This is a phase IIb clinical trial to investigate the efficacy and safety of subcutaneous immunotherapy with a modified parvalbumin called mCyp c 1 for the treatment of fish allergy to subjects allergic to fish.
Fish allergy is a persistent food allergy (usually lifelong) which can be life threatening due to the danger for anaphylaxis (severe allergic reaction) upon accidental exposure to fish. Until today there is no curative treatment for fish allergy. The only treatment is avoidance. Patients with fish allergy have to avoid fish of all types and carry an adrenaline autoinjector and rescue medication, in case of accidental exposure to fish. That way patients with fish allergy have to continuously control what they are eating and this causes a great deal of stress and impacts their quality of life. The major allergen responsible for fish allergy is the protein parvalbumin. It is recognized by the vast majority (96-100%) of fish allergic patients. During the past, treatment of food allergy with immunotherapy was successful but dangerous, due to serious side effects (anaphylaxis). A novel biotechnological product, a recombinant hypoallergenic parvalbumin, called mCyp c 1, is used for the first time in a phase IIb clinical trial, to test the efficacy of subcutaneous immunotherapy for the treatment of fish allergy. The investigational medicinal product mCyp c1, is based on the recombinant wild type carp parvalbumin (rCyp c 1) and is the result of site directed mutagenesis, by which the disruption of the two calcium binding sites of carp parvalbumin is performed. The modified parvalbumin mCyp c 1, is both hypoallergenic and immunogenic. That way it is a promising molecule for the safe and effective treatment of fish allergy. This molecule has proven to be safe in a phase I/IIa study that has been performed, during which mCyp c 1 was administered with subcutaneous injections. During this study only local reactions at the injection site were observed. There were no observed systemic reactions. Even more, there were clear indications that mCyp c 1 was recognized by the immune system. The results of this phase I/IIa study guarantee the necessity of a phase IIb clinical trial with mCyp c 1, in order to study the efficacy of this modified parvalbumin in the treatment of fish allergy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
45
Subcutaneous immunotherapy
Subcutaneous immunotherapy
National University Hospital NUHD Denmark
Gentofte Municipality, Denmark
Odense University Hospital OUH Denmark
Odense, Denmark
Sotiria General Hospital for the Diseases of the Thorax
Athens, Greece
Landspitali University Hospital Reykjavik LSH Iceland
Efficacy of subcutaneous immunotherapy with mCyp c 1 for the treatment of fish allergy (change from baseline in the threshold of fish protein that induces an allergic reaction)
The primary outcome measure will be efficacy as determined by the change from baseline in the threshold of fish protein that induces an allergic reaction. This threshold will be assessed by means of a standardized double blind placebo controlled food challenge (DBPCFC) with cod-fish after completion of six months of immunotherapy. Success is defined as a statistically significant change in the threshold dose of protein that provokes a reaction in DBPCFC.
Time frame: 7 months after treatment begining
Safety (recording of adverse events)- Number of participants with adverse events and recording of the nature of adverse events
The fundamental secondary endpoint will be safety as indicated by clinical safety and tolerability and by the careful recording of adverse events; other surrogates of safety will be: physical examination, vital signs, 12-Lead ECG and laboratory evaluations.
Time frame: Up to 13 months
Severity of reaction in food challenge
To study any possible change from baseline in the severity of the reaction in the baseline Double Blind Placebo Controled Food Challenge (DBPCFC) after treatment with mCyp c 1
Time frame: 7 months after treatment begining
Skin prick test (SPT) reactivity
To study any possible change(s) from baseline in skin prick test (SPT) reactivity against fish and mCyp c 1 (titrated) after treatment with mCyp c 1
Time frame: 7 months after treatment begining
Serum specific IgE, IgG, IgG4 and IgA antibodies
To study any possible change(s) from baseline in serum specific IgE, IgG, IgG4 and IgA antibodies against fish and rCyp c 1 (ImmunoCAP) after treatment with mCyp c 1
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Reykjavik, Iceland
Universitiy Medical Centre Utrecht UMCU The Netherlands
Utrecht, Netherlands
Medical Universtity of Lodz
Lodz, Poland
Hospital Universitario Reina Sofia (Cordoba) Spain
Córdoba, Spain
Hospital Clinico San Carlos SERMAS Spain
Madrid, Spain
Hospital Regional Universitario de Malaga Spain
Málaga, Spain
Time frame: 7 months after treatment begining
Biological activity of IgE
To study any possible change from baseline in the biological activity of IgE (stripped basophil histamine release test) after treatment with mCyp c 1
Time frame: 7 months after treatment begining