E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Allergic rhinitis / rhinoconjunctivitis with or without mild to moderate asthma due to sensitization to grass and olive pollen |
Rinitis alérgica / rinoconjuntivitis con o sin asma leve a moderada por sensibilización a pólen de gramineas y olivo |
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E.1.1.1 | Medical condition in easily understood language |
Grasses and olive tree allergy |
Alergia frente a Gramíneas y Olivo |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10036019 |
E.1.2 | Term | Pollen allergy |
E.1.2 | System Organ Class | 100000004870 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The main objective of this trial is to evaluate the clinical efficacy of subcutaneously administered polymerized allergenic extracts, comparing with placebo in subjects with rhinitis / rhinoconjunctivitis according to the ARIA classification, with or without controlled intermittent or persistent (mild-moderate) asthma, according to the definition of GEMA 5.0, by the combined score of symptoms and medication consumption for rhinitis / rhinoconjunctivitis and asthma for each trial subject. |
El objetivo principal de este ensayo es evaluar la eficacia clínica de los extractos alergénicos polimerizados administrados por vía subcutánea, comparando con placebo en sujetos con rinitis/rinoconjuntivitis según la clasificación ARIA, con o sin asma intermitente o persistente (leve-moderada) controlada, según la definición de GEMA 5.0, mediante la puntuación combinada de síntomas y consumo de medicación para rinitis/rinoconjuntivitis y asma para cada sujeto del ensayo. |
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E.2.2 | Secondary objectives of the trial |
As secondary objectives will be assessed the tolerance, changes in immunological parameters, the subject quality of life, after the treatment and the safety of the subcutaneous immunotherapy |
Como objetivos secundarios se evaluarán la tolerancia, cambios en parámetros inmunológicos, la calidad de vida del sujeto tras el tratamiento y la seguridad de la inmunoterapia subcutánea |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Subject who has signed the informed consent. - Subjects of both sexes aged between 14 and 65 years. - Subjects with confirmed clinical history of inhalational allergy (rhinitis and / or moderate-severe intermittent or persistent rhinoconjunctivitis according to the ARIA classification with or without intermittent or persistent controlled mild-moderate asthma according to the GEMA 5.0 classification caused by grass and olive allergy. - Subjects with a positive prick test (papule diameter ≥ 5 mm) to a standardized extract of pollen from grasses (Phleum pratense, Holcus lanatus, Dactylis glomerata, Poa pratensis, Festuca elatior, Lolium perenne), or one of the components of the mixture and an olive extract, made within 12 months prior to signing the informed consent. - Specific IgE (CAP or Immulite) against one of the components of the mixture of grasses, preferably Phleum pratense and olive or one of the molecular components of allergenic sources with a value ≥ 3 KU / L, determined within the 12 months prior to signing the informed consent. - Women of childbearing age (from menarche) should submit a urine pregnancy test with a negative result at the time of joining the trial. - Women of childbearing potential, and men participating in the trial, should commit to using an appropriate method of contraception. Medically acceptable methods of contraception are intrauterine devices placed at least 3 months in advance, surgical sterilization (for example, tubal ligation), barrier methods, or the use of oral contraceptives. - Subjects diagnosed with asthma according to the GEMA 5.0 guide. - Subjects capable of complying with the dosage regimen. - Subjects who have a smartphone to record symptoms and medication. |
- Sujeto que haya firmado el consentimiento informado. - Sujetos de ambos sexos con edad comprendida entre 14 y 65 años. - Sujetos con historia clínica confirmada de alergia inhalatoria (rinitis y/o rinoconjuntivitis intermitente o persistente moderada-grave según la clasificación ARIA con o sin asma intermitente o persistente controlada leve-moderada según la clasificación GEMA 5.0 causada por alergia a gramíneas y olivo. - Sujetos con un prick test positivo (diámetro de la pápula ≥ 5 mm) a un extracto estandarizado mezcla de polen de gramíneas (Phleum pratense, Holcus lanatus, Dactylis glomerata, Poa pratensis, Festuca elatior, Lolium perenne), o a uno de los componentes de la mezcla y a un extracto de olivo, realizados dentro de los 12 meses anteriores a la firma del consentimiento informado. - IgE específica (CAP o Immulite) frente a uno de los componentes de la mezcla de gramíneas, preferiblemente a Phleum pratense y olivo o a uno de los componentes moleculares de las fuentes alergénicas con un valor ≥ 3 KU/L, determinados dentro de los 12 meses anteriores a la firma del consentimiento informado. - Las mujeres en edad fértil (desde menarquía) deben presentar una prueba de embarazo en orina con resultado negativo en el momento de su incorporación al ensayo. - Las mujeres en edad fértil, y los hombres que participen en el ensayo, deben comprometerse a utilizar un método anticonceptivo adecuado. Los métodos anticonceptivos médicamente aceptables son dispositivos intrauterinos colocados con, al menos, 3 meses de antelación, la esterilización quirúrgica (por ejemplo, ligadura de trompas), métodos de barrera o el uso de anticonceptivos orales. - Sujetos diagnosticados de asma según la guía GEMA 5.0. - Sujetos capaces de cumplir con el régimen de dosificación. - Sujetos que posean un smartphone para el registro de síntomas y medicación. |
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E.4 | Principal exclusion criteria |
- Subjects polisensitized to other aeroallergens with the exception of epithelia with exposure and occasional symptoms and non-seasonal pollens with grasses and olive - Subjects who have received prior immunotherapy in the preceding 5 years for any of the allergens tested or a cross-reactive allergen or are currently receiving immunotherapy with any allergen. - Subjects in which immunotherapy may be subject to an absolute general contraindication according to the criteria of the Immunotherapy Committee of the Spanish Society of Allergy and Clinical Immunology and the European Allergy and Clinical Immunology Immunotherapy Subcommittee. - Subjects with severe or uncontrolled persistent asthma, with an FEV1 <70% with respect to the reference value despite adequate pharmacological treatment at the time of inclusion in the trial. Likewise, subjects with intermittent or persistent rhinitis / rhinoconjunctivitis with severe symptoms in which the suspension of oral or systemic antihistamine treatment is contraindicated. - Subjects who have previously presented a serious secondary reaction during the performance of diagnostic skin tests using the prick test. - Subjects under treatment with ß-blockers. - Clinically unstable subjects at the time of enrollment in the trial (acute asthma exacerbation, respiratory infection, feverish process, acute urticaria, etc.). - Subjects with active chronic urticaria, severe dermographism, severe atopic dermatitis, sunburns, active psoriasis with lesions in areas where skin tests will be performed, or a history of hereditary angioedema. - Subjects who have any pathology in which the administration of adrenaline is contraindicated (hyperthyroidism, HT, heart disease, etc.). - Subjects with some other disease not related to moderate rhinoconjunctivitis or asthma, but of potential severity and that may interfere with treatment and follow-up (epilepsy, psychomotor disorder, uncontrolled diabetes, malformations, multiple operations, kidney disease,). - Subjects with autoimmune disease (thyroiditis, lupus, etc.), tumor diseases or with a diagnosis of immunodeficiencies. - Subject whose condition prevents him / her from offering cooperation and who has severe psychiatric disorders. - Subjects with a known allergy to other investigational drug components other than the allergen. - Subjects with diseases of the lower respiratory tract other than asthma such as emphysema or bronchiectasis. - Subjects who are direct relatives of the researchers. - Pregnant or lactating women. |
- Sujetos polisensibilizados a otros aeroalérgenos a excepción de epitelios con exposición y sintomatología ocasional y pólenes no coestacionales con gramíneas y olivo. - Sujetos que hayan recibido inmunoterapia previa en los 5 años precedentes para cualquiera de los alérgenos testados o un alérgeno con reactividad cruzada o estén actualmente recibiendo inmunoterapia con cualquier alérgeno. - Sujetos en los que la inmunoterapia pueda ser objeto de contraindicación general absoluta según los criterios del Comité de Inmunoterapia de la Sociedad Española de Alergia e Inmunología Clínica y del European Allergy and Clinical Immunology Immunotherapy Subcommittee. - Sujetos con asma persistente grave o no controlada, con un FEV1 < 70% con respecto al valor de referencia a pesar de un tratamiento farmacológico adecuado en el momento de la inclusión en el ensayo. Así mismos sujetos con rinitis / rinoconjuntivitis intermitente o persistente con síntomas severos en los cuales la suspensión del tratamiento antihistamínico por vía oral o sistémica sea contraindicado. - Sujetos que hayan presentado previamente una reacción secundaria grave durante la realización de pruebas cutáneas de diagnóstico mediante prick test. - Sujetos en tratamiento con ß-bloqueantes. - Sujetos inestables desde el punto de vista clínico en el momento de la inclusión en el ensayo (exacerbación asmática aguda, infección respiratoria, proceso febril, urticaria aguda, etc.). - Sujetos con urticaria crónica activa, dermografismo severo, dermatitis atópica severa, quemaduras solares, psoriasis activa con lesiones en zonas donde se realizarán pruebas cutáneas, o antecedentes de angioedema hereditario. - Sujetos que tengan alguna patología en la que esté contraindicada la administración de adrenalina (hipertiroidismo, HTA, cardiopatía, etc.). - Sujetos con alguna otra enfermedad no relacionada con la rinoconjuntivitis moderada o con el asma, pero de potencial gravedad y que pueda interferir con el tratamiento y seguimiento (epilepsia, alteración psicomotora, diabetes no controlada, malformaciones, multioperados, nefropatías,). - Sujetos con enfermedad autoinmune (tiroiditis, lupus, etc.), enfermedades tumorales o con diagnóstico de inmunodeficiencias. - Sujeto cuyo estado le impide ofrecer cooperación y o que presente trastornos psiquiátricos severos. - Sujetos con alergia conocida a otros componentes del medicamento en investigación diferentes del alérgeno. - Sujetos con enfermedades de la vía respiratoria inferior diferentes al asma como el enfisema o las bronquiectasias. - Sujetos que sean familiares directos de los investigadores. - Mujeres embarazadas o en período de lactancia. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Overall score of symptoms and medication throughout the trial. |
Puntuación global de síntomas y medicación durante todo el ensayo. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Begining and end of the clinical trial |
Principio y final del ensayo |
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E.5.2 | Secondary end point(s) |
- Symptom free days - Days off medication - Asthmatic exacerbations - Analog visual scale (EVA) - Immunological parameters: total IgE, specific IgE, specific IgG, specific IgG4 - ACT Asthma Control Questionnaire - Quality of life questionnaire in rhinitis ESPRINT-15 - Consumption of health resources - Safety of specific immunotherapy |
- Días libres de síntomas - Días libres de medicación - Exacerbaciones asmáticas - Escala visual analógica (EVA) - Parámetros inmunológicos: IgE total, IgE específica, IgG específica, IgG4 específica - Cuestionario de control de asma ACT - Cuestionario de calidad de vida en rinitis ESPRINT-15 - Consumo de recursos sanitarios - Seguridad de la inmunoterapia específica |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Begining and end of the clinical trial |
Principio y final del ensayo |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 13 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The trial will finished with the database closed out. |
El ensayo finalizará con el cierre de la base de datos de los resultados del ensayo. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |