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Trial registered on ANZCTR
Registration number
ACTRN12615001155583
Ethics application status
Approved
Date submitted
6/08/2015
Date registered
29/10/2015
Date last updated
20/10/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Comparison of baked milk to placebo in IgE mediated cow's milk allergic children in tolerance induction
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Scientific title
Comparison of baked milk to placebo in IgE mediated cow's milk allergic children in tolerance induction
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Secondary ID [1]
287220
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Cow's milk allergy
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Condition category
Condition code
Diet and Nutrition
296080
296080
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0
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Other diet and nutrition disorders
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Inflammatory and Immune System
296081
296081
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0
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Allergies
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A mixture of milk powder containing 1.3 g cow's milk and wheat flour is baked in the oven for 30 min at 180 degrees Celsius. Each 60 g bread contains milk powder equal to 1.3 g cow's milk. Breads prepared for placebo include exactly the same ingredients except milk powder.
The placebo and cow's milk containing breads are supplied by the same manufacturer.
Patients' adherence is monitored by weekly phone calls and also by charts documenting daily consumpted bread amount, side effects and accidental dairy product consumption.
1. Active group: Receiving bread that contains 1.3 g baked milk, at least 60 g a day, for 12 months
2. Placebo group: Receiving bread with no milk, at least 60 g a day, for 12 months
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Intervention code [1]
292507
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Treatment: Other
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Comparator / control treatment
Control group: Receiving baked bread with no milk as placebo
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Tolerance, measured by double blind placebo controlled food challenge with raw cow's milk
Tolerance, measured by ability of raw cow's milk consumption without any adverse effects
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Assessment method [1]
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Timepoint [1]
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baseline, 6 and 12 months
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Secondary outcome [1]
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To evaluate tolerance induction by comparing following parameters at baseline, at 6 and 12 months of the study;
-skin prick test reactivity with raw cow's milk including different dilutions as 1/1, 1/100, 1/1000
-regulatory T cell proliferation response to raw cow's milk
-basophil activation test (CD63 expression) reactivity to raw cow's milk
-milk, casein, beta lactoglobulin specific IgA/IgG4/IgE levels
All those parameters will be assessed at baseline, 6 and 12 months of the study for all patients
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Assessment method [1]
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Timepoint [1]
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baseline, 6 and 12 months
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Eligibility
Key inclusion criteria
IgE mediated cow's milk allergic patients, with a positive skin prick test (SPT) or detectable serum milk-specific IgE and an allergic reaction within six months before study entry, or milkspecific IgE levels or SPT highly predictive for clinical reactivity (if <2 years old, a level>5kUA/L; if>2years old, a level>15kUA/L; SPT wheal diameter >8 mm).
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Minimum age
6
Months
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Maximum age
36
Months
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Negative SPT and undetectable milk-specific
IgE; unstable asthma, allergic rhinitis, or atopic dermatitis;milk-induced eosinophilic
gastroenteropathy; a recent reaction to a heated milk-product.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Double blind placebo controlled food challenge (DBPCFC) with 1.3 g baked milk powder containing bread will be performed at the baseline for all participants.
Patients with no reactions will be included to the study, randomly as active or placebo group (central randomisation by computer). Daily consumption of baked milk will be provided during 12 months of period. The patients consuming bread with baked milk or with no milk will be assessed 6 and 12 months later with DBPCFC raw cow’s milk.
Patients continuing milk free diet will be assessed 6 and 12 months later with bread containing 1.3 g baked milk.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
2/03/2015
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Turkey
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State/province [1]
7080
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Marmara University Scientific Research Projects Office
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Address [1]
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Marmara Universitesi Rektorlugu
Goztepe Yerleskesi
Fahrettin Kerem Gokay Street, No: 53, Postal code: 34722
Kadikoy/Istanbul/Turkey
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Country [1]
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Turkey
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Primary sponsor type
Individual
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Name
Ayca Kiykim
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Address
Marmara Medical Faculty, Fevzi Cakmak Mahallesi, Mimar Sinan Caddesi, NO:41, Pendik, 34899, Istanbul
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Country
Turkey
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
290453
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Country [1]
290453
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293309
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Marmara University Ethics Committee
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Ethics committee address [1]
293309
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Ethics committee country [1]
293309
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Turkey
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Date submitted for ethics approval [1]
293309
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Approval date [1]
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07/03/2014
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Ethics approval number [1]
293309
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Summary
Brief summary
Cow’s milk allergy is the important cause of food related anaphylaxis during childhood. It is classified under IgE related and non IgE food allergy. Although general aspect is strict avoidance of dairy product consumption, accidental reactions like anaphylaxis occur. Besides, strict avoidance of cow’s milk products in this age group of 6 months to 4 years compromise the physical development of those children. Some of them may tolerate processed dairy products. Baking is one of the methods for processing cow’s milk to break the 3-D construction and decrease the allergenicity. Previous studies report that 65-80 % of cow’s milk allergic children may tolerate baked milk. Patients who admitted to our outpatient clinic with allergic symptoms developing after cow’s milk consumption with IgE related mechanisms verified by either positive specific milk IgE or skin prick test, aged between 6 to 36 months will be included. Double blind placebo controlled (DBPC) baked milk challenge will be performed then patients who tolerate baked milk will be randomized. Active group will consume baked milk while the placebo group will consume milk free bread for 12 months, then DBPC milk challenge tests will be performed. Children unable to tolerate baked milk at the beginning remain free of cow’s milk during the study. Immunologic parameters will be noted in all stages and evaluated at the end of the study. Although partial tolerance (allergic reaction with higher allergen doses) develops during the process it will be our secondary income to decrease anaphylaxis risk.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Ayca Kiykim
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Address
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Marmara University Hospital Pediatric Allergy and Immunology Fevzi
Cakmak Mahallesi, Mimar Sinan Caddesi, No: 41, Postal code: 34899
Pendik/Istanbul
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Country
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Turkey
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Phone
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+905423432245
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Ismail Cinel
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Address
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Marmara University Hospital
Fevzi Cakmak Mahallesi, Mimar Sinan Caddesi, No: 41, Postal code: 34899
Pendik/Istanbul
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Country
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Turkey
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Phone
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+90 532 4129596
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Safa Baris
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Address
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Marmara University Hospital Pediatric Allergy and Immunology Fevzi
Cakmak Mahallesi, Mimar Sinan Caddesi, No: 41, Postal code: 34899
Pendik/Istanbul
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Country
59336
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Turkey
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Phone
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+905052614986
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
Type
Is Peer Reviewed?
DOI
Citations or Other Details
Attachment
Plain language summary
No
BACKGROUND AND OBJECTIVES: About 65-80% of childr...
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Study results article
Yes
Send to Int Arch Allergy Immunol. 2018 Nov 7:1-9....
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Documents added automatically
No additional documents have been identified.
Download to PDF