Clinical Trial Results:
A Double-blind, Placebo-controlled, Randomized Phase III Pivotal Trial to Assess the Efficacy and Safety of Peanut Epicutaneous Immunotherapy with Viaskin® Peanut in Peanut-allergic Children (PEPITES Study)
Summary
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EudraCT number |
2015-002461-37 |
Trial protocol |
IE DE |
Global end of trial date |
18 Aug 2017
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Results information
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Results version number |
v1(current) |
This version publication date |
15 Sep 2021
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First version publication date |
15 Sep 2021
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
V712-301
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02636699 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
DBV Technologies
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Sponsor organisation address |
177-181 avenue Pierre Brossolette, Montrouge, France, 92120
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Public contact |
Chief Medical Officer, DBV Technologies, 33 1-55-42-78-78, clinicaltrials@dbv-technologies.com
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Scientific contact |
Chief Medical Officer, DBV Technologies, 33 1-55-42-78-78, clinicaltrials@dbv-technologies.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
Yes
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EMA paediatric investigation plan number(s) |
EMEA-001481-PIP01-13 | ||
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
18 Aug 2017
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
18 Aug 2017
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To assess the efficacy and safety of DBV712 (Viaskin® Peanut) to induce desensitization to peanut in peanut-allergic participants aged 4 to 11 years old after a 12-month treatment period by epicutaneous immunotherapy.
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Protection of trial subjects |
This study was designed and conducted in accordance with the International Council for Harmonisation Good Clinical Practice, as required by the major Regulatory Authorities, and in accordance with the ethical principles of the Declaration of Helsinki. The study was also carried out in keeping with local legal requirements.
The study was conducted with Investigators and staff who were trained and experienced in the diagnosis and management of peanut allergy and anaphylaxis, and equipped and capable of performing a double-blind, placebo-controlled food challenge (DBPCFC) in children.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
08 Jan 2016
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Australia: 24
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Country: Number of subjects enrolled |
Canada: 89
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Country: Number of subjects enrolled |
Germany: 29
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Country: Number of subjects enrolled |
Ireland: 20
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Country: Number of subjects enrolled |
United States: 194
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Worldwide total number of subjects |
356
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EEA total number of subjects |
49
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
356
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
This Phase III study was conducted in participants aged 4 to 11 years old with peanut allergy at 31 active centers in Australia, Canada, Germany, Ireland and USA. Participants were randomized in a 2:1 ratio to receive DBV712 250 micrograms (μg) or placebo. | ||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
Overall maximum study duration for each participant was approximately 61 weeks (6-week screening period, 53-week treatment period and 2-week follow-up period). During the screening period, participants underwent a DBPCFC up to a highest dose of 300 milligrams (mg) peanut protein to confirm their allergy and their entry peanut eliciting dose (ED). | ||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator, Carer, Assessor | ||||||||||||||||||||||||||||||
Blinding implementation details |
DBV712 250 μg and placebo patches were supplied in identical pouches and were similar in physical appearance, thereby enabling double-blind conditions.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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DBV712 250 μg | ||||||||||||||||||||||||||||||
Arm description |
Participants applied 1 new DBV712 250 μg patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | ||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Viaskin Peanut
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Investigational medicinal product code |
DBV712
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Other name |
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Pharmaceutical forms |
Cutaneous patch
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Routes of administration |
Cutaneous use
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Dosage and administration details |
The active treatment, DBV712, is a cutaneous patch (DBV712 patch) containing a dry deposit of a formulation of peanut protein extract. The drug substance is an unmodified, lyophilized peanut extract produced from the extraction and freeze drying of defatted peanut flour. Application of the DBV712 patch at a similar time for each daily application (morning or evening) was recommended.
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Arm title
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Placebo | ||||||||||||||||||||||||||||||
Arm description |
Participants applied 1 new placebo patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | ||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Cutaneous patch
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Routes of administration |
Cutaneous use
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Dosage and administration details |
The placebo treatment consists of a matching cutaneous patch and dry deposit formulation, in which the peanut proteins were replaced by mannitol. Application of the placebo patch at a similar time for each daily application (morning or evening) was recommended.
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Baseline characteristics reporting groups
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Reporting group title |
DBV712 250 μg
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Reporting group description |
Participants applied 1 new DBV712 250 μg patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Participants applied 1 new placebo patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
DBV712 250 μg
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Reporting group description |
Participants applied 1 new DBV712 250 μg patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | ||
Reporting group title |
Placebo
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Reporting group description |
Participants applied 1 new placebo patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). |
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End point title |
Difference in Percentage of Treatment Responders at Month 12; Analyzed in the Overall Population | ||||||||||||
End point description |
The DBPCFCs to determine ED were performed at screening and Month 12, with each challenge occurring over 2 days. The participant was gradually fed increasing amounts of standardized blinded oral formulas containing either peanut protein (during 1 of the 2 days of the challenge), or without any peanut protein (during the other day of the challenge). A participant was defined as a treatment responder if:
• ED was ≥300 mg peanut protein at Month 12 DBPCFC (for screening ED subgroup 1), or
• ED was ≥1,000 mg peanut protein at Month 12 DBPCFC (for screening ED subgroup 2).
Participants with missing treatment response at Month 12 were imputed as non-responders. The percentage of treatment responders at Month 12 is presented. Analysis was performed in the overall population. The intent-to-treat (ITT) population was comprised of all participants who were randomized.
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End point type |
Primary
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End point timeframe |
At Month 12
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Statistical analysis title |
DBV712 versus Placebo | ||||||||||||
Statistical analysis description |
Analysis of the difference in response rates between DBV712 250 μg group and Placebo group and 2-sided Newcombe 95% confidence interval (CI). P-value was obtained from a 2-sided 5% test to evaluate the null hypothesis of no difference in response rates between treatment groups using the Wald method. Clinical relevance was evaluated based on the lower bound of the Newcombe 95% CI of the difference in response rates ≥15%.
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Comparison groups |
DBV712 250 μg v Placebo
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Number of subjects included in analysis |
356
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
Wald | ||||||||||||
Parameter type |
Difference in Response Rates (%) | ||||||||||||
Point estimate |
21.7
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
12.4 | ||||||||||||
upper limit |
29.8 |
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End point title |
Difference in Percentages of Treatment Responders at Month 12; Analyzed in Each Screening ED Subgroup | ||||||||||||||||||
End point description |
The DBPCFCs to determine ED were performed at screening and Month 12, with each challenge occurring over 2 days. The participant was gradually fed increasing amounts of blinded oral formulas containing either peanut protein (during 1 of the 2 days of the challenge), or without any peanut protein (during the other day of the challenge). A participant was defined as a treatment responder if:
• ED was ≥300 mg peanut protein at Month 12 DBPCFC (for screening ED subgroup 1), or
• ED was ≥1,000 mg peanut protein at Month 12 DBPCFC (for screening ED subgroup 2).
Participants with missing treatment response at Month 12 were imputed as non-responders. The percentage of treatment responders at Month 12 is presented below. Analysis was performed for each separate screening ED subgroup. The ITT population was comprised of all participants who were randomized. 'n' denotes number of participants analyzed in each screening ED subgroup.
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End point type |
Secondary
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End point timeframe |
At Month 12
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Statistical analysis title |
DBV712 versus Placebo (Screening ED subgroup 1) | ||||||||||||||||||
Statistical analysis description |
Analysis of the difference in response rates between DBV712 250 μg group and Placebo group and 2-sided Newcombe 95% CI. P-value was obtained from a 2-sided 5% test to evaluate the null hypothesis of no difference in response rates between treatment groups using the Wald method. Clinical relevance was evaluated based on the lower bound of the Newcombe 95% CI of the difference in response rates >0.
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Comparison groups |
DBV712 250 μg v Placebo
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Number of subjects included in analysis |
356
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||||||||
P-value |
= 0.105 | ||||||||||||||||||
Method |
Wald | ||||||||||||||||||
Parameter type |
Difference in Response Rates (%) | ||||||||||||||||||
Point estimate |
19
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Confidence interval |
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level |
95% | ||||||||||||||||||
sides |
2-sided
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lower limit |
-6.4 | ||||||||||||||||||
upper limit |
38.4 | ||||||||||||||||||
Statistical analysis title |
DBV712 versus Placebo (Screening ED subgroup 2) | ||||||||||||||||||
Statistical analysis description |
Analysis of the difference in response rates between DBV712 250 μg group and Placebo group and 2-sided Newcombe 95% CI. P-value was obtained from a 2-sided 5% test to evaluate the null hypothesis of no difference in response rates between treatment groups using the Wald method. Clinical relevance was evaluated based on the lower bound of the Newcombe 95% CI of the difference in response rates >0.
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Comparison groups |
DBV712 250 μg v Placebo
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Number of subjects included in analysis |
356
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||||||||
P-value |
< 0.001 | ||||||||||||||||||
Method |
Wald | ||||||||||||||||||
Parameter type |
Difference in Response Rates (%) | ||||||||||||||||||
Point estimate |
22.3
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Confidence interval |
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level |
95% | ||||||||||||||||||
sides |
2-sided
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lower limit |
12.1 | ||||||||||||||||||
upper limit |
30.8 |
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End point title |
Cumulative Reactive Dose (CRD) of Peanut Protein at Baseline and Month 12 | ||||||||||||||||||
End point description |
The CRD was calculated as the sum of all doses given (including any repeated and partial doses). The median CRD of peanut protein at baseline and Month 12 is presented. Analysis was performed using the modified baseline observation carried forward method to impute missing data at Month 12. The ITT population was comprised of all participants who were randomized.
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End point type |
Secondary
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End point timeframe |
Baseline and Month 12
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Statistical analysis title |
DBV712 versus Placebo | ||||||||||||||||||
Statistical analysis description |
The treatment effect was estimated using the Hodges-Lehmann estimate of the difference in median CRDs at Month 12.
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Comparison groups |
Placebo v DBV712 250 μg
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Number of subjects included in analysis |
356
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||||||||
P-value |
< 0.001 | ||||||||||||||||||
Method |
Wilcoxon rank-sum test | ||||||||||||||||||
Parameter type |
Difference in Median CRD | ||||||||||||||||||
Point estimate |
297
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Confidence interval |
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level |
95% | ||||||||||||||||||
sides |
2-sided
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lower limit |
130 | ||||||||||||||||||
upper limit |
317 |
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End point title |
Relative Change From Baseline in Peanut-specific Immunoglobulin E (IgE) Over Time | |||||||||||||||||||||
End point description |
Venous blood samples were drawn to assess peanut-specific IgE levels at baseline and Months 3, 6 and 12. The median relative changes from baseline in IgE levels for each timepoint are presented. Relative change from baseline=100×(value at the visit–value at baseline)/value at baseline. The ITT population was comprised of all participants who were randomized. Only those with non-missing data were included in the analysis. 'n' denotes number of participants analyzed for each timepoint.
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End point type |
Secondary
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End point timeframe |
Baseline and Months 3, 6 and 12
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No statistical analyses for this end point |
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End point title |
Relative Changes From Baseline in Peanut-specific Immunoglobulin G4 Subtype (IgG4) Over Time | |||||||||||||||||||||
End point description |
Venous blood samples were drawn to assess peanut-specific IgG4 levels at baseline and Months 3, 6 and 12. The median relative changes from baseline in IgG4 levels for each timepoint are presented. Relative change from baseline=100×(value at the visit–value at baseline)/value at baseline. The ITT population was comprised of all participants who were randomized. Only those with non-missing data were included in the analysis. 'n' denotes number of participants analyzed for each timepoint.
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End point type |
Secondary
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End point timeframe |
Baseline and Months 3, 6 and 12
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Treatment-emergent adverse events (TEAEs) were collected from Day 1, throughout the 53-week treatment period and additional 2-week follow-up period. Overall time frame of up to 55 weeks.
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Adverse event reporting additional description |
The safety population was comprised of all participants who were randomized and received at least 1 dose of IP. Adverse events occurring after the end of the treatment period were recorded only if the Investigator considered there was a causal relationship with the IP and as such, were considered also as TEAEs.
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Assessment type |
Systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
20.0
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Reporting groups
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Reporting group title |
DBV712 250 μg
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Reporting group description |
Participants applied 1 new DBV712 250 μg patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Participants applied 1 new placebo patch for 24 hours (±4 hours) every day for 12 months. The application duration was progressively increased to a duration of 24 hours daily over a 15-day period (6 hours during the first week, 12 hours during the second week and 24 hours from the third week onwards). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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09 Dec 2015 |
Sections affected by important changes in the protocol as per amendment 1:
- Study design
- Efficacy endpoints
- Safety endpoints
- Exploratory endpoints
- Inclusion criteria
- Exclusion criteria
- Criteria for withdrawal from IP and study
- Prohibited prior and concomitant medication
- DBPCFC stopping rules
- Safety criteria
- Statistical methods. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |