Dupilumab as an Adjunct to Oral Immunotherapy in Pediatric Patients With Peanut Allergy

IF 12.6 1区 医学 Q1 ALLERGY Allergy Pub Date : 2024-12-14 DOI:10.1111/all.16420
R. Sharon Chinthrajah, Sayantani B. Sindher, Kari C. Nadeau, Jeffrey G. Leflein, Jonathan M. Spergel, Daniel H. Petroni, Stacie M. Jones, Thomas B. Casale, Julie Wang, Warner W. Carr, Wayne G. Shreffler, Robert A. Wood, Erik Wambre, Jinzhong Liu, Bolanle Akinlade, Amanda Atanasio, Jamie M. Orengo, Jennifer D. Hamilton, Mohamed A. Kamal, Andrea T. Hooper, Kiran Patel, Elizabeth Laws, Leda P. Mannent, Daniel C. Adelman, Anoshie Ratnayake, Allen R. Radin
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Abstract

BackgroundPeanut allergy is a common, life‐threatening food allergy in children. We evaluated whether dupilumab, which blocks the activity of interleukin (IL)‐4/IL‐13, enhances the efficacy of oral immunotherapy (OIT) AR101 in pediatric patients with peanut allergy.MethodsA Phase II, multicenter, randomized, double‐blind study was conducted in the USA (NCT03682770) in pediatric patients (6–≤ 17 years old) with confirmed peanut allergy. Patients were randomized 2:1 to receive dupilumab + OIT or placebo + OIT during a 28–40‐week up‐dosing period. Patients in the dupilumab + OIT group were re‐randomized 1:1 and received dupilumab + OIT or placebo + OIT during 24‐week OIT maintenance, undergoing a 2044 mg (cumulative) of peanut protein double‐blind, placebo‐controlled food challenge (DBPCFC) following up‐dosing, maintenance, and at 12‐week post‐treatment follow‐up.ResultsThe study enrolled 148 patients, 123 of whom were included in the modified full analysis set, with a mean age of 11.1 years. Dupilumab + OIT treatment (n = 84) led to a 20.2% increase (p < 0.05) in the number of patients who passed a DBPCFC to 2044 mg (cumulative) of peanut protein following the up‐dosing period versus placebo (OIT alone, n = 39). Following the OIT maintenance period, continuous dupilumab treatment improved the number of patients who passed a DBPCFC to 2044 mg (cumulative) of peanut protein versus patients continuously on OIT alone (16.6% difference [95% CI −9.7, 42.8], p = 0.2123). Safety was consistent with known dupilumab safety profile.ConclusionsDupilumab provided a modest increase efficacy of OIT in children and adolescents with peanut allergy, though it did not provide protection against OIT‐related anaphylaxis.Trial RegistrationClinicalTrials.gov identifier: NCT03793608
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杜匹单抗作为口服免疫疗法的辅助药物用于花生过敏的儿科患者
背景花生过敏是一种常见的、危及生命的儿童食物过敏。我们评估了阻断白细胞介素(IL)-4/IL-13活性的dupilumab是否能增强口服免疫疗法(OIT)AR101对花生过敏儿科患者的疗效。方法在美国(NCT03682770)对确诊花生过敏的儿科患者(6-≤17岁)进行了一项II期、多中心、随机、双盲研究。患者以 2:1 的比例被随机分配,在 28-40 周的给药期内接受杜利单抗 + OIT 或安慰剂 + OIT。杜利单抗+OIT组患者按1:1重新随机分组,在为期24周的OIT维持治疗期间接受杜利单抗+OIT或安慰剂+OIT,并在给药后、维持治疗后和治疗后12周的随访期间接受2044毫克(累计)花生蛋白双盲、安慰剂对照食物挑战(DBPCFC)。与安慰剂(单用 OIT,n = 39)相比,Dupilumab + OIT 治疗(n = 84)使通过 DBPCFC 达 2044 毫克(累积)花生蛋白的患者人数在给药后增加了 20.2% (p < 0.05)。在 OIT 维持期之后,与持续服用 OIT 的患者相比,持续服用杜比鲁单抗可使通过 DBPCFC 达到 2044 毫克(累积)花生蛋白的患者人数增加(差异为 16.6% [95% CI -9.7,42.8],p = 0.2123)。结论Dupilumab能适度提高OIT对花生过敏儿童和青少年的疗效,但不能预防与OIT相关的过敏性休克:NCT03793608
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来源期刊
Allergy
Allergy 医学-过敏
CiteScore
26.10
自引率
9.70%
发文量
393
审稿时长
2 months
期刊介绍: Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.
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