NCT03066986

Brief Summary

The purpose of this study is to assess the potential use of delta-inulin as an adjuvant to facilitate the desired immune response to Jack Jumper Ant (JJA) venom with a lower dose of venom, thus reducing adverse reactions, venom requirements and costs of treatment. Specifically we aim to compare outcomes of in-hospital JJA sting challenges and JJA venom specific IgE, and IgG4 responses to semi-rush JJA VIT at maintenance doses of 25 and 50 mcg of JJA venom, with and without delta-inulin adjuvant.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
40

participants targeted

Target at P50-P75 for phase_1

Timeline
Completed

Started Oct 2016

Longer than P75 for phase_1

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2016

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

February 20, 2017

Completed
9 days until next milestone

First Posted

Study publicly available on registry

March 1, 2017

Completed
4.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2021

Completed
Last Updated

August 11, 2020

Status Verified

August 1, 2020

Enrollment Period

5.2 years

First QC Date

February 20, 2017

Last Update Submit

August 8, 2020

Conditions

Keywords

Venom anaphylaxisMyrmecia piluosaImmunological adjuvantImmunotherapyJack jumper ant

Outcome Measures

Primary Outcomes (3)

  • Response to in-hospital JJA sting following 12 months of maintenance treatment

    Number of subjects in each group experiencing systemic allergic reaction to in-hospital JJA sting after 12 months of maintenance treatment.

    15 months

  • Specific IgG4 responses to JJA venom during treatment

    Specific IgG4 responses (mcgA/L) to JJA venom immunotherapy by group

    18 months

  • Specific IgE responses to JJA venom during treatment

    Specific IgE responses (kU/L) to JJA venom immunotherapy by group

    18 months

Secondary Outcomes (3)

  • Changes in VST to JJA venom during treatment

    15 months

  • Adverse reactions to JJA venom immunotherapy

    18 months

  • Incidental reactions to field stings during JJA venom immunotherapy

    18 months

Study Arms (4)

25mcg JJA venom

EXPERIMENTAL

Subjects will receive semi-rush JJA VIT (without delta-inulin) aiming to achieve a maintenance dose of JJA venom of 25mcg (dose finding comparison).

Biological: Dose finding comparison

25mcg JJA venom + 5mg delta-inulin

EXPERIMENTAL

Subjects will receive semi-rush JJA VIT with delta-inulin (at a fixed dose of 5 mg with each dose of venom) aiming to achieve a maintenance dose of JJA venom of 25mcg (dose finding comparison, adjuvant comparison).

Drug: Delta-inulinBiological: Dose finding comparison

50mcg JJA venom

ACTIVE COMPARATOR

Subjects will receive semi-rush JJA VIT (without delta-inulin) aiming to achieve a maintenance dose of JJA venom of 50mcg, ie. the current standard of care.

Biological: Dose finding comparison

50mcg JJA venom + 5mg delta-inulin

EXPERIMENTAL

Subjects will receive semi-rush JJA VIT with delta-inulin (at a fixed dose of 5 mg with each dose of venom) aiming to achieve a maintenance dose of JJA venom of 50mcg (adjuvant comparison).

Drug: Delta-inulinBiological: Dose finding comparison

Interventions

Addition of adjuvant, delta-inulin to JJA VIT regime, to determine if this will allow lower doses and shorter regimes to promote protective responses, reducing costs and morbidity of JJA VIT.

Also known as: Advax
25mcg JJA venom + 5mg delta-inulin50mcg JJA venom + 5mg delta-inulin

Define minimum effective maintenance dose (50mcg vs 25mcg). In "real world" sting challenges after 12 months of JJA VIT objective systemic reaction rates after 50 and 100 mcg maintenance doses respectively 14/130 and 12/126 subjects vs reaction rates to stings in similar subjects without JJA VIT 70-76%. Venom delivery in sting likely \<20mcg. Therefore minimum effective maintenance dose not yet defined.

25mcg JJA venom25mcg JJA venom + 5mg delta-inulin50mcg JJA venom50mcg JJA venom + 5mg delta-inulin

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Previous immediate systemic allergic reaction to definite or possible JJA sting.
  • Venom-specific lgE response to JJA venom (by intradermal skin testing or serological analysis).
  • Age between 18 and 65 years at the time of starting treatment.
  • Gives informed consent, including acknowledgement that any protection from JJA sting anaphylaxis may be short lived and that JJA VIT and in particular, JJA sting challenges have the potential to cause systemic allergic reactions, including anaphylaxis.

You may not qualify if:

  • Pregnant (women of child-bearing age will have a urine pregnancy test on first day of treatment) or intended pregnancy during treatment.
  • Beta-blocker, ACE-inhibitor or mono-amine oxidase therapy for any reason.
  • Unstable heart disease.
  • Poorly controlled lung disease; defined as being severe enough to cause breathlessness on mild or moderate exertion, i.e. unable to walk up a modest incline.
  • Any other chronic or severe medical condition which puts the patient at increased risk if they participated in this study in the investigators opinion.
  • Previous JJA VIT, any ongoing immunotherapy or use of immunosuppressive drugs.
  • Raised baseline mast cell tryptase

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Royal Adelaide Hospital

Adelaide, South Australia, 5000, Australia

Location

MeSH Terms

Interventions

delta inulin

Study Officials

  • Pravin Hissaria, FRACP FRCPA

    Royal Adelaide Hospital and SA Pathology

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Dr Adriana Le, Clinical Immunologist/Allergist, Royal Adelaide Hospital

Study Record Dates

First Submitted

February 20, 2017

First Posted

March 1, 2017

Study Start

October 1, 2016

Primary Completion

December 1, 2021

Study Completion

December 1, 2021

Last Updated

August 11, 2020

Record last verified: 2020-08

Data Sharing

IPD Sharing
Will share

IPD will be shared with collaborating institutions/organisations, specifically Royal Hobart Hospital JJA Program and Vaxine Pty Ltd, Flinders Medical Centre. We are prepared to share de-identified data with other researchers. We do not expect any substantive results to be available until February 2018. Enquries for obtaining data should be directed to the primary investigators P Hissaria or TA Le.

Shared Documents
STUDY PROTOCOL, ICF, CSR
Time Frame
Primary and secondary outcome data to be shared with collaborators until end of study (end 2021)
Access Criteria
Data access will be limited to collaborators and data safety monitor

Locations