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CompletedNCT05440643Updated May 11, 2026

Peanut Sublingual Immunotherapy (SLIT)-Tablet for Treatment of Peanut Allergy

A Phase 1/2 interventional study of Peanut SLIT-tablet and Placebo in Peanut Allergy, sponsored by ALK-Abelló A/S. Completed at 42 sites in 2 countries. Open to participants aged 4 Years to 65 Years. Per ClinicalTrials.gov, last updated 2026-05-11.

Sponsored by ALK-Abelló A/S · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
209
Allocation
Randomized
Ages
4 Years to 65 Years
Sex
All
01

Study summary

This clinical research study investigates the safety, tolerability and efficacy of a peanut SLIT-tablet in adults, adolescents, and children with peanut allergy.

Read the detailed description

This is a phase I/II, dose-escalation, multi-site trial including subjects with peanut allergy confirmed by screening double-blind, placebo-controlled food challenge. The trial is conducted in 3 parts; part 1 will determine the entry dose of the up-dosing regimen (UDR) in adults and adolescents; part 2 will characterize the tolerability of the up-dosing regimen in adults, adolescents and children; part 3 will evaluate the efficacy of 2 maintenance doses of the SLIT-tablet primarily in adolescents and children; a small number of adults may also be included.

Peanut SLIT tablets administered as 9 doses covering a 4000-fold increase in dose will be used in the study.

In part 1, subjects will receive a peanut SLIT-tablet with one of five doses once daily for 2 weeks.

In part 2, subjects will receive a series of increasing doses of the peanut SLIT-tablet, where each dose is taken once daily for 2 weeks. The entry dose for the up-dosing regimen will be determined from part 1.

In part 3, subjects will be randomized into 3 treatment groups (UDR and Maintenance A, UDR and Maintenance B, Placebo UDR and Placebo). Subjects will receive a series of increasing doses of the peanut SLIT-tablet , where each dose is taken once daily for 2 weeks, followed by Maintenance A or B once daily for 24 weeks; or the corresponding Placebo.

The trial will consist of up to 10 cohorts (part 1 is cohort 1-5; part 2 is cohort 6-10) and 3 treatment groups in part 3.

02

Conditions studied

  • Peanut Allergy

Keywords

  • Peanut allergy
  • Children
  • Adolescent
  • Adult
03

Who can participate

Ages eligible
4 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

KEY INCLUSION CRITERIA:

Subjects are eligible to be included in the trial only if all the following criteria apply:

  • Part 1: Male or female aged 12 through 65 years (inclusive) on the day of enrollment Part 2: Male or female aged 4 through 65 years (inclusive) on the day of enrollment Part 3: Male or female aged 4 through 65 years (inclusive) on the day of randomization
  • Documented clinical history of an IgE-mediated allergic reaction towards peanut- containing food
  • Peanut-specific serum IgE ≥ 0.7 kU/L at screening measured at central laboratory
  • Skin prick test to peanut ≥ 5 mm at screening
  • Cohorts 1-8: Experience dose-limiting symptoms at the 10 mg, 30 mg or 100 mg challenge dose of peanut protein on screening DBPCFC Cohorts 9-10: Experience dose-limiting symptoms at the 1 mg or 3 mg challenge dose of peanut protein on the screening DBPCFC Part 3: Experience dose-limiting symptoms at the 3 mg, 10 mg, 30 mg or 100 mg challenge dose of peanut protein on screening DBPCFC

KEY EXCLUSION CRITERIA:

Subjects are excluded from the trial if any of the following criteria apply:

  • Diagnosis or history of eosinophilic esophagitis
  • Uncontrolled asthma as defined by the Asthma Control Test questionnaire with a score of 19 or below at enrollment (subjects with a diagnosis of asthma only)
  • All subjects ≥ 5 years old with FEV1 or PEFR \< 70% of predicted value at enrollment Subjects 4 years old with a history of recurrent wheeze requiring inhaled corticosteroids for 2 consecutive weeks or more within 3 months prior to enrollment
  • Up-dosing with any allergy immunotherapy product. Maintenance dose of any subcutaneous immunotherapy product other than peanut is allowed
  • History of peanut oral immunotherapy within the last 12 months prior to visit 1
  • Chronic or acute oral inflammation at enrollment
  • History of cardiovascular disease, including uncontrolled or inadequately controlled hypertension
  • Currently using any prohibited medication on the list of prohibited medication
  • Part 1 and 2: Allergic symptoms in reaction to the placebo part of the screening DBPCFC Part 3: Dose-limiting allergic symptoms in reaction to the placebo part of the screening DBPCFC
  • History of severe or life-threatening episode of anaphylaxis or anaphylactic shock within 60 days of the screening DBPCFC
  • Part 1 and 2: Asthma according to below criteria:

    • Severe asthma as per the current GINA guidelines
    • Uncontrolled or poorly controlled asthma as per the current GINA guidelines
    • Asthma that requires more than a daily dose above 800 µg of inhaled budesonide (or clinically comparable inhaled corticosteroids)
    • History of 2 or more systemic corticosteroid courses within 6 months of screening
    • Prior intubation/mechanical ventilation for asthma
    • Emergency room visit or hospitalization for asthma in the 12 months prior to screening
    • Any history of a life-threatening asthma attack
  • Part 3: Asthma fulfilling the below criteria:

    • History of 2 or more systemic corticosteroid courses within 6 months of screening
    • Prior intubation/mechanical ventilation for asthma
    • Emergency room visit or hospitalization for asthma in the 12 months prior to screening
    • Any history of a life-threatening asthma attack
    • (US only) Severe asthma as per the current GINA guidelines
    • (US only) Uncontrolled or poorly controlled asthma as per the current GINA guidelines
    • (US only) Asthma that requires more than a daily maintenance dose above 800 μg of inhaled budesonide (or clinically comparable inhaled corticosteroids)
04

Study design

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

Study arms

  • Experimental
    Part 1: Cohort 1

    Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 1: Cohort 2

    Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 1: Cohort 3

    Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 1: Cohort 4

    Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 1: Cohort 5

    Adults and adolescents - peanut SLIT-tablet once daily for 2 weeks

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 2: Cohort 6

    Adults - UDR with once daily peanut SLIT-tablet

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 2: Cohort 7

    Adolescents - UDR with once daily peanut SLIT-tablet

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 2: Cohort 8

    Children - UDR with once daily peanut SLIT-tablet

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 2: Cohort 9

    Highly sensitized Adults/Adolescents - UDR with once daily peanut SLIT-tablet

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 2: Cohort 10

    Highly sensitized Children - UDR with once daily peanut SLIT-tablet

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 3: Maintenance A

    UDR A + maintenance dose A

    Biological: Peanut SLIT-tablet

  • Experimental
    Part 3: Maintenance B

    UDR B + maintenance dose B

    Biological: Peanut SLIT-tablet

  • Placebo comparator
    Part 3: Placebo

    Placebo UDR + placebo maintenance

    Other: Placebo

Interventions

  • BiologicalPeanut SLIT-tablet

    Peanut extract

  • OtherPlacebo

    Placebo

05

What researchers measure

Primary outcomes

  1. Part 1 and 2: Dose tolerability response rate

    The dose tolerability response rate is defined as the percentage of subjects who experience at most moderate local application site reactions after the last peanut SLIT-tablet intake of the dose step. Local application site reactions are treatment-related adverse events occurring in close proximity to the application site of the SLIT-tablet with a temporal relationship to tablet administration.

    Time frame: 2 weeks per dose

  2. Part 3: TD-600 response rate

    The TD (tolerated dose)-600 response rate is defined as the percentage of subjects able to consume 600 mg (1044 mg cumulative) peanut protein without dose-limiting symptoms at the exit double-blind placebo-controlled food challenge (DBPCFC) after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.

    Time frame: After 24 weeks of maintenance treatment, up to 48 weeks.

Secondary outcomes

  1. Part 1, 2 and 3: Treatment-emergent adverse events

    An adverse event is any untoward medical occurrence in a clinical trial subject and which does not necessarily have a causal relationship with the administered investigational medicinal product (IMP). A treatment-emergent adverse event has a start date on or after the time of first IMP intake and no later than 7 days after the last IMP intake.

    Time frame: Part 1 and 2: 2 weeks per dose; Part 3: from first IMP intake to 7 days after last IMP intake, up to 48 weeks.

  2. Part 3: TD-300 response rate

    The TD-300 response rate is defined as the percentage of subjects able to consume 300 mg (444 mg cumulative) peanut protein without dose-limiting symptoms at the exit DBPCFC after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.

    Time frame: After 24 weeks of maintenance treatment, up to 48 weeks.

  3. Part 3: TD-1000 response rate

    The TD-1000 response rate is defined as the percentage of subjects able to consume 1000 mg (2044 mg cumulative) peanut protein without dose-limiting symptoms at the exit DBPCFC after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.

    Time frame: After 24 weeks of maintenance treatment, up to 48 weeks.

  4. Part 3: TD-2000 response rate

    The TD-2000 response rate is defined as the percentage of subjects able to consume 2000 mg (4044 mg cumulative) peanut protein without dose-limiting symptoms at the exit DBPCFC after 24 weeks of maintenance treatment. Subjects that do not complete the exit DBPCFC are classified as non-responders.

    Time frame: After 24 weeks of maintenance treatment, up to 48 weeks.

  5. Part 3: Maximum tolerated dose of peanut protein during DBPCFC

    The highest single challenge dose of peanut protein that a subject can consume without experiencing dose-limiting symptoms during the DBPCFC.

    Time frame: At screening, 1 - 3 weeks, and after 24 weeks of maintenance treatment, up to 48 weeks.

  6. Part 3: Maximum severity of symptoms at each challenge dose of peanut protein during DBPCFC

    The highest severity of any symptom experienced at any challenge dose during the DBPCFC. Possible values are 0=none, 1=mild, 2=moderate or 3=severe.

    Time frame: At screening, 1 - 3 weeks, and after 24 weeks of maintenance treatment, up to 48 weeks.

  7. Part 3: Response rate - use of epinephrine as rescue medication during exit DBPCFC

    The response rate is defined as the percentage of subjects that receive epinephrine as rescue medication during the exit DBPCFC.

    Time frame: After 24 weeks of maintenance treatment, up to 48 weeks.

06

Study locations

42 sites
  • Arkansas Children's Hospital
    Little Rock, Arkansas 72202, United States
  • Children's Hospital of Los Angeles - USC School of Medicine
    Los Angeles, California 90027, United States
  • UCLA - Pediatrics
    Los Angeles, California 90095, United States
  • Stanford University - Lucile Packard Children's Hospital
    Palo Alto, California 94304, United States
  • Peninsula Research Associates (PRA)
    Rolling Hills Estates, California 90274, United States
  • Eastern Virginia Medical School - Children's Hospital
    San Diego, California 92123, United States
  • Allergy & Asthma Clinical Research
    Walnut Creek, California 94598, United States
  • Children's Hospital Colorado
    Aurora, Colorado 80045, United States
  • Quality Research of South Florida
    Hialeah, Florida 33016, United States
  • MOORE-PH Dermatology - Clinical Research
    Tampa, Florida 33609, United States
  • USF Asthma Allergy and Immunology Clinical Research Unit
    Tampa, Florida 33609, United States
  • Center for Advance Pediatrics
    Atlanta, Georgia 30329, United States
  • Ann Robert H. Lurie Childrens Hospital of Chicago
    Chicago, Illinois 60611-2605, United States
  • Rush University
    Chicago, Illinois 60612, United States
  • Sneeze, Wheeze, & Itch Associates, LLC
    Normal, Illinois 61761, United States
  • Family Allergy Asthma Research Institute
    Louisville, Kentucky 40215-1176, United States
  • Velocity Clinical Research - Lafayette
    Lafayette, Louisiana 70508, United States
  • Johns Hopkins University School of Medicine
    Baltimore, Maryland 21287-0005, United States
  • Asthma, Allergy and Sinus Center
    White Marsh, Maryland 21162, United States
  • Boston Food Allergy Center
    Boston, Massachusetts 02111, United States
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
  • University of Michigan
    Ann Arbor, Michigan 48109, United States
  • Allergy Partners of NJ
    Ocean City, New Jersey 07712, United States
  • Northwell Health
    Great Neck, New York 11021, United States
  • NYU Langone Health - Fink Children's Ambulatory Care Center
    New York, New York 10016, United States
  • Icahn School of Medicine at Mt. Sinai, Pediatric Allergy, Kravis Children Hospital
    New York, New York 10029, United States
  • University of North Carolina
    Chapel Hill, North Carolina 27599, United States
  • Aventiv research, Inc
    Columbus, Ohio 43212, United States
  • Children's Hospital of Philadephia
    Philadelphia, Pennsylvania 19104, United States
  • Children's Hospital of Pittsburg of UPMC - Immunology and Rheumatology
    Pittsburgh, Pennsylvania 15224, United States
  • The University of Texas Southwestern Medical Center
    Dallas, Texas 75390, United States
  • Western Sky Medical Research
    El Paso, Texas 79903, United States
  • Baylor College of Medicine (BCM) Texas Children's Hospital Pediatrics and Immunology
    Houston, Texas 77030, United States
  • BC Children's Hospital
    Vancouver, British Colombia V5H 3V4, Canada
  • The Children's Hospital Foundation of Manitoba
    Winnipeg, Manitoba R3A 1M3, Canada
  • Halton Pediatric Allergy
    Burlington, Ontario L7L 6W6, Canada
  • Hamilton Allergy
    Hamilton, Ontario, Canada
  • Ottawa Allergy Research Corporation
    Ottawa, Ontario K1H 1E4, Canada
  • The Hospital for Sick Children, Toronto
    Toronto, Ontario M5G 1E8, Canada
  • McGill University Health Centre (MUHC) - Research Institute (RI-MUHC)
    Montreal, Quebec H3H 2R9, Canada
  • CHU-Saint-Justine
    Montreal, Quebec H3T 1C5, Canada
  • Clinique Specialisee en Allergie de la Capitale
    Québec, G1V 4W2, Canada
07

Registry details

Key details

Study ID
NCT05440643
Lead sponsor
ALK-Abelló A/S
Collaborators
Parexel
Responsible party
Sponsor
First posted
Jul 1, 2022
Start date
Sep 7, 2022
Primary completion
Mar 10, 2026
Completion
Apr 5, 2026
Last update
May 11, 2026

Study contacts

Edwin Kim, MD
principal investigator · University of North Carolina

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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