to the class of study drugs Body weight more than 90 kg, or subjects with weight-IgE combination that yields a dose requirement greater than 600 mg dosing Use of beta-blockers (oral), (ACE) inhibitors, angiotensin-receptor blockers or calcium channel blockers Pregnancy or lactation Inability to swallow placebo capsules Mental illness or history of drug or alcohol abuse that, in the opinion of the investigator, would interfere with the subject's ability to comply with study requirements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Julie Wang, MD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Principal Investigator
Facility Information:
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33310179
Citation
Wang Z, Wang ZZ, Geliebter J, Tiwari R, Li XM. Traditional Chinese medicine for food allergy and eczema. Ann Allergy Asthma Immunol. 2021 Jun;126(6):639-654. doi: 10.1016/j.anai.2020.12.002. Epub 2020 Dec 10.
Results Reference
derived

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E-B-FAHF-2, Multi OIT and Xolair (Omalizumab) for Food Allergy

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