ARC001: Oral Desensitization to Peanut in Peanut-Allergic Children and Adults Using Characterized Peanut Allergen OIT

Sponsor
Aimmune Therapeutics, Inc. (Industry)
Overall Status
Completed
CT.gov ID
NCT01987817
Collaborator
(none)
56
8
2
11
7
0.6

Study Details

Study Description

Brief Summary

This is a multi-center, randomized, double-blind placebo controlled study of efficacy and safety of characterized peanut oral immunotherapy in peanut allergic individuals.

Condition or Disease Intervention/Treatment Phase
  • Biological: AR101 powder provided in capsules
  • Biological: Placebo powder provided in capsules
Phase 2

Detailed Description

This is a multicenter, randomized, double-blind placebo controlled study of efficacy and safety of characterized peanut OIT in peanut allergic individuals. All eligible subjects will receive an escalating dose of CPNA or placebo. Approximately 50 subjects will be randomized 1:1 to peanut OIT or placebo.

Study Design

Study Type:
Interventional
Actual Enrollment :
56 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Triple (Participant, Care Provider, Investigator)
Primary Purpose:
Treatment
Official Title:
Phase 2 Oral Desensitization to Peanut in Peanut-Allergic Children and Adults Using Characterized Peanut Allergen Oral Immunotherapy
Actual Study Start Date :
Feb 6, 2014
Actual Primary Completion Date :
Jan 7, 2015
Actual Study Completion Date :
Jan 7, 2015

Arms and Interventions

Arm Intervention/Treatment
Experimental: AR101 powder provided in capsules

Study product provided as peanut protein in pull-apart capsules

Biological: AR101 powder provided in capsules
Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol

Placebo Comparator: Placebo powder provided in capsules

Placebo formulation in pull-apart capsules containing only inactive ingredients

Biological: Placebo powder provided in capsules
Study product formulated to contain only inactive ingredients for use as defined in the protocol

Outcome Measures

Primary Outcome Measures

  1. The Percentage of Subjects Who Tolerate at Least 300 mg (443 mg Cumulative) of Peanut Protein With no More Than Mild Symptoms at the Exit DBPCFC [6-9 Months]

    The primary endpoint was the percentage of subjects who achieved desensitization, as determined by tolerating at least 300 mg (443 mg cumulative) of peanut protein at the Exit Double Blind Placebo Controlled Food Challenge (DBPCFC) with no more than mild symptoms (i.e., desensitization responders)

Secondary Outcome Measures

  1. Change From Baseline in Maximum Tolerated Dose of Peanut Protein at the Exit DBPCFC [6-9 months]

    The change in maximum tolerated dose of peanut protein from baseline (screening) to the Exit Double-Blind, Placebo-Controlled Food Challenge

  2. Number of Participants by Maximum Dose Achieved With no or Mild Symptoms at Exit DBPCFC [6-9 months]

  3. Changes in Peanut-Specific IgE From Baseline to Exit DBPCFC [6-9 months]

  4. Changes in Peanut-Specific IgG4 From Baseline to Exit DBPCFC [6-9 months]

  5. Change in Skin Prick Test (SPT) Mean Peanut Wheal Diameter Results From Baseline [Baseline, 6-9 months]

Eligibility Criteria

Criteria

Ages Eligible for Study:
4 Years to 26 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
No
Key Inclusion Criteria:
  • Ages 4 through 26 years, inclusive

  • Clinical history of allergy to peanuts or peanut-containing foods

  • Serum IgE to peanut >0.35 kU/L (determined by UniCAP within the past 12 months) and/or a SPT to peanut >3 mm compared to control

  • Experience dose-limiting symptoms at or before the 100mg dose of peanut protein (measured as 200 mg of peanut flour) on abbreviated screening OFC conducted via PRACTALL guidelines

  • Use of birth control by females of child-bearing potential

Key Exclusion Criteria:
  • History of Cardiovascular disease

  • History of frequent or repeated, severe or life-threatening episodes of anaphylactic shock

  • History of other chronic disease

  • History of eosinophilic gastrointestinal disease

  • Severe asthma

  • Mild or moderate asthma if uncontrolled

  • Use of omalizumab within the past 6 months or current use of other non-traditional forms of allergen immunotherapy

  • Use of beta-blockers(oral), angiotensin-converting enzyme (ACE)

  • Pregnancy, lactation

  • Having the same place of residence as another study subject

  • Participation in an interventional clinical trial 30 days prior to randomization

Contacts and Locations

Locations

Site City State Country Postal Code
1 Arkansas Children's Hospital Little Rock Arkansas United States 72202
2 UC San Diego San Diego California United States 92123
3 Boston Children's Hospital Boston Massachusetts United States 02115
4 Mount Sinai Medical Center New York New York United States 10029
5 University of North Carolina Chapel Hill North Carolina United States 27599
6 Cincinnati Children's Hospital Medical Center Cincinnati Ohio United States 45229
7 The Children's Hospital of Philadelphia Philadelphia Pennsylvania United States 19104
8 Children's Medical Center Dallas Dallas Texas United States 75235

Sponsors and Collaborators

  • Aimmune Therapeutics, Inc.

Investigators

  • Study Chair: Director of Regulatory Affairs, Aimmune Therapeutics, Inc.

Study Documents (Full-Text)

More Information

Publications

None provided.
Responsible Party:
Aimmune Therapeutics, Inc.
ClinicalTrials.gov Identifier:
NCT01987817
Other Study ID Numbers:
  • ARC001
First Posted:
Nov 19, 2013
Last Update Posted:
Nov 30, 2021
Last Verified:
Nov 1, 2021
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
Yes
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Aimmune Therapeutics, Inc.
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail A total of 67 subjects signed the informed consent and went through the screening process. 11 subjects failed screening, resulting in 56 subjects being enrolled and initially randomized. The randomized population comprised 29 subjects in the AR101 group and 27 subjects in the placebo group. The final intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment) had one fewer subject in the placebo group (n=26).
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Period Title: Overall Study
STARTED 29 27
COMPLETED 23 26
NOT COMPLETED 6 1

Baseline Characteristics

Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules Total
Arm/Group Description Study product provided as peanut protein in pull-apart capsules AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol Total of all reporting groups
Overall Participants 29 26 55
Age (years) [Median (Full Range) ]
Median (Full Range) [years]
7.0
8.0
8.0
Sex: Female, Male (Count of Participants)
Female
9
31%
10
38.5%
19
34.5%
Male
20
69%
16
61.5%
36
65.5%
Ethnicity (NIH/OMB) (Count of Participants)
Hispanic or Latino
0
0%
0
0%
0
0%
Not Hispanic or Latino
29
100%
26
100%
55
100%
Unknown or Not Reported
0
0%
0
0%
0
0%
Race (NIH/OMB) (Count of Participants)
American Indian or Alaska Native
0
0%
1
3.8%
1
1.8%
Asian
1
3.4%
1
3.8%
2
3.6%
Native Hawaiian or Other Pacific Islander
0
0%
0
0%
0
0%
Black or African American
1
3.4%
2
7.7%
3
5.5%
White
26
89.7%
20
76.9%
46
83.6%
More than one race
0
0%
0
0%
0
0%
Unknown or Not Reported
1
3.4%
2
7.7%
3
5.5%

Outcome Measures

1. Primary Outcome
Title The Percentage of Subjects Who Tolerate at Least 300 mg (443 mg Cumulative) of Peanut Protein With no More Than Mild Symptoms at the Exit DBPCFC
Description The primary endpoint was the percentage of subjects who achieved desensitization, as determined by tolerating at least 300 mg (443 mg cumulative) of peanut protein at the Exit Double Blind Placebo Controlled Food Challenge (DBPCFC) with no more than mild symptoms (i.e., desensitization responders)
Time Frame 6-9 Months

Outcome Measure Data

Analysis Population Description
The number of participants analyzed per outcome measure reflects the intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment)
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Measure Participants 29 26
Count of Participants [Participants]
23
79.3%
5
19.2%
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection AR101 Powder Provided in Capsules, Placebo Powder Provided in Capsules
Comments
Type of Statistical Test Superiority
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments
Method Fisher Exact
Comments
Method of Estimation Estimation Parameter Risk Difference (RD)
Estimated Value 60.0
Confidence Interval (2-Sided) 95%
35 to 79
Parameter Dispersion Type:
Value:
Estimation Comments
2. Secondary Outcome
Title Change From Baseline in Maximum Tolerated Dose of Peanut Protein at the Exit DBPCFC
Description The change in maximum tolerated dose of peanut protein from baseline (screening) to the Exit Double-Blind, Placebo-Controlled Food Challenge
Time Frame 6-9 months

Outcome Measure Data

Analysis Population Description
The number of participants analyzed per outcome measure reflects the intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules. AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Measure Participants 29 26
Least Squares Mean (95% Confidence Interval) [Change from baseline in MTD (log10 mg)]
1.254
0.341
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection AR101 Powder Provided in Capsules, Placebo Powder Provided in Capsules
Comments MTD for the baseline and Exit DBPCFC are transformed back to log10 scale before calculations. A value of 0.3 mg is substituted for subjects who could not tolerate the lowest DBPCFC dose before log10 transformation.
Type of Statistical Test Superiority
Comments
Statistical Test of Hypothesis p-Value <0.0001
Comments The p-value is based on the F-test for treatment effect adjusted for MTD from baseline (log10 mg). The p-value and confidence intervals are based on the normality assumption.
Method ANCOVA
Comments Least squares means and 95% CIs based on ANCOVA model of change from baseline in MTD at Exit DBPCFC (terms for treatment & MTD at baseline (log10 mg).
Method of Estimation Estimation Parameter Treatment difference
Estimated Value 0.912
Confidence Interval (2-Sided) 95%
0.5184 to 1.3065
Parameter Dispersion Type:
Value:
Estimation Comments
3. Secondary Outcome
Title Number of Participants by Maximum Dose Achieved With no or Mild Symptoms at Exit DBPCFC
Description
Time Frame 6-9 months

Outcome Measure Data

Analysis Population Description
The number of participants analyzed per outcome measure reflects the intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment)
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules. AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Measure Participants 29 26
0.3 mg
0
0%
1
3.8%
3 mg
2
6.9%
2
7.7%
10 mg
3
10.3%
7
26.9%
30 mg
1
3.4%
5
19.2%
100 mg
0
0%
6
23.1%
300 mg
5
17.2%
5
19.2%
600 mg
18
62.1%
0
0%
4. Secondary Outcome
Title Changes in Peanut-Specific IgE From Baseline to Exit DBPCFC
Description
Time Frame 6-9 months

Outcome Measure Data

Analysis Population Description
The number of participants analyzed per outcome measure reflects the intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment) Relative change from baseline is calculated as the ratio of exit visit result to the baseline result, within treatment group.
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules. AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Measure Participants 29 26
Peanut-Specific IgE, Baseline
32.571
53.839
Peanut-Specific IgE, Exit
36.889
57.060
Relative Change From Baseline of Peanut-Specific IgGE
1.231
1.060
5. Secondary Outcome
Title Changes in Peanut-Specific IgG4 From Baseline to Exit DBPCFC
Description
Time Frame 6-9 months

Outcome Measure Data

Analysis Population Description
The number of participants analyzed per outcome measure reflects the intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment) Relative change from baseline is calculated as the ratio of exit visit result to the baseline result, within treatment group.
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules. AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Measure Participants 29 26
Peanut-Specific IgG4, Baseline
0.734
0.510
Peanut-Specific IgG4, Exit
3.609
0.540
Relative Change From Baseline of Peanut-Specific IgG4
5.068
1.066
6. Secondary Outcome
Title Change in Skin Prick Test (SPT) Mean Peanut Wheal Diameter Results From Baseline
Description
Time Frame Baseline, 6-9 months

Outcome Measure Data

Analysis Population Description
The number of participants analyzed per outcome measure reflects the intent-to-treat (ITT) population (subjects who received at least 1 dose of randomized study treatment)
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules. AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
Measure Participants 29 26
Peanut Wheal, Baseline (mm)
14.1
13.7
Peanut Wheal, Exit (mm)
7.1
11.8
Change in Peanut Wheel from Baseline (mm)
-7.0
-1.8

Adverse Events

Time Frame 6-9 months
Adverse Event Reporting Description
Arm/Group Title AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Arm/Group Description Study product provided as peanut protein in pull-apart capsules. AR101 powder provided in capsules: Study product formulated to contain peanut protein at different dosage strengths for use as defined in the protocol Placebo formulation in pull-apart capsules containing only inactive ingredients Placebo powder provided in capsules: Study product formulated to contain only inactive ingredients for use as defined in the protocol
All Cause Mortality
AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/29 (0%) 0/26 (0%)
Serious Adverse Events
AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 1/29 (3.4%) 1/26 (3.8%)
Immune system disorders
Hypersensitivity 1/29 (3.4%) 1/26 (3.8%)
Other (Not Including Serious) Adverse Events
AR101 Powder Provided in Capsules Placebo Powder Provided in Capsules
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 28/29 (96.6%) 22/26 (84.6%)
Ear and labyrinth disorders
Ear pain 2/29 (6.9%) 0/26 (0%)
Tympanic membrane perforation 0/29 (0%) 1/26 (3.8%)
Eye disorders
Conjunctivitis allergic 1/29 (3.4%) 0/26 (0%)
Gastrointestinal disorders
Vomiting 4/29 (13.8%) 2/26 (7.7%)
Diarrhoea 1/29 (3.4%) 3/26 (11.5%)
Nausea 3/29 (10.3%) 1/26 (3.8%)
Abdominal pain 2/29 (6.9%) 1/26 (3.8%)
Abdominal pain upper 1/29 (3.4%) 2/26 (7.7%)
Dental caries 1/29 (3.4%) 0/26 (0%)
Toothache 0/29 (0%) 1/26 (3.8%)
General disorders
Pyrexia 5/29 (17.2%) 4/26 (15.4%)
Malaise 0/29 (0%) 2/26 (7.7%)
Immune system disorders
Hypersensitivity 26/29 (89.7%) 14/26 (53.8%)
Infections and infestations
Upper Respiratory Tract Infection 2/29 (6.9%) 5/26 (19.2%)
Viral Infection 3/29 (10.3%) 1/26 (3.8%)
Pharyngitis streptococcal 2/29 (6.9%) 1/26 (3.8%)
Croup Infectious 1/29 (3.4%) 0/26 (0%)
Ear infection 0/29 (0%) 1/26 (3.8%)
Ear lobe infection 1/29 (3.4%) 0/26 (0%)
Gastroenteritis 0/29 (0%) 1/26 (3.8%)
Gastroenteritis viral 1/29 (3.4%) 0/26 (0%)
Molluscum contagiosum 1/29 (3.4%) 0/26 (0%)
Nasopharyngitis 1/29 (3.4%) 0/26 (0%)
Otitis externa 1/29 (3.4%) 0/26 (0%)
Tinea infection 1/29 (3.4%) 0/26 (0%)
Viral upper respiratory tract infection 1/29 (3.4%) 0/26 (0%)
Injury, poisoning and procedural complications
Arthropod stings 1/29 (3.4%) 1/26 (3.8%)
Ligament sprain 0/29 (0%) 2/26 (7.7%)
Animal bite 0/29 (0%) 1/26 (3.8%)
Arthropod bite 1/29 (3.4%) 0/26 (0%)
Ankle fracture 0/29 (0%) 1/26 (3.8%)
Contusion 1/29 (3.4%) 0/26 (0%)
Excoriation 1/29 (3.4%) 0/26 (0%)
Forearm fracture 0/29 (0%) 1/26 (3.8%)
Skeletal injury 0/29 (0%) 1/26 (3.8%)
Upper limb fracture 1/29 (3.4%) 0/26 (0%)
Metabolism and nutrition disorders
Decreased appetite 0/29 (0%) 1/26 (3.8%)
Musculoskeletal and connective tissue disorders
Muscle twitching 0/29 (0%) 1/26 (3.8%)
Nervous system disorders
Headache 3/29 (10.3%) 3/26 (11.5%)
Presyncope 1/29 (3.4%) 1/26 (3.8%)
Somnolence 2/29 (6.9%) 0/26 (0%)
Dizziness 0/29 (0%) 1/26 (3.8%)
Respiratory, thoracic and mediastinal disorders
Nasal congestion 2/29 (6.9%) 3/26 (11.5%)
Cough 2/29 (6.9%) 2/26 (7.7%)
Oropharyngeal pain 3/29 (10.3%) 1/26 (3.8%)
Asthma 0/29 (0%) 1/26 (3.8%)
Epistaxis 0/29 (0%) 1/26 (3.8%)
Rhinorrhoea 0/29 (0%) 1/26 (3.8%)
Throat irritation 0/29 (0%) 1/26 (3.8%)
Skin and subcutaneous tissue disorders
Urticaria 3/29 (10.3%) 2/26 (7.7%)
Dermatitis contact 0/29 (0%) 1/26 (3.8%)
Papule 0/29 (0%) 1/26 (3.8%)
Rash 1/29 (3.4%) 0/26 (0%)
Rash papular 1/29 (3.4%) 0/26 (0%)
Surgical and medical procedures
Tooth extraction 0/29 (0%) 1/26 (3.8%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

Institutions cannot publish until the multi-center sponsor publication is published Or, institutions cannot publish until 18 months after study completion And Sponsor review of any publications is required prior to any institution publications according to contractual agreements

Results Point of Contact

Name/Title Director of Regulatory Affairs
Organization Aimmune Therapeutics, Inc.
Phone 650-409-5164
Email RegulatoryAffairs@aimmune.com
Responsible Party:
Aimmune Therapeutics, Inc.
ClinicalTrials.gov Identifier:
NCT01987817
Other Study ID Numbers:
  • ARC001
First Posted:
Nov 19, 2013
Last Update Posted:
Nov 30, 2021
Last Verified:
Nov 1, 2021