Clinical trial • Phase II/III • Immunology

BIRCH POLLEN ALLERGOID GLUTARALDEHYDE MODIFIED for Allergic rhinitis due to birch pollen | Allergic rhinoconjunctivitis

Phase II/III trial of BIRCH POLLEN ALLERGOID GLUTARALDEHYDE MODIFIED for Allergic rhinitis due to birch pollen | Allergic rhinoconjunctivitis.

Overview

Trial Therapeutic Area
Immunology
Trial Disease
Allergic rhinitis due to birch pollen | Allergic rhinoconjunctivitis
Trial Stage
Phase II/III
Drug Modality
Vaccine

Key dates

Initial CTIS Submission Date
30-01-2025
First CTIS Authorization Date
11-04-2025

Trial design

Randomised, placebo preparation for subcutanoues use with appearance, smell, taste and excipients identical to verum, but without the active substance; clu-rx-bet low dose (birch pollen allergoid glutaraldehyde modified) - solution for injection, subcutaneous use; clu-rx-bet mid dose (birch pollen allergoid glutaraldehyde modified) - solution for injection, subcutaneous use; clu-rx-bet high dose (birch pollen allergoid glutaraldehyde modified) - solution for injection, subcutaneous use. product-level dosing details available: max daily dose 0.7 ml; max total dose 6.2 ml; exact dosing schedule not specified in ctis record.-controlled Phase II/III trial across 3 sites in Germany.

Randomised
Yes
Comparator
Placebo preparation for subcutanoues use with appearance, smell, taste and excipients identical to verum, but without the active substance; CLU-RX-BET low dose (birch pollen allergoid glutaraldehyde modified) - solution for injection, subcutaneous use; CLU-RX-BET mid dose (birch pollen allergoid glutaraldehyde modified) - solution for injection, subcutaneous use; CLU-RX-BET high dose (birch pollen allergoid glutaraldehyde modified) - solution for injection, subcutaneous use. Product-level dosing details available: max daily dose 0.7 ml; max total dose 6.2 ml; exact dosing schedule not specified in CTIS record.
Single Multiple Or Escalation Dose Combined
Yes
Target Sample Size
660

Eligibility

Recruits 660 No vulnerable populations selected. Participants must be adults able to provide written informed consent (Patients who signed and dated the informed consent form obtained prior to any study specific examination). 'Legal incapacity' and institutionalisation are listed as exclusion criteria. Participants must be able to understand and complete an electronic diary; assent processes are not applicable because enrolment is restricted to adults (18-65 years)..

Pregnancy Exclusion
Existing or intended pregnancy, lactation or inadequate contraceptive measures for women with child-bearing potential or a positive pregnancy test at screening
Vulnerable Population
No vulnerable populations selected. Participants must be adults able to provide written informed consent (Patients who signed and dated the informed consent form obtained prior to any study specific examination). 'Legal incapacity' and institutionalisation are listed as exclusion criteria. Participants must be able to understand and complete an electronic diary; assent processes are not applicable because enrolment is restricted to adults (18-65 years).

Inclusion criteria

  • {"criterion_text":"- Patients who signed and dated the informed consent form obtained prior to any study specific examination\n- Female or male patients between 18 and 65 years of age at the time of signing the informed consent form\n- Patients with moderate-to-severe allergic rhinitis / rhinoconjunctivitis due to birch pollen for at least two years according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guideline (Bousquet et al., 2008), with well-controlled mild-to-moderate asthma defined in GINA guidelines (Global Initiative for Asthma, 2024), or without asthma\n- Forced expiratory volume (FEV1) in one second > 80 % of predicted normal value (only for asthmatic patients)\n- Sensitization to Betula verrucosa pollen, verified by: positive skin prick test (wheal diameter ≥ 3 mm and negative control < 2 mm and positive (histamine) control ≥ 3 mm) and serum allergen-specific IgE to Betula verrucosa ≥ 0.7 kU/L (CAP EAST class ≥ 2) and a Retrospective Rhinitis Total Symptom Score (RRTSS) ≥ 2 (0-3 scale) based on the most severe days during one of the two BPS preceding enrolment and positive response to nasal provocation with Betula verrucosa pollen allergen extract (at least at the third concentration step)\n- Assumed compliance and ability of the patient to understand the patient´s electronic diary and to follow the instructions of the study staff\n- Compliance and ability of the patient to complete an electronic diary for self-evaluation of the symptoms and rescue medication\n- Safety laboratory results within the normal range or considered to be not clinically significant in any other case"}

Exclusion criteria

  • {"criterion_text":"- Previous immunotherapy with birch pollen allergen extracts according to the homologous group of tree pollen of the \"Birch group\" / “Fagales group”, as defined in Annex 1 in the Guideline on allergen products: production and quality issues (EMEA/CHMP/BWP/304831/2008), within the last 5 years\n- Serious systemic reactions to allergen-specific immunotherapy in the past\n- Hypersensitivity to excipients of the IMP\n- Any severe or unstable lung disease e. g. active tuberculosis, cystic fibrosis, COPD\n- Severe, or partly controlled or uncontrolled asthma according to GINA guideline (Global Initiative for Asthma, 2024)\n- Asthmatic patients with FEV1 ≤ 80 % of predicted normal value at screening\n- Chronic or severe acute diseases of nose or eyes\n- Irreversible secondary disorders of the target organs (e. g. emphysema, bronchiectasis)\n- Therapy with immunoglobulins\n- Completed or ongoing treatment with anti-IgE-antibody (like Omalizumab) and/or checkpoint-inhibitor\n- Diseases of the immune system including autoimmune and immune deficiencies (with exception to well-controlled Hashimoto thyroiditis and type-1 diabetes mellitus)\n- Patients with co-sensitizations or co-allergies to any perennial or seasonal allergen (with exception of alder, hazel and hornbeam), which interfere with the conduct of the study (e. g. with the tNPT or CSMS recording), especially if the result in SPT for this allergen is higher than that for Betula verrucosa\n- Severe acute or chronic inflammatory or infectious diseases\n- Chronic or acute diseases of the heart, kidney or liver with severe impairment of their function\n- Malignancy within the previous 5 years\n- Active chronic urticaria\n- Active severe atopic eczema\n- Alcohol, drug, or medication abuse within the past year and/or during the study\n- Existing or intended pregnancy, lactation or inadequate contraceptive measures for women with child-bearing potential or a positive pregnancy test at screening\n- Systemic and local (eye drops) treatment with beta-blockers\n- Use of non-allowed medication\n- Contraindication for adrenalin (for example, acute or chronic symptomatic coronary heart disease, severe hypertension, hyperthyroidism, glaucoma)\n- Patients with co-sensitizations to any perennial or seasonal allergen overlapping during PBPP or BPS but which are not cross-reactive with Betula verrucosa and, measured at the same time, with specific IgE levels ≥ class 2 CAP/PHADIA (unless the relevance can be excluded by component resolved diagnosis)\n- Severe psychiatric, psychological, or neurological disorders; completed or ongoing longterm treatment with tranquilizer or psychoactive drugs (including tricyclic anti-depressants)\n- Relationship or dependence with the sponsor and/or investigator\n- Legal incapacity\n- Patients who are jurisdictional or governmentally institutionalized\n- Risk of non-compliance by the patient with the study procedures\n- Simultaneous participation in other clinical trials\n- Simultaneous specific immunotherapy with other allergens\n- Participation, meaning randomization, in a clinical trial in the last three months before enrolment\n- Contraindications for SCIT (Pfaar et al., 2022; Pitsios et al., 2015)\n- Contraindications for SPT\n- Contraindications for NPT"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary (efficacy) endpoint is defined as the absolute differences in mean CSMS (Combined Symptom and Medication Score) during Peak Birch Pollen Period (PBPP) of each active treatment group compared with placebo treatment group.","definition_or_measurement_approach":"Absolute differences in mean Combined Symptom and Medication Score (CSMS) during the Peak Birch Pollen Period (PBPP) comparing each active treatment group with placebo."}

Secondary endpoints

  • {"endpoint_text":"- Absolute and relative differences in mean CSMS during the Birch Pollen Season (BPS) between active and placebo treatment groups.","definition_or_measurement_approach":"Comparison of absolute and relative differences in mean CSMS during the full Birch Pollen Season between active and placebo groups."}
  • {"endpoint_text":"- Absolute and relative differences in mean dSS during PBPP and BPS.","definition_or_measurement_approach":"Comparison of absolute and relative differences in mean daily Symptom Score (dSS) during PBPP and BPS."}
  • {"endpoint_text":"- Absolute and relative differences in the 6 mean individual symptom scores (4 nasal and 2 ocular) during PBPP and BPS.","definition_or_measurement_approach":"Comparison of absolute and relative differences in the six individual symptom scores (four nasal, two ocular) during PBPP and BPS."}
  • {"endpoint_text":"- Absolute and relative differences in mean dMS during PBPP and BPS.","definition_or_measurement_approach":"Comparison of absolute and relative differences in mean daily Medication Score (dMS) during PBPP and BPS."}
  • {"endpoint_text":"- Global Rhinoconjunctivitis Discomfort with a 10.0-point Visual Analogue Scale (VAS).","definition_or_measurement_approach":"Global discomfort measured using a 10-point Visual Analogue Scale (VAS)."}
  • {"endpoint_text":"- Change in Rhinoconjunctivitis quality of life questionnaire (RQLQ) between active and placebo treatment groups comparing basal and post-treatment scoring.","definition_or_measurement_approach":"Change from baseline to post-treatment in RQLQ scores comparing active versus placebo groups."}
  • {"endpoint_text":"- Well and severe days: A well day is defined as a day without administration of any rescue medication (dMS = 0) and with dSS < 0.34 (range 0-3). A severe day is defined (acc. to Pfaar et al., 2014) as a day with a single score = 3 in any of the six symptoms. Percentages of well and severe days will be calculated for each subject as the number of well or severe days in the PBPP and BPS in relation to the number of days comprising both periods.","definition_or_measurement_approach":"Well day: dMS = 0 and dSS < 0.34. Severe day: any single symptom score = 3. Percentages of well and severe days computed per subject for PBPP and BPS."}
  • {"endpoint_text":"- Symptom-free days during PBPP and PBP are defined as the days with absence of symptoms, (dSS = 0), and without administration of any rescue medication (dMS = 0), expressed as percentage of days during the PBPP and BPS.","definition_or_measurement_approach":"Symptom-free days: dSS = 0 and dMS = 0; expressed as percentage of days in PBPP and BPS."}
  • {"endpoint_text":"- tNPT titrated Nasal Provocation Test: To assess the efficacy of each dose of CLURX- BET compared to placebo. Defined as percentage of patients with an increased dosing step and the change in number of dosing steps needed to provoke a positive response in the titrated nasal provocation test (tNPT) post-treatment compared with pre-treatment (i. e. any improvement) in each of the four study groups.This is based on the change of the response to nasal provocation (tNPT)","definition_or_measurement_approach":"tNPT: percentage of patients with increased dosing step post-treatment vs pre-treatment and change in number of dosing steps required to provoke a positive response."}
  • {"endpoint_text":"- To analyse the safety and tolerability of each dose of CLU-RX-BET compared to placebo by Treatment-Emergent Adverse Drug Reactions (TEADR) and patients affected with TEADRs in each group.","definition_or_measurement_approach":"Safety/tolerability assessed by incidence and nature of Treatment-Emergent Adverse Drug Reactions (TEADRs) and number of patients affected per group."}

Recruitment

Planned Sample Size
660
Recruitment Window Months
25
Consent Approach
Written informed consent: 'Patients who signed and dated the informed consent form obtained prior to any study specific examination' (adults 18-65). Participants must be able to understand and complete an electronic diary; no assent procedures described (trial restricted to adults). Languages of consent documents not specified in CTIS record.

Geography

Total Number Of Sites
3
Total Number Of Participants
660

Germany

Earliest CTIS Part Ii Submission Date
28-03-2025
Latest Decision Or Authorization Date
11-04-2025
Processing Time Days
14
Number Of Sites
3
Number Of Participants
40

Sites

Site Name
Praxis für HNO und Allergologie Dr. Yury Yarin
Department Name
HNO, Allergology
Principal Investigator Name
Dr. Yury Yarin
Principal Investigator Email
dr.yarin@googlemail.com
Contact Person Name
Dr. Yury Yarin
Contact Person Email
dr.yarin@googlemail.com
Site Name
HNO-Praxis Dr. med. Udo Schäfer
Department Name
HNO, Allergology
Principal Investigator Name
Dr. Udo Schäfer
Principal Investigator Email
schaefer@hno-praxis-dresden.de
Contact Person Name
Dr. Udo Schäfer
Contact Person Email
schaefer@hno-praxis-dresden.de
Site Name
Pneumologie, Allergologie Praxis Dr. Thomas Ginko
Department Name
Pulmonary and bronchial medicine, allergology
Principal Investigator Name
Dr. Thomas Ginko
Principal Investigator Email
tginko@icloud.com
Contact Person Name
Dr. Thomas Ginko
Contact Person Email
tginko@icloud.com

Sponsor

Primary sponsor

Full Name
ROXALL Medizin GmbH
Organisation Type
Pharmaceutical company
Country Of Registered Address
Germany

Third parties

  • {"country":"Germany","full_name":"ICRC-Weyer GmbH","duties_or_roles":"sponsorDuties codes: 10, 6","organisation_type":"Pharmaceutical company"}

Investigational products

Investigational Product Name
CLU-RX-BET low dose
Active Substance
BIRCH POLLEN ALLERGOID GLUTARALDEHYDE MODIFIED
Modality
Vaccine
Routes Of Administration
Subcutaneous
Route
Subcutaneous
Authorisation Status
Authorised
Dose Levels
low dose
Maximum Dose
max daily dose 0.7 ml; max total dose 6.2 ml
Investigational Product Name
CLU-RX-BET mid dose
Active Substance
BIRCH POLLEN ALLERGOID GLUTARALDEHYDE MODIFIED
Modality
Vaccine
Routes Of Administration
Subcutaneous
Route
Subcutaneous
Authorisation Status
Authorised
Dose Levels
mid dose
Maximum Dose
max daily dose 0.7 ml; max total dose 6.2 ml
Investigational Product Name
CLU-RX-BET high dose
Active Substance
BIRCH POLLEN ALLERGOID GLUTARALDEHYDE MODIFIED
Modality
Vaccine
Routes Of Administration
Subcutaneous
Route
Subcutaneous
Authorisation Status
Authorised
Dose Levels
high dose
Maximum Dose
max daily dose 0.7 ml; max total dose 6.2 ml
Investigational Product Name
Placebo preparation for subcutanoues use with appearance, smell, taste and excipients identical to verum, but without the active substance, i. e. allergen extract.
Modality
Other

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