The objectives of this study are to evaluate the safety and efficacy of Viaskin Milk after 12 months of epicutaneous immunotherapy (EPIT) treatment, for desensitizing IgE-mediated cow's milk allergic children and to assess the long-term safety and therapeutic benefit with Viaskin Milk.
This is a multi-center, double-blind, placebo-controlled, randomized trial to study the safety and efficacy of Viaskin Milk applied epicutaneously every day to subjects from 2 to 17 years of age with IgE-mediated cow's milk allergy (CMA). Subjects will receive blinded treatment for 1 year at one of the 3 doses of Viaskin Milk: 150µg, 300µg, 500µg or placebo. After the first year, all subjects were to switch to the highest dose of Viaskin Milk, 500µg, and continue treatment in an open-label manner for up to a maximum of 3 additional years. Following results of the 12-month blinded period, all eligible subjects who wish to continue participation in the study will switch from Viaskin Milk 500µg to Viaskin Milk 300µg for 24 months of treatment. Eligible subjects with confirmed IgE-mediated CMA will perform a first Double-Blind Placebo-Controlled Food Challenge (DBPCFC) at screening with escalating doses of cow's milk proteins. Subjects showing a positive DBPCFC at screening, defined as the appearance of objective signs or symptoms to an eliciting dose of cow's milk proteins ≤300 mg (approximately ≤9.4mL of cow's milk) will be randomized in the study to receive a 12 month treatment (blinded treatment period), at which time a second DBPCFC will be performed to evaluate the primary efficacy endpoint of the study. Approximately 194 subjects will be randomized in this study. The total duration of participation in the study will differ for each individual subject and could be up to approximately 6 years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
198
Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 150 mcg cow's milk proteins.
Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 300 mcg cow's milk proteins.
Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Arkansas Children's Hospital
Little Rock, Arkansas, United States
Rady Children's Hospital
San Diego, California, United States
Percentage (%) of Subjects Who Are Treatment Responders After 12 Months of EPIT Treatment.
A treatment responder is defined as a subject who meets at least one of the following criteria: * A ≥10-fold increase in the Cumulative Reactive Dose (CRD) of cow's milk proteins at the Month 12 double-blind placebo-controlled food challenge (DBPCFC) as compared to baseline value and reaching at least 144 mg of cow's milk proteins; * A CRD of cow's milk proteins ≥1444 mg at the Month 12 DBPCFC.
Time frame: From baseline to Month 12 (double-blind period)
Mean Cumulative Reactive Dose (CRD) of Cow's Milk Proteins.
Change in CRD from Month 0 (baseline) to Month 12 Double-Blind Placebo-Controlled Food Challenge expressed in mg of cow's milk proteins.
Time frame: From baseline to Month 12 (double-blind period)
Median Cumulative Reactive Dose (CRD) of Cow's Milk Proteins.
Change in Median CRD from Month 0 (baseline) to Month 12 Double-Blind Placebo-Controlled Food Challenge expressed in mg of cow's milk proteins.
Time frame: From baseline to Month 12 (double-blind period)
Change in Levels of sIgE to Cow's Milk.
Median change from baseline value in levels of IgE specific to cow's milk proteins
Time frame: From baseline to Week 3, Month 3, Month 6, Month 12 (double-blind period)
Change in Levels of sIgG4 to Cow's Milk.
Median change from baseline value in levels of IgG4 specific to cow's milk proteins
Time frame: From baseline to Week 3, Month 3, Month 6, Month 12 (double-blind period)
Change in Levels of sIgE to Caseins, α-lactalbumin and β-lactoglobulin
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Stanford University School of Medicine
Stanford, California, United States
Children's Hospital Colorado
Aurora, Colorado, United States
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
Johns Hopkins Hospital
Baltimore, Maryland, United States
Massachusetts General Hospital
Boston, Massachusetts, United States
Mount Sinai Medical Center
New York, New York, United States
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, United States
...and 7 more locations
Median change from baseline in levels of IgE specific to caseins, α-lactalbumin and β-lactoglobulin proteins
Time frame: From baseline to Week 3, Month 3, Month 6, Month 12 (double-blind period)
Change in Levels of sIgG4 to Caseins, α-lactalbumin and β-lactoglobulin
Median change from baseline in levels of IgG4 specific to caseins, α-lactalbumin and β-lactoglobulin proteins
Time frame: From baseline to Week 3, Month 3, Month 6, Month 12 (double-blind period)
Change in Skin Prick Test (SPT) Wheal.
Median change from baseline in SPT Wheal diameter
Time frame: From baseline to Month 3, Month 6, Month 12 (double-blind period)
Change in the Severity of Symptoms Elicited During the Milk Double-Blind Placebo-Controlled Food Challenge (DBPCFC).
Summary of total objective severity score for DBPCFC. The total objective severity score is calculated as the sum of the severity grades (0-Absent, 1-Mild, 2-Moderate or 3-Severe) of the following objective symptoms: pruritus, urticaria/angioedema, rash, sneezing/itching, nasal congestion, rhinorrhea, laryngeal, wheezing, diarrhea, vomiting, cardiovascular and conjunctivitis for DBPCFC with cow's milk formula. The total objective score ranges from a minimum of 0 to a maximum of 36 (if the maximum grade 3 was reported for each of the 12 symptoms), with a higher score meaning a worse outcome. A negative score in the changes to Month 0 means improvement.
Time frame: From baseline to Month 12 (double-blind period)
Change in Quality of Life (QoL) Assessments.
Summary of Global Score for Food Allergy Quality of Life Questionnaire Parent Child Form (FAQLQ-PF). The scores range from 1 (no problem/impairment) to 7 (maximal problem/impairment). A negative score in the changes to Month 0 means improvement.
Time frame: From baseline to Month 12 (double-blind period)
Percentage (%) of Subjects Who Are Treatment Responders Over the Course of the Viaskin Milk 300µg Open-label Treatment Period Using Observed Data
A treatment responder is defined as a subject who meets at least one of the following criteria: A ≥10-fold increase in the Cumulative Reactive Dose (CRD) of cow's milk proteins at the Month 12 double-blind placebo-controlled food challenge (DBPCFC) as compared to baseline value and reaching at least 144 mg of cow's milk proteins; A CRD of cow's milk proteins ≥1444 mg at the Month 12 DBPCFC. DBPCFC at Month 12 and Month 24 after switch to Viaskin Milk 300µg was optional and therefore outcome measure was assessed on observed data only.
Time frame: From baseline to Month 12 and Month 24 after switch to Viaskin Milk 300µg (Open-Label 300µg period)
Cumulative Reactive Dose (CRD) of Cow's Milk Protein Over the Course of the Open-label Treatment Period
Median CRD during Double-Blind Placebo-Controlled Food Challenge expressed in mg of cow's milk proteins.
Time frame: Baseline, Month 12 and Month 24 after switch to Viaskin Milk 300µg (Open-Label 300µg period)
Treatment-Emergent Adverse Events
Overview of Treatment Emergent Adverse Events (TEAEs) and serious Treatment-Emergent Adverse Events
Time frame: Whole study including double-blind and open-label periods (up to 6 years).