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

Xiu-Min Li

Status and phase

Unknown

Phase 2

Conditions

Food Allergy

Treatments

Drug: Chinese Herbal Medication

Drug: Placebo

Drug: Omalizumab

Drug: Multi OIT

Study type

Interventional

Funder types

Other

Identifiers

NCT02879006

GCO 16-1384

Details and patient eligibility

About

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.

Full 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.

Enrollment

33 patients

Sex

All

Ages

6 to 40 years old

Volunteers

No 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