Andorf Sandra, Manohar Monali, Dominguez Tina, Block Whitney, Tupa Dana, Kshirsagar Rohun A, Sampath Vanitha, Chinthrajah R Sharon, Nadeau Kari C
Sean N. Parker Center for Allergy and Asthma Research at Stanford University, 269 Campus Drive CCSR 3215, MC 5366, Stanford, CA 94305-5101 USA.
Allergy Asthma Clin Immunol. 2017 Dec 21;13:51. doi: 10.1186/s13223-017-0223-8. eCollection 2017.
A number of clinical studies focused on treating a single food allergy through oral immunotherapy (OIT) with adjunctive omalizumab treatment have been published. We previously demonstrated safety and tolerability of a rapid OIT protocol using omalizumab in a phase 1 study to achieve desensitization to multiple (up to 5) food allergens in parallel, rapidly (7-36 weeks; median = 18 weeks). In the current long-term, observational study, we followed 34 food allergic participants for over 5 years, who had originally undergone the phase 1 rapid OIT protocol.
After reaching the maintenance dose of 2 g protein for each of their respective food allergens as a part of the phase 1 study, the long-term maintenance dose was reduced for some participants based on a pragmatic team-based decision. Participants were followed up to 62 months through standard oral food challenges (OFCs), skin prick tests, and blood tests.
Each participant passed the 2 g OFC to each of their offending food allergens (up to 5 food allergens in total) at the end of the long-term follow-up (LTFU) study.
Our data demonstrate the feasibility of long-term maintenance dosing of a food allergen without compromising the desensitized status conferred through rapid-OIT. Registry: Clinicaltrials.gov. Registration numbers: NCT01510626 (original study), NCT03234764 (LTFU study). Date of registration: November 29, 2011 (original study); July 26, 2017 (LTFU study, retrospectively registered).
已经发表了多项关于通过口服免疫疗法(OIT)联合奥马珠单抗治疗单一食物过敏的临床研究。我们之前在一项1期研究中证明了使用奥马珠单抗的快速OIT方案的安全性和耐受性,该方案能够在7至36周(中位数 = 18周)内迅速实现对多种(多达5种)食物过敏原的脱敏。在当前这项长期观察性研究中,我们对34名食物过敏参与者进行了5年多的随访,这些参与者最初接受了1期快速OIT方案。
作为1期研究的一部分,在每种食物过敏原达到2g蛋白质的维持剂量后,一些参与者根据基于团队的实际决策降低了长期维持剂量。通过标准口服食物激发试验(OFC)、皮肤点刺试验和血液检测对参与者进行了长达62个月的随访。
在长期随访(LTFU)研究结束时,每位参与者对每种引发过敏的食物过敏原(总共多达5种食物过敏原)都通过了2g的OFC。
我们的数据表明,在不影响快速OIT所赋予的脱敏状态的情况下,对食物过敏原进行长期维持给药是可行的。注册信息:Clinicaltrials.gov。注册号:NCT01510626(原始研究),NCT03234764(LTFU研究)。注册日期:2011年11月29日(原始研究);2017年7月26日(LTFU研究,追溯注册)。