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Inhibition of Anaphylaxis by Ibrutinib

Primary Purpose

Food Allergy, Anaphylaxis Food

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Ibrutinib
Sponsored by
Ann & Robert H Lurie Children's Hospital of Chicago
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Food Allergy

Eligibility Criteria

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

Inclusion Criteria:

  • History of food allergy to peanut (or tree nut).
  • Male or female age ≥ 18 years.
  • Positive skin prick testing and basophil activation test to the trigger food, either peanut or tree nut.
  • Adequate organ and marrow function as defined below:
  • leukocytes ≥ 3,000/mcL
  • absolute neutrophil count ≥ 1,500/mcL
  • platelets ≥ 100,000/mcl
  • total bilirubin within normal institutional limits
  • AST(SGOT)/ALT(SPGT) within normal institutional limits
  • Creatinine within normal institutional limits
  • Women of child bearing potential must agree to two forms of highly effective contraception (hormonal, device, or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform the Principal Investigator and her treating physician immediately.
  • A female of child bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria:

    • Has not undergone a hysterectomy or bilateral oophorectomy; or
    • Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months).
  • Ability to understand and the willingness to sign a written informed consent.
  • Ability to clearly understand and speak English at an 8th grade reading level. For safety reasons, subjects must speak English due to the anticipated need for clear and timely communication with investigators and the study team in emergency situations, since the investigators and study team are English speaking.

Exclusion Criteria:

  • Subjects who have been on immunomodulatory therapies or oral corticosteroids within 1 month prior to study participation will be excluded, and those taking antihistamines must stop these drugs for one week prior to enrollment and must refrain from taking antihistamines during the duration of the study so as not to interfere with SPT responses.
  • Subjects with symptoms not consistent with type 1 food reactions (atopic dermatitis, eosinophilic esophagitis and any other non-IgE-mediated food sensitivities) will be excluded.
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ibrutinib.
  • Uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, beta-blocker use or psychiatric illness/social situations that would limit compliance with study requirements.
  • Subjects must not be pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants.
  • Subjects on anticoagulants, anti-platelet therapy, or any other predisposition towards bleeding.

Sites / Locations

  • Ann & Robert H. Lurie Childrens Hospital of Chicago

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Open Label Administration

Arm Description

Allergic subjects will be given ibrutinib 420mg daily for 2-7 doses to determine the shortest amount of time and fewest ibrutinib doses required to suppress food skin prick testing and basophil activation test reactivity.

Outcomes

Primary Outcome Measures

Length of treatment for skin prick test
To determine the fewest ibrutinib doses required to eliminate food skin prick reactivity

Secondary Outcome Measures

Length of treatment for basophil reactivity
To determine the fewest ibrutinib doses required to eliminate basophil reactivity to food antigen
Skin compared to basophil reactivity
To determine the timing of when skin prick testing (SPT) response to peanut or tree nuts is altered compared to basophil activation test (BAT) responses.

Full Information

First Posted
May 5, 2017
Last Updated
November 14, 2018
Sponsor
Ann & Robert H Lurie Children's Hospital of Chicago
Collaborators
Northwestern University Feinberg School of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT03149315
Brief Title
Inhibition of Anaphylaxis by Ibrutinib
Official Title
Inhibition of Anaphylaxis by Ibrutinib
Study Type
Interventional

2. Study Status

Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
April 10, 2017 (Actual)
Primary Completion Date
November 14, 2018 (Actual)
Study Completion Date
November 14, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Ann & Robert H Lurie Children's Hospital of Chicago
Collaborators
Northwestern University Feinberg School of Medicine

4. Oversight

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

5. Study Description

Brief Summary
This is a phase II open label study on the use of Ibrutinib on the inhibition of food-induced anaphylaxis in adults with food allergy. Ibrutinib (brand name Imbruvica) is currently FDA approved for the treatment of mantle cell lymphoma (MCL), chronic lymphocytic leukemia (CLL), and Waldenstrom's macroglobulineia (WM). We propose to administer this approved drug to adults with food allergy to inhibit food allergy responses.
Detailed Description
This is open-label study designed to determine the fewest doses and shortest length of time, from two days to up to 7 days, needed for ibrutinib to fully inhibit tests for food allergy, and to determine the length of persistence of efficacy after the drug is stopped.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Food Allergy, Anaphylaxis Food

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Open Label Administration
Arm Type
Experimental
Arm Description
Allergic subjects will be given ibrutinib 420mg daily for 2-7 doses to determine the shortest amount of time and fewest ibrutinib doses required to suppress food skin prick testing and basophil activation test reactivity.
Intervention Type
Drug
Intervention Name(s)
Ibrutinib
Other Intervention Name(s)
Ibruvica
Intervention Description
Ibrutinib 420mg, PO once daily for 2-7 days
Primary Outcome Measure Information:
Title
Length of treatment for skin prick test
Description
To determine the fewest ibrutinib doses required to eliminate food skin prick reactivity
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Length of treatment for basophil reactivity
Description
To determine the fewest ibrutinib doses required to eliminate basophil reactivity to food antigen
Time Frame
30 days
Title
Skin compared to basophil reactivity
Description
To determine the timing of when skin prick testing (SPT) response to peanut or tree nuts is altered compared to basophil activation test (BAT) responses.
Time Frame
30 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: History of food allergy to peanut (or tree nut). Male or female age ≥ 18 years. Positive skin prick testing and basophil activation test to the trigger food, either peanut or tree nut. Adequate organ and marrow function as defined below: leukocytes ≥ 3,000/mcL absolute neutrophil count ≥ 1,500/mcL platelets ≥ 100,000/mcl total bilirubin within normal institutional limits AST(SGOT)/ALT(SPGT) within normal institutional limits Creatinine within normal institutional limits Women of child bearing potential must agree to two forms of highly effective contraception (hormonal, device, or barrier method of birth control; abstinence) prior to study entry, for the duration of study participation, and for 90 days following completion of therapy. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform the Principal Investigator and her treating physician immediately. A female of child bearing potential is any woman (regardless of sexual orientation, having undergone a tubal ligation, or remaining celibate by choice) who meets the following criteria: Has not undergone a hysterectomy or bilateral oophorectomy; or Has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months). Ability to understand and the willingness to sign a written informed consent. Ability to clearly understand and speak English at an 8th grade reading level. For safety reasons, subjects must speak English due to the anticipated need for clear and timely communication with investigators and the study team in emergency situations, since the investigators and study team are English speaking. Exclusion Criteria: Subjects who have been on immunomodulatory therapies or oral corticosteroids within 1 month prior to study participation will be excluded, and those taking antihistamines must stop these drugs for one week prior to enrollment and must refrain from taking antihistamines during the duration of the study so as not to interfere with SPT responses. Subjects with symptoms not consistent with type 1 food reactions (atopic dermatitis, eosinophilic esophagitis and any other non-IgE-mediated food sensitivities) will be excluded. History of allergic reactions attributed to compounds of similar chemical or biologic composition to ibrutinib. Uncontrolled inter-current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, beta-blocker use or psychiatric illness/social situations that would limit compliance with study requirements. Subjects must not be pregnant or nursing due to the potential for congenital abnormalities and the potential of this regimen to harm nursing infants. Subjects on anticoagulants, anti-platelet therapy, or any other predisposition towards bleeding.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anne Marie Singh, MD
Organizational Affiliation
Ann & Robert H. Lurie Childrens Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Bruce Bochner, MD
Organizational Affiliation
Northwestern Feinberg School of Medicine
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ann & Robert H. Lurie Childrens Hospital of Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29360526
Citation
Dispenza MC, Pongracic JA, Singh AM, Bochner BS. Short-term ibrutinib therapy suppresses skin test responses and eliminates IgE-mediated basophil activation in adults with peanut or tree nut allergy. J Allergy Clin Immunol. 2018 May;141(5):1914-1916.e7. doi: 10.1016/j.jaci.2017.12.987. Epub 2018 Jan 31. No abstract available. Erratum In: J Allergy Clin Immunol. 2018 Oct;142(4):1374.
Results Reference
derived

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Inhibition of Anaphylaxis by Ibrutinib

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