ClinicalTrials.gg
WithdrawnNCT01834352WOITUpdated Jun 17, 2016

Walnut Oral Immunotherapy for Tree Nut Allergy

A Phase 1/2 interventional study of Walnut Protein Flour and Oat flour in Nut Hypersensitivities, sponsored by University of North Carolina, Chapel Hill. Withdrawn. Open to participants aged 6 Years to 45 Years. Per ClinicalTrials.gov, last updated 2016-06-17.

Sponsored by University of North Carolina, Chapel Hill · Phase 1/2, Interventional, and Treatment

Why this study was withdrawn
Concern for cross contamination in weighing tree nuts in facility with peanuts
Phase
Phase 1/2
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
6 Years to 45 Years
Sex
All
01

Study summary

The purpose of this study is to determine if walnut oral immunotherapy can be used in subjects allergic to tree nuts to decrease their tree nut allergy and induce changes in their immune system.

Read the detailed description

Tree nut

02

Conditions studied

  • Nut Hypersensitivities

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Keywords

  • Walnut hypersensitivity
  • Tree nut hypersensitivity
03

In context

Nut Hypersensitivity

33 studies on the registry are indexed under Nut Hypersensitivity; 9 are open to participants now.

Browse Nut Hypersensitivity studies →

Lead sponsor

University of North Carolina, Chapel Hill is the lead sponsor of 1,372 studies on the registry; 133 are open to participants now.

Of its 161 completed or terminated interventional studies of FDA-regulated products, 139 (86%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
6 Years to 45 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age 6 to 45 years, either sex, any race, any ethnicity with a convincing clinical history of walnut or another tree nut allergy and either a positive prick skin test (> 3mm) or serologic evidence of allergic sensitization (defined as specific IgE > 0.35 kU/L) to walnut and at least one other tree nut.
  • A positive 2000 mg oral food challenge at enrollment to walnut and to one other tree nut.
  • Written from participant and/or parent/guardian
  • Written assent from all subjects as appropriate
  • All females of child bearing age must be using appropriate

Exclusion criteria

Exclusion Criteria:

  • History of severe anaphylaxis to walnut or other tree nuts, defined as symptoms associated with hypoxia, hypotension or neurologic compromise (cyanosis or SpO2 \< 92% at any stage, hypotension, confusion, collapse, loss of consciousness; or incontinence).
  • Known allergy to oat
  • Chronic disease (other than asthma, atopic dermatitis, rhinitis) requiring therapy or other respiratory or medical conditions deemed by the investigator to put the subject at increased risk of anaphylaxis or poor outcomes from receiving OIT or undergoing food challenge.
  • Poor control or persistent activation of atopic dermatitis
  • Active eosinophilic or other inflammatory (e.g., celiac) gastrointestinal disease in the past 2 years.
  • Participation in any interventional study for food allergy in the past 6 months
  • Participant is on "build-up phase" of immunotherapy (i.e., has not reached maintenance dosing).
  • Severe asthma (2007 NHLBI Criteria Steps 5 or 6, see Appendix 2) or poorly controlled mild or moderate asthma
  • Inability to discontinue antihistamines for initial day escalation, skin testing or OFC
  • Use of omalizumab or other non-traditional forms of allergen immunotherapy (e.g., oral or sublingual) or immunomodulator therapy (not including ) or biologic therapy within the past year
  • Use of beta-blockers (oral), angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARB) or calcium channel blockers
  • Pregnancy or lactation
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
0 participants (actual)

Study arms

  • Active comparator
    Walnut protein flour

    Walnut protein flour that is ingested in gradually increasing amounts up to a maintenance dose.

    Drug: Walnut Protein Flour

  • Placebo comparator
    Oat flour

    Oat flour administered in identical increasing amounts as the active walnut protein flour.

    Drug: Oat flour

Interventions

  • DrugWalnut Protein Flour

    Daily ingestion of gradually increasing amounts of walnut protein flour in order to induce desensitization to walnut and an unrelated tree nut.

    Also known as: Walnut OIT

  • DrugOat flour

    Oat flour that is administered as a placebo in identical increasing doses as the active walnut flour treatment.

    Also known as: Placebo

06

What researchers measure

Primary outcomes

  1. Effectiveness of walnut oral immunotherapy (WOIT) on clinical desensitization to a second tree nut.

    The determination of the effectiveness of WOIT in inducing clinical desensitization to a second tree nut to which the subject is allergic when compared to placebo. This will be measured by the change in the amount of tree nut the subject can consume during their food challenge at 38 weeks compared to their consumption during the baseline challenge at study entry.

    Time frame: 38 weeks

Secondary outcomes

  1. Percentage of subjects who can tolerate a 5000mg oral food challenge to walnut protein following the desensitization phase of the study

    The percentage of subjects who can consume all of the 5000mg of walnut protein without symptoms during the food challenge after the desensitization phase of the study.

    Time frame: 38 weeks

  2. The percentage of subjects who are able to reach a cumulative protein dose of 2000mg at the desensitization oral food challenge to walnut and the test tree nut.

    The percentage of subjects who are able to consume a cumulative protein dose of 2000 mg of walnut and test tree nut without symptoms during the desensitization oral food challenge.

    Time frame: 38 weeks

  3. The percentage of subjects who demonstrate clinical tolerance at the end of the study to walnut and the test tree nut.

    The percentage of subjects who are able to demonstrate clinical tolerance by consuming all of the walnut and test tree nut without symptoms during the oral food challenge at the end of the study.

    Time frame: 36 months

Other outcomes

  1. Increase in walnut and test tree nut IgG4 over the course of the study.

    The increase in the walnut and test tree nut specific IgG4 over the course of the study as an indication of the impact of WOIT on the immune system.

    Time frame: 36 months

  2. Decrease in the walnut and test tree nut specific IgE over the course of the study.

    The decrease in the walnut and test tree nut specific IgE over the course of the study as an indication of the impact of WOIT on the immune system.

    Time frame: 36 months

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Kulis M, Li Y, Lane H, Pons L, Burks W. Single-tree nut immunotherapy attenuates allergic reactions in mice with hypersensitivity to multiple tree nuts. J Allergy Clin Immunol. 2011 Jan;127(1):81-8. doi: 10.1016/j.jaci.2010.09.014. Epub 2010 Nov 18. PubMed 21093029 ↗
  • Hofmann AM, Scurlock AM, Jones SM, Palmer KP, Lokhnygina Y, Steele PH, Kamilaris J, Burks AW. Safety of a peanut oral immunotherapy protocol in children with peanut allergy. J Allergy Clin Immunol. 2009 Aug;124(2):286-91, 291.e1-6. doi: 10.1016/j.jaci.2009.03.045. Epub 2009 May 27. PubMed 19477496 ↗
  • Jones SM, Pons L, Roberts JL, Scurlock AM, Perry TT, Kulis M, Shreffler WG, Steele P, Henry KA, Adair M, Francis JM, Durham S, Vickery BP, Zhong X, Burks AW. Clinical efficacy and immune regulation with peanut oral immunotherapy. J Allergy Clin Immunol. 2009 Aug;124(2):292-300, 300.e1-97. doi: 10.1016/j.jaci.2009.05.022. Epub 2009 Jul 3. PubMed 19577283 ↗
  • Varshney P, Jones SM, Scurlock AM, Perry TT, Kemper A, Steele P, Hiegel A, Kamilaris J, Carlisle S, Yue X, Kulis M, Pons L, Vickery B, Burks AW. A randomized controlled study of peanut oral immunotherapy: clinical desensitization and modulation of the allergic response. J Allergy Clin Immunol. 2011 Mar;127(3):654-60. doi: 10.1016/j.jaci.2010.12.1111. PubMed 21377034 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Nov 2013, a primary completion of Dec 2013 and a completion of Dec 2013. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 12, 2013
First posted
Apr 17, 2013
Start
Nov 2013
Primary completionActual
Dec 2013
CompletionActual
Dec 2013
Last update
Jun 17, 2016
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 17, 2016, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01834352
Responsible party
Wesley Burks, MD (Professor, University of North Carolina, Chapel Hill) — Principal investigator
First posted
Apr 17, 2013
Start date
Nov 2013
Primary completion
Dec 2013
Completion
Dec 2013
Last update
Jun 17, 2016

Study contacts

Wesley Burks, MD
principal investigator · UNC Chapel Hill
Edwin Kim, MD
study director · UNC Chapel Hill

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is withdrawn, as verified in Mar 2014. You cannot join it, but the record below documents what was studied.

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