AzTrials
AzTrials

Rhinitis, Allergic, SeasonalPhase 2NCT01335139

Long-Term Effects of Sublingual Grass Therapy

A Phase 2 study testing Sublingual immunotherapy (SLIT) and Subcutaneous immunotherapy (SCIT) in people with Rhinitis, Allergic, Seasonal, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The purpose of this research study is to investigate whether sublingual immunotherapy (SLIT, grass pollen tablets under the tongue) has long term effects in severe hay fever. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Rhinitis, Allergic, Seasonal
What is being tested?
Sublingual immunotherapy (SLIT) and Subcutaneous immunotherapy (SCIT)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
106 participants
Where
1 siteUnited Kingdom
Study dates
Mar 2011to Feb 2015
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • A clinical history of grass pollen-induced allergic rhinoconjunctivitis for at least 2 years with peak symptoms in May, June, or July;
  • A clinical history of moderate to severe rhinoconjunctivitis symptoms interfering with usual daily activities or with sleep as defined according to the Allergic Rhinitis and its Impact on Asthma (ARIA) classification of rhinitis;
  • A clinical history of rhinoconjunctivitis for at least 2 years requiring treatment with either antihistamines or nasal corticosteroids during the grass pollen season;
  • Positive skin prick test response, defined as wheal diameter greater than or equal to 3 mm, to Phleum pratense (e.g., Timothy grass);
  • Positive specific IgE, defined as greater than or equal to IgE class 2 (0.7 kU/L), against Phleum pratense;
  • A positive response to nasal allergen challenge with Phleum pretense, defined as an increase in TNSS greater than or equal to 7 points above baseline;
  • For women of childbearing age, a willingness to use an effective form of contraception for the duration of the trial; and
  • The ability to give informed consent and comply with study procedures.

Who cannot join

  • Prebronchodilator forced expiratory volume at 1 second (FEV1) less than 70% of predicted value at either screening or baseline visit;
  • A clinical history of moderate to severe allergic rhinitis, according to the ARIA classification, due to tree pollen near or overlapping the grass pollen season;
  • A clinical history of persistent asthma and/or requiring regular inhaled corticosteroids for > 4 weeks per year outside of the grass pollen season;
  • A clinical history of moderate- severe allergic rhinitis, according to the ARIA classification, caused by an allergen to which the participant is regularly exposed;
  • History of emergency visit or hospital admission for asthma in the previous 12 months;
  • History of chronic obstructive pulmonary disease;
Show all 19Show fewer
  • History of significant recurrent acute sinusitis, defined as 2 episodes per year for the last 2 years, all of which required antibiotic treatment;
  • History of chronic sinusitis, defined as a sinus symptoms lasting greater than 12 weeks that includes 2 or more major factors or 1 major factor and 2 minor factors. Major factors are defined as facial pain or pressure, nasal obstruction or blockage, nasal discharge or purulence or discolored postnasal discharge, purulence in nasal cavity, or impaired or loss of smell. Minor factors are defined as headache, fever, halitosis, fatigue, dental pain, cough, and ear pain, pressure, or fullness.
  • At randomization, current symptoms of, or treatment for, upper respiratory tract infection, acute sinusitis, acute otitis media, or other relevant infectious process; serous otitis media is not an exclusion criterion. Participants may be re-evaluated for eligibility after symptoms resolve.
  • Any tobacco smoking within the last 6 months or a history of ≥ 10 pack years;
  • Previous treatment by immunotherapy with grass pollen allergen within the previous 5 years.
  • Any history of grade 4 anaphylaxis due to any cause as defined by the World Allergy Organization (WAO) grading criteria for immunotherapy;
  • History of bleeding disorders or treatment with anticoagulation therapy;
  • History of anti-IgE monoclonal antibody treatment;
  • Ongoing systemic immunosuppressive treatment;
  • History of intolerance to the study therapy, rescue medications, or their excipients;
  • For women of childbearing age a positive serum or urine pregnancy test with sensitivity of less than 50 mIU/mL within 72 hours before the start of study therapy;
  • The use of any investigational drug within 30 days of the screening visit; or
  • The presence of any medical condition that the investigator deems incompatible with participation in the trial.

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Royal Brompton Hospital

    London, SW3 6LY

Other trials in United Kingdom

About this study

Official title: A Randomized, Double-blind, Single-center, Placebo Controlled Study of Sublingual Immunotherapy and Subcutaneous Immunotherapy in Adults With Seasonal Allergic Rhinitis (ITN043AD)

The purpose of this research study is to investigate whether sublingual immunotherapy (SLIT, grass pollen tablets under the tongue) has long term effects in severe hay fever.

Read the detailed description

This is a randomized, double-blind, single-center, placebo-controlled, three-arm study comparing SLIT with placebo and SCIT with placebo. The main comparison will be between SLIT and placebo.

Individuals with severe grass pollen hay fever, with or without associated seasonal asthma, will be recruited during the pollen season of March through September 2011. Eligible participants will be randomized to one of the following three treatment arms administered in a double-blind (masked), double-dummy fashion in a 1:1:1 ratio:

  • SLIT + SCIT placebo
  • SCIT + SLIT placebo
  • SLIT placebo + SCIT placebo

Participants will receive treatment over a 2-year period followed by a 1-year blinded (masked) withdrawal phase. Participants will be provided with anti-allergic rescue medications (antihistamine, topical intranasal corticosteroids, and short-acting beta agonists) throughout the study. Clinical endpoint assessments will be performed at prior to initiating their assigned treatment, after 1 and 2 years of treatment, and after the 1-year withdrawal period at 3 years.

Being tested
Sublingual immunotherapy (SLIT), Subcutaneous immunotherapy (SCIT), Placebo
Keywords
sublingual immunotherapy, subcutaneous immunotherapy
Medical subject headings
Rhinitis, Allergic, Seasonal

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sublingual immunotherapy (SLIT)Biological

    Also called Grazax®

    Participants randomized to receive sublingual allergen tablet immunotherapy with placebo injections.

  • Subcutaneous immunotherapy (SCIT)Biological

    Also called Alutard SQ Grass Pollen®

    Participants randomized to receive subcutaneous injection immunotherapy with placebo tablets. Subcutaneous immunotherapy was included as a positive control.

  • PlaceboOther

    Participants randomized to double-placebo tablets and injections. This group was included as a negative control.

Study groups in NCT01335139
Study groupRoleWhat they receive
SCIT + PlaceboExperimentalSubcutaneous immunotherapy (SCIT) + sublingual immunotherapy (SLIT) placebo
Receives: Biological: Subcutaneous immunotherapy (SCIT); Other: Placebo
SLIT + PlaceboExperimentalSublingual immunotherapy (SLIT) + subcutaneous immunotherapy (SCIT) placebo
Receives: Biological: Sublingual immunotherapy (SLIT); Other: Placebo
Placebo + PlaceboPlacebo comparatorSublingual immunotherapy (SLIT) placebo + subcutaneous immunotherapy (SCIT) placebo
Receives: Other: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Nasal Response to Allergen Challenge

    Defined as the average of the Total Nasal Symptom Score (TNSS) area under the curve (AUC) measured at 0 to 1 hours and the AUC measured at 1 to 10 hours after allergen challenge. The primary outcome consists of the comparison of SLIT + SCIT placebo versus SLIT placebo + SCIT placebo.

    Measured: 3 years

Secondary outcomes (15)
  1. Skin Late Phase Response (LPR) to Intradermal Testing

    Recorded as the mean diameter of the swelling measured at the specified time points after allergen challenge at 1, 2, and 3 years. The analysis of this outcome will compare the mean diameter of the swelling at 1, 2, and 3 years separately, adjusting for baseline diameter using ANCOVA at the 0.05 level of significance.

    Measured: Baseline (Time 0) and 1,-2, and -3 years

  2. Skin Early Phase Response (EPR) to Intradermal Testing

    Recorded as the mean diameter of the swelling measured at the specified time points after allergen challenge at 1, 2, and 3 years. The analysis of this outcome will compare the mean diameter of the swelling at 1, 2, and 3 years separately, adjusting for baseline diameter using ANCOVA at the 0.05 level of significance.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  3. Nasal LPR

    Defined as the TNSS AUC over the specified time periods after allergen challenge at 1, 2, and 3 years. The analysis of these this outcome will compare the mean TNSS AUC at 1, 2, and 3 years separately, adjusting for baseline LPR using ANCOVA at the 0.05 level of significance.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  4. Nasal EPR

    Defined as the TNSS AUC over the specified time periods after allergen challenge at 1, 2, and 3 years. The analysis of these this outcome will compare the mean TNSS AUC at 1, 2, and 3 years separately, adjusting for baseline EPR using ANCOVA at the 0.05 level of significance.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  5. Peak Total Nasal Symptom Score (TNSS) EPR

    Maximum TNSS score measured between 0 and 1 hour after challenge.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  6. Peak Nasal Inspiratory Flow (PNIF) LPR

    Defined as PNIF AUC over the specified time periods after allergen challenge at 1, 2 and 3 years. The analyses for this outcome will compare the mean PNIF AUC at 1, 2, and 3 years separately, adjusting for baseline PNIF using ANCOVA at the 0.05 level of significance.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  7. Peak Nasal Inspiratory Flow (PNIF) LPR Area Under the Curve (AUC)

    Defined as PNIF AUC over the specified time periods after allergen challenge at 1, 2 and 3 years. The analyses for this outcome will compare the mean PNIF AUC at 1, 2, and 3 years separately, adjusting for baseline PNIF using ANCOVA at the 0.05 level of significance.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  8. Peak Nasal Inspiratory Flow (PNIF) EPR Area Under the Curve (AUC)

    Defined as PNIF AUC over the specified time periods after allergen challenge at 1, 2 and 3 years. The analyses for this outcome will compare the mean PNIF AUC at 1, 2, and 3 years separately, adjusting for baseline PNIF using ANCOVA at the 0.05 level of significance. AUC measured hourly between 1 and 10 hours after challenge.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  9. Skin Prick Test Endpoint Titration

    Assessed as the mean wheal diameters (mm) in response to skin prick tests in duplicate with 1000 SQ, 10,000 SQ and 100,000 SQ units of grass pollen allergen.

    Measured: Baseline (Time 0) and 1, -2, and -3 years

  10. Use of Rescue Medications During the Pollen Season

    A composite rescue medication score will be derived using a pre-defined scoring algorithm.

    Measured: 1, -2, and -3 years

  11. Mini Rhinoconjunctivitis Quality-of-Life Questionnaire Score

    Mini Rhinoconjunctivitis Quality-of-Life Questionnaire (MiniRQLQ) scores will be collected pre-, peak-, and post-pollen season at 1, 2, and 3 years.

    Measured: 1, -2, and -3 years

  12. Hay Fever Severity Score

    Measured at the end of each pollen season at 1, -2, and -3 years.

    Measured: 1, 2 and 3 years

  13. Weekly Visual Analog Symptom (VAS) Scores

    Weekly Visual Analogue Scale scores will be summarized descriptively by group and year.

    Measured: 1, -2, and -3 years

  14. EXPLORATORY: Mechanistic Assessments of Local Immune Responses

    Measured in the nasal mucosa before and after nasal allergen challenge. Nasal secretions will be assayed for inflammatory mediators and local antibodies.

    Measured: 1, 2, and 3 years

  15. EXPLORATORY: Mechanistic Assessments of Peripheral Blood Subsets

    Peripheral blood mononuclear cells (PBMCs) samples will be analyzed.

    Measured: 1, 2, and 3 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Apr 2011 (estimated)
  2. Study startMar 2011
  3. Primary completionFeb 2015
  4. Study completionFeb 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
106 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01335139
Sponsor's protocol ID
DAIT ITN043AD
Other IDs
2010-023536-16
Status last verified
May 2017
First submitted
8 Apr 2011
Last updated
2 Jun 2017
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Participant level data and additional relevant materials are available to the public in TrialShare, the Immune Tolerance Network (ITN) Clinical Trials Research Portal. ITN TrialShare makes data from the consortium's clinical trials publicly available.

Publications

  • Cox LS. Sublingual Immunotherapy for Allergic Rhinitis: Is 2-Year Treatment Sufficient for Long-term Benefit? JAMA. 2017 Feb 14;317(6):591-593. doi: 10.1001/jama.2017.0128. No abstract available.

    PubMed 28196239
  • Scadding GW, Calderon MA, Shamji MH, Eifan AO, Penagos M, Dumitru F, Sever ML, Bahnson HT, Lawson K, Harris KM, Plough AG, Panza JL, Qin T, Lim N, Tchao NK, Togias A, Durham SR; Immune Tolerance Network GRASS Study Team. Effect of 2 Years of Treatment With Sublingual Grass Pollen Immunotherapy on Nasal Response to Allergen Challenge at 3 Years Among Patients With Moderate to Severe Seasonal Allergic Rhinitis: The GRASS Randomized Clinical Trial. JAMA. 2017 Feb 14;317(6):615-625. doi: 10.1001/jama.2016.21040.

    PubMed 28196255
  • Altman MC, Segnitz RM, Larson D, Jayavelu ND, Smith MT, Patel S, Scadding GW, Qin T, Sanda S, Steveling E, Eifan AO, Penagos M, Jacobson MR, Parkin RV, Shamji MH, Togias A, Durham SR. Nasal and blood transcriptomic pathways underpinning the clinical response to grass pollen immunotherapy. J Allergy Clin Immunol. 2023 Nov;152(5):1247-1260. doi: 10.1016/j.jaci.2023.06.025. Epub 2023 Jul 15.

    PubMed 37460024

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Sublingual immunotherapy (SLIT) and Subcutaneous immunotherapy (SCIT) in people with Rhinitis, Allergic, Seasonal, run by National Institute of Allergy and Infectious Diseases (NIAID) at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 2 Jun 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Nasal Response to Allergen Challenge (time frame: 3 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01335139, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Jun 2017; AzTrials last refreshed its copy on 6 Nov 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in