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The Impact of Grass SLIT Treatment on Birch Pollen Induced Allergic Rhinitis - a Pilot Evaluation

Primary Purpose

Allergic Rhinoconjunctivitis

Status
Completed
Phase
Phase 4
Locations
Canada
Study Type
Interventional
Intervention
Grastek®
Placebo
Sponsored by
Queen's University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Allergic Rhinoconjunctivitis focused on measuring rhinitis, allergy

Eligibility Criteria

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

Inclusion Criteria:

  1. Participant demonstrates understanding and has provided an appropriately signed and dated informed consent.
  2. Male or Female, 18 to 65 years of age, at time of the Screening visit.
  3. Participant has a history of at least moderate allergic rhinoconjunctivitis due to hypersensitivity to birch pollen for a minimum of 2 years.
  4. Participant responds to the birch pollen and timothy grass pollen through a standard skin prick test administered at the Screening visit. A positive test will be defined as a wheal diameter at least 5mm or larger than the negative control (normal saline) wheal. A historical skin-prick test performed within three-hundred sixty-five (365) days or one (1) year at the site will be accepted in lieu of performing a new skin prick test.
  5. Participant understands and is willing, able and likely to comply with study procedures and restrictions.
  6. Participant, if female, has a negative urine pregnancy test at Visit 1 and is willing to use a medically acceptable form of birth control. Acceptable methods of birth control for this study include:

    • oral, patch, or intra-vaginal hormonal contraceptives
    • Norplant System®
    • Depo-Provera®
    • IUD
    • double barrier method
    • abstinence
    • surgically sterile females (hysterectomy or tubal ligation)
    • > 1 year post-menopausal females
    • same sex partner
    • partner vasectomy (> 3 months)
  7. Participant is healthy as determined by pre-study medical history, physical examination and vital signs.
  8. Participant is able to read, comprehend, and record all information in English.
  9. Participant has a serum specific IgE level to both birch and timothy grass of ≥0.7 ku/L.

Exclusion Criteria:

  1. Has significant current nasal or ocular symptoms that the study doctor associates with perennial allergic or non-allergic rhinitis.
  2. Female participant who is pregnant or lactating.
  3. Has a history of any illness that, in the opinion of the study investigator, might confound the results of the study or poses an additional risk to the participant by their participation in the study. This includes a clinically relevant medical or surgical history or presence of other respiratory disease (exceptions made for asthma and allergic rhinitis as defined in further exclusion criteria), or gastrointestinal, renal, hepatic, hematological, lymphatic, neurological, cardiovascular, psychiatric, musculoskeletal, immunological, dermatological, connective tissue diseases or disorders, or a history of malignancy within the past 5 years, with the exception of non-melanoma skin cancer.
  4. Has any significant abnormalities found during physical exam as determined by the investigator.
  5. Has a current medical history of significant pulmonary disease and/or active asthma requiring daily drug therapy. Mild, intermittent asthma is permitted (managed with short acting beta-agonist less than 3 times per week). Isolated exercise-induced bronchospasm is also permitted.
  6. Has received an investigational drug within the last thirty (30) days.
  7. Has had use of immunotherapy containing grass or birch within the last 3 years.
  8. Has significant nasal polyps, nasal septal perforation, or nasal tract malformations as noted on physical exam.
  9. Administration of adrenaline (epinephrine) is contraindicated (e.g. participants with acute or chronic symptomatic coronary heart disease or concomitant beta-blocker therapy).
  10. Is unlikely to cooperate with the requirements of the study including having the ability to communicate with the investigator appropriately.

Sites / Locations

  • Kingston General Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Grastek®

Placebo

Arm Description

48 participants will receive Grastek® once per day for 120 days. Grastek® is a standardized sublingual immunotherapy (SLIT) tablet containing 2800 BAU of standardized allergen extract from Timothy grass (Phleum pretense). This SLIT product is approved by Health Canada and the Food and Drug Administration (FDA) for the treatment of grass-pollen induced allergic rhinoconjunctivitis (AR) in Canada and the United States respectively.

48 participants will receive placebo once per day for 120 days.

Outcomes

Primary Outcome Measures

Change in Total Nasal Symptom Score (TNSS) From Baseline to Post-treatment.
To determine the effect of 4 months of treatment with Grastek® on the symptoms of birch pollen induced AR in participants with both timothy grass pollen-induced and birch pollen-induced allergen rhinitis (AR) TNSS is comprised of the sum of 4 symptoms: runny nose, itchy nose sneezing and nasal congestion. Each of these symptoms are evaluated based on a 4 point Likert scale from 0-3. 0 = no symptoms, 1 = mild symptoms, 2 = moderate symptoms and 3 = severe symptoms. TNSS can therefore have a range from 0 to 12.

Secondary Outcome Measures

Analysis of Blood Samples for Potential Biomarkers by Comparing Baseline and Post-treatment Samples.
To determine potential biomarkers predictive of clinical efficacy for birch pollen-induced AR following treatment with Grastek®

Full Information

First Posted
March 4, 2015
Last Updated
June 26, 2017
Sponsor
Queen's University
Collaborators
Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02394600
Brief Title
The Impact of Grass SLIT Treatment on Birch Pollen Induced Allergic Rhinitis - a Pilot Evaluation
Official Title
The Impact of Grass SLIT Treatment on Birch Pollen Induced Allergic Rhinitis - a Pilot Evaluation
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
April 2015 (undefined)
Primary Completion Date
April 2016 (Actual)
Study Completion Date
June 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Queen's University
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This pilot study is a Phase IV, single center, placebo-controlled, parallel study design conducted using the Environmental Exposure Unit (EEU). The study will aim to be determine whether there are any benefits from Grastek® for the treatment of birch-pollen induced allergic rhinoconjunctivitis. Grastek® is a Health Canada and FDA approved sublingual immunotherapy (SLIT) for the treatment of grass-pollen induced allergic rhinoconjunctivitis. The EEU provides a closed environment in which participants are exposed to a predetermined, controlled, constant level of airborne pollen. 96 participants will complete this study and will either receive Grastek® or placebo in a 1:1 ratio. The study will consist of a screening visit, a pre-treatment pollen exposure visit, 60 days of treatment with Grastek® or placebo, two treatment visits and a follow-up pollen exposure visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Allergic Rhinoconjunctivitis
Keywords
rhinitis, allergy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
93 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Grastek®
Arm Type
Experimental
Arm Description
48 participants will receive Grastek® once per day for 120 days. Grastek® is a standardized sublingual immunotherapy (SLIT) tablet containing 2800 BAU of standardized allergen extract from Timothy grass (Phleum pretense). This SLIT product is approved by Health Canada and the Food and Drug Administration (FDA) for the treatment of grass-pollen induced allergic rhinoconjunctivitis (AR) in Canada and the United States respectively.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
48 participants will receive placebo once per day for 120 days.
Intervention Type
Drug
Intervention Name(s)
Grastek®
Intervention Description
one tablet daily for four months
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
sugar pill
Intervention Description
one tablet daily for four months
Primary Outcome Measure Information:
Title
Change in Total Nasal Symptom Score (TNSS) From Baseline to Post-treatment.
Description
To determine the effect of 4 months of treatment with Grastek® on the symptoms of birch pollen induced AR in participants with both timothy grass pollen-induced and birch pollen-induced allergen rhinitis (AR) TNSS is comprised of the sum of 4 symptoms: runny nose, itchy nose sneezing and nasal congestion. Each of these symptoms are evaluated based on a 4 point Likert scale from 0-3. 0 = no symptoms, 1 = mild symptoms, 2 = moderate symptoms and 3 = severe symptoms. TNSS can therefore have a range from 0 to 12.
Time Frame
4 months
Secondary Outcome Measure Information:
Title
Analysis of Blood Samples for Potential Biomarkers by Comparing Baseline and Post-treatment Samples.
Description
To determine potential biomarkers predictive of clinical efficacy for birch pollen-induced AR following treatment with Grastek®
Time Frame
4 months

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: Participant demonstrates understanding and has provided an appropriately signed and dated informed consent. Male or Female, 18 to 65 years of age, at time of the Screening visit. Participant has a history of at least moderate allergic rhinoconjunctivitis due to hypersensitivity to birch pollen for a minimum of 2 years. Participant responds to the birch pollen and timothy grass pollen through a standard skin prick test administered at the Screening visit. A positive test will be defined as a wheal diameter at least 5mm or larger than the negative control (normal saline) wheal. A historical skin-prick test performed within three-hundred sixty-five (365) days or one (1) year at the site will be accepted in lieu of performing a new skin prick test. Participant understands and is willing, able and likely to comply with study procedures and restrictions. Participant, if female, has a negative urine pregnancy test at Visit 1 and is willing to use a medically acceptable form of birth control. Acceptable methods of birth control for this study include: oral, patch, or intra-vaginal hormonal contraceptives Norplant System® Depo-Provera® IUD double barrier method abstinence surgically sterile females (hysterectomy or tubal ligation) > 1 year post-menopausal females same sex partner partner vasectomy (> 3 months) Participant is healthy as determined by pre-study medical history, physical examination and vital signs. Participant is able to read, comprehend, and record all information in English. Participant has a serum specific IgE level to both birch and timothy grass of ≥0.7 ku/L. Exclusion Criteria: Has significant current nasal or ocular symptoms that the study doctor associates with perennial allergic or non-allergic rhinitis. Female participant who is pregnant or lactating. Has a history of any illness that, in the opinion of the study investigator, might confound the results of the study or poses an additional risk to the participant by their participation in the study. This includes a clinically relevant medical or surgical history or presence of other respiratory disease (exceptions made for asthma and allergic rhinitis as defined in further exclusion criteria), or gastrointestinal, renal, hepatic, hematological, lymphatic, neurological, cardiovascular, psychiatric, musculoskeletal, immunological, dermatological, connective tissue diseases or disorders, or a history of malignancy within the past 5 years, with the exception of non-melanoma skin cancer. Has any significant abnormalities found during physical exam as determined by the investigator. Has a current medical history of significant pulmonary disease and/or active asthma requiring daily drug therapy. Mild, intermittent asthma is permitted (managed with short acting beta-agonist less than 3 times per week). Isolated exercise-induced bronchospasm is also permitted. Has received an investigational drug within the last thirty (30) days. Has had use of immunotherapy containing grass or birch within the last 3 years. Has significant nasal polyps, nasal septal perforation, or nasal tract malformations as noted on physical exam. Administration of adrenaline (epinephrine) is contraindicated (e.g. participants with acute or chronic symptomatic coronary heart disease or concomitant beta-blocker therapy). Is unlikely to cooperate with the requirements of the study including having the ability to communicate with the investigator appropriately.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anne K Ellis, MD
Organizational Affiliation
Queen's University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kingston General Hospital
City
Kingston
State/Province
Ontario
ZIP/Postal Code
K7L 2V7
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
29432967
Citation
Ellis AK, Tenn MW, Steacy LM, Adams DE, Day AG, Walker TJ, Nolte H. Lack of effect of Timothy grass pollen sublingual immunotherapy tablet on birch pollen-induced allergic rhinoconjunctivitis in an environmental exposure unit. Ann Allergy Asthma Immunol. 2018 May;120(5):495-503.e2. doi: 10.1016/j.anai.2018.02.003. Epub 2018 Feb 9.
Results Reference
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The Impact of Grass SLIT Treatment on Birch Pollen Induced Allergic Rhinitis - a Pilot Evaluation

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