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Autism Spectrum DisorderPhase 1NCT04535817

Xolair Interventional Study in ASD Patients With Comorbid Atopy

A Phase 1 study testing Omalizumab Injection [Xolair] in people with Autism Spectrum Disorder and Atopy, run by Beth Israel Deaconess Medical Center at 1 site in United States.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

Following the publication of two case studies that reported behavioral benefit in ASD patients treated with omalizumab, the investigators will conduct a pilot trial to test the proof-of-concept efficacy of omalizumab in ASD patients with comorbid atopic disease. Read more about this study

Who is it for?
Ages 18 to 30 years
Conditions the study is for
Autism Spectrum Disorder, Atopy
What is being tested?
Omalizumab Injection [Xolair]
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited States
Study dates
1 Jan 2021to 1 Jan 2022
Phase
Phase 1
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 30 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Age between 18-30 years old.
  • Clinical diagnosis of ASD during childhood that is still active.
  • History of atopic diseases, including asthma, atopic dermatitis, and allergic rhinitis.
  • Total serum IgE level ≥ 30 IU/ml and ≤ 400 IU/ml

Who cannot join

  • History of omalizumab use.
  • Subjects who have used oral or systemic steroid burst within 6 weeks of study enrollment. Subjects who are receiving a maintenance dose of Prednisone of 5 mg/day or less will be allowed provided the dose of Prednisone is not changed during the study.
  • Subjects actively taking the antipsychotic medication, Loxapine.
  • History of cancer or pre-cancer.
  • Subjects with active or unstable seizure disorder.
  • History or active signs of psychosis.
Show all 13Show fewer
  • Body weight > 90kg
  • For subjects who meet allergic rhinitis inclusion criteria, RCAT >20
  • IQ < 70
  • Adaptive Behavior Composite score < 90, based on the Vineland 3rd Edition
  • Lactating or pregnant females. Xolair has not been sufficiently tested for safe use in pregnant females.
  • Subjects who are deemed by the study staff to be unable to cooperate with or understand the instructions that will be given during the study.
  • Subjects with severe medical condition(s) that in the view of a Physician Investigator prohibits participation in the study.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

Other trials in United States

About this study

Official title: The Effect of Omalizumab (Xolair) on Improving Neuropsychiatric Symptoms in a Subset of ASD Patients With Atopic Disease and Elevated Total IgE Levels

Following the publication of two case studies that reported behavioral benefit in ASD patients treated with omalizumab, the investigators will conduct a pilot trial to test the proof-of-concept efficacy of omalizumab in ASD patients with comorbid atopic disease. Investigators will evaluate behavioral improvement using three questionnaires. Investigators will also perform fMRI on all subjects and obtain serum samples for quantification of immunological biomarkers. If the trial is conclusive, the investigators will conduct a larger-scale, randomized-controlled trial to further understand the pathology of allergy in this subpopulation of ASD patients and the efficacy of this intervention.

Read the detailed description

This clinical trial is a Phase I, single-arm, open-label study. All 20 subjects will be given the same dosage of the study drug. Following baseline testing, subjects will undergo treatment during a 24 week treatment period and will receive six subcutaneous injections total, one injection every 4 weeks. A 24-week follow-up period after the treatment period will be concluded with patient interview. Behavioral questionnaires will be administered throughout the duration of the trial. fMRI will be conducted at baseline and at the conclusion of the treatment period. Blood will be drawn for serum testing at baseline, at Week 12 during the treatment period, and at the conclusion of the treatment period. Vitals and CGI will also be assessed throughout the trial.

Being tested
Omalizumab Injection [Xolair]
Keywords
omalizumab
Medical subject headings
Autism Spectrum Disorder

What participants receive

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

  • Omalizumab Injection [Xolair]Drug

    Also called Xolair

    300mg via 2 subcutaneous injections every 4 weeks

Study groups in NCT04535817
Study groupRoleWhat they receive
Treatment GroupExperimentalSubjects will receive subcutaneous treatment of 300mg of omalizumab during the 24-week treatment period. One injection will be administered every 4 weeks.
Receives: Drug: Omalizumab Injection [Xolair]

What is being measured

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

  1. Change from Baseline to Week 12 in Social Responsiveness Scale (SRS) Edition 2

    Social communication and behavior - The scoring is based on T-score which is based on the sum of responses as follows (76 to higher - severe, 66 to 75- moderate deficiencies, 60 to 65 - mild deficiencies, 59 and below is not clinically significant for ASD).

    Measured: Baseline and Week 12

  2. Change from Baseline to Week 24 in Social Responsiveness Scale (SRS) Edition 2

    Social communication and behavior - The scoring is based on T-score which is based on the sum of responses as follows (76 to higher - severe, 66 to 75- moderate deficiencies, 60 to 65 - mild deficiencies, 59 and below is not clinically significant for ASD).

    Measured: Baseline and Week 24

  3. Change from Baseline to Week 48 in Social Responsiveness Scale (SRS) Edition 2

    Social communication and behavior - The scoring is based on T-score which is based on the sum of responses as follows (76 to higher - severe, 66 to 75- moderate deficiencies, 60 to 65 - mild deficiencies, 59 and below is not clinically significant for ASD).

    Measured: Baseline and Week 48

  4. Change from Week 24 to Week 48 in Social Responsiveness Scale (SRS) Edition 2

    Social communication and behavior - The scoring is based on T-score which is based on the sum of responses as follows (76 to higher - severe, 66 to 75- moderate deficiencies, 60 to 65 - mild deficiencies, 59 and below is not clinically significant for ASD).

    Measured: Week 24 (conclusion of treatment period) and Week 48 (follow-up)

  5. Change from Baseline to Week 12 in Aberrant Behavior Checklist (ABC)

    Social behavior test - The total score is calculated based on 5 sub-scales (Irritability, Social Withdrawal, Stereotypic Behavior, Hyperactive/Noncompliance, and Inappropriate Speech). There are 58 questions that are scored on a 0-3 scale 0 -"not at all a problem", 1- "the behavior is a problem but slight in degree", 2- "the problem is moderately serious" and 3- "the problem is severe in degree". Based on this sub-scores are calculated and added to get the total score.

    Measured: Baseline and Week 12

  6. Change from Baseline to Week 24 in Aberrant Behavior Checklist (ABC)

    Social behavior test - The total score is calculated based on 5 sub-scales (Irritability, Social Withdrawal, Stereotypic Behavior, Hyperactive/Noncompliance, and Inappropriate Speech). There are 58 questions that are scored on a 0-3 scale 0 -"not at all a problem", 1- "the behavior is a problem but slight in degree", 2- "the problem is moderately serious" and 3- "the problem is severe in degree". Based on this sub-scores are calculated and added to get the total score.

    Measured: Baseline and Week 24 (conclusion of treatment period)

  7. Change from Baseline to Week 48 in Aberrant Behavior Checklist (ABC)

    Social behavior test - The total score is calculated based on 5 sub-scales (Irritability, Social Withdrawal, Stereotypic Behavior, Hyperactive/Noncompliance, and Inappropriate Speech). There are 58 questions that are scored on a 0-3 scale 0 -"not at all a problem", 1- "the behavior is a problem but slight in degree", 2- "the problem is moderately serious" and 3- "the problem is severe in degree". Based on this sub-scores are calculated and added to get the total score.

    Measured: Baseline and Week 48 (follow-up)

  8. Change from Week 24 to Week 48 in Aberrant Behavior Checklist (ABC)

    Social behavior test - The total score is calculated based on 5 sub-scales (Irritability, Social Withdrawal, Stereotypic Behavior, Hyperactive/Noncompliance, and Inappropriate Speech). There are 58 questions that are scored on a 0-3 scale 0 -"not at all a problem", 1- "the behavior is a problem but slight in degree", 2- "the problem is moderately serious" and 3- "the problem is severe in degree". Based on this sub-scores are calculated and added to get the total score.

    Measured: Week 24 (conclusion of treatment period) and Week 48 (follow-up)

  9. Change from Baseline to Week 1 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 1

  10. Change from Baseline to Week 4 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 4

  11. Change from Baseline to Week 8 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 8

  12. Change from Baseline to Week 12 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 12

  13. Change from Baseline to Week 16 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 16

  14. Change from Baseline to Week 20 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 20

  15. Change from Baseline to Week 24 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 24 (conclusion of treatment period)

  16. Change from Baseline to Week 48 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Baseline and Week 48 (follow-up)

  17. Change from Week 24 to Week 48 in Autism Treatment Evaluation Checklist (ATEC)

    Social Behavior Test - The total score is calculated by adding together the scores of 4 subtests (Speech/Language Communication, Sociability, Sensory/Cognitive Awareness, and Health/Physical/Behavior). This 67 question test will provide scores for each subtest and a total score, for which a higher score indicates greater symptom severity.

    Measured: Week 24 (conclusion of treatment period) and Week 48 (follow-up)

Secondary outcomes (9)
  1. Inflammatory Marker Levels

    Inflammatory marker serum concentration quantification (free IgE, total IgE, interleukin 6, tumor necrosis factor alpha, tryptase).

    Measured: Baseline, Week 12, and Week 24 (conclusion of treatment period)

  2. Structural MRI

    The software Freesurfer will be used to calculate volume of brain regions and diffusion parameters (e.g. fractional anisotropy and mean diffusivity) from structural T1 and diffusion tensor images respectively. Paired t-test will be used to compare brain volume at baseline and post-treatment.

    Measured: Baseline and Week 24 (conclusion of treatment period)

  3. Functional MRI (resting state)

    Correlation analysis will be used to calculate the connectivity across different brain regions. Paired t-test will be used to compare differences in activity at baseline and post-treatment.

    Measured: Baseline, and Week 24 (conclusion of treatment period)

  4. Generalized Anxiety Disorder 7-item (GAD-7)

    Anxiety symptom questionnaire - Scoring is based on how frequently the subject experienced 7 GAD-related symptoms in the last two weeks. Each question is rated on a 0-3 scale: 0 - "Not at all", 1 - "Several days", 2 - "More than half the days", 3 - "Nearly every day." Defined cutoffs will be used to define severity.

    Measured: Baseline, Week 1, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (conclusion of treatment period), and Week 48 (follow-up)

  5. Epworth Sleepiness Scale (ESS)

    Sleepiness Questionnaire - Scoring is based on how likely the subject is to doze off or fall asleep during 8 daily activities. Higher scores indicate more severe sleepiness.

    Measured: Baseline, Week 1, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (conclusion of treatment period), and Week 48 (follow-up)

  6. Pittsburgh Sleep Quality Index (PSQI)

    Sleep Quality Questionnaire - Scoring is based on 19 self-administered questions and 5 roommate questions. An algorithm provided with the questionnaire will be used to calculate global sleep quality score, for which a higher score indicates greater severity.

    Measured: Baseline, Week 1, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (conclusion of treatment period), and Week 48 (follow-up)

  7. Asthma Control Test (ACT)

    A 5 question patient survey designed to identify patients with poorly controlled asthma based on the symptom severity over the last 4 weeks.

    Measured: Baseline, Week 1, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (conclusion of treatment period), and Week 48 (follow-up)

  8. Rhinitis Control Assessment Test (RCAT)

    A 6 question patient survey designed to evaluate rhinitis symptom control based on symptom severity and frequency over the past week.

    Measured: Baseline, Week 1, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (conclusion of treatment period), and Week 48 (follow-up)

  9. Validated Investigator Global Assessment of Atopic Dermatitis (vIGA-AD)

    A clinical assessment tool used to describe severity of atopic dermatitis. The vIGA-AD includes a single scale from 0-4, in which 0 is "clear" and 4 is "severe."

    Measured: Baseline, Week 1, Week 4, Week 8, Week 12, Week 16, Week 20, Week 24 (conclusion of treatment period), and Week 48 (follow-up)

Timeline

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

  1. First posted2 Sep 2020
  2. Study start1 Jan 2021 (estimated)
  3. Primary completion1 Jan 2022 (estimated)
  4. Study completion1 Jan 2022 (estimated)

Why it stopped: We are terminating due to loss of funding because of Covid-19.

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 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Baseline testing, followed by 24-week treatment period, followed by 24-week follow-up period.
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04535817
Sponsor's protocol ID
2020P000753
Status last verified
Aug 2021
First submitted
13 Aug 2020
Last updated
18 Aug 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: There is no plan to share data with researchers not directly involved in this study and on the research team.

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Omalizumab Injection [Xolair] in people with Autism Spectrum Disorder and Atopy, run by Beth Israel Deaconess Medical Center at 1 site in United States.

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 4 inclusion and 13 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: withdrawn, as of the sponsor's last update on 18 Aug 2021. 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 States. 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

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 was withdrawn before enrolling participants, so there are no results.

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?

Change from Baseline to Week 12 in Social Responsiveness Scale (SRS) Edition 2 (time frame: Baseline and Week 12). The study lists 17 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 18 Aug 2021.

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