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Efficacy and Safety of AR101 in Oral Immunotherapy for Peanut Allergy: Results of ARC001, a Randomized, Double-Blind, Placebo-Controlled Phase 2 Clinical Trial.
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Efficacy and Safety of AR101 in Oral Immunotherapy for Peanut Allergy: Results of ARC001, a Randomized, Double-Blind, Placebo-Controlled Phase 2 Clinical Trial.

J Andrew Bird, Jonathan M Spergel, Stacie M Jones, Rima Rachid, Amal H Assa'ad, Julie Wang, Stephanie A Leonard, Susan S Laubach, Edwin H Kim, Brian P Vickery, …
Journal of Allergy and Clinical Immunology, Vol.6(2), pp.476-485
03/01/2018
DOI: 10.1016/j.jaip.2017.09.016
PMID: 29092786
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https://doi.org/10.1016/j.jaip.2017.09.016View
Published (Version of record)Journal of Allergy and Clinical Immunology: In Practice, 2018-03-01, Volume 6, Issue 2, Pages 476-485.e3

Abstract

<p>BACKGROUND: Peanut oral immunotherapy, using a variety of approaches, has been previously shown to induce desensitization in peanut-allergic subjects, but no products have been approved for clinical use by regulatory agencies.</p> <p>OBJECTIVE: We performed the first phase 2 multicentered study to assess the safety and efficacy of AR101, a novel oral biologic drug product.</p> <p>METHODS: A randomized, double-blind, placebo-controlled trial was conducted at 8 US centers. Eligible subjects were 4 to 26 years old, sensitized to peanut, and had dose-limiting symptoms to ≤143 mg of peanut protein in a screening double-blind, placebo-controlled food challenge (DBPCFC). Subjects were randomized 1:1 to daily AR101 or placebo and gradually up-dosed from 0.5 to 300 mg/day. The primary endpoint was the proportion of subjects in each arm able to tolerate ≥443 mg (cumulative peanut protein) at exit DBPCFC with no or mild symptoms.</p> <p>RESULTS: Fifty-five subjects (29 AR101, 26 placebo) were enrolled. In the intention-to-treat analysis, 23 of 29 (79%) and 18 of 29 (62%) AR101 subjects tolerated ≥443 mg and 1043 mg at exit DBPCFC, respectively, versus 5 of 26 (19%) and 0 of 26 (0%) placebo subjects (both P < .0001). Compared with placebo, AR101 significantly reduced symptom severity during exit DBPCFCs and modulated peanut-specific cellular and humoral immune responses. Gastrointestinal (GI) symptoms were the most common treatment-related adverse events (AEs) in both groups, with 6 AR101 subjects (21%) withdrawing, 4 of those due primarily to recurrent GI AEs.</p> <p>CONCLUSIONS: In this study, AR101 demonstrated an acceptable safety profile and demonstrated clinical activity as a potential immunomodulatory treatment option in peanut-allergic children over the age of 4, adolescents, and young adults.</p>
Internal Medicine Pediatrics Allergy and Immunology Medical Immunology AR101 ARC001 Desensitization Double-blind placebo-controlled trial Food allergy OIT Oral immunotherapy Peanut allergy

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