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Trial registered on ANZCTR
Registration number
ACTRN12619000897167
Ethics application status
Approved
Date submitted
2/06/2019
Date registered
26/06/2019
Date last updated
17/02/2022
Date data sharing statement initially provided
26/06/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Is early introduction of tree nuts in infants at high risk of food allergy feasible? The TreEAT Pilot Study: a randomised controlled trial
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Scientific title
Is early introduction of tree nuts in infants at high risk of food allergy feasible? The TreEAT Pilot Study: a randomised controlled trial
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Secondary ID [1]
298392
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Nil known
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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:
food allergy
313082
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Condition category
Condition code
Inflammatory and Immune System
311569
311569
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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
Multiple tree nut (cashew, almond, walnut, hazelnut) in hospital oral food challenge. Prepared by specialised allergy dietitian and administered by an allergy trained nurse and supervised by an allergist. Total dose is 20g delivered in a carrier food of the participants choice (ie fruit puree, yogurt, custard, bread, crackers) over 6 doses in a 4 hour period:
Smear, 1/8 teaspoon, ¼ teaspoon, ½ teaspoon, 1 teaspoon, approx. 2 teaspoons (remainder of dose). Total challenge dose of 20g of nut protein (approx 4 teaspoons)
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Intervention code [1]
314635
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Prevention
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Comparator / control treatment
Current standard care (individual tree nut introduction via unsupervised home introduction protocol) Allergy Department Royal Children's Hospital Melbourne Home Introduction of Food Protocol, 2019. This involves introduction of each individual tree nut in a ground or meal form in a slow graded introduction process over several days. Families will have this information provided in a written format and have the process explained by the Allergy Dietitian.
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Control group
Active
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Outcomes
Primary outcome [1]
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Tree nut allergy/tolerance measured via clinical history and examination.
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Assessment method [1]
320275
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Timepoint [1]
320275
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18mths of age
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Secondary outcome [1]
371046
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Number of adverse food reactions measured via clinical history and examination.
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Assessment method [1]
371046
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Timepoint [1]
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18mths of age
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Secondary outcome [2]
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Severity of symptoms of adverse food reactions measured via clinical history and examination
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Assessment method [2]
371047
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Timepoint [2]
371047
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18mths of age
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Secondary outcome [3]
371048
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Medical treatment required for adverse food reactions measured via clinical history and examination.
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Assessment method [3]
371048
0
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Timepoint [3]
371048
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18mths of age
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Secondary outcome [4]
371049
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Compliance to home tree nut introduction measured via questionnaire (designed specifically for this study).
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Assessment method [4]
371049
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Timepoint [4]
371049
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18mths of age
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Secondary outcome [5]
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Quality of life (FASQL)
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Assessment method [5]
371050
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Timepoint [5]
371050
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Baseline and 18mths of age
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Secondary outcome [6]
371051
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Skin prick test wheal size to egg
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Assessment method [6]
371051
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Timepoint [6]
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Baseline and 18mths of age
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Secondary outcome [7]
371052
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Tree nut (cashew, hazelnut, almond, walnut) via specific IgE serum assay.
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Assessment method [7]
371052
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Timepoint [7]
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Baseline and 18mths of age
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Secondary outcome [8]
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Frequency of ongoing tree nut ingestion during the study measured via questionnaire (specifically designed for this study)
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Assessment method [8]
371536
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Timepoint [8]
371536
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18 mths of age
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Secondary outcome [9]
371539
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Skin prick test wheal size (mm) to peanut
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Assessment method [9]
371539
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Timepoint [9]
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At 18mths of age
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Secondary outcome [10]
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Tree nut (cashew, almond, walnut, hazelnut) component resolved diagnostics
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Assessment method [10]
371540
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Timepoint [10]
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At 18mths of age
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Secondary outcome [11]
371541
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Tree nut (almond, cashew, walnut and hazelnut) basophil activation test result.
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Assessment method [11]
371541
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Timepoint [11]
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At 18mths of age
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Secondary outcome [12]
372003
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To measure acceptability of the home tree nut introduction protocol via parent completed questionnaire (designed specifically for this study)
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Assessment method [12]
372003
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Timepoint [12]
372003
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At 18 months of age
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Secondary outcome [13]
372004
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To measure acceptability of the supervised multi-nut oral food challenge via parent completed questionnaire (designed specifically for this study)
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Assessment method [13]
372004
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Timepoint [13]
372004
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At 18 months of age.
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Eligibility
Key inclusion criteria
- Infants >4mths and less than 11mths of age currently referred to the Royal Children's Hospital Allergy Department.
- History of likely IgE-mediated egg and/or peanut reaction as determined by RCH allergist with positive skin prick test to egg and/or peanut (>=3mm)
- Has a legally acceptable representative capable of understanding the informed consent document and providing consent on the participants behalf
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Minimum age
4
Months
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Maximum age
11
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
- any history of food induced anaphylaxis
- pre existing tree nut allergy
- any tree nut already tolerated (ingestion on >3 occasions without reaction)
- unable to eat solid food
- inability or unwillingness of participant or legally acceptable representative to give written informed consent.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2019
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Actual
3/03/2020
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Date of last participant enrolment
Anticipated
20/12/2019
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Actual
31/05/2021
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Date of last data collection
Anticipated
1/06/2021
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Actual
2/02/2022
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Sample size
Target
20
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
13885
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The Royal Childrens Hospital - Parkville
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Recruitment postcode(s) [1]
26657
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
302932
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Other
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Name [1]
302932
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Murdoch Children's Research Institute
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Address [1]
302932
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Flemington Rd
PARKVILLE, VIC 3052
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Country [1]
302932
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Australia
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Primary sponsor type
Other
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Name
Murdoch Childrens Research Institute
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Address
Flemington Rd
Parkville, VIC 3052
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Kirsten Perrett
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Address [1]
302893
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Population Allergy
Murdoch Children's Research Institute
Flemington Rd PARKVILLE, VIC 3052
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Country [1]
302893
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Australia
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Secondary sponsor category [2]
312051
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Charities/Societies/Foundations
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Name [2]
312051
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Australian Food Allergy foundation
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Address [2]
312051
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L2 363 Little Collins St
Melbourne VIC 3000
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Country [2]
312051
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303496
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Royal Children’s Hospital Human Research Ethics Committee
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Ethics committee address [1]
303496
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Flemington Rd PARKVILLE, VIC 3052
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Ethics committee country [1]
303496
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Australia
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Date submitted for ethics approval [1]
303496
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31/01/2019
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Approval date [1]
303496
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25/06/2019
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Ethics approval number [1]
303496
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38348
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Summary
Brief summary
Early and regular ingestion of the common allergens, peanut and egg has been shown to be an effective allergy prevention strategy. Little is known about tree nut allergy. Current allergy testing methods are indicative of IgE sensitisation only and are not diagnostic of food allergy. Current practice at RCH allergy clinic in children who are egg and/or peanut allergic is to advise families to introduce each individual tree nut into their child’s diet via a cautious home introduction protocol without prior allergy testing (screening). The safety and effectiveness of this strategy has not been formally evaluated. This pilot study is a 2-armed, open-label, randomised, controlled trial (RCT) to assess the safety and feasibility of a supervised hospital based multi-tree nut oral food challenge (OFC) versus standard care (home introduction of individual tree nuts) in infants with egg and/or peanut allergy to reduce the risk of developing tree nut allergy.
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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
93862
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Dr Kirsten Perrett
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Address
93862
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Population Allergy Group
Murdoch Childrens Research Institute
Flemington Rd
PARKVILLE, VIC 3052
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Country
93862
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Australia
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Phone
93862
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+61 399366278
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Fax
93862
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Email
93862
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[email protected]
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Contact person for public queries
Name
93863
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Kirsten Perrett
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Address
93863
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Population Allergy Group
Murdoch Childrens Research Institute
Flemington Rd
PARKVILLE VIC 3052
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Country
93863
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Australia
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Phone
93863
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+61 399366278
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Fax
93863
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Email
93863
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[email protected]
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Contact person for scientific queries
Name
93864
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Kirsten Perrett
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Address
93864
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Population Allergy Group
Murdoch Childrens Research Institute
Flemington Rd
PARKVILLE VIC 3052
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Country
93864
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Australia
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Phone
93864
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+61 399366278
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Fax
93864
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Email
93864
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF