Ignite Creation Date:
2024-05-06 @ 10:55 AM
Last Modification Date:
2024-10-26 @ 12:37 PM
Study NCT ID:
NCT03388866
Status:
COMPLETED
Last Update Posted:
2020-08-26
First Post:
2017-11-22
Brief Title:
Effect of Sublingual Immunotherapy in Patients With Atopic Dermatitis
Sponsor:
Casa Espirita Terra de Ismael
Organization:
Casa Espirita Terra de Ismael
Study Overview
Official Title:
Effect of Sublingual Immunotherapy With Mite Extract in Patients With Atopic Dermatits Placebo-controlled Double-blind Randomized Study
Status:
COMPLETED
Status Verified Date:
2020-08
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
Atopic dermatitis AD is a chronic and recurrent inflammatory disease prevalent between 1 and 20 in the world population with a predominance of childhood but which may be present in adult life AD results from a complex interaction between genetic and environmental factors with the presence of a defect in the skin barrier and deregulation of the immune response culminating in an inflammatory response in the skin predominantly type 2 Disease control is based on restoring skin hydration smoothing itching and controlling the process specific sensitizing agents such as inhalant allergens and foods that may pathogenesis of the disease In selected patients who present IgE mediated response to inhalant allergens allergen-specific immunotherapy can be effective Classically the subcutaneous route is the most used however sublingual immunotherapy SLIT has been used in increasing form There are still few studies on the efficacy and safety of SLIT in atopic dermatitis Therefore the present study aims to to investigate the role of SLIT in the management of patients with AD allergic mites through a randomized double-blind and placebo-controlled study
Detailed Description:
A total of 94 patients 3 years of age or older with clinical diagnosis of AD without distinction of gender ethnicity or social group will be selected at HCFMRP-USP Allergy and Dermatology outpatient clinics These patients will undergo clinical evaluation and laboratory tests including blood count total IgE inhalant panel specific IgE and immediate hypersensitivity skin tests and mite allergen-specific IgG4 Der p 1 and Der p 2 before of the study To calculate the sample size a response rate to the medication was defined as a 15 - point decrease in SCORAD a score that includes lesion extent intensity and subjective symptoms such as pruritus and sleep which was determined through the experience of the service It was estimated that 40 of the patients in the treatment group and 15 of the placebo group reached the proposed rate through a test with 80 power and the need for 47 individuals in each group was defined
Patients in the treatment group will undergo allergen-specific immunotherapy sublingually with weekly doses of extracts of mites Dermatophagoides pteronyssinus and Dermatophagoides farinae 60 and 40 respectively according to the scheme described in Tables 1 and 2 Patients in the control group will be submitted to the same administration schedule but with the diluent of the allergenic extract doubly distilled water solution and glycerin Patients will be divided into groups according to randomization
Subjects will be randomly divided into blocks of random size 4 or 6 and stratified according to age less than 12 years and greater equal 12 years performed through the RedCap platform available at FMRPUSP This process will be performed by laboratory staff who will provide the extracts and the researchers will not have access to the lists of patients in each group As for blinding the bottles with extract and placebo will be provided by the already coded laboratory and the team will only be responsible for the delivery and storage of the same
Table 1 - Weekly dose schedule Monday Wednesday Friday
1 st week 1 drop 2 drops 4 drops
2 nd week 6 drops 8 drops 8 drops
Table 2 - Monthly Dilution Schedule Dilution of mite extract
1st and 2nd weeks 1st month 1 1000000 v v 3rd and 4th weeks 1st month 1 100000 v v
1st and 2nd weeks 2nd month1 10000 v v 3rd and 4th weeks 2nd month 11000 v v
1st and 2nd weeks 3rd month 1 100 vv 3rd and 4th weeks 3rd month 110 vv 3rd to 18th month 110 v v
Individuals will be the outpatient clinics of the Allergy and Dermatology Service of the HCFMRP-USP All medical records and clinical and dermatological examination will be recorded in medical records as well as clinical evaluation by SCORAD quality of life questionnaire and personal scale of symptoms being evaluated at the beginning of treatment after two three six nine twelve fifteen and eighteen months of evolution
Serum levels of IgG4 specific mite for Der p 1 and Der p 2 will be determined by ImmunoCAP and evaluated at the beginning and the end of treatment Interleukins 4 5 9 10 13 17 TNFα TGFβ and interferon-γ will be performed in plasma in the beginning with 9 months of evolution and at the end of the study
Patients in the treatment group will undergo allergen-specific immunotherapy sublingually with weekly doses of extracts of mites Dermatophagoides pteronyssinus and Dermatophagoides farinae 60 and 40 respectively according to the scheme described in Tables 1 and 2 Patients in the control group will be submitted to the same administration schedule but with the diluent of the allergenic extract doubly distilled water solution and glycerin Patients will be divided into groups according to randomization
Subjects will be randomly divided into blocks of random size 4 or 6 and stratified according to age less than 12 years and greater equal 12 years performed through the RedCap platform available at FMRPUSP This process will be performed by laboratory staff who will provide the extracts and the researchers will not have access to the lists of patients in each group As for blinding the bottles with extract and placebo will be provided by the already coded laboratory and the team will only be responsible for the delivery and storage of the same
Table 1 - Weekly dose schedule Monday Wednesday Friday
1 st week 1 drop 2 drops 4 drops
2 nd week 6 drops 8 drops 8 drops
Table 2 - Monthly Dilution Schedule Dilution of mite extract
1st and 2nd weeks 1st month 1 1000000 v v 3rd and 4th weeks 1st month 1 100000 v v
1st and 2nd weeks 2nd month1 10000 v v 3rd and 4th weeks 2nd month 11000 v v
1st and 2nd weeks 3rd month 1 100 vv 3rd and 4th weeks 3rd month 110 vv 3rd to 18th month 110 v v
Individuals will be the outpatient clinics of the Allergy and Dermatology Service of the HCFMRP-USP All medical records and clinical and dermatological examination will be recorded in medical records as well as clinical evaluation by SCORAD quality of life questionnaire and personal scale of symptoms being evaluated at the beginning of treatment after two three six nine twelve fifteen and eighteen months of evolution
Serum levels of IgG4 specific mite for Der p 1 and Der p 2 will be determined by ImmunoCAP and evaluated at the beginning and the end of treatment Interleukins 4 5 9 10 13 17 TNFα TGFβ and interferon-γ will be performed in plasma in the beginning with 9 months of evolution and at the end of the study
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None