Peanut AllergyPhase 2ZENITHNCT07015996
Efficacy of Tezepelumab in Peanut Oral Immunotherapy
A Phase 2 study testing Tezepelumab and Peanut Oral Immunotherapy (OIT) in people with Peanut Allergy, run by National Institute of Allergy and Infectious Diseases (NIAID) at 10 sites in United States.
Trial summary
The proposed study is a proof-of-concept Phase 2, double-blind, randomized placebo-controlled clinical trial evaluating the safety and efficacy of tezepelumab and peanut Oral Immunotherapy (OIT) for the treatment of peanut allergy. Read more about this study
- Who is it for?
- Ages 12 to 55 years
- Conditions the study is for
- Peanut Allergy
- What is being tested?
- Tezepelumab and Peanut Oral Immunotherapy (OIT)
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 62 participants
- Where
- 10 sitesUnited States
- Study dates
- 27 Jul 2026to May 2029
- Phase
- Phase 2
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 12 to 55 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Participant and/or parent/legal guardian must be able to understand and provide informed consent (parental permission and informed assent of minor, if applicable).
- Age 12 to 55 years inclusive with a personal history of an allergic reaction to peanut ingestion
- A positive reaction at or below ingestion of 100 mg of peanut protein in a single dose (≤ 144 mg cumulative dose) during the Screening DBPCFC
- A negative challenge to the placebo (oat) during the Screening DBPCFC
- Sensitization to peanut as evidenced by either one of the following:
- positive sIgE to Ara h2 ≥ 0.35 kU/L by ImmunoCAPTM testing, or
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- wheal ≥ 3 mm on skin prick test to peanut extract compared to a negative control
- Female participants of childbearing potential must have a negative pregnancy test upon study entry
- Female participants with reproductive potential must agree to use an FDA approved method of contraception for the duration of the study
- Willing and able to comply with the study protocol requirements
- Participants with other food allergies must agree to continue avoidance of these food items from their diet to avoid confounding the safety and efficacy data of the study
Who cannot join
- Currently in build-up phase of aeroallergen immunotherapy
- Current food allergen immunotherapy or use of any food allergen immunotherapy within the past 12 months
- Pregnant, planning a pregnancy during the study, or breast-feeding
- History of intolerance, hypersensitivity, or allergic reactions to tezepelumab, or the inactive ingredients (excipients) of tezepelumab, other IgG biologics, or rescue medications and their excipients
- Allergy to oat (participant reported)
- History of severe systemic allergic reaction to peanut with symptoms including the need for mechanical ventilation and/or severe hypotension requiring intensive care unit admission
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- Asthma requiring high dose inhaled corticosteroid therapy for control (2007 NHLBI Criteria Steps 5 or 6 in adults and adolescents)
- History of a life-threatening asthma attack within 12 months prior to screening (e.g., requiring an ICU admission or intubation with mechanical ventilation), need for oral corticosteroids for asthma management within the last 6 months, or current Asthma Control Test score less than 19 at screening
- History of ischemic cardiovascular disease or other cardiac disease, which, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or that may impact the quality or interpretation of the data obtained from the study
- History of eosinophilic gastrointestinal disease at screening
- History of disease affecting the immune system such as autoimmune disease (e.g., systemic lupus erythematosus), immune complex disease (e.g., serum sickness), or immunodeficiency, which, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or that may impact the quality or interpretation of the data obtained from the study
- History of malignancy of any type, excluding basal cell and squamous cell cancers of the skin that only required surgical excision or in situ carcinoma of the cervix study provided that curative therapy was completed at least 12 months prior to screening
- Current known helminth infection
- Positive QuantiFERON - TB Gold test or TB Gold Plus, or T-SPOT® TB test unless the potential participant has been treated with appropriate chemoprophylaxis. In the case of an indeterminate or borderline Interferon Gamma Release Assay (IGRA), an IGRA may be repeated.
- Any of the following:
- HIV
- Current or prior infection with hepatitis B virus (HBV)
- Current or prior infection with hepatitis C virus (HCV), except adequately treated HCV with sustained virologic response ≥ 12 weeks.
- Active liver disease, defined as either:
- AST, ALT, and/or Alk phos >2x ULN, or
- other active liver disease which, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or that may impact the quality or interpretation of the data obtained from the study
- Any of the following:
- Current use of beta-blockers, angiotensin-converting enzyme inhibitors, or angiotensin-receptor blockers
- Received any investigational product within the past 4 months or 5 half-lives (whichever is longer) prior to screening
- Received systemic corticosteroids within 14 days prior to screening
- Receipt of immunoglobulin or other blood product within 30 days prior to screening
- Receipt of live attenuated vaccine within 30 days prior to screening
- Use of an immunosuppressant or immunomodulating drug within 30 days prior to screening
- Use of biologics targeting the human immune system within the past 12 months prior to screening
- Use of any herbal medications, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or that may impact the quality or interpretation of the data obtained from the study
- Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the site investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or that may impact the quality or interpretation of the data obtained from the study
Trial locations and contacts
10 sites in 1 country. Contact the study team or a site near you to ask about taking part.
10 sites in 1 country
United States10 sites, 10 recruiting
- Not yet recruiting
The University of Michigan: Division of Allergy and Clinical Immunology
Ann Arbor, Michigan, 48105
Lea Franco, 734-615-2592, Foodallergytrials@med.umich.edu
Ian Slack, MD
- Recruiting
Johns Hopkins Children's Center: Department of Allergy & Immunology
Baltimore, Maryland, 21287
Paul Jones, 410-502-1711, pjones48@jh.edu
Bob Wood, MD
- Recruiting
Massachusetts General Hospital: Department of Medicine: Allergy & Clinical Immunology Unit
Boston, Massachusetts, 02114
Andrew Kim, 617-643-8683, akim90@mgh.harvard.edu
Sarita Patil, MD
- Not yet recruiting
Boston Children's Hospital: Allergy and Asthma Program
Boston, Massachusetts, 02115
Isabella Viola, 617-355-1734, Isabella.Viola@childrens.harvard.edu
Rima Rachid, MD
- Recruiting
North Carolina Children's Hospital: Department of Pediatrics, Division of Allergy, Immunology and Rheumatology
Chapel Hill, North Carolina, 27599
Latoya Obende, 919-962-4409, Latoya_obende@med.unc.edu
Edwin Kim, MD
- Recruiting
Cincinnati Children's Hospital Medical Center: Division of Allergy and Immunology
Cincinnati, Ohio, 45229
Jenny Duncan, 513-517-1146, Jenny.Duncan@cchmc.org
Amal Assa'ad, MD
- Not yet recruiting
University of Texas Southwestern Medical Center: Division of Allergy and Immunology
Dallas, Texas, 75390-9063
- Recruiting
Arkansas Children's Hospital Research Institute: Department of Pediatrics, Allergy & Immunology
Little Rock, Arkansas, 72202
Marissa Pilcher, 501-364-3886, PilcherMR@archildrens.org
Stacie Jones, MD
- Not yet recruiting
University of California, Los Angeles: Department of Medicine, Division of Clinical Immunology and Allergy
Los Angeles, California, 90095
Stacey Zedeck, (310) 794-5561, uclafoodallergy@mednet.ucla.edu
Maria Garcia-Lloret, MD
- Recruiting
Icahn School of Medicine at Mount Sinai: Department of Pediatrics Allergy & Immunology
New York, New York, 10029-6574
Tejal Schwartz, 212-241-9149, tejal.schwartz@mssm.edu
Scott Sicherer, MD
About this study
Official title: Efficacy of Tezepelumab in Peanut Oral Immunotherapy: a Double-Blind, Randomized, Placebo-Controlled Trial
The proposed study is a proof-of-concept Phase 2, double-blind, randomized placebo-controlled clinical trial evaluating the safety and efficacy of tezepelumab and peanut Oral Immunotherapy (OIT) for the treatment of peanut allergy. Study participation is divided into 3 periods: (i) a monotherapy period comprised of injections of either Tezepelumab or placebo from week 0 to week 8, (ii) followed by a combination therapy period comprised of 56 weeks during which peanut OIT is built up and maintained, and (iii) a treatment withdrawal period comprised of 12 weeks. This study will enroll 62 peanut-allergic individuals from 12 to 55 years of age who experience dose-limiting symptoms to <=100 mg of peanut protein in a single dose (<= 144 mg cumulative dose) as assessed by DBPCFC.
The primary objective is to determine whether 56 weeks of tezepelumab plus peanut OIT as compared to 56 weeks of placebo plus peanut OIT induces sustained unresponsiveness to peanut 12 weeks after stopping combination therapy.
- Conditions
- Peanut Allergy
- Being tested
- Tezepelumab, Peanut Oral Immunotherapy (OIT), Placebo for Tezepelumab
- Keywords
- Tezepelumab, Peanut, Oral Immunotherapy
- Medical subject headings
- Peanut Hypersensitivity
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TezepelumabBiological
Monotherapy Period: Participants randomized to tezepelumab will receive two subcutaneous (SQ) injections of tezepelumab 210 mg during the monotherapy period.
Combination Therapy Period: Participants randomized to Tezepelumab will continue to receive Tezepelumab 210 mg every 4 weeks.
Withdrawal Period: Participants will stop receiving Tezepelumab injections.
Peanut Oral Immunotherapy (OIT)Drug
Monotherapy Period: Not Applicable. Combination Therapy Period: During combination therapy period, each participant will start peanut OIT. Participants will start on a minimum of 0.1 mg peanut OIT, with starting dose depending on last tolerated dose from screening double-blind placebo-controlled food challenge (DBPCFC) and build to a maximum of 6 mg peanut OIT on the initial dose escalation (IDE) day. Participants will return every 2 weeks for dose escalation to a goal maintenance dose of 2000 mg peanut protein.
Withdrawal Period: Participants will stop peanut OIT.
Placebo for TezepelumabBiological
Monotherapy Period: Participants randomized to placebo for tezepelumab will receive two subcutaneous (SQ) injections of placebo 210 mg during the monotherapy period.
Combination Therapy Period: Participants randomized to placebo will continue to receive placebo for Tezepelumab every 4 weeks.
Withdrawal Period: Participants will stop receiving placebo injections.
| Study group | Role | What they receive |
|---|---|---|
| Tezepelumab plus Peanut Oral Immunotherapy (OIT) Group | Experimental | Eligible participants will be randomized in a 1:1 fashion to receive Tezepelumab during the monotherapy period of the trial. Throughout the combination therapy period, which also includes an OIT build-up and maintenance period, participants will remain on tezepelumab 210 mg every 4 weeks until reaching the final period of the trial, the withdrawal period. Receives: Biological: Tezepelumab; Drug: Peanut Oral Immunotherapy (OIT) |
| Placebo for Tezepelumab plus peanut Oral Immunotherapy (OIT) Group | Placebo comparator | Eligible participants will be randomized in a 1:1 fashion to receive placebo for Tezepelumab during the monotherapy period of the trial. Throughout the combination therapy period, which also includes an OIT build-up and maintenance period, participants will remain on placebo for tezepelumab every 4 weeks until reaching the final period of the trial, the withdrawal period. Receives: Drug: Peanut Oral Immunotherapy (OIT); Biological: Placebo for Tezepelumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Consumption of a cumulative dose of 4000 mg of peanut protein without dose-limiting symptoms during the open Oral Food Challenge (OFC)
The primary endpoint is sustained unresponsiveness to peanut 12 weeks after stopping combination therapy, as assessed by passing the open OFC to peanut at Week 76
Measured: At week 76
Secondary outcomes (7)
Highest single dose of peanut protein consumed without doselimiting symptoms during the open Oral Food Challenge (OFC)
Measured: At week 64 and 76
Consumption of a cumulative dose of 4000 mg of peanut protein without doselimiting symptoms during the open Oral Food Challenge (OFC)
Measured: At week 64
Highest cumulative dose of peanut protein consumed without dose limiting symptoms during the open Oral Food Challenge (OFC)
Measured: At week 64 and 76
An adverse event related to monotherapy
Measured: During 8 weeks of therapy
An adverse event related to combination therapy
Measured: During 56 weeks of therapy
An adverse event related to tezepelumab plus peanut Oral Immunotherapy (OIT) discontinuation
Measured: 12 weeks after discontinuation of treatment
An adverse event related to placebo plus peanut Oral Immunotherapy (OIT) discontinuation
Measured: 12 weeks after discontinuation of treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jun 2025
- Study start27 Jul 2026
- Primary completionMay 2029 (estimated)
- Study completionMay 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Peanut AllergyStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 62 participants (estimated)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Collaborators
- Immune Tolerance Network (ITN), PPD Development, LP, Rho Federal Systems Division, Inc.
- Responsible party
- Sponsor
- Investigators
- Edwin H Kim, M.D., M.S., Study chair, North Carolina Children's Hospital: Department of Pediatrics, Division of Allergy, Immunology and RheumatologySarita Patil, M.D., Study chair, Massachusetts General Hospital: Department of Medicine: Allergy & Clinical Immunology Unit
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07015996
- Sponsor's protocol ID
- DAIT ITN097AD
- Acronym
- ZENITH
- Status last verified
- Sep 2026
- First submitted
- 3 Jun 2025
- Last updated
- 22 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Immunology Database and Analysis Portal (ImmPort), a long-term archive of clinical and mechanistic data from DAIT-funded grants and contracts.