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    Clinical Trial Results:
    A phase II-III trial assessing the efficacy and safety of three doses of the ALK HDM tablet in house dust mite allergic subjects

    Summary
    EudraCT number
    2006-001795-20
    Trial protocol
    SE   DE   ES   DK   GB   IT  
    Global end of trial date
    23 Apr 2008

    Results information
    Results version number
    v1(current)
    This version publication date
    16 Feb 2016
    First version publication date
    26 Jul 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    MT-02
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    ALK-Abelló A/S
    Sponsor organisation address
    Bøge Allé 1, Hørsholm, Denmark, 2970
    Public contact
    Clinical Development, ALK-Abelló A/S, +45 45747576, ClinicalTrials@alk.net
    Scientific contact
    Clinical Development, ALK-Abelló A/S, +45 45747576, ClinicalTrials@alk.net
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    23 Apr 2008
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    23 Apr 2008
    Global end of trial reached?
    Yes
    Global end of trial date
    23 Apr 2008
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the efficacy of specific immunotherapy with three dosages of the ALK HDM tablet given once daily compared to placebo in subjects suffering from house dust mite allergy. The evaluation is based on reduction in inhaled corticosteroid (ICS)
    Protection of trial subjects
    Safety surveillance Subjects had access to symptomatic medications if needed. As regards ICS and medications to relieve asthma and rhinoconjunctivitis symptoms these medications were provided by the sponsor
    Background therapy
    Subjects were provided with the asthma rescue medication: • Budesonide Turbuhalers®, 100 μg or 200 μg. • Salbutamol inhaler, 200 μg per inhalation. Dosing: Prn. Subjects were supplied with the following rescue medication: • Desloratadine 5 mg tablets. Dosing: 1 tablet daily prn. • Budesonide nasal spray 32 μg micronised budesonide per actuation. Dosing: the lowest dosage acceptable to the subject. In case of asthma exacerbations or severe rhinoconjunctivitis symptoms which could not be relieved with the asthma medication or rhinoconjunctivitis rescue medication provided, the investigator could treat the subject with an oral corticosteroid. The oral steroid provided was: • Prednisone/prednisolone 5 mg tablets. Dosing: Up to 50 mg daily for three day
    Evidence for comparator
    Placebo comparator
    Actual start date of recruitment
    18 Aug 2006
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Spain: 19
    Country: Number of subjects enrolled
    Sweden: 10
    Country: Number of subjects enrolled
    United Kingdom: 27
    Country: Number of subjects enrolled
    Denmark: 67
    Country: Number of subjects enrolled
    France: 64
    Country: Number of subjects enrolled
    Germany: 128
    Country: Number of subjects enrolled
    Italy: 43
    Country: Number of subjects enrolled
    Poland: 246
    Worldwide total number of subjects
    604
    EEA total number of subjects
    604
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    39
    Adults (18-64 years)
    559
    From 65 to 84 years
    6
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects was recruited from 81 sites in Denmark, France, Germany, Italy, Poland, Spain, Sweden and U.K. The trial was initiated in the summer of 2006 (first subject first visit − 18 August 2006)

    Pre-assignment
    Screening details
    Male or female ≥14 years, clinical history ≥1 year of HDM-induced mild to moderate persistent asthma (steps 2 and 3 according the GINA guidelines) and mild to severe allergic rhinitis (ARIA guidelines), positive SPT (≥3 mm) and specific IgE (≥ class 2) to D. pteronyssinus and/or D. farinae, FEV1 > 70% of predicted value with appropriate medication.

    Period 1
    Period 1 title
    overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo
    Arm description
    -
    Arm type
    Placebo

    Investigational medicinal product name
    SQ HDM SLIT-tablet
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral lyophilisate
    Routes of administration
    Sublingual use
    Dosage and administration details
    The daily dose of IMP was one lyophilisate [tablet], preferably taken in the morning. The tablet was placed under the tongue, and swallowing was to be avoided for one minute. In addition, eating and drinking was not allowed within 5 minutes after intake of IMP.

    Arm title
    1 SQ-HDM
    Arm description
    Active IMP, strength 1 SQ-HDM
    Arm type
    Experimental

    Investigational medicinal product name
    SQ HDM SLIT-tablet
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral lyophilisate
    Routes of administration
    Sublingual use
    Dosage and administration details
    The daily dose of IMP was one lyophilisate [tablet], preferably taken in the morning. The tablet was placed under the tongue, and swallowing was to be avoided for one minute. In addition, eating and drinking was not allowed within 5 minutes after intake of IMP.

    Arm title
    3 SQ-HDM
    Arm description
    Active IMP, strength 3 SQ-HDM
    Arm type
    Experimental

    Investigational medicinal product name
    SQ HDM SLIT-tablet
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral lyophilisate
    Routes of administration
    Sublingual use
    Dosage and administration details
    The daily dose of IMP was one lyophilisate [tablet], preferably taken in the morning. The tablet was placed under the tongue, and swallowing was to be avoided for one minute. In addition, eating and drinking was not allowed within 5 minutes after intake of IMP.

    Arm title
    6 SQ-HDM
    Arm description
    Active IMP, strength 6 SQ-HDM
    Arm type
    Experimental

    Investigational medicinal product name
    SQ HDM SLIT-tablet
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral lyophilisate
    Routes of administration
    Sublingual use
    Dosage and administration details
    The daily dose of IMP was one lyophilisate [tablet], preferably taken in the morning. The tablet was placed under the tongue, and swallowing was to be avoided for one minute. In addition, eating and drinking was not allowed within 5 minutes after intake of IMP.

    Number of subjects in period 1
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM
    Started
    143
    146
    159
    156
    Completed
    126
    132
    134
    140
    Not completed
    17
    14
    25
    16
         Consent withdrawn by subject
    3
    3
    6
    3
         Adverse event, non-fatal
    1
    2
    8
    4
         Not specified
    3
    3
    2
    1
         Pregnancy
    2
    1
    2
    -
         Non-compliance
    3
    3
    3
    5
         Lost to follow-up
    5
    2
    4
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group title
    1 SQ-HDM
    Reporting group description
    Active IMP, strength 1 SQ-HDM

    Reporting group title
    3 SQ-HDM
    Reporting group description
    Active IMP, strength 3 SQ-HDM

    Reporting group title
    6 SQ-HDM
    Reporting group description
    Active IMP, strength 6 SQ-HDM

    Reporting group values
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM Total
    Number of subjects
    143 146 159 156 604
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0 0
        Newborns (0-27 days)
    0 0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0 0
        Children (2-11 years)
    0 0 0 0 0
        Adolescents (12-17 years)
    11 7 12 9 39
        Adults (18-64 years)
    131 139 145 144 559
        From 65-84 years
    1 0 2 3 6
        85 years and over
    0 0 0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    31.4 ± 12.1 31.7 ± 12 31.6 ± 12.4 31.6 ± 12.9 -
    Gender categorical
    Units: Subjects
        Female
    67 71 75 73 286
        Male
    76 75 84 83 318

    End points

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    End points reporting groups
    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group title
    1 SQ-HDM
    Reporting group description
    Active IMP, strength 1 SQ-HDM

    Reporting group title
    3 SQ-HDM
    Reporting group description
    Active IMP, strength 3 SQ-HDM

    Reporting group title
    6 SQ-HDM
    Reporting group description
    Active IMP, strength 6 SQ-HDM

    Primary: reduction of ICS dose from baseline to end of trial after approximately 1 year of treatment

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    End point title
    reduction of ICS dose from baseline to end of trial after approximately 1 year of treatment
    End point description
    The primary efficacy analysis defined in the protocol was the comparison of each of the 3 active dose groups to placebo. The approach to this multiple comparisons issue was defined in the protocol as a hierarchical ordering of the null hypotheses, with the following ranking: 1. SQ HDM SLIT-tablet 6 DU versus placebo 2. SQ HDM SLIT-tablet 3 DU versus placebo 3. SQ HDM SLIT-tablet 1 DU versus placebo
    End point type
    Primary
    End point timeframe
    approximately 1 year
    End point values
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM
    Number of subjects analysed
    143
    146
    159
    156
    Units: microgram(s)/24 hours
        arithmetic mean (standard deviation)
    -122 ± 279
    -155 ± 259
    -116 ± 235
    -204 ± 274
    Statistical analysis title
    Reduction in ICS, 6 SQ-HDM versus placebo
    Statistical analysis description
    Comparison of the reduction in ICS from baseline with the reduction observed in the placebo group for 6 SQ-HDM, 3 SQ-HDM and 1 SQ-HDM; in that order
    Comparison groups
    Placebo v 6 SQ-HDM
    Number of subjects included in analysis
    299
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0036 [1]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    -81.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -136.1
         upper limit
    -26.7
    Variability estimate
    Standard error of the mean
    Dispersion value
    27.9
    Notes
    [1] - Statistically significant difference between the 6 DU group and placebo
    Statistical analysis title
    Reduction in ICS, 3 SQ-HDM versus placebo
    Comparison groups
    Placebo v 3 SQ-HDM
    Number of subjects included in analysis
    302
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.8544 [2]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    -5.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -59.8
         upper limit
    49.6
    Variability estimate
    Standard error of the mean
    Dispersion value
    27.8
    Notes
    [2] - No statistically significant differences to placebo were observed for the 3 SQ-HDM group
    Statistical analysis title
    Reduction in ICS, 1 SQ-HDM versus placebo
    Comparison groups
    Placebo v 1 SQ-HDM
    Number of subjects included in analysis
    289
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.1334 [3]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    -42.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -98.4
         upper limit
    13.1
    Variability estimate
    Standard error of the mean
    Dispersion value
    28.4
    Notes
    [3] - No statistically significant difference to placebo were observed for the 1 SQ-HDM group

    Secondary: IgE-blocking factor at end-of-trial visit versus placebo

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    End point title
    IgE-blocking factor at end-of-trial visit versus placebo
    End point description
    IgE blocking factor specific for Dermatophagoides pteronyssinus. Samples only collected and analysed from trial sites in Germany and Denmark (30% of the trial population)
    End point type
    Secondary
    End point timeframe
    Approximately 1 year (change from baseline to end of trial in active versus placebo)
    End point values
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM
    Number of subjects analysed
    36 [4]
    34 [5]
    39 [6]
    44 [7]
    Units: arbitrary units
        arithmetic mean (standard error)
    0 ± 0.08
    0.08 ± 0.12
    0.09 ± 0.16
    0.17 ± 0.17
    Notes
    [4] - Only analysed for sites in Germany and Denmark
    [5] - Only analysed for sites in Germany and Denmark
    [6] - Only analysed for sites in Germany and Denmark
    [7] - Only analysed for sites in Germany and Denmark
    Statistical analysis title
    6 SQ-HDM versus placebo
    Statistical analysis description
    A mixed model including as fixed effect the visit 4 value, treatment group, visit and treatment group by visit interaction. For each pairwise comparison all available data from all four treatment groups were included. To allow correlation of observations on the same subject a random subject effect was included in the model. Possible different error variance for each treatment group was adjusted for. The error variance was fitted as seperate compound symmetry for each treatment group
    Comparison groups
    6 SQ-HDM v Placebo
    Number of subjects included in analysis
    80
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [8]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    0.166
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.116
         upper limit
    0.215
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.025
    Notes
    [8] - Highly statistical significant difference between 6 SQ-HDM and placebo
    Statistical analysis title
    3 SQ-HDM versus placebo
    Statistical analysis description
    A mixed model including as fixed effect the visit 4 value, treatment group, visit and treatment group by visit interaction. For each pairwise comparison all available data from all four treatment groups were included. To allow correlation of observations on the same subject a random subject effect was included in the model. Possible different error variance for each treatment group was adjusted for. The error variance was fitted as seperate compound symmetry for each treatment group
    Comparison groups
    Placebo v 3 SQ-HDM
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001 [9]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    0.096
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.054
         upper limit
    0.138
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.021
    Notes
    [9] - Highly statistical significant difference between 3 SQ-HDM and placebo
    Statistical analysis title
    1 SQ-HDM versus placebo
    Statistical analysis description
    A mixed model including as fixed effect the visit 4 value, treatment group, visit and treatment group by visit interaction. For each pairwise comparison all available data from all four treatment groups were included. To allow correlation of observations on the same subject a random subject effect was included in the model. Possible different error variance for each treatment group was adjusted for. The error variance was fitted as seperate compound symmetry for each treatment group
    Comparison groups
    Placebo v 1 SQ-HDM
    Number of subjects included in analysis
    70
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0003 [10]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    0.075
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.035
         upper limit
    0.115
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.02
    Notes
    [10] - Highly statistical significant difference between 1 SQ-HDM and placebo

    Secondary: Change from baseline in FEV1

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    End point title
    Change from baseline in FEV1
    End point description
    FEV1 (lung function) was assessed to document the controlled status with respect to asthma of the subjects throughout the trial, in anticipation that all treatment groups would be comparable
    End point type
    Secondary
    End point timeframe
    approximately 1 year (from baseline to end of trial)
    End point values
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM
    Number of subjects analysed
    133 [11]
    138 [12]
    143 [13]
    147 [14]
    Units: precentage of predicted FEV1
        arithmetic mean (standard deviation)
    -1.3 ± 8.8
    -0.56 ± 10.2
    -2.09 ± 9.4
    -1.81 ± 8.2
    Notes
    [11] - Number of subjects with end-of-trial visit
    [12] - Number of subjects with end-of-trial visit
    [13] - Number of subjects with end-of-trial visit
    [14] - Number of subjects with end-of-trial visit
    Statistical analysis title
    6 SQ-HDM vs placebo: change from baseline in %FEV1
    Statistical analysis description
    The estimates are based on a repeated measurements analysis with a linear mixed model. Treatment group, baseline value, visit and treatment group by visit interaction are iuncluded as fixed effects and centre is included as a random effect.
    Comparison groups
    Placebo v 6 SQ-HDM
    Number of subjects included in analysis
    280
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.667 [15]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    -0.425
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.362
         upper limit
    1.512
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.988
    Notes
    [15] - lung function parameters reflect the controlled status with respect to asthma of the subjects throughout the trial, and all treatment groups were completely comparable
    Statistical analysis title
    3 SQ-HDM vs placebo: change from baseline in %FEV1
    Statistical analysis description
    The estimates are based on a repeated measurements analysis with a linear mixed model. Treatment group, baseline value, visit and treatment group by visit interaction are iuncluded as fixed effects and centre is included as a random effect.
    Comparison groups
    Placebo v 3 SQ-HDM
    Number of subjects included in analysis
    276
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.3802 [16]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    -0.873
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.823
         upper limit
    1.077
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.995
    Notes
    [16] - lung function parameters reflect the controlled status with respect to asthma of the subjects throughout the trial, and all treatment groups were completely comparable
    Statistical analysis title
    1 SQ-HDM vs placebo: change from baseline in %FEV1
    Statistical analysis description
    The estimates are based on a repeated measurements analysis with a linear mixed model. Treatment group, baseline value, visit and treatment group by visit interaction are iuncluded as fixed effects and centre is included as a random effect.
    Comparison groups
    Placebo v 1 SQ-HDM
    Number of subjects included in analysis
    271
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.7433 [17]
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    0.329
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.639
         upper limit
    2.296
    Variability estimate
    Standard error of the mean
    Dispersion value
    1.003
    Notes
    [17] - lung function parameters reflect the controlled status with respect to asthma of the subjects throughout the trial, and all treatment groups were completely comparable

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    During the entire trial - approximately 2 months prior to randomisation (screening/baseline phase)and 12 months after randomisation (treatment phase)
    Adverse event reporting additional description
    All events meeting the definition of an AE were collected and reported from the first trial-related activity after the subject signed the informed consent and until the end of trial telephone follow-up. Adverse events were defined according to ICH Harmonised Tripartite Guideline E2A, Step 5
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    11.1
    Reporting groups
    Reporting group title
    Placebo
    Reporting group description
    -

    Reporting group title
    1 SQ-HDM
    Reporting group description
    Active IMP, strength 1 SQ-HDM

    Reporting group title
    3 SQ-HDM
    Reporting group description
    Active IMP, strength 3 SQ-HDM

    Reporting group title
    6 SQ-HDM
    Reporting group description
    Active IMP, strength 6 SQ-HDM

    Serious adverse events
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM
    Total subjects affected by serious adverse events
         subjects affected / exposed
    4 / 143 (2.80%)
    6 / 146 (4.11%)
    3 / 159 (1.89%)
    6 / 156 (3.85%)
         number of deaths (all causes)
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Lipoma
         subjects affected / exposed
    1 / 143 (0.70%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Spinal fracture
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    1 / 159 (0.63%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Surgical and medical procedures
    Adenoidectomy
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    1 / 159 (0.63%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Migraine
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    1 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Paraesthesia
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Pregnancy
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Inguinal hernia
         subjects affected / exposed
    1 / 143 (0.70%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Testicular torsion
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    1 / 143 (0.70%)
    0 / 146 (0.00%)
    1 / 159 (0.63%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Depression
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Bone disorder
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Bacterial infection
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    0 / 143 (0.00%)
    1 / 146 (0.68%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic tonsillitis
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastroenteritis
         subjects affected / exposed
    0 / 143 (0.00%)
    0 / 146 (0.00%)
    1 / 159 (0.63%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    1 / 143 (0.70%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    1 / 156 (0.64%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urethritis
         subjects affected / exposed
    1 / 143 (0.70%)
    0 / 146 (0.00%)
    0 / 159 (0.00%)
    0 / 156 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo 1 SQ-HDM 3 SQ-HDM 6 SQ-HDM
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    76 / 143 (53.15%)
    80 / 146 (54.79%)
    105 / 159 (66.04%)
    102 / 156 (65.38%)
    Gastrointestinal disorders
    Oral pruritus
         subjects affected / exposed
    5 / 143 (3.50%)
    16 / 146 (10.96%)
    31 / 159 (19.50%)
    27 / 156 (17.31%)
         occurrences all number
    5
    17
    46
    31
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    8 / 143 (5.59%)
    10 / 146 (6.85%)
    14 / 159 (8.81%)
    14 / 156 (8.97%)
         occurrences all number
    8
    11
    17
    21
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    22 / 143 (15.38%)
    21 / 146 (14.38%)
    22 / 159 (13.84%)
    25 / 156 (16.03%)
         occurrences all number
    26
    26
    32
    32
    Upper respiratory tract infection
         subjects affected / exposed
    11 / 143 (7.69%)
    10 / 146 (6.85%)
    9 / 159 (5.66%)
    10 / 156 (6.41%)
         occurrences all number
    13
    13
    10
    10
    Pharyngitis
         subjects affected / exposed
    3 / 143 (2.10%)
    10 / 146 (6.85%)
    8 / 159 (5.03%)
    3 / 156 (1.92%)
         occurrences all number
    3
    12
    9
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    21 Sep 2006
    Modification of in- and exclusion criteria
    14 Dec 2006
    Change on inclusion criterion regarding ACQ score
    05 Nov 2007
    change of trial period from '1-2 years' to '1 year'

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported

    Online references

    http://www.ncbi.nlm.nih.gov/pubmed/24797423
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