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NCT05038904

Preventing Anaphylaxis With Acalabrutinib

Completed Phase 2 Results posted Last updated 28 September 2023
What this trial tests

Phase 2 trial testing Acalabrutinib in Food Allergy in 10 participants. Completed in 31 December 2022.

Timeline
16 December 2021
Primary endpoint
8 December 2022
31 December 2022

Quick facts

Lead sponsorJohns Hopkins University
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationna
Designsingle group
Maskingnone
Primary purposetreatment
Enrollment10
Start date16 December 2021
Primary completion8 December 2022
Estimated completion31 December 2022
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Johns Hopkins University

Who can join

18 and older, any sex, with Food Allergy or Food Allergy Peanut. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Highest Dose of Peanut That is Tolerated During Oral Food Challenge Primary · Baseline and Day 2 of treatment

The highest dose of peanut protein (in mg) tolerated during oral food challenge before and after acalabrutinib treatment was determined by assessing clinical symptoms and physcial exam findings in each organ system during the challenge. Symptoms were given a numeric score based on the American Academy of Allergy, Asthma, and Immunology/European Academy of Allergy and Clinical Immunology PRACTALL consensus system to grade symptom severity and the likelihood of their representing a true objective clinical reaction to peanut.

Baseline
GroupValue95% CI
Acalabrutinib291 – 444
Aftet treatment
GroupValue95% CI
Acalabrutinib4,044444 – 4,044
Area Under the Curve Severity of Clinical Reaction to Peanut Secondary · Baseline and Day 2 of treatment

The severity of participants' cliinical reaction during oral food challenge before and after acalabrutinib treatment was determined using the American Academy of Allergy, Asthma, and Immunology/European Academy of Allergy and Clinical Immunology PRACTALL consensus system to grade objective clinical findings on physical exam on a scale of 0 (absent) to 3 (severe) in 9 different organ system categories. Total symptom scores for each food dose ranged from a minimum if 0 (no symptoms) to 27 (severe objective symptoms in all organ systems), and the area under the curve for all scores during the foo

Baseline
GroupValue95% CI
Acalabrutinib27.8315.91 – 39.75
After treatment
GroupValue95% CI
Acalabrutinib3.760.12 – 7.39
Skin Prick Test Size to Peanut Secondary · Baseline and Day 2 of treatment

The skin prick test to peanut extract wheal area (in square mm) was measured at baseline and after treatment.

Baseline
GroupValue95% CI
Acalabrutinib12627.5 – 480
After treatment
GroupValue95% CI
Acalabrutinib57.70 – 345
Basophil Activation Testing Secondary · Baseline and Day 2 of treatment

The percent of peripheral blood basophils activated by stimulation ex vivo with peanut extract was assessed by CD63 surface expression.

Baseline
GroupValue95% CI
Acalabrutinib31.73.5 – 70.7
After treatment
GroupValue95% CI
Acalabrutinib1.560 – 4.6

Adverse events — posted to ClinicalTrials.gov

Time frame: 6 months. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Acalabrutinib
Serious: 3/10 (30%)
Deaths: 0/10

Serious adverse events (3 terms)

ReactionSystemAcalabrutinib
Sports-related concussionInjury, poisoning and procedural complications
Sports-related injuryInjury, poisoning and procedural complications
Emergency room visit after baseline food challengeInjury, poisoning and procedural complications
Other adverse events (9 terms — click to expand)

ReactionSystemAcalabrutinib
AnemiaBlood and lymphatic system disorders
HyperglycemiaMetabolism and nutrition disorders
NeutropeniaBlood and lymphatic system disorders
Elevated liver function testsHepatobiliary disorders
EosinophiliaBlood and lymphatic system disorders
COVID-19 infectionInfections and infestations
LeukocytosisBlood and lymphatic system disorders
HypokalemiaGeneral disorders
HypoalbuminemiaGeneral disorders

Most-reported serious reactions: Sports-related concussion, Sports-related injury, Emergency room visit after baseline food challenge.

Data from ClinicalTrials.gov NCT05038904 adverse events section.

Sponsor's own description

Food allergy is a potentially life-threatening condition, and its prevalence continues to increase despite public health efforts. There are currently no known therapies that can reliably prevent food-induced anaphylaxis. This is an open-label study designed to determine the ability acalabrutinib to prevent signs and symptoms of anaphylaxis during an oral food challenge in food-allergic adults.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Mast Cells as a Target-A Comprehensive Review of Recent Therapeutic Approaches.
    Baran J, Sobiepanek A, Mazurkiewicz-Pisarek A, Rogalska M, et al · · 2023 · cited 35× · PMID 37190096 · DOI 10.3390/cells12081187
  2. Mast cells: a novel therapeutic avenue for cardiovascular diseases?
    Poto R, Marone G, Galli SJ, Varricchi G. · · 2024 · cited 27× · PMID 38630620 · DOI 10.1093/cvr/cvae066
  3. A phase II study of Bruton's tyrosine kinase inhibition for the prevention of anaphylaxis.
    Suresh RV, Dunnam C, Vaidya D, Wood RA, et al · · 2023 · cited 26× · PMID 37384412 · DOI 10.1172/jci172335
  4. Human Lung Mast Cells: Therapeutic Implications in Asthma.
    Poto R, Criscuolo G, Marone G, Brightling CE, et al · · 2022 · cited 26× · PMID 36430941 · DOI 10.3390/ijms232214466
  5. The role of biologics in pediatric food allergy and eosinophilic gastrointestinal disorders.
    Sindher SB, Barshow S, Tirumalasetty J, Arasi S, et al · · 2023 · cited 24× · PMID 36872039 · DOI 10.1016/j.jaci.2023.01.007
  6. Treatment of food allergy: Oral immunotherapy, biologics, and beyond.
    Sindher SB, Hillier C, Anderson B, Long A, et al · · 2023 · cited 22× · PMID 37100276 · DOI 10.1016/j.anai.2023.04.023
  7. Bruton's tyrosine kinase inhibition for the treatment of allergic disorders.
    Lin EV, Suresh RV, Dispenza MC. · · 2024 · cited 20× · PMID 38492772 · DOI 10.1016/j.anai.2024.03.002
  8. Research Advances in Mast Cell Biology and Their Translation Into Novel Therapies for Anaphylaxis.
    Dispenza MC, Metcalfe DD, Olivera A. · · 2023 · cited 11× · PMID 36958519 · DOI 10.1016/j.jaip.2023.03.015

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