Efficacy and Safety of Several Doses of Viaskin Peanut in Adults and Children With Peanut Allergy

Peanut allergy is a common allergy in the United States, with a prevalence in the general
population as high as 1%. So far, there is no approved treatment of peanut allergy. Peanut
allergy management is based on strict peanut avoidance and injectable epinephrine after the
allergic systemic reactions have started. Specific Immunotherapy methods currently available
have shown some limitations in their use because of safety issues. Hence, there is an
important unmet medical need for efficient and safe treatment of peanut allergy.

DBV Technologies has developed an epicutaneous delivery system, called Viaskin, a method
based on delivering precise quantity of the allergen on the upper layers of the skin.
Avoiding contact between the allergen and the bloodstream should confer to epicutaneous
immunotherapy (EPIT) a higher level of safety as systemic reactions should be circumvented

The VIPES study is a 12-month double-blind, placebo-controlled,randomized trial to study the
efficacy and safety of Viaskin Peanut in subjects from 6 to 55 years old with a history of
immediate hypersensitive reaction to peanut protein.

The trial will be conducted at sites with investigators and staff trained and experienced in
the diagnosis and the management of peanut allergy and anaphylaxis, and who are capable of
performing a double-blind placebo-controlled food challenge (DBPCFC) in adult and/or
pediatric subjects. Three doses of peanut proteins, i.e. 50 mcg, 100 mcg and 250 mcg will be
evaluated for the study. Following the confirmation of peanut allergy at screening, subjects
will be randomized in a 1:1:1:1 ratio into four different treatment groups, including 50
mcg, 100 mcg and 250 mcg peanut protein or placebo. Treatment will be comprised of daily
applications of Viaskin Peanut or placebo patch for 12 months. Each subject will undergo two
DBPCFCs: one at screening and one at Month 12. A follow up visit will be performed 2 weeks
after completion of treatment and the last DBPCFC.

Inclusion Criteria:

- Peanut-allergic subjects between 6 and 55 years of age, with a well-documented
medical history of systemic reactions after ingestion of peanut and currently
following a strict peanut-free diet.

- Peanut-specific immunoglobulin E (IgE) level (Phadia CAP-system) > 0.7 kU/L and a
positive skin prick test to peanut with a largest wheal diameter ≥ 8 mm

- Positive double-blind placebo-controlled food challenge (DBPCFC) at ≤ 300 mg of
peanut proteins: the eliciting dose of peanut proteins during the DBPCFC is capped at
300 mg, i.e. subjects must react to peanut before reaching or at the dose of 300 mg
peanut proteins.

- Negative pregnancy test for women of childbearing potential. Females of childbearing
age must use effective methods of contraception to prevent pregnancy and agree to
continue to practice an acceptable method of contraception for the duration of
participation in the study. Sexual abstinence will be accepted as an effective method
of contraception for girls below 15 years of age.

- Ability to perform spirometry maneuvers in accordance with the American Thoracic
Society guidelines (2005) for subjects 9 years of age and above Subjects below 9
years of age can perform peak expiratory flow (PEF) instead.

- Willing to comply with all study requirements during their participation in the
study.

- Provide signed informed consent and assent as appropriate.

Exclusion Criteria:

- Subjects with a history of severe anaphylaxis to peanut with the following symptoms:
hypotension, hypoxia, neurological compromise (collapse, loss of consciousness or
incontinence).

- Pregnancy or lactation.

- FEV1 <80% of the predicted value at screening for subjects 9 years of age and above.
PEF < 80% of predicted for subjects below 9 years of age.

- Subjects who did not react at or below the dose of 300 mg of peanut proteins during
the DBPCFC at screening.

- Known allergy or known hypersensitivity to placebo excipients either of the Viaskin
patches or of the food challenge formulas.

- Subjects reacting objectively to the placebo formula at screening.

- Severe reaction during the screening food challenge, defined as need for intubation,
hypotension persisting after epinephrine administration, or the need for more than
two doses of epinephrine.

- Inability to discontinue short-acting antihistamines for three days or long-acting
antihistamines for five to seven days (depending on half-life) prior to skin prick
testing or food challenges.

- Subjects treated with systemic long-acting corticosteroids (depot corticosteroids)
within 12 weeks prior to the screening visit and/or systemic short-acting
corticosteroid within 4 weeks prior to the screening visit or any systemic
corticosteroid at screening.

- Subjects with asthma defined as follows:

1. uncontrolled persistent asthma by National Asthma Education and Prevention
Program Asthma guidelines (2007) or by Global Initiative for Asthma (2011) or
being treated with combination therapy of medium dose inhaled corticosteroid
with a long acting inhaled β2-agonists;

2. at least two systemic corticosteroid courses for asthma in the past year or one
oral corticosteroid course for asthma in the past three months;

3. prior intubation for asthma in the past two years.

- Subjects on β-blocking agents, angiotensin-converting enzyme inhibitors,
angiotensin-receptor blockers, calcium channel blockers or tricyclic antidepressant
therapy.

- Subjects undergoing any type of immunotherapy to any food within one year prior to
the screening visit.

- Subjects presently on aeroallergen immunotherapy and unwilling or unable to
discontinue.

- Subjects currently treated with anti-tumor necrosis factor drugs or anti-IgE drugs
(such as omalizumab) or any biologic immunomodulatory therapy within one year prior
to the screening visit.

- Allergy or known history of reaction to Tegaderm®.

- Subjects suffering from generalized dermatologic diseases (e.g. severe atopic
dermatitis, uncontrolled generalized eczema, keratosis pilaris, ichthyosis vulgaris)
with no intact skin zones to apply the patches.

- Any disorder in which epinephrine is contraindicated such as coronary artery disease,
uncontrolled hypertension, or serious ventricular arrhythmias.

- Participation in another clinical intervention study in the three months prior to the
screening visit.

- Subjects on any experimental drugs or treatments.

Other inclusion/exclusion criteria may apply.