Trial Outcomes & Findings for Milk Patch for Eosinophilic Esophagitis (NCT NCT02579876)

NCT ID: NCT02579876

Last Updated: 2019-07-10

Results Overview

Esophageal biopsy samples will be obtained prior to randomization and after completion of treatment. Intraepithelial eosinophils will be counted in all high powered fields (HPFs) using light microscopy. A HPF will be counted only if at least half of the field is occupied by tissue. The maximum eosinophil count per HPF will be reported for each esophageal biopsy site (at each of 2 levels). The maximum eosinophil count for each patient will be calculated from either level. For the final outcome, mean from each individual patients maximum eosinophil count/hpf along with standard deviation will be calculated.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

20 participants

Primary outcome timeframe

From baseline to month 11 (end of double blind phase)

Results posted on

2019-07-10

Participant Flow

Participant milestones

Participant milestones
Measure
Viaskin Milk 500 mcg
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Overall Study
STARTED
15
5
Overall Study
COMPLETED
14
5
Overall Study
NOT COMPLETED
1
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Milk Patch for Eosinophilic Esophagitis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Viaskin Milk 500 mcg
n=15 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Total
n=20 Participants
Total of all reporting groups
Age, Categorical
<=18 years
15 Participants
n=99 Participants
5 Participants
n=107 Participants
20 Participants
n=206 Participants
Age, Categorical
Between 18 and 65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Age, Continuous
10.46 years
STANDARD_DEVIATION 2.99 • n=99 Participants
12.71 years
STANDARD_DEVIATION 2.03 • n=107 Participants
10.69 years
STANDARD_DEVIATION 3.64 • n=206 Participants
Sex: Female, Male
Female
5 Participants
n=99 Participants
0 Participants
n=107 Participants
5 Participants
n=206 Participants
Sex: Female, Male
Male
10 Participants
n=99 Participants
5 Participants
n=107 Participants
15 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
White
15 Participants
n=99 Participants
5 Participants
n=107 Participants
20 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
United States
15 participants
n=99 Participants
5 participants
n=107 Participants
20 participants
n=206 Participants
Eosinophils (Eos) per high power field (HPF) on Milk
72.4 Eos/hpf
STANDARD_DEVIATION 29.52 • n=99 Participants
60.93 Eos/hpf
STANDARD_DEVIATION 49.39 • n=107 Participants
64 Eos/hpf
STANDARD_DEVIATION 44.5 • n=206 Participants

PRIMARY outcome

Timeframe: From baseline to month 11 (end of double blind phase)

Esophageal biopsy samples will be obtained prior to randomization and after completion of treatment. Intraepithelial eosinophils will be counted in all high powered fields (HPFs) using light microscopy. A HPF will be counted only if at least half of the field is occupied by tissue. The maximum eosinophil count per HPF will be reported for each esophageal biopsy site (at each of 2 levels). The maximum eosinophil count for each patient will be calculated from either level. For the final outcome, mean from each individual patients maximum eosinophil count/hpf along with standard deviation will be calculated.

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=14 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Change in Maximum Esophageal Eosinophil Count From Baseline to End of Double-blind Treatment. (Intent to Treat Population)
-10.8 Eosinophils (Eos)/high power field (HPF)
Standard Deviation 37.73
-24.2 Eosinophils (Eos)/high power field (HPF)
Standard Deviation 63

PRIMARY outcome

Timeframe: Month 11(end of double blind phase)

Esophageal biopsy samples will be obtained prior to randomization and after completion of treatment. Intraepithelial eosinophils will be counted in all high powered fields (HPFs) using light microscopy. A HPF will be counted only if at least half of the field is occupied by tissue. The maximum eosinophil count per HPF will be reported for each esophageal biopsy site (at each of 2 levels). The maximum eosinophil count for each patient will be calculated from either level. For the final outcome, mean from each individual patients maximum eosinophil count/hpf along with standard deviation will be calculated.

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=7 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=2 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Change in Eosinophils/High Power Field at End of Double-blind (DB) (Per Protocol Patients)
-26.86 Eosinophils (Eos)/high power field
Standard Deviation 22.53
42.5 Eosinophils (Eos)/high power field
Standard Deviation 31.82

SECONDARY outcome

Timeframe: Total Symptom Score at End of DB Phase, Month 11

Symptoms of Eosinophilic Esophagitis range from abdominal pain, gastroesophageal reflux, vomiting, and difficult swallowing. Investigator assessment of the subject's symptoms was completed on a 4-point Likert scale for 3 separate symptoms (vomiting, abdominal pain and dysphagia). Investigator assessment of the subject's symptoms was completed on a 4-point Likert scale for 3 separate symptoms (vomiting, abdominal pain and dysphagia). (0-none, 1-mild, 2-moderate, 3-severe, ). Total score is reported with a range of 0 to 9. A lower score is better.

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=14 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Eosinophilic Esophagitis Symptom Score (Intent to Treat Population)
1.07 units on a scale
Standard Deviation 1.49
1.40 units on a scale
Standard Deviation 1.14

SECONDARY outcome

Timeframe: At end of DB phase, at 11 months

Upper endoscopies with biopsies (2 each of proximal and distal, plus any inflamed areas) will be completed before and after each treatment period. Each endoscopy will be scored using a validated standardized measure which examines 4 major esophageal features (rings, furrows, exudates and edema) and the presence of minor features of narrow caliber esophagus, feline esophagus, stricture and crepe paper esophagus. Each feature is graded: 0-none, 1 mild, 2-moderate, 3-severe. The scores are summed including both minor and major criteria. Total score is presented and lower score is better. The range is from 0-12

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=14 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Esophageal Endoscopy Score (ITT)
1.93 score on a scale
Standard Deviation 1.58
1.60 score on a scale
Standard Deviation 1.67

SECONDARY outcome

Timeframe: End of DB Phase, at 11 months

Maximum Eosinophils/HPF after milk reintroduction at the end of double bind phase

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=7 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=2 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Eosinophils Per HPF at End of Double Bind Protocol (Per Protocol) Patients
25.57 Eos/hpf
Standard Deviation 31.19
95 Eos/hpf
Standard Deviation 63.64

SECONDARY outcome

Timeframe: Month 11, end of Double Blind Phase

Measure of Pediatric Eosinophilic Esophagitis symptom Score (PEESS) at the end of DB phase for the Intent to Treat Population The PEESS® is a 20 question survey asking patient symptom intensity and frequency on a 5 point scale (0 to 4) for each question for the preceding month. Therefore, the total score can range from 0 to 80. The total score is reported and lower score is better

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=14 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Pediatric Eosinophilic Esophagitis Symptom Score (ITT)
11.15 units on a scale
Standard Deviation 11.07
13.2 units on a scale
Standard Deviation 7.33

SECONDARY outcome

Timeframe: Month 11 (end of double blind phase)

Upper endoscopies with biopsies (2 each of proximal and distal, plus any inflamed areas) will be completed before and after each treatment period. Each endoscopy will be scored using a validated standardized measure which examines 4 major esophageal features (rings, furrows, exudates and edema) and the presence of minor features of narrow caliber esophagus, feline esophagus, stricture and crepe paper esophagus. Each feature is graded: 0-none, 1 mild, 2-moderate, 3-severe. The scores including both major and minor criteria are summed. Total score is presented and lower score is better. The range is from 0-12

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=7 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=2 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Endoscopy Score (Per Protocol Patients)
1.43 score on a scale
Standard Deviation 1.51
3 score on a scale
Standard Deviation 1.41

SECONDARY outcome

Timeframe: Month 11, End of Double Blind Placebo Control

Pediatric Eosinophilic Esophagitis Symptom Score at end of DB phase using the validated Pediatric Eosinophilic Esophagitis Symptom Score (PEESS).The PEESS® is a 20 question survey asking patient symptom intensity and frequency on a 5 point scale (0 to 4) for each question for the preceding month. Therefore, the total score can range from 0 to 80. The total score is reported and lower score is better.

Outcome measures

Outcome measures
Measure
Viaskin Milk 500 mcg
n=7 Participants
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=2 Participants
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Pediatric Eosinophil Esophagitis Symptom Score (PP Population)
12.2 score on a scale
Standard Deviation 8.57
17 score on a scale
Standard Deviation 1.41

Adverse Events

Viaskin Milk 500 mcg

Serious events: 0 serious events
Other events: 15 other events
Deaths: 0 deaths

Viaskin Placebo

Serious events: 1 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Viaskin Milk 500 mcg
n=15 participants at risk
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 participants at risk
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Respiratory, thoracic and mediastinal disorders
Vocal Cord Dysfunction
0.00%
0/15 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
20.0%
1/5 • Number of events 1 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported

Other adverse events

Other adverse events
Measure
Viaskin Milk 500 mcg
n=15 participants at risk
Viaskin patch containing milk protein. The patch is applied to the skin Viaskin Milk 500 mcg: Biological: Viaskin Milk 500 mcg Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing 500 mcg cow's milk proteins.
Viaskin Placebo
n=5 participants at risk
Viaksin patch without any milk protein. Viaskin Placebo: Biological: Viaskin Placebo Subjects epicutaneously administered daily (up to 24 hours application per day) with a patch containing a matching placebo formulation.
Gastrointestinal disorders
General GI Symptoms
66.7%
10/15 • Number of events 10 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
40.0%
2/5 • Number of events 2 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
Respiratory, thoracic and mediastinal disorders
Upper Respiratory Infections
46.7%
7/15 • Number of events 7 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
100.0%
5/5 • Number of events 5 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
General disorders
Administration Site Conditions
80.0%
12/15 • Number of events 12 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
100.0%
5/5 • Number of events 5 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
Ear and labyrinth disorders
Ear infections
6.7%
1/15 • Number of events 1 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
0.00%
0/5 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
Musculoskeletal and connective tissue disorders
Muscloskeletal
13.3%
2/15 • Number of events 2 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
20.0%
1/5 • Number of events 1 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
Skin and subcutaneous tissue disorders
Skin
6.7%
1/15 • Number of events 1 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
0.00%
0/5 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
Infections and infestations
Infections
53.3%
8/15 • Number of events 8 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported
60.0%
3/5 • Number of events 3 • The length of time is 1 year from the start of the study to end of double blind phase
All adverse events (AEs) were collected from the start of the study. . All Treatment emergent AEs are reported

Additional Information

Jonathan Spergel

The Children's Hospital of Philadelphia

Phone: 215 590 1000

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place