Food Oral Immunotherapy for Peanut Allergy

Study Overview
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Brief Summary
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This is an open label observational single center study of clinical food oral immunotherapy outcomes with biomarker samples and participant and/or caregiver-completed questionnaires in participants between 6 months and 65 years of age with IgE-mediated peanut allergy undergoing food oral immunotherapy.

Detailed Description
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In this research study the investigators want to learn more about the experience of participants with peanut allergy and their caregivers undergoing food oral immunotherapy (OIT) for peanut allergy. Food oral immunotherapy (OIT) is a treatment for individuals with a food allergy to reduce the body's allergic response to the food allergen, resulting in fewer symptoms. The treatment is also called desensitization. An individual becomes desensitized to the food allergen by ingesting small amounts of the food that are slowly increased. Over time, this helps the body's immune system become used to the food so that it no longer causes an allergic reaction. By desensitizing to peanut, it may lower the risk of life-threatening allergic reactions and cause a decreased sensitivity to peanut. The investigators specifically want to learn more about the effects of food OIT on quality of life and other outcomes important to participants with peanut allergy and their caregivers and to ultimately develop tests to predict who may respond favorably to food OIT.

Official Title
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Outcomes of Clinical Food Oral Immunotherapy for Peanut Allergy

Conditions
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Peanut Allergy

Intervention / Treatment
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* Drug: Peanut oral immunotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals between 6 months and 65 years of age with a diagnosis of immunoglobulin E (IgE)-mediated peanut allergy and their caregivers; a diagnosis of IgE-mediated peanut allergy is defined by: (1) documented history of peanut allergy or determined to be allergic by oral food challenge; (2) evidence of peanut-specific IgE by either: positive skin prick test to peanut allergen (reaction wheal at least 3 mm larger than saline control) or serum peanut-specific IgE > 0.34 kilo-unit/liter (kU/L) or international unit/milliliter (IU/mL) at screening visit Referral by Massachusetts General Hospital (MGH) allergist for food oral immunotherapy Willing to sign informed consent or whose caregiver is willing to sign the informed consent (age appropriate) Willing to sign the assent form, if age appropriate Exclusion Criteria: History of severe or life-threatening episode of anaphylaxis or anaphylactic shock within 60 days of screening Severe or poorly controlled asthma Diagnosis of other severe or complicating medical problems, including autoimmune or chronic immune inflammatory conditions or gastrointestinal inflammatory conditions, such as inflammatory bowel diseases and eosinophilic gastrointestinal disorders Current use of beta blocker medication(s) Inability to cooperate with and/or perform oral food challenge procedures Females who are pregnant, planning to become pregnant, or breastfeeding Investigator determination of safety concern for any reason

Ages Eligible for Study
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Minimum Age: 6 Months
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: This is an open label observational single center study of clinical food oral immunotherapy outcomes with biomarker samples and participant and/or caregiver-completed questionnaires in participants between 6 months and 65 years of age with IgE-mediated peanut allergy undergoing food oral immunotherapy.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: active peanut OIT<br>active peanut oral immunotherapy | Drug: Peanut oral immunotherapy<br>* Peanut oral immunotherapy for peanut allergy<br>* Other names: Peanut allergen powder;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The proportion of participants who tolerate the maintenance dose of 300 mg peanut protein with no symptoms within two years of starting OIT | Feasibility analysis as assessed by the proportion of participants who tolerate the maintenance dose in a dichotomous manner | 2 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in quality of life scores from baseline to end of treatment | Change in quality of life scores from baseline assessment to end of treatment assessment using the Food Allergy Quality of Life Questionnaire (FAQLQ) total score. The FAQLQ total and domain scores range from 1-7 where 1 was the best possible score (i.e. fewest problems or better health related quality of life) and with the total score being the average of the domain scores. The domains include Emotional Impact, Social and Dietary Restrictions, and Food Anxiety. | 4 years | 
| Change in peanut specific serum immunoglobulin E (IgE) from baseline to end of treatment | Change in peanut specific serum immunoglobulin E (IgE) [in kilo-units per liter (kU/L) or international units per milliliter (IU/mL)] from baseline to end of treatment | 4 years | 
| Change in skin prick test reactivity to peanut extract from baseline to end of treatment | Change in skin prick test wheal diameter measurement in millimeters to peanut extract from baseline to end of treatment | 4 years | 
| The proportion of participants who tolerate a cumulative dose of 5000 mg peanut protein on oral food challenge without treatment after 12 months on maintenance dose | Desensitization to peanut as assessed by cumulative tolerated dose | 4 years | 
| Number of participants with treatment-related adverse events as assessed by CTCAE v4.0 | Safety analysis as assessed by patient-reported or observed allergic symptoms that will be analyzed and tabulated | 4 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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food allergy