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The NACHO Trial (Nut Allergy Children OIT)

Study Purpose

Most food allergies that begin in early childhood are mild and resolve by school age, but nut allergies persist in about 80-90% of individuals into adulthood. The consumption of nuts, particularly cashew nuts, has increased dramatically in Finland in the 21st century, leading to a rise in severe allergic reactions to cashew nuts among young children. Of the food anaphylaxis cases reported in the Finnish Anaphylaxis Registry between 2015-2020, 49% were caused by nuts, with cashew nuts being the most common trigger. The standard treatment for nut allergies is strict avoidance of nuts and symptom management with emergency medications. Oral immunotherapy (OIT) is a food allergy treatment that increases tolerance, and it has primarily been studied in school-aged children, with desensitization achieved in about 80% of cases. Permanent tolerance, depending on the allergen, develops in 30-50% of cases within five years. International guidelines recommend peanut OIT for children over the age of 4 who have severe peanut allergies. The likelihood of achieving tolerance, especially permanent tolerance, appears to improve the earlier the treatment is started. To date, only one study (NUIT CRACKER) has been published on cashew nut desensitization in children over 4 years old, involving 50 children, where 88% achieved desensitization to both cashew nuts and pistachios. The aim of this study is to develop a cashew nut desensitization protocol and investigate its effectiveness in achieving tolerance and permanent desensitization in children aged 1-17 years, compared to cashew nut avoidance. The study will assess the safety of cashew nut desensitization and its impact on the quality of life of patients and their families.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 1 Year - 17 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

1. Age 6 months
  • - 17 years.
2. Sensitization to cashew nut (allergen-specific IgE or positive skin PRICK test) 3. Positive oral food challenge for cashew nut.

Exclusion Criteria:

1. Poor adherence. 2. Uncontrolled or severe asthma. 3. Uncontrolled active or severe or atopic dermatitis. 4. Chronic urticaria. 5. Eosinophilic esophagitis or other gastrointestinal eosinophilic disorders. 6. Active malignant neoplasia. 7. Active systemic, autoimmune disease. 8. Diabetes treated with insulin. 9. Severe systemic illness or severe medical conditions such as cardiovascular or lung diseases. 10. Medication with beta blockers. 11. Medication with ACE-inhibitors. 12. Mastocytosis. 13. Pregnancy or breastfeeding. 14. Language barriers (not fluent Finnish or Swedish)

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT06930950
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

N/A
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

HUS Skin and Allergy Hospital
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

N/A
Principal Investigator Affiliation N/A
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other
Overall Status Recruiting
Countries Finland
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Oral Immunotherapy for Food Allergy, Tree Nut Allergy, Cashew Nut Allergy
Arms & Interventions

Arms

Active Comparator: Intervention group

The group that will receive oral immunotherapy for cashew nut

No Intervention: Control group

The group that will continue avoiding cashew nut for 12 months before crossover to active OIT to cashew nut

Interventions

Other: - Cashew nut oral immunotherapy

Cashew nut oral immunotherapy (OIT) where the aim is desensitizing individuals with cashew nut allergies. The approach involves the gradual administration of increasing doses of cashew nut protein. The goal of OIT is to increase the threshold of tolerance to cashew nuts, thereby reducing the risk of severe allergic reactions upon accidental exposure

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

HUS Skin and Allergy Hospital, Helsinki, Finland

Status

Recruiting

Address

HUS Skin and Allergy Hospital

Helsinki, ,

Site Contact

Heidi Sandström MD

[email protected]

+358504287931

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