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Intradermal allergen immunotherapy in adults with seasonal allergic rhinitis
DOI 10.1186/ISRCTN78413121
ClinicalTrials.gov identifier
EudraCT number 2012-002193-31
Public title Intradermal allergen immunotherapy in adults with seasonal allergic rhinitis
Scientific title A randomised, double-blind, single-centre, controlled trial of low dose intradermal allergen immunotherapy in adults with seasonal allergic rhinitis
Acronym PollenLITE
Serial number at source 12950
Study hypothesis We are performing a clinical trial of a new vaccine treatment for hay fever, which affects 1 in 4 people in the UK. Injection of small quantities of grass pollen high up in the skin (in an area called the dermis) provokes a local allergic response, visible as a lump lasting a day or two. When these injections are repeated every 2 weeks, a dramatic reduction is seen in the size of this lump, suggesting that the allergic reactions are being switched off. Our aim is now to test if this also switches off grass allergy in the nose and improves hay fever symptoms. A clinical trial will be performed at Guy’s Hospital in 2013, with 90 hay fever sufferers divided into 2 groups to receive between 7 and 8 injections of grass pollen into the dermis, or similar dummy injections, before the grass pollen season. In the summer, participants will score their symptoms and how much hay fever medication they need. We will then compare these scores in the 2 groups. We will also perform experiments to see how this ‘vaccine’ might work: we take blood samples at the beginning and end of the study for experiments. Also, we will collect a small sample of skin, but only from 40 of the participants selected at random, although they will free to decline this. We will also perform tests to examine if the effect of the vaccine is long lasting. We believe that these injections are safe, although we will observe all participants for 1 hour after the first injection and for 30 minutes after subsequent injections. This study also has the potential to define a new scientific and clinical principle that could also be applied to other allergic diseases e.g. asthma and food allergies.

More details can be found at: http://public.ukcrn.org.uk/Search/StudyDetail.aspx?StudyID=12950
Lay summary Not provided at time of registration
Ethics approval First MREC, 25 July 2012 ref: 12/LO/0941
Study design Randomised interventional trial
Countries of recruitment United Kingdom
Disease/condition/study domain Respiratory disease
Participants - inclusion criteria 1. Adults aged 18 to 65 years
2. A clinical history of grass pollen-induced allergic rhinoconjunctivitis for at least 2 years with peak symptoms in May, June, or July.
3. A clinical history of moderate-severe persistent rhinoconjunctivitis symptoms interfering with usual daily activities or with sleep.
4. A clinical history of rhinoconjunctivitis that remains troublesome despite treatment with either antihistamines or nasal corticosteroids during the grass pollen season.
5. Positive skin prick test response, defined as wheal diameter greater than or equal to 3 mm, to Phleum pratense.
6. Positive specific IgE, defined as greater than or equal to IgE class 2, against Phleum pratense.
7. For women of childbearing age, a willingness to use an effective form of contraception for the duration of intradermal injections.
8. The ability to give informed consent and comply with study procedures
9. Male or female
Participants - exclusion criteria 1. Pre-bronchodilator FEV1 less than 70% of predicted value at screening visit
2. A history of seasonal grass pollen-induced asthma requiring regular treatment with salbutamol or inhaled corticosteroids. Patients with mild seasonal grass pollen-induced asthma may be included, provided symptoms are satisfactorily controlled with occasional salbutamol only.
3. A clinical history of symptomatic seasonal allergic rhinitis and/or asthma due to tree pollen or weed pollen near or overlapping the grass pollen season.
4. A clinical history of symptomatic allergic rhinitis and/or asthma caused by a perennial allergen to which the participant is regularly exposed.
5. Emergency department visit or hospital admission for asthma in the previous 12 months.
6. History of chronic obstructive pulmonary disease.
7. History of significant recurrent acute sinusitis, defined as 2 episodes per year for the last 2 years, all of which required antibiotic treatment.
8. History of chronic sinusitis, defined as a sinus symptoms lasting greater than 12 weeks that includes 2 or more major factors or 1 major factor and 2 minor factors. Major factors are defined as facial pain or pressure, nasal obstruction or blockage, nasal discharge or purulence or discoloured postnasal discharge, purulence in nasal cavity, or impaired or loss of smell. Minor factors are defined as headache, fever, halitosis, fatigue, dental pain, cough, and ear pain, pressure, or fullness.
9. At randomisation, current symptoms of, or treatment for, upper respiratory tract infection, acute sinusitis, acute otitis media, or other relevant infectious process; serous otitis media is not an exclusion criterion. Participants may be re-evaluated for eligibility after symptoms resolve
10. Current smokers or a history of greater than or equal to 5 pack years
11. Previous treatment by immunotherapy with grass pollen allergen within the previous 5 years
12. History of life-threatening anaphylaxis or angioedema
13. Ongoing systemic immunosuppressive treatment
14. History of intolerance of grass pollen immunotherapy, rescue medications or their excipients
15. For females of childbearing age a positive serum or urine pregnancy test with sensitivity of less than 50 mIU/mL within 72 hours of first administration of study therapy
16. Lactating females
17. The use of any investigational drug within 30 days of the screening visit
18. Ongoing treatment with beta-blockers, calcium channel blockers, tricyclic antidepressants, monoamine oxidase inhibitors or anti-IgE monoclonal antibody
19. The presence of any medical condition that the investigator deems incompatible with participation in the trial
20. Individuals with insufficient understanding of the trial
Anticipated start date 20/09/2012
Anticipated end date 21/03/2013
Status of trial Completed
Patient information material Not available in web format, please use the contact details below to request a patient information sheet
Target number of participants UK Sample Size: 90; Description: 45 active, 45 control
Interventions Intradermal Injecitons, Active: Grass Pollen extract
Control: Histamine; Follow Up Length: 24 months
Primary outcome measure(s) Combined symptom/medication score measured at summer 2013
Secondary outcome measure(s) No secondary outcome measures
Sources of funding NIHR Evaluation, Trials and Studies Coordinating Centre (UK)
Trial website
Contact name Dr  Stephen  Till
  Address King's College London
Department of Asthma
St. Thomas Street
  City/town London
  Zip/Postcode SE1 9RT
  Country United Kingdom
  Email stephen.till@kcl.ac.uk
Sponsor King's College London (UK)
  Address King's College London
Guy's Campus
Hodgkin Building
New Hunts House
  City/town London
  Zip/Postcode SE1 1UL
  Country United Kingdom
  Sponsor website: http://www.kcl.ac.uk/
Date applied 19/11/2012
Last edited 19/11/2012
Date ISRCTN assigned 19/11/2012
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