← Product Code [MST](/submissions/IM/subpart-f%E2%80%94immunological-test-systems/MST) · K113377

# GLIADIN IGA AND GLIADIN LGA (K113377)

_Grifols USA, LLC · MST · Dec 14, 2012 · Immunology · SESE_

**Canonical URL:** https://fda.innolitics.com/submissions/IM/subpart-f%E2%80%94immunological-test-systems/MST/K113377

## Device Facts

- **Applicant:** Grifols USA, LLC
- **Product Code:** [MST](/submissions/IM/subpart-f%E2%80%94immunological-test-systems/MST.md)
- **Decision Date:** Dec 14, 2012
- **Decision:** SESE
- **Submission Type:** Traditional
- **Regulation:** 21 CFR 866.5750
- **Device Class:** Class 2
- **Review Panel:** Immunology

## Intended Use

The a-Gliatest® IgA is intended for the semi-quantitative determination of IgA antibodies directed against gliadin in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings. The a-Gliatest® IgG is intended for the semi-quantitative determination of IgG antibodies directed against gliadin in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings. The a-GliaPep® IgA is intended for the semi-quantitative determination of IgA antibodies directed against deamidated gliadin peptide in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings. The a-GliaPep® IgG is intended for the semi-quantitative determination of IgG antibodies directed against deamidated gliadin peptide in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

## Device Story

The devices are ELISA-based in vitro diagnostic test kits for the semi-quantitative detection of IgA or IgG antibodies against gliadin or deamidated gliadin peptide in human serum. Each kit includes a microtiter plate coated with the respective antigen, assay controls, calibrators, HRP-conjugated anti-human IgA or IgG, TMB substrate, and wash/stop solutions. The assay is performed in a clinical laboratory setting by trained personnel. The provider adds patient serum to the wells; antibodies bind to the immobilized antigen; HRP-conjugate is added, followed by TMB substrate to produce a colorimetric signal proportional to the antibody concentration. The optical density is measured at 450 nm. Results are compared against a calibration curve to determine antibody levels. The output aids clinicians in diagnosing celiac disease when used alongside other serological tests and clinical findings, potentially facilitating earlier diagnosis and management of the condition.

## Clinical Evidence

Clinical performance was evaluated using 241-285 clinical samples per assay, including biopsy-confirmed celiac patients and disease controls (autoimmune, IBD, IBS, Type 1 diabetes). Sensitivity ranged from 79.6% to 90.5% and specificity from 75.7% to 93.2% across the four assays. Method comparison studies against the predicate (n=178-201) showed overall agreement between 85.4% and 86.5%. Analytical performance included precision (CV% <17.3%), linearity (R2 >0.99), and LoD (1.1-2.4 AU/mL).

## Technological Characteristics

ELISA-based solid-phase immunoassay. Components: microtiter plates coated with purified α-gliadin or deamidated gliadin peptide, HRP-conjugated goat anti-human IgA/IgG, TMB substrate. Detection: colorimetric at 450 nm. Storage: 2-8°C. Sample volume: 100 µL. Dilution: 1:101. Connectivity: None (standalone).

## Regulatory Identification

A radioallergosorbent immunological test system is a device that consists of the reagents used to measure by immunochemical techniques the allergen antibodies (antibodies which cause an allergic reaction) specific for a given allergen. Measurement of specific allergen antibodies may aid in the diagnosis of asthma, allergies, and other pulmonary disorders.

## Special Controls

*Classification.* Class II (special controls). The device, when intended to detect any of the allergens included in Table 1 in this paragraph, is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to the limitations in § 866.9.    Table 1—Class II Exempt Allergens Under § 866.5750—Radioallergosorbent (RAST) Immunological Test Systems
  Allergen code Allergen product Source  (taxonomical name)   Grass Pollens  g1 Sweet vernal grass  Anthoxanthum odoratum.  g3 Cocksfoot grass, Orchard grass  Dactylis glomerata.  g4 Meadow fescue  Festuca elatior.  g5 Rye-grass (perennial rye grass)  Lolium perenne.  g7 Common reed (common reed grass)  Phragmites communis.  g8 Meadow grass, Kentucky blue (June grass)  Poa pratensis.  g9 Redtop, Bentgrass  Agrostis stolonifera ,Agrostis gigantea (Agrostis alba ). g11 Brome grass  Bromus inermis.  g12 Cultivated rye (cultivated rye grass)  Secale cereale.  g13 Velvet grass  Holcus lanatus.  g14 Cultivated oat (cultivated oat grass)  Avena sativa.  g15 Cultivated wheat (cultivated wheat grass)  Triticum aestivum (Triticum spp.). g16 Meadow foxtail (meadow foxtail grass)  Alopecurus pratensis.  g17 Bahia grass  Paspalum notatum.  g24 Wheat grass, Western  Agropyron smithii (Elymus smithii ). g30 Bluegrass, annual  Poa annua.  g70 Wild rye grass  Elymus triticoides Elymus condensatus.  g71 Canary grass  Phalaris arundinacea.  g201 Barley, cultivated  Hordeum vulgare.  g202 Maize, corn (cultivated corn)  Zea mays.  g203 Salt grass  Distichlis spicata.  g204 False oat-grass  Arrhenatherum elatius.  g216 Cyn d 1  Cynodon dactylon.  g701 Phl p 1.0102, Phl p 5.0101  Phleum pratense.  g702 Phl p 7.0101  Phleum pratense.  g703 Phl p 12.0101  Phleum pratense.   Weed Pollens  w2 Western ragweed  Ambrosia psilostachya.  w4 False ragweed  Ambrosia acanthicarpa (Franseria acanthicarpa ). w5 Wormwood  Artemisia absinthium Artemisia annua.  w6 Mugwort  Artemisia vulgaris.  w7 Marguerite, ox-eye daisy  Chrysanthemum leucanthemum.  w8 Dandelion  Taraxacum vulgare ,Taraxacum officinale.  w9 Plantain (English), Ribwort  Plantago lanceolata.  w10 Goosefoot, lamb's quarters  Chenopodium album.  w11 Saltwort (prickly), Russian thistle  Salsola kali (Salsola pestifer ). w12 Goldenrod  Solidago virgaurea (Solidago spp.). w13 Cocklebur, common  Xanthium commune.  w14 Common pigweed (rough pigweed)  Amaranthus retroflexus.  w15 Scale, Lenscale  Atriplex lentiformis.  w16 Rough marsh elder  Iva ciliate ,Iva annua.  w17 Firebush (Kochia)  Kochia scoparia.  w18 Sheep sorrel  Rumex acetosella.  w19 Wall pellitory  Parietaria officinalis.  w20 Nettle (Common stinging nettle)  Urtica dioica.  w21 Wall pellitory  Parietaria judaica.  w22 Japanese hop (careless weed)  Humulus japonicas (Humulus scandens ). w23 Yellow dock, Yellow dockweed  Rumex crispus.  w24 Spiny pigweed  Amaranthus spinosus.  w27 Carnation  Dianthus spp. w28 Rose  Rosa rugosa.  w33 Clover  Trifolium pratense.  w35 Mexican tea  Chenopodium ambrosioides.  w36 Rabbit bush  Ambrosia deltoidea (Franseria deltoides ). w37 Salt bush, annual  Atriplex wrightii.  w39 Water hemp, Western  Amaranthus rudis (Acnida tamariscina ). w41 Burrobrush  Hymenoclea salsola.  w42 Poverty weed  Baccharis neglecta.  w43 Common sagebrush  Artemisia tridentata.  w45 Alfalfa  Medicago sativa.  w46 Dog fennel  Eupatorium capillifolium.  w53 Geranium  Geranium spp. w67 Groundsel bush  Baccharis halimifolia.  w69 Iodine bush  Allenrolfea occidentalis.  w70 Ragweed, slender  Ambrosia confertiflora.  w75 Wing scale (wingscale)  Atriplex canescens.  w82 Careless weed  Amaranthus palmeri ,Amaranthus hybridus.  w90 Japanese hop  Humulus japonicas (Humulus scandens ). w203 Rape (rape pollen)  Brassica napus.  w204 Sunflower  Helianthus annuus.  w206 Camomile  Matricaria chamomilla.  w207 Lupin  Lupinus spp. w210 Sugar-beet  Beta vulgaris.  w211 Par j 2.0101  Parietaria judaica.  w231 Art v 1  Artemisia vulgaris (Mugwort). w232 Sal k 1  Salsola kali.  w233 Art v 3  Artemisa vulgaris (LTP, Mugwort). w234 Pla l 1  Plantago lanceolata.  w235 Che a 1.0101  Chenopodium album.  w236 Mer a 1.0101  Mercurialis annua.  a753 Art v 1  Artemisia vulgaris (Mugwort weed).  Tree Pollens  t1 Box-elder (Maple)  Acer negundo ,Acer saccharum.  t2 Gray alder, speckled alder (alder)  Alnus incana.  t4 Hazel, hazelnut  Corylus avellana ,Corylus americana.  t5 American beech (beech)  Fagus grandifolia (Fagus americana ). t6 Mountain juniper, Mountain cedar  Juniperus ashei (Juniperus sabinoides ). t8 Elm  Ulmus americana.  t9 Olive  Olea europaea.  t10 Walnut  Juglans californica ,Juglans nigra.  t11 Maple leaf sycamore, London plane, Plane tree  Platanus acerifolia.  t61 Sycamore  Platanus occidentalis.  t12 Willow  Salix caprea ,Salix nigra.  t14 Cottonwood (Eastern Cottonwood/Black Cottonwood)  Populus deltoides.  t15 White ash  Fraxinus americana.  t16 White pine  Pinus strobus.  t18 Eucalyptus, gum-tree  Eucalyptus globulus (Eucalyptus spp.). t19/t26 Acacia  Acacia longifolia (Acacia spp.). t20 Mesquite  Prosopis glandulosa/ Prosopis juliflora.  t21 Melaleuca, cajeput tree  Melaleuca quinquenervia (Melaleuca leucadendron ). t22 Pecan, hickory  Carya illinoinensis (Carya pecan ). t23 Italian/Mediterranean/funeral cypress  Cupressus sempervirens.  t24 Japanese cypress  Chamaecyparis obtusa (Chamaecyparis spp.). t25 Ash  Fraxinus excelsior.  t27 Maple, red  Acer rubrum.  t29 Acacia  Acacia spp. t30 Birch, white  Betula populifolia.  t32 Willow, black  Salix nigra.  t33 Ash, Arizona  Fraxinus velutina.  t35 Cedar, salt  Tamarix gallica.  t37 Bald cypress (white bald cypress)  Taxodium distichum.  t38 Elm, Chinese/Siberian  Ulmus pumila.  t40 Hazelnut tree  Corylus americana.  t41 White hickory  Carya alba (Carya tomentosa ). t42 Oak, red  Quercus rubra.  t43 Loblolly pine  Pinus taeda.  t44 Hackberry  Celtis occidentalis.  t45 Cedar elm  Ulmus crassifolia.  t47 Juniper, one seed  Juniperus monosperma.  t48 Pine, lodgepole  Pinus contorta.  t49 Pine, ponderosa  Pinus ponderosa.  t50 Beech, European  Fagus sylvatica.  t51 Tree of Heaven  Ailanthus altissima.  t52 Western white pine  Pinus monticola.  t54 Russian olive  Elaeagnus angustifolia.  t55 Scotch broom  Cytisus scoparius.  t56 Bayberry  Myrica cerifera.  t57 Red cedar  Juniperus virginiana.  t60 Western juniper  Juniperus occidentalis.  t61 Sycamore  Platanus occidentalis.  t70 Mulberry (white mulberry)  Morus alba.  t71 Red mulberry  Morus rubra.  t72 Queen palm  Arecastrum romanzoffiamon.  t73 Australian pine  Casuarina equisetifolia.  t77 Oak mix (red, white, black)  Quercus spp. t80 Japanese cypress  Chamaecyparis obtusa.  t81 Japanese alder  Alnus japonica.  t83 Mango tree  Mangifera indica.  t90 Walnut, black  Juglans nigra.  t96 Poplar, white (poplar)  Populus alba.  t103/t218 Virginia live oak (live oak)  Quercus virginiana.  t105 Pepper tree  Schinus molle.  t110 Orange tree  Citrus sinensis.  t201 Spruce, Norway spruce  Picea abies (Picea excelsa ). t202 Alder, smooth  Alnus incana spp.Rugosa (Alnus rugosa ). t203 Horse chestnut  Aesculus hippocastanum.  t205 Elder  Sambucus nigra.  t206 Chestnut  Castanea sativa.  t207 Douglas fir  Pseudotsuga menziesii (Pseudotsuga taxifolia ). t208 Linden  Tilia cordata.  t209 Horn beam  Carpinus betulus.  t210 Privet  Ligustrum vulgare.  t211 Sweet gum  Liquidambar styraciflua.  t212 Cedar  Libocedrus decurrens.  t213 Pine  Pinus radiata.  t214 Date palm  Phoenix canariensis.  t215 Lilac  Syringa vulgaris.  t217 Pepper tree  Schinus molle.  t217 Red alder  Alnus rubra.  t218 Virginia live oak  Quercus virginiana.  t218 Bayberry (bayberry/sweet gale)  Myrica gale.  t219 Palo verde  Cercidium floridum.  t219 Red cedar  Juniperus virginiana.  t220 Bet v 4  Betula verrucosa (Birch). t221 Bet v 2.0101, Bet v 4  Betula verrucosa (Birch). t222 Cypress (Arizona cypress)  Cupressus arizonica.  t223 Oil palm  Elaeis guineensis.  t224 Ole e 1  Olea europaea.  t225 Bet v 6  Betula verrucosa (Birch). t226 Cup a 1  Cupressus arizonica.  t227 Ole e 7  Olea Europaea.  t228 Aspen, quaking  Populus tremuloides.  t229 Eastern hemlock  Tsuga canadensis.  t230 Redwood (sequoia)  Sequoia sempervirens.  t232 Pussy willow  Salix discolor.  t240 Ole e 9.0101  Olea Europaea.  t241 Pla a 1.0101  Platanus acerifolia.  t242 Pla a 2  Platanus acerifolia.  t243 Pla a 3.0101  Platanus acerifolia.  t244 Cor a 1.0103  Corylus avellana.  t245 Aln g 1.0101  Alnus glutinosa.  t246 Cry j 1  Cryptomeria japonica.  t280 Locust tree  Robinia pseudoacacia.  t401 Brazilian peppertree  Schinus terebinthifolius.  t402 Mastic tree  Pistacia lentiscus.  t404 Tree of heaven  Ailanthus altissima.  t406 Date palm  Phoenix dactylifera.  a482 Ole e 1  Olea europaea (Olive Oil).  Mites  d207 Blo t 5.0101  Blomia tropicalis.  d208 Lep d 2.0101  Lepidoglyphus destructor.   Microorganisms, Molds, Yeast  m1  Penicillium chrysogenum (Penicillium notatum ) Penicillium chrysogenum (Penicillium notatum ). m2  Cladosporium herbarum (Hormodendrum ) Cladosporium herbarum (Hormodendrum ). m3  Aspergillus fumigatus  Aspergillus fumigatus.  m4  Mucor racemosus  Mucor racemosus.  m5  Candida albicans  Candida albicans.  m7  Botrytis cinerea  Botrytis cinerea.  m8  Drechslera halodes (Setomelanomma rostrata, Helminthosporium halodes, Helminthosporium interseminatum ) Drechslera halodes (Setomelanomma rostrata, Helminthosporium halodes.  m9  Fusarium moniliforme (Fusarium proliferatum ) Fusarium moniliforme (Fusarium proliferatum ). m10  Stemphylium botryosum  Stemphylium herbarum (Stemphylium botryosum ). m11  Rhizopus nigricans  Rhizopus nigricans.  m12  Aureobasidium pullulans  Aureobasidium pullulans.  m13  Phoma betae  Phoma betae.  m14  Epicoccum purpurascens  Epicoccum purpurascens (Epicoccum nigrum ). m15  Trichoderma viride  Trichoderma viride.  m16  Curvularia lunata  Curvularia lunata ,Curvularia specifera (K923044 ). m17  Cladosporium fulvum  Cladosporium fulvum.  m18  Fusarium culmorum  Fusarium culmorum.  m19  Aspergillus versicolor  Aspergillus versicolor.  m20  Mucor mucedo  Mucor mucedo.  m21  Aspergillus clavatus  Aspergillus clavatus.  m22  Micropolyspora faeni  Saccharopolyspora rectivirgula (Micropolyspora faeni ). m23  Thermoactinomyces vulgaris  Thermoactinomyces vulgaris.  m24  Stachybotrys atra  Stachybotrys chartarum (Stachybotrys atra ). m24  Paecilomyces spp Paecilomyces spp. m25  Aspergillus versicolor  Aspergillus versicolor.  m25  Penicillium brevicompactum  Penicillium brevicompactum.  m26  Cladosporium cladosporioides  Cladosporium cladosporioides.  m26  Penicillium citrinum  Penicillium citrinum.  m27  Penicillium spp Penicillium spp. m29  Aspergillus repens  Aspergillus repens.  m30  Penicillium roqueforti  Penicillium roqueforti.  m32  Cladosporium cladosporioides  Cladosporium cladosporioides.  m34  Serpula lacrymans  Serpula lacrymans.  m36  Aspergillus terreus  Aspergillus terreus.  m37  Trichophyton mentagrophytes  Trichophyton mentagrophytes.  m40  Aspergillus amstelodami  Aspergillus amstelodami.  m43  Saccharomyces Carlsberg  Saccharomyces carlsbergensis.  m44  Saccharomyces cerevisiae  Saccharomyces cerevisiae.  m45  Hormodendrum hordei  Hormodendrum hordei.  m46  Bipolaris spicifera  Bipolaris spicifera.  m47  Aspergillus nidulans  Aspergillus nidulans.  m48  Aspergillus oryzae  Aspergillus oryzae.  m49  Fusarium oxysporum  Fusarium oxysporum.  m50  Micropolyspora faeni  Saccharopolyspora rectivirgula (Micropolyspora faeni ). m51  Thermoactinomyces vulgaris  Thermoactinomyces vulgaris.  m53  Microspora canis  Microsporum canis (Microspora canis ). m54  Aspergillus flavus  Aspergillus flavus.  m63  Helminthosporium intersemin  Helminthosporium intersemin.  m66  Mucor plumbeus  Mucor plumbeus.  m67  Mycogone  Mycogone perniciosa.  m68  Nigrospora oryzae  Nigrospora oryzae.  m69  Rhodotorula  Rhodotorula rubra (Rhodotorula mucilaginosa ). m70  Malassezia furfur (Pityrosporum orbiculare ) Malassezia furfur (Pityrosporum orbiculare ). m71  Spondylocladium  Spondylocladium spp. m72  Epidermophyton  Epidermophyton floccosum.  m73  Epicoccum nigrum  Epicoccum purpurascens (Epicoccum nigrum ). m80  Staphylococcal enterotoxin A (Sta a SEA ) Staphylococcus aureus.  m80  Helminthosporium spp Helminthosporium spp. m81  Staphylococcal enterotoxin B (Sta a SEB ) Staphylococcus aureus.  m88  Stemphylium solani  Stemphylium solani.  m93  Gliocladium fimbriatum  Gliocladium fimbriatum.  m94  Phycomyces blakesleeanus  Phycomyces blakesleeanus.  m201  Tilletia tritici (Ustilago nuda, Ustilago tritici ) (Barley smut) Tilletia tritici (Ustilago nuda, Ustilago tritici ). m202  Acremonium kiliense (Cephalosporium acremonium ) Acremonium kiliense (Cephalosporium acremonium ). m203  Trichosporon pullulans  Trichosporon pullulans.  m204  Ulocladium chartarum  Ulocladium chartarum.  m205  Trichophyton rubrum  Trichophyton rubrum.  m207  Aspergillus niger  Aspergillus niger.  m208  Chaetomium globosum  Chaetomium globosum.  m209  Penicillium frequentans  Penicillium glabrum (Penicillium frequentans ). m209  Stachybotrys chartarum  Stachybotrys chartarum (Stachybotrys atra ). m210  Trichophyton mentagrophytes var. goetzii  Trichophyton mentagrophytes var. goetzii.  m211  Trichophyton mentagrophytes var. interdigitale  Trichophyton mentagrophytes var. interdigitale.  m211 Oat smut  Ustilago avenae.  m212  Micropolyspora faeni  Saccharopolyspora rectivirgula (Micropolyspora faeni ). m212  Geotrichum candidum  Geotrichum candidum.  m213 Bermuda grass smut  Ustilago cynodontis.  m214 Johnson grass smut  Sphacelotheca cruenta.  m215 Corn smut  Ustilago maydis.  m218 Asp f 1.0101  Aspergillus fumigatus.  a3050 Asp r 1  Aspergillus restrictus.  m219 Asp f 2  Aspergillus fumigatus.  m220 Asp f 3.0101  Aspergillus fumigatus.  m221 Asp f 4  Aspergillus fumigatus.  m222 Asp f 6.0101  Aspergillus fumigatus.  m223  Staphylococcal enterotoxin C (Sta a SEC ) Staphylococcus aureus.  m224  Staphylococcal enterotoxin D (Sta a SED ) Staphylococcus aureus.  m226  Staphylococcal enterotoxin TSST (Sta a TSST ) Staphylococcus aureus.  m227  Malassezia spp. (Pityrosporum spp.) Malassezia spp. (Pityrosporum spp.). m228  Aspergillus flavus.   m229 Alt a 1.0101  Alternaria alternata (Alternaria tenuis ). m230 Alt a 6.0101  Alternaria alternata (Alternaria tenuis ). m231 Cla h 8.0101  Cladosporium herbarum (Hormodendrum ). m300  Eurotium spp Eurotium spp. m304  Aspergillus oryzae  Aspergillus oryzae.  m305  Penicillium brevicompactum  Penicillium brevicompactum.  m309  Aspergillus terreus  Aspergillus terreus.  m310  Aspergillus nidulans  Aspergillus nidulans.  m311  Aspergillus flavus  Aspergillus flavus.  m312  Aspergillus clavatus  Aspergillus clavatus.   Epidermal & Animal  e6 Guinea pig epithelium  Cavia porcellus.  e7 Pigeon droppings  Columba palumbus ,Columba livia.  e25 Chicken serum  Gallus domesticus (Gallus gallus domesticus; Gallus spp.). e26 Parrot serum  Psittacoidea spp. e62 Camel  Camelus dromedaries.  e70 Goose feathers  Anser anser.  e71 Mouse epithelium  Mus musculus (Mus spp.). e73 Rat epithelium  Rattus norvegicus.  e74 Rat urine proteins  Rattus norvegicus ,Rattus rattus.  e75 Rat serum proteins  Rattus norvegicus ,Rattus rattus.  e76 Mouse serum proteins  Mus musculus (Mus spp.). e77 Budgerigar droppings  Melopsittacus undulatus.  e78 Budgerigar feathers  Melopsittacus undulatus.  e79 Budgerigar serum proteins  Melopsittacus undulatus.  e80 Goat epithelium  Capra hircus.  e81 Sheep epithelium  Ovis aries (Ovis spp.). e82 Rabbit epithelium  Oryctolagus cuniculus (Oryctolagus spp.). e83 Swine epithelium  Sus scrofa (Sus scrofa domesticus; Sus spp.). e84 Hamster epithelium  Cricetus cricetus, Mesocricetus auratus, and Phodopus sungorus.  e85 Chicken feathers  Gallus domesticus (Gallus gallus domesticus; Gallus spp.). e86 Duck feathers  Anas platyrhynchos.  e87 Rat epithelium, serum proteins, and urine proteins  Rattus norvegicus Rattus rattus.  e88 Mouse epithelium, serum proteins, and urine proteins (mouse)  Mus musculus (Mus spp.). e89 Turkey feathers  Meleagris gallopavo.  e90 Budgerigar serum proteins, feathers, and droppings  Melopsittacus undulatus.  e91 Pigeon serum proteins, feathers, and droppings  Streptopelia roseogrisea ,Psittacidae spp. e92 Parrot serum proteins, feathers, and droppings  Ara spp. e93 Pigeon serum proteins  Streptopelia roseogrisea.  e94 Fel d 1.0101  Felis domesticus.  a345 Fel d 1  Felis domesticus.  e98 Parrot droppings  Psittacoidea spp. e101 Can f 1.0101  Canis familiaris (Canis domesticus ). a174 Can f 1  Canis familiaris (Canis domesticus ). e102 Can f 2.0101  Canis familiaris (Canis domesticus ). e196 Parakeet feathers  Nymphicus hollandicus.  e197 Parakeet droppings  Nymphicus hollandicus.  e198 Parakeet serum  Nymphicus hollandicus.  e199 Canary bird serum  Serinus canarius.  e200 Canary bird droppings  Serinus canarius.  e201 Canary bird feathers (Canary feathers)  Serinus canarius.  e202 Reindeer epithelium  Rangifer tarandus.  e203 Mink epithelium  Mustela spp. e204 Bos d 6  Bos domesticus (Bos taurus; Bos spp.). e205 Horse, serum proteins  Equus caballus (Equus spp.). e206 Rabbit, serum proteins  Oryctolagus cuniculus (Oryctolagus spp.). e208 Chinchilla epithelium  Chinchilla laniger.  e209 Gerbil epithelium  Meriones unguiculatus.  e210 Fox epithelium  Vulpes vulpes.  e211 Rabbit, urine proteins  Oryctolagus cuniculus (Oryctolagus spp.). e212 Swine, urine proteins  Sus scrofa (Sus scrofa domesticus; Sus spp.). e213 Parrot feathers  Ara spp. e214 Finch feathers  Lonchura domestica.  e215 Pigeon feathers  Streptopelia roseogrisea (Streptopelia spp.),Columbia spp. e216 Deer epithelium  Dama dama.  e217 Ferret epithelium  Mustela putorius.  e218 Chicken droppings  Gallus domesticus (Gallus gallus domesticus; Gallus spp.). e219 Chicken, serum proteins  Gallus domesticus (Gallus gallus domesticus; Gallus spp.). e220 Fel d 2, Cat serum albumin  Felis domesticus.  e221 Can f 3  Canis familiaris (Canis domesticus ) (Dog serum albumin ). e222 Swine serum albumin (Sus s PSA)  Sus scrofa (Sus scrofa domesticus; Sus spp.). e225 Lovebird feathers  Psittacoidea agapomis.  e226 Can f 5.0101  Canis familiaris.  e227 Equ c 1.0101  Equus caballus.  e228 Fel d 4.0101  Felis domesticus.  e230 Equ c 3  Equus caballus.  e231 Mus m 1  Mus musculus.   Food  f9 Rice  Oryza sativa.  f12 Pea (green pea)  Pisum sativum.  f15 White bean  Phaseolus vulgaris.  f19 Cayenne pepper  Capsicum frutescens (Capsicum annum ). f21 Sugar cane  Saccharum officinarum.  f22 Raspberry  Rubus idaeus.  f26 Pork  Sus scrofa (Sus scrofa domesticus; Sus spp.). f29 Watermelon  Citrullus lanatus (Citrullus vulgaris ). f31 Carrot  Daucus carota.  f32 Oyster mushroom  Pleurotus ostreatus.  f33 Orange  Citrus sinensis.  f35 Potato  Solanum tuberosum.  f43 Mother's milk  Homo sapiens.  f44 Strawberry  Fragaria vesca (Fragaria spp.). f45 Yeast, baker's  Saccharomyces cerevisiae.  f46 Pepper, Red  Capsicum annuum.  f47 Garlic  Allium sativum.  f48 Onion  Allium cepa.  f49 Apple  Malus x domestica (Malus spp.). f51 Bamboo shoot  Phyllostachys pubescens.  f52 Cacao/chocolate  Theobroma cacao.  f54 Sweet potato  Ipomoea batatas.  f55 Common millet  Panicum miliaceum.  f56 Foxtail millet  Setaria italica.  f57 Japanese millet  Echinochloa crus-galli.  f58 Pacific squid  Todarodes pacificus.  f59 Octopus  Octopus vulgaris (Octopus spp.). f63 Kefir NA.  f67 Parmesan cheese NA.  f81 Cheese, cheddar type NA.  f82 Cheese, mold type NA.  f83 Chicken  Gallus domesticus (Gallus gallus domesticus; Gallus spp.). f86 Parsley  Petroselinum crispum.  f87 Melon  Cucumis melo Cucumis melo + Citrullus lanatus.  f88 Mutton (lamb)  Ovis aries (Ovis spp.). f90 Malt  Hordeum vulgare.  f92 Banana  Musa spp. f93 Cacao  Theobroma cacao.  f94 Pear  Pyrus communis (Pyrus spp.). f97 Yam  Dioscorea spp.Dioscorea opposita.  f97 Chamomile tea  Matricaria chamomilla.  f98 Gliadin  Triticum aestivum (Triticum spp.). f102 Cantaloupe  Cucumis melo var. cantalupensis.  f105 Chocolate  Theobroma cacao.  f109 Cottonseed  Gossypium hirsutum.  f110 Giant radish  Raphanus sativus.  f118 Zucchini  Cucurbita pepo.  f119 Radish  Raphanus sativus.  f120 Venison  Capreolus capeolus.  f121 Pinto bean  Phaseolus vulgaris.  f122 Cheese, American NA.  f127 Black-eyed pea  Vigna unguiculata.  f131 Black Olive  Olea europaea.  f136 Red beet  Beta vulgaris var. conditiva.  f139 Goat's Cheese  Capra aegagrus.  f140 Bran NA.  f141 Corn (vegetables)  Zea mays.  f152 Green bell pepper  Capsicum annuum.  f155 Brewer's yeast  Saccharomyces carlsbergensis.  f157 Duck  Anas domesticus.  f158 Goose  Anser anser.  f160 Camembert cheese NA.  f162 Nectarine  Prunus persica var. nucipersica.  f163 Kohlrabi  Brassica oleracea var. gongylodes.  f65 Perch   f166 Leek  Allium porrum.  f170 Cheese (Switzerland) (Swiss cheese) NA.  f174 Fig  Ficus carica.  f177 Cranberry  Vaccinium macrocarpon.  f179 Raisin  Vitis spp. f182 Lima bean  Phaseolus lunatus.  f198 Flaxseed (bruised grain)  Linum usitatissimum.  f199 Untreated native milk  Bos domesticus (Bos taurus; Bos spp.). f208 Lemon  Citrus limon.  f209 Grapefruit  Citrus paradisi.  f210 Pineapple  Ananas comosus.  f211 Blackberry  Rubus fruticosus.  f212 Mushroom (champignon)  Agaricus hortensis (Agaricus spp.). f213 Rabbit  Oryctolagus cuniculus (Oryctolagus spp.). f214 Spinach  Spinacia oleracea.  f215 Lettuce  Lactuca sativa.  f216 Cabbage  Brassica oleracea var. capitata.  f217 Brussels sprouts  Brassica oleracea var. gem.  f218 Paprika, sweet pepper  Capsicum annuum.  f219 Fennel seed  Foeniculum vulgare.  f219 Sage  Salvia officinalis.  f220 Cinnamon  Cinnamomum spp. f221 Coffee  Coffea spp. f222 Tea  Camellia sinensis.  f223 Green olive  Olea europaea.  f225 Summer squash, pumpkin  Cucurbita pepo.  f225 Pumpkin  Cucurbita maxima.  f226 Pumpkin seed  Cucurbita pepo.  f227 Sugar-beet seed  Beta vulgaris.  f229 Safflower Seed  Carthamus tinctorius.  f231 Milk, boiled  Bos domesticus (Bos taurus; Bos spp.). f234 Vanilla  Vanilla planifolia.  f237 Apricot  Prunus armeniaca.  f241 Gouda cheese NA.  f242 Cherry  Prunus avium.  f244 Cucumber  Cucumis sativus.  f246 Guar, guar gum  Cyamopsis tetragonoloba.  f247 Honey NA.  f248 Rosemary  Rosmarinus officinalis.  f254 Plaice  Pleuronectes platessa.  f255 Plum  Prunus domestica ,Prunus americana.  f258 Squid  Loligo spp. f259 Grape  Vitis vinifera (Vitis spp.). f260 Broccoli  Brassica oleracea var. italica (Brassica oleracea var. cultivar ). f261 Asparagus  Asparagus officinalis.  f262 Aubergine, eggplant  Solanum melongena.  f263 Green pepper  Piper nigrum ,Capsicum annuum.  f264 Eel  Anguilla anguilla.  f265 Caraway  Carum carvi.  f265 Cumin  Cuminum cyminum.  f266 Mace  Myristica fragrans.  f267 Cardamon  Elettaria cardamomum.  f268 Clove  Syzygium aromaticum.  f269 Basil  Ocimum basilicum.  f270 Ginger  Zingiber officinale.  f271 Anise  Pimpinella anisum.  f272 Tarragon  Artemisia dracunculus.  f273 Thyme  Thymus vulgaris.  f274 Marjoram  Origanum majorana.  f275 Lovage  Levisticum officinale.  f276 Fennel, fresh  Foeniculum vulgare.  f277 Dill  Anethum graveolens.  f278 Bay leaf  Laurus nobilis.  f279 Chili pepper  Capsicum frutescens.  f280 Black pepper  Piper nigrum.  f281 Curry (Santa Maria) NA.  f282 Nutmeg  Myristica fragrans.  f283 Oregano  Origanum vulgare.  f284 Turkey meat  Meleagris gallopavo.  f285 Elk/moose meat  Alces spp. f286 Mare's milk  Equus caballus (Equus spp.). f287 Red kidney bean  Phaseolus vulgaris.  f288 Blueberry  Vaccinium myrtillus (Vaccinium spp.). f289 Date  Phoenix dactylifera.  f291 Cauliflower  Brassica oleracea var. botrytis.  f292 Guava  Psidium guajava.  f293 Papaya  Carica papaya.  f294 Passion fruit, Maracuja  Passiflora edulis (Passiflora spp.). f295 Carambola  Averrhoa carambola.  f296 Carob  Ceratonia siliqua.  f297 Gum Arabic  Acacia senegal (Acacia spp.). f298 Tragacanth  Astragalus spp. f299 Sweet chestnut (chestnut)  Castanea sativa.  f300 Pinto bean  Phaseolus spp. f301 Persimmon (kaki fruit, sharon)  Diospyros kaki.  f302 Mandarin (tangerine, clementine, satsumas)  Citrus reticulata.  f305 Fenugreek  Trigonella foenum-graecum.  f306 Lime  Citrus aurantifolia.  f307 Hake  Merluccius merluccius.  f308 Sardine (pilchard)  Sardina pilchardus.  f310 Blue vetch  Lathyrus sativus.  f311 Megrim  Lepidorhombus whiffiagonis.  f315 Green bean  Phaseolus vulgaris.  f316 Rape seed  Brassica napus.  f317 Coriander  Coriandrum sativum.  f318 Jack fruit  Artocarpus heterophyllus.  f319 Beetroot  Beta vulgaris.  f320 Crayfish  Astacus astacus.  f321 Horse meat  Equus caballus (Equus spp.). f322 Red currant  Ribes sylvestre.  f324 Hop (fruit cone)  Humulus lupulus.  f325 Saffron  Colchicum autumnale.  f328 Fig  Ficus carica.  f329 Watermelon  Citrullus lanatus.  f330 Rose hip  Rosa spp. f331 Saffron  Crocus sativus.  f332 Mint  Mentha piperita.  f333 Linseed  Linum usitatissimum.  f336 Jujube  Ziziphus jujuba.  f336 Wine vinegar  Vitis vinifera (Vitis spp.). f337 Sole  Solea solea.  f337 English sole  Parophrys vetulus.  f338 Wine, white  Vitis vinifera (Vitis spp.). f339 Allspice  Pimenta dioica.  f339 Wine, red  Vitis vinifera (Vitis spp.). f341 Cranberry  Vaccinium oxycoccus ,Vaccinium macrocarpon.  f342 Olive (black, fresh)  Olea europaea.  f343 Raspberry  Rubus idaeus.  f344 Sage  Salvia officinalis.  f346 Chives  Allium schoenoprasum.  f347 Quinoa  Chenopodium quinoa.  f348 Litchi  Litchi chinensis.  f349 Chum salmon roe  Oncorhynchus keta.  f358 Artichoke  Cynara scolymus.  f360 Yogurt NA.  f368 Black bass  Micropterus dolomieu (Micropterus dolomieui ). f374 Karaya gum  Sterculia urens.  f375 Horseradish  Armoracia rusticana.  f377 Maple syrup NA.  f379 Okra  Abelmoschus esculentus.  f382 Beet, sugar  Beta vulgaris var. altissima.  f401 Loquat  Eriobotrya japonica.  f402 Fig  Ficus carica.  f403 Brewer's yeast  Saccharomyces cerevisiae.  f405 Mint  Mentha spp. f406 Arugula  Eruca vesicaria.   House Dust  h1 Greer Labs., Inc NA.  h2 Hollister-Stier Labs NA.  h6 Japan NA.   Venoms & Insects  i7 Midge  Chironomus yoshimatsui.  i8 Moth  Bombyx mori ,Heterocera spp. i47 Water flea  Daphnia spp. i49 Deer fly  Chrysops spp. i51 Black ant  Camponotus pennsylvanicus.  i54 Flea mix (dog/cat), common flea  Ctenocephalides spp. i71 Mosquito  Aedes communis ,Aedes spp.and Culex spp. i72 Green nimitti  Cladotanytarsus lewisi.  i73 Blood worm  Chironomus thummi ,Chironomusri parius ,Chironomus spp. i75 European hornet  Vespa crabro.  i76 Berlin beetle  Trogoderma angustum.  i77 European paper wasp  Polistes dominulus.  i78 Fly  Musca domestica.  i80 Bumblebee  Bombus pennsylvanicus.  i201 Horse bot fly  Gasterophilus intestinalis.  i202 Grain weevil  Sitophilus granarius.  i203 Mediterranean flour moth  Ephestia kuehniella (Anagasta kuehniella ). i204 Horse fly  Tabanus spp. i205 Bumblebee  Bombus terrestris.  i208 Api m 1.0101  Apis mellifera.  a45 Api m 1  Apis mellifera.  i209 Ves v 5.0101  Vespula vulgaris.  a670 Ves v 5  Vespula vulgaris.  i210 Pol d 5.0101  Polistes dominulus.  i211 Ves v 1.0101  Vespula vulgaris.  i213 Api m 4  Apis mellifera.  i214 Api m 2  Apis mellifera.  i215 Api m 3  Apis mellifera.  i216 Api m 5  Apis mellifera.  i217 Api m 10  Apis mellifera.  i220 Bla g 1.0101  Blattella germanica.  i221 Bla g 2.0101  Blattella germanica.  i222 Bla g 5.0101  Blattella germanica.  i223 Bla g 7  Blattella germanica.  a46 Api m 2  Apis mellifera.   Miscellaneous  o1 Cotton, crude fibers  Gossypium spp. o3 Cotton (treated)  Gossypium spp. o70 Seminal fluid  Homo sapiens.  o71  Staphylococcus aureus  Staphylococcus aureus.  o72  Pichia pastoris crude extract customer specific Pichia pastoris.  o72 Sperm-sediment  Homo sapiens.  o73  Pichia pastoris crude extr. vector customer specific Pichia pastoris.  o74  Pichia pastoris with vector customer specific Pichia pastoris.  o201 Tobacco leaf, tobacco dust  Nicotiana tabacum.  o202 Artemia salina, fish feed  Artemia salina.  o203 Tetramin, fish feed NA.  o207 Daphnia, fish feed  Daphnia spp. o211 Mealworm  Tenebrio molitor.  o212 Streptavidin  Streptomyces avidini.  o213 MBP (maltose binding protein)  Escherichia coli.  o214 CCD; MUXF3 from bromelain  Ananas comosus.  o72 Enterotoxin A (Sta a SEA)  Staphylococcus aureus.  o73 Enterotoxin B (Sta a SEB)  Staphylococcus aureus.   Parasites  p1 Ascaris  Ascaris suum.  p2 Echinococcus  Echinococcus granulosus.  p3 Schistosoma  Schistosoma mansoni.  p4 Anisakis (Herring Worm)  Anisakis simplex (Anisakis spp.). p5 Toxocara canis  Toxocara canis.  p10 Ani s 3.0101  Anisakis simplex (Anisakis spp.). p11 Ani s 1  Anisakis simplex (Anisakis spp.).  Occupational  k4 Threshing dust NA.  k5 Flax NA.  k7 Hay Dust NA.  k8 Hop (hops)  Humulus lupulus.  k12 Grain mill dust NA.  k14 Kapok NA.  k20 Sheep's wool (treated) (wool)  Ovis aries (Ovis spp.). k21 Sheep's wool (Untreated)  Ovis aries (Ovis spp.). k23 Straw Dust NA.  k33 Oak NA.  k70 Green coffee bean  Coffea spp. k71 Castor bean  Ricinus communis.  k72 Ispaghula  Plantago psyllium/Plantago ovata.  k73 Silk waste NA.  k74 Silk  Bombyx mori.  k75 Isocyanate TDI (Toluene diisocyanate) NA.  k76 Isocyanate MDI (Diphenylmethane diisocyanate) NA.  k77 Isocyanate HDI (Hexamethylen diisocyanate) NA.  k78 Ethylene oxide NA.  k79 Phthalic anhydride NA.  k80 Formaldehyde/Formalin NA.  k81 Ficus  Ficus benjamina (Ficus spp.). k83 Cotton seed  Gossypium hirsutum.  k84 Sunflower seed  Helianthus annuus.  k85 Chloramin T NA.  k86 Trimellitic anhydride, TMA NA.  k87 Asp o 21, alpha-amylase  Aspergillus oryzae.  k89 Orris root  Iris florentina.  k99 HSA (Human Serum Albumin) (Hom s HSA)  Homo sapiens.  k201 Car p 1, Papain  Carica papaya.  k202 Ana c 2, Bromelain  Ananas comosus.  k204 Maxatase  Bacillus licheniformis.  k205 Alcalase  Bacillus spp. k206 Savinase, Protease 1 (Bac l Subtilisin)  Bacillus spp. k208 Gal d 4, Lysozyme  Gallus domesticus (Gallus gallus domesticus; Gallus spp.). k209 Hexahydrophtalic anhydrid NA.  k210 Maleic anhydride NA.  k211 Methyltetrahydrophtalic anhydrid NA.  k212 Abachi wood dust  Triplochiton scleroxylon.  k213 Pepsin (Sus s Pepsin)  Sus scrofa (Sus scrofa domesticus; Sus spp.). k213 TCPA NA.  k214 Bougainvillea  Bougainvillea spp. k225 Horse radish peroxidase (Arm r HRP)  Armoracia rusticana.  k226 Ascorbate oxidase (Cuc p ascorbate oxidase)  Cucurbita pepo.  k301 Flour dust  Triticum spp. k501 Savinase customer specific Proprietary knowledge of customer.  k502 Lipolase customer specific Proprietary knowledge of customer.  k503 Termamyl customer specific Proprietary knowledge of customer.  k504 Clazinase customer specific Proprietary knowledge of customer.

## Predicate Devices

- Aeskulisa® Glia A ([K052439](/device/K052439.md))
- Aeskulisa® Glia G ([K052439](/device/K052439.md))

## Submission Summary (Full Text)

> This content was OCRed from public FDA records by [Innolitics](https://innolitics.com). If you use, quote, summarize, crawl, or train on this content, cite Innolitics at https://innolitics.com.
>
> Innolitics is a medical-device software consultancy. We help companies design, build, and clear FDA-regulated software and AI/ML devices, including [a 510(k)](https://innolitics.com/services/510ks/), [a De Novo](https://innolitics.com/services/regulatory/), [a SaMD](https://innolitics.com/services/end-to-end-samd/), [an AI/ML medical device](https://innolitics.com/services/medical-imaging-ai-development/), or [an FDA regulatory strategy](https://innolitics.com/services/regulatory/).

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K113377

Grifols USA, Inc.
2410 Lillyvale Avenue
Los Angeles, CA
90032-3548
Tel. (323) 225-2221
(800) 421-0008
www.grifols.com

Page 1 of 17

### 510(k) Summary

DEC 1 4 2012

1. Date 510(k) Summary Prepared: 12 December 2012

- 2. 510(k) Owner: Grifols USA, LLC
- 3. Submitter: Grifols USA, LLC

Submitter Name: Grifols USA, LLC. Contact Person: Catherine L. Wong Address: 2410 Lillyvale Avenue Los Angeles, CA 90032-3514 (323) 227-7280 Telephone: Fax No .: (323) 441-7902

- Device Information 4.
Proprietary and Established Names:

a-Gliatest® IgA, a-Gliatest®IgG, a-GliaPep® IgA, and a-GliaPep®IgG

Common Names:

Gliadin IgA and Gliadin IgG

- 5. Regulatory Information:
Regulation No .: 21 CFR § 866.5750 Radioallergosorbent (RAST) immunological test system Regulation Section: Classification: Class 2 : Product Code: MST, Antibodies, Gliadin Panel: Immunology

- Predicate Devices: 6.
Aeskulisa® Glia A (K052439), predicate for a-Gliatest® IgA and a-GliaPep® IgA Aeskulisa® Glia G (K052439), predicate for a-Gliatest® IgG and a-GliaPep® IgG

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#### 7. Device Description

Each test kit for a-Gliatest® IgA, a-Gliatest® IgG, a-GliaPep® IgA, and a-GliaPep® IgG consists of one (1) microtiter plate (12 strips of 8 microwells coated with purified a-gliadin antigen or deamidated gliadin peptide antigen), assay controls (positive and negative), a ready-to-use set of five (5) calibrators, Horseradish Peroxidase (HRP) goat anti-human IgA or IgG conjugate, serum diluent, Tetramethylbenzidine (TMB) enzyme substrate, stop solution, and washing solution required for the assay.

#### 8. Intended Use

Intended Use for a-Gliatest® IgA: .

> The a-Gliatest® IgA is intended for the semi-quantitative determination of IgA antibodies directed against gliadin in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Intended Use for a-Gliatest® IgG:

The a-Gliatest® IgG is intended for the semi-quantitative determination of IgG antibodies directed against gliadin in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Intended Use for a-GliaPep® IgA: .

> The a-GliaPep® IgA is intended for the semi-quantitative determination of IgA antibodies directed against deamidated gliadin peptide in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Intended Use for a-GliaPep® IgG:

The a-GliaPep® IgG is intended for the semi-quantitative determination of IgG antibodies directed against deamidated gliadin peptide in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

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#### Summary of Comparison with Predicate Device 9.

The devices, a-Gliatest® IgA, a-Gliatest® IgG, a-GliaPep® IgA, and a-GliaPep® IgG, have been compared with their predicate devices (Aeskulisa ) Glia A and Aeskulisa® · Glia G, K052439), and found to be substantially equivalent.

The design, features, technological characteristics, specifications and performance of the devices have been compared with those of the predicate devices, as shown in Tables 1, 2, 3 and 4.

| No. | Item                                 | α-Gliatest® IgA                                                                                                                                                                                                                                                                                                  | α-GliaPep® IgA                                                                                                                                                                                                                                                                                                                     | Predicate<br>AESKULISA® Glia-A<br>(K052439)                                                                                                                                                                                                                                                                                                                                       |
|-----|--------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1.  | Intended Use                         | The α-Gliatest® IgA is<br>intended for the<br>semi-quantitative<br>determination of IgA<br>antibodies directed against<br>gliadin in human serum. The<br>assay is an aid in the<br>diagnosis of celiac disease<br>and should be used in<br>conjunction with other<br>serological tests and clinical<br>findings. | The α-GliaPep® IgA is<br>intended for the<br>semi-quantitative<br>determination of IgA<br>antibodies directed against<br>deamidated gliadin peptide<br>in human serum. The assay<br>is an aid in the diagnosis of<br>celiac disease and should be<br>used in conjunction with<br>other serological tests and<br>clinical findings. | The AESKULISA Glia-A is<br>a solid phase enzyme<br>immunoassay for the<br>semi-quantitative and<br>qualitative detection of IgA<br>antibodies against gliadin in<br>human serum. The assay is<br>an aid in the diagnosis of<br>celiac disease<br>(gluten-sensitive<br>enteropathy) and should be<br>used in conjunction with<br>other serological tests and<br>clinical findings. |
| 2.  | Methodology                          | ELISA                                                                                                                                                                                                                                                                                                            | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 3.  | Analyte                              | IgA antibodies against<br>gliadin in human serum                                                                                                                                                                                                                                                                 | IgA antibodies against<br>deamidated gliadin peptide<br>in human serum                                                                                                                                                                                                                                                             | IgA antibodies against<br>gliadin in human serum                                                                                                                                                                                                                                                                                                                                  |
| 4.  | Enzyme-<br>Conjugate                 | Horseradish peroxidase                                                                                                                                                                                                                                                                                           | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 5.  | Substrate/<br>Chromogen              | TMB                                                                                                                                                                                                                                                                                                              | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 6.  | OD Reading                           | 450 nm                                                                                                                                                                                                                                                                                                           | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 7.  | Positive<br>Control                  | Human serum                                                                                                                                                                                                                                                                                                      | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 8.  | Negative<br>Control                  | Human serum                                                                                                                                                                                                                                                                                                      | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 9.  | Storage                              | 2-8°C                                                                                                                                                                                                                                                                                                            | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 10. | Patient Sample<br>Dilution           | 1:101                                                                                                                                                                                                                                                                                                            | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |
| 11. | Patient Sample<br>Volume<br>Required | 100 µL                                                                                                                                                                                                                                                                                                           | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                              |

Table 1 Device Similarities Between a-Gliatest® IgA, a-GliaPep® IgA and Predicate (Aeskulisa® Glia A, K052439)

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| No. Item | α-Gliatest® IgA                  | α-GliaPep® IgA                        | Predicate<br>AESKULISA® Glia-A (K052439) |                                                                                                                                                                                  |
|----------|----------------------------------|---------------------------------------|------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1.       | Capture<br>Antigen               | Purified α-gliadin<br>antigen         | Deamidated gliadin peptide               | Purified α-gliadin antigen                                                                                                                                                       |
| 2.       | Controls                         | Positive, Negative<br>Controls        | Positive, Negative Controls              | Positive, Negative, and Cut-off<br>Controls                                                                                                                                      |
| 3.       | Calibrators                      | 5 Levels: 0, 10, 20,<br>50, 100 AU/mL | 5 Levels: 0, 10, 20, 50, 100<br>AU/mL    | 6 Levels: 0, 3, 10, 30, 100, 300<br>U/mL                                                                                                                                         |
| 4.       | Cut-off                          | 8 AU/mL                               | 8 AU/mL                                  | 15 AU/mL                                                                                                                                                                         |
| 5.       | Incubation<br>Times              | 45-30-15 minutes                      | 45-30-15 minutes                         | GLIA-A and GLIA-G<br>(REF 7501US and REF<br>7502US, respectively):<br>30-15-15 minutes<br>GLIA-A and GLIA-G<br>(REF 7501US and REF<br>7502US, respectively):<br>30-30-30 minutes |
| 6.       | Sample<br>Diluent                | Ready-to-use                          | Ready-to-use                             | 5X concentrate                                                                                                                                                                   |
| 7.       | Wash<br>Solution/<br>Buffer      | 20X concentrated                      | 20X concentrated                         | 50X concentrated                                                                                                                                                                 |
| 8.       | Linearity<br>Range               | 1.1 - 100 AU/mL                       | 1.1 - 100 AU/mL                          | 7.4 - 102.5 U/mL                                                                                                                                                                 |
| 9.       | Claimed<br>Limit of<br>Detection | 1.1 AU/mL                             | 1.1 AU/mL                                | 1.0 U/mL                                                                                                                                                                         |

Table 2 Device Differences Between a-Gliatest® IgA, a-GliaPep® IgA and Predicate (Aeskulisa® Glia A, K052439)

# Table 3 Device Similarities Between a-Gliatest® IgG, a-GliaPep® IgG and Predicate (Aeskulisa® Glia A, K052439

| No. | Item         | α-Gliatest® IgG                                                                                                                                                                                                                                                                                                  | α-GliaPep® IgG                                                                                                                                                                                                                                                                                                                     | Predicate<br>AESKULISA® Glia-G<br>(K052439)                                                                                                                                                                                                                                                                                                                                         |
|-----|--------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1.  | Intended Use | The α-Gliatest® IgG is<br>intended for the<br>semi-quantitative<br>determination of IgG<br>antibodies directed against<br>gliadin in human serum. The<br>assay is an aid in the<br>diagnosis of celiac disease<br>and should be used in<br>conjunction with other<br>serological tests and clinical<br>findings. | The α-GliaPep® IgG is<br>intended for the<br>semi-quantitative<br>determination of IgG<br>antibodies directed against<br>deamidated gliadin peptide<br>in human serum. The assay<br>is an aid in the diagnosis of<br>celiac disease and should be<br>used in conjunction with<br>other serological tests and<br>clinical findings. | The AESKULISA® Glia-G<br>is a solid phase enzyme<br>immunoassay for the<br>semi-quantitative and<br>qualitative detection of IgG<br>antibodies against gliadin in<br>human serum. The assay is<br>an aid in the diagnosis of<br>celiac disease (gluten-<br>sensitive enteropathy) and<br>should be used in<br>conjunction with other<br>serological tests and clinical<br>findings. |
| 2.  | Methodology  | ELISA                                                                                                                                                                                                                                                                                                            | Same                                                                                                                                                                                                                                                                                                                               | Same                                                                                                                                                                                                                                                                                                                                                                                |
| 3.  | Analyte      | IgG antibodies against<br>gliadin in human serum                                                                                                                                                                                                                                                                 | IgG antibodies against<br>deamidated gliadin peptide<br>in human serum                                                                                                                                                                                                                                                             | IgA antibodies against<br>gliadin in human serum                                                                                                                                                                                                                                                                                                                                    |

.

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.

·

|       | No. Item                                    | a-Gliatest® IgG        | a-GliaPep® IgG | Predicate<br>AESKULISA® Glia-G<br>(K052439) |  |  |
|-------|---------------------------------------------|------------------------|----------------|---------------------------------------------|--|--|
| র্ব - | Enzyme-<br>Conjugate                        | Horseradish peroxidase | Same           | Same                                        |  |  |
| 5.    | Substrate/<br>Chromogen                     | TMB                    | Same           | Same                                        |  |  |
| 6.    | OD Reading                                  | 450 nm                 | Same           | Same                                        |  |  |
| 7.    | Positive<br>Control                         | Human serum            | Same           | Same                                        |  |  |
| 8.    | Negative<br>Control                         | Human serum            | Same           | Same                                        |  |  |
| ರ     | Storage                                     | 2-8°C                  | Same           | Same                                        |  |  |
| 10.   | Patient Sample 1:101<br>Dilution            |                        | Same           | Same                                        |  |  |
| 11.   | Patient Sample 100 uL<br>Volume<br>Required |                        | Same           | Same                                        |  |  |

# Table 4 Device Differences Between α-Gliatest® IgG, α-GliaPep® IgG and Predicate
(Aeskulisa® Glia A, K052439)
Marketer Clian Cara Cases Cara Cara Cara Cara Cara Cara Cara Car

| No. | Item                             | α-Gliatest® IgG                       | α-GliaPep® IgG                        | Predicate<br>AESKULISA® Glia-G (K052439)                                               |
|-----|----------------------------------|---------------------------------------|---------------------------------------|----------------------------------------------------------------------------------------|
| 1.  | Capture<br>Antigen               | Purified α-gliadin<br>antigen         | Deamidated gliadin peptide            | Purified α-gliadin antigen                                                             |
| 2.  | Controls                         | Positive, Negative<br>Controls        | Positive, Negative Controls           | Positive, Negative, and Cut-off<br>Controls                                            |
| 3.  | Calibrators                      | 5 Levels: 2, 10, 20,<br>50, 100 AU/mL | 5 Levels: 0, 10, 20, 50, 100<br>AU/mL | 6 Levels: 0, 3, 10, 30, 100, 300<br>U/mL                                               |
| 4.  | Cut-off                          | 50 Au/mL                              | 10 AU/mL                              | 15 AU/mL                                                                               |
| 5.  | Incubation<br>Times              | 45-30-15 minutes                      | 45-30-15 minutes                      | Glia-A and Glia-G<br>(REF 7501US and REF<br>7502US, respectively):<br>30-15-15 minutes |
|     |                                  |                                       |                                       | Glia-A and GLIA-G<br>(REF 7501US and REF<br>7502US, respectively):<br>30-30-30 minutes |
| 6.  | Sample<br>Diluent                | Ready-to-use                          | Ready-to-use                          | 5X concentrated                                                                        |
| 7.  | Wash<br>Solution/<br>Buffer      | 20X concentrated                      | 20X concentrated                      | 50X concentrated                                                                       |
| 8.  | Linearity<br>Range               | 2.5 - 99.4 AU/mL                      | 1.1 - 100 AU/mL                       | 12.4 - 117.6 U/mL                                                                      |
| 9.  | Claimed<br>Limit of<br>Detection | 2.4 AU/mL                             | 1.1 AU/mL                             | 1.0 U/mL                                                                               |

{5}------------------------------------------------

#### Standard/Guidance Document Referenced 10.

The following standards were referenced in the submission:

- CLSI EP5-A2, "Evaluation of Precision Performance of Quantitative Measurement . Methods"
- CLSI EP6-A, "Evaluation of the Linearity of Quantitative Measurement . Procedures; A Statistical Approach"
- CLSI EP7-A2, "Interference Testing in Clinical Chemistry" .
- CLSI EP17-A, "Protocols for Determination of Limits of Detection and Limits of . Quantitation"
- CLSI C28-A2, "How to Define and Determine Reference Intervals in the Clinical . Laboratory"
- CLSI EP9-A2, "Method Comparison and Bias Estimation Using Patient Samples" .

#### 11. Performance Characteristics

#### 11.1 Analytical Performance

#### 11.1.1 Precision Study

- The intra-assay precision studies were each performed in one (1) assay run. Results are summarized in Tables 5 - 8.

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 98.0 | 73.7 | 68.7 | 17.9 | 8.8  | 3.0  | 3.0  | 1.9  |
| SD           | 3.50 | 2.62 | 2.08 | 0.49 | 0.30 | 0.20 | 0.08 | 0.15 |
| CV%          | 3.6  | 3.6  | 3.0  | 2.7  | 3.5  | 6.8  | 2.7  | 7.7  |

Table 5 Intra-assay Precision Results for a-Gliatest® IgA

### Table 6 Intra-assay Precision Results for a-Gliatest® IgG

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 99.6 | 80.4 | 75.0 | 61.9 | 60.6 | 24.3 | 10.0 | 5.1  |
| SD           | 2.38 | 3.35 | 2.53 | 2.35 | 2.39 | 0.86 | 0.36 | 0.28 |
| CV%          | 2.4  | 4.2  | 3.4  | 3.8  | 3.9  | 3.6  | 3.6  | 5.4  |

# Table 7 Intra-assay Precision Results for a-GliaPep® IgA

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 98.2 | 86.6 | 65.8 | 17.8 | 9.7  | 4.4  | 2.7  | 1.8  |
| SD           | 6.61 | 2.83 | 4.43 | 0.95 | 0.94 | 0.25 | 0.19 | 0.15 |
| CV%          | 6.7  | 3.3  | 6.7  | 5.3  | 9.8  | 5.7  | 7.0  | 8.6  |

{6}------------------------------------------------

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 97.5 | 55.6 | 24.5 | 15.1 | 10.4 | 8.1  | 6.2  | 4.0  |
| SD           | 5.69 | 2.73 | 1.29 | 0.95 | 0.62 | 0.30 | 0.44 | 0.19 |
| CV%          | 5.8  | 4.9  | 5.3  | 6.3  | 5.9  | 3.6  | 7.1  | 4.7  |

Table 8 Intra-assay Precision Results for a-GliaPep® IgG

The inter-run (between days) precision study results are summarized in Tables 9 -12.

Table 9 Inter-run Precision Results for a-Gliatest® IgA

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 95.9 | 77.8 | 69.0 | 17.8 | 9.0  | 3.3  | 3.1  | 1.9  |
| SD           | 3.15 | 7.68 | 3.94 | 0.82 | 1.30 | 0.24 | 0.26 | 0.33 |
| CV%          | 3.3  | 9.9  | 5.7  | 4.6  | 14.4 | 7.2  | 8.3  | 17.3 |

### Table 10 Inter-run Precision Results for a-Gliatest® IgG

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 97.9 | 82.4 | 75.5 | 64.4 | 60.2 | 26.1 | 10.6 | 5.8  |
| SD           | 1.53 | 2.48 | 2.62 | 2.12 | 4.73 | 2.76 | 0.46 | 0.99 |
| CV%          | 1.6  | 3.0  | 3.5  | 3.3  | 7.9  | 11.0 | 4.3  | 16.9 |

# Table 11 Inter-run Precision Results for a-GliaPep 9 IgA

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 96.6 | 84.4 | 61.1 | 18.1 | 9.6  | 3.8  | 2.8  | 1.5  |
| SD           | 2.19 | 4.97 | 4.50 | 2.24 | 0.81 | 0.54 | 0.20 | 0.22 |
| CV%          | 2.3  | 5.9  | 7.4  | 12.4 | 8.4  | 14.2 | 7.2  | 14.9 |

# Table 12 Inter-run Precision Results for a-GliaPep® IgG

| Sample No.   | 1    | 2    | 3    | 4    | 5    | 6    | 7    | 8    |
|--------------|------|------|------|------|------|------|------|------|
| Mean (AU/mL) | 97.5 | 49.3 | 25.4 | 15.9 | 10.0 | 7.9  | 5.9  | 4.1  |
| SD           | 2.17 | 4.39 | 2.44 | 1.30 | 0.81 | 0.33 | 0.29 | 0.39 |
| CV%          | 2.2  | 8.9  | 9.6  | 8.2  | 8.1  | 4.2  | 4.9  | 9.4  |

The inter-lot precision study results are summarized in Tables 13-16.

# Table 13 Inter-lot Precision Results for a-Gliatest® IgA

| Serum Sample No. | 1    | 2    | 3    | 4    | 5    |
|------------------|------|------|------|------|------|
| Mean (AU/mL)     | 87.3 | 42.8 | 22.7 | 11.6 | 7.1  |
| S.D.             | 0.81 | 2.46 | 1.22 | 1.18 | 0.28 |
| C.V. (%)         | 0.9  | 5.8  | 5.4  | 10.1 | 3.9  |

{7}------------------------------------------------

| Serum Sample No. | 1    | 2    | 3    | 4    | 5    |
|------------------|------|------|------|------|------|
| Mean (AU/mL)     | 84.9 | 50.3 | 42.7 | 24.4 | 11.1 |
| S.D.             | 2.13 | 1.07 | 0.72 | 1.01 | 0.15 |
| C.V. (%)         | 2.5  | 2.1  | 1.7  | 4.1  | 1.4  |

Table 14 Inter-lot Precision Results for a-Gliatest® IgG

### Table 15 Inter-lot Precision Results for a-GliaPep® IgA

| Serum Sample No. | 1    | 2    | 3    | 4    | 5    |
|------------------|------|------|------|------|------|
| Mean (AU/mL)     | 85.4 | 42.6 | 22.6 | 14.3 | 7.3  |
| S.D.             | 1.79 | 1.86 | 1.83 | 0.50 | 0.38 |
| C.V. (%)         | 2.1  | 4.4  | 8.1  | 3.5  | 5.1  |

Table 16 Inter-lot Precision Results for a-GliaPep® IgG

| Serum Sample No. | 1    | 2    | 3    | 4    | 5    |
|------------------|------|------|------|------|------|
| Mean (AU/mL)     | 83.1 | 45.6 | 26.3 | 13.1 | 4.1  |
| S.D.             | 0.99 | 1.31 | 0.39 | 1.34 | 0.12 |
| C.V. (%)         | 1.2  | 2.9  | 1.5  | 10.2 | 3.0  |

#### 11.1.2 Linearity/Assay Reportable Range

Linearity was studied using four (4) positive serum samples each for the a-Gliatest® IgA, a-Gliatest® IgG, a-GliaPep® IgA, and a-GliaPep® IgG. Each sample was diluted with a low concentration serum sample at around the limit of detection (LoD), 1.1 AU/mL for a-Gliatest® IgA, 2.4 AU/mL for a-Gliatest® IgG, 1.1 AU/mL for a-GliaPep® IgA , and 1.1 AU/mL for a-GliaPep® IgG, respectively, using a dilution scheme.

The results of one (1) representative sample for a-Gliatest® IgA show a slope of 1.017 (95% C.I. 0.991 to 1.044), Y-intercept of -1.637 (95% C.I. -3.210 to -0.064) and R2 of 0.9988. The results of one (1) representative sample for a-Gliatest® IgG show a slope of 0.997 (95% C.I. 0.931 to 1.064), Y-intercept of 1.857 (95% C.I. -2.182 to 5.896) and R2 of 0.9924. The results of one (1) representative sample for a-GliaPep® IgA show a slope of 1.018 (95% C.I. 0.994 to 1.042), Y-intercept of -1.697 (95% C.I. -3.075 to 0.320) and R2 of 0.9990. The results of one (1) representative sample for a-Gliatest® IgG show a slope of 1.014 (95% C.I. 0.987 to 1.041), Y-intercept of -1.705 (95% C.I. -3.354 to -0.056) and R2 of 0.9988.

{8}------------------------------------------------

The results of the study support the linear range and the claimed assay range of 1.1-100 AU/mL for a-Gliatest® IgA, 2.5-99.4 AU/mL for a-Gliatest® IgG, 1.1-100 AU/mL for a-GliaPep® IgA, and 1.1-100 AU/mL for α-GliaPep® IgG.

#### 11.1.3 Traceability, Stability and Expected Values (Controls and Calibrators)

### Traceability

Calibrators are not traceable to any recognized standards. Calibrators are dilutions of pooled sera with anti-gliadin antibody from patients with celiac disease. The new calibrator and control lots are formulated from an array of anti-gliadin antibody positive sera obtained from various commercial plasma centers stored at -70°C. The calibrators and controls are taken from different pooled sera. As new lots of calibrators are developed, studies are performed to calibrate values against original calibrators. Each lot of calibrator is also tested in comparison with normal human sera, clinical samples and internal standards. The concentration values of the calibrators are as follows:

| Calibrator | α-Gliatest® IgA | α-Gliatest® IgG |
|------------|-----------------|-----------------|
| Cal S5     | 100 AU/mL       | 100 AU/mL       |
| Cal S4     | 50 AU/mL        | 50 AU/mL        |
| Cal S3     | 20 AU/mL        | 20 AU/mL        |
| Cal S2     | 10 AU/mL        | 10 AU/mL        |
| Cal S1     | 0 AU/mL         | 2 AU/mL         |

| Calibrator | α-GliaPep® IgA | α-GliaPep® IgG |
|------------|----------------|----------------|
| Cal S5     | 100 AU/mL      | 100 AU/mL      |
| Cal S4     | 50 AU/mL       | 50 AU/mL       |
| Cal S3     | 20 AU/mL       | 20 AU/mL       |
| Cal S2     | 10 AU/mL       | 10 AU/mL       |
| Cal S1     | 0 AU/mL        | 0 AU/mL        |

#### Kit Stability .

Stability studies support the expiration date claims of 12 months at 2-8°C for the α-Gliatest® IgA, α-Gliatest® IgG, α -GliaPep® IgA, and a-GliaPep® IgG.

{9}------------------------------------------------

#### . Sample Stability

Specimens should be stored at 2-8°C for no longer than five (5) days. For longer storage, serum specimens should be frozen at -20°C. Repeated freezing and thawing of samples should be avoided.

#### 11.1.4 Detection Limit

The limits of blank (LoB) and the claimed limits of detection (LoD) for a-Gliatest® IgA, a-Gliatest® IgG, a-GliaPep® IgA and a-GliaPep® IgG, are shown in Table 17.

|                 | LoB (AU/mL) | Claimed LoD<br>(AU/mL) |
|-----------------|-------------|------------------------|
| α-Gliatest® IgA | 0.59        | 1.1                    |
| α-Gliatest® IgG | 1.66        | 2.4                    |
| α-GliaPep® IgA  | 0.13        | 1.1                    |
| α-GliaPep® IgG  | 0.18        | 1.1                    |

Table 17 Limits of Blank and Claimed Limits of Detection for «-Gliatest® IgA & IgG and a-GliaPep® IgA & IgG

#### Analytical Specificity 11.1.5

Cross-reactivity studies were performed for a-Gliatest® IgA, a-Gliatest® IgG, a-GliaPep® IgA, and a-GliaPep® IgG, using 148 characterized clinical samples from individuals with autoimmune disorders, such as Hashimoto's Thyroiditis (HT), Graves' Disease (GD), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), Sjogren's, Systemic Sclerosis and Autoimmune Hepatitis (AH); patients with Inflammatory Bowel Disease (IBD), including Crohn's Disease and Ulcerative Colitis (UC); Irritable Bowel Syndrome (IBS), Type 1 Diabetes and H. pylori infection.

One (1) RA, 11 SLE, seven (7) HT, six (6) GD, one (1) AH, one (1) Crohn's Disease, five (5) IBS, and four (4) Type 1 Diabetes out of 148 samples (36/148, 24.3%) were tested positive for a-Gliatest IgA. One (1) RA, two (2) SLE, one (1) GD, one (1) Sjogren's, two (2) Crohn's Disease, two (2) UC, five (5) IBS, and three (3) Type 1 Diabetes out of 148 samples (17/148, 11.5%) were tested positive for a-Gliatest IgG.

Four (4) HT, one (1) GD, one (1) AH, two (2) IBS, one (1) Type 1 Diabetes, and one (1) H. pylori out of 148 samples (10/148, 6.8%) were 

{10}------------------------------------------------

tested positive for a-GliaPep IgA. Two (2) RA, two (2) SLE, three (3) HT, four (4) GD, one (1) AH, two (2) Crohn's Disease, one (1) UC, two (2) IBS, two (2) Type 1 Diabetes, and three (3) H. pylori out of 148 samples (22/148, 14.9%) were tested positive for a-GliaPep IgG.

Interference was studied by mixing the serum samples with known anti-gliadin antibody levels with the potentially interfering substances.

- The study results demonstrated that hemoglobin (up to 2 g/L), . bilirubin (up to 342 umol/L), rheumatoid factor (up to 100 IU/mL) or lipids (triglycerides up to 1.08 mmol/L) does not significantly interfere with the performance of the a-Gliatest IgA.
- The study results demonstrated that hemoglobin (up to 2 g/L), ● bilirubin (up to 256 umol/L), rheumatoid factor (up to 100 IU/mL) or lipids (triglycerides up to 1.08 mmol/L) does not significantly interfere with the performance of the a-Gliatest IgG.
- � The study results demonstrated that hemoglobin (up to 1.5 g/L), bilirubin (up to 256 umol/L), theumatoid factor (up to 100 IU/mL) or lipids (triglycerides up to 1.08 mmol/L) does not significantly interfere with the performance of the a-GliaPep IgA.
- The study results demonstrated that hemoglobin (up to 1.5 g/L), bilirubin (up to 342 umol/L), rheumatoid factor (up to 100 IU/mL) or lipids (triglycerides up to 1.47 mmol/L) does not significantly interfere with the performance of the α-GliaPep IgG.

#### 11.1.6 Assay Cut-off

The normal range of each assay was established by testing over 160 serum samples from healthy subjects and non-celiac controls, such as Inflammatory Bowel Disease (IBD) patients, on each assay.

The assay cut-off value for a-Gliatest® IgA was determined as follows: <8 AU/mL Negative ≥8 AU/mL Positive

{11}------------------------------------------------

The assay cut-off value for a-Gliatest® IgG was determined as follows: <50 AU/mL Negative ≥5() AU/mL Positive

The assay cut-off value for α-GliaPep® IgA was determined as follows: <8 AU/mL Negative Positive ≥8 AU/mL

The assay cut-off value for a-GliaPep® IgG was determined as follows: <10 AU/mL Negative ≥10 AU/mL Positive

#### 11.2 Method Comparison Studies

#### a-Gliatest® IgA 11.2.1

A method comparison study was performed which compared the a-Gliatest® IgA to a comparator test using 178 clinical samples. These samples consist of clinically-diagnosed celiac positive (clinical history and/or biospy) and negative samples. The negative samples were obtained from healthy blood donors, inflammatory bowel disease (IBD) patients, irritable bowel syndrome (IBS) patients, patients affected by food intolerances, patients with autoimmune disorders, patients with infectious diseases and patients with Type 1 diabetes. All samples were tested using a-Gliatest® IgA and the comparator test kit. The results of the studies are summarized in Table 18.

|  |  |  |  | Table 18 Results of Method Comparison Study for a-Gliatest IgA |  |  |  |
|--|--|--|--|----------------------------------------------------------------|--|--|--|
|--|--|--|--|----------------------------------------------------------------|--|--|--|

|                                      |          | Aeskulisa Glia A (K052439)<br>(Cut-off = 15 AU/mL) |          |       |
|--------------------------------------|----------|----------------------------------------------------|----------|-------|
|                                      |          | Positive                                           | Negative | Total |
| α-Gliatest® IgA<br>(Cut-off 8 AU/mL) | Positive | 52                                                 | 18       | 70    |
|                                      | Negative | 6                                                  | 102      | 108   |
|                                      | Total    | 58                                                 | 120      | 178   |

Positive Agreement = 89.7% (95% C.I. 78.8% - 96.1%) Negative Agreement = 85.0% (95% C.I. 77.3% - 90.9%) Overall Agreement = 86.5% (95% C.I. 80.6% - 91.2%)

C.I. = Confidence Interval

{12}------------------------------------------------

#### a-Gliatest® IgG 11.2.2

A method comparison study was performed which compared the a-Gliatest® IgG to a comparator test using 198 clinical samples. These samples consist of 51 clinically-diagnosed celiac positive (clinical history and/or biospy), which include 10 total IgA-deficient celiac patients, and negative samples. The negative samples were obtained from healthy blood donors, inflammatory bowel disease (IBD) patients, irritable bowel syndrome (IBS) patients, patients affected by food intolerances, patients with autoimmune disorders, patients with infectious diseases and patients with Type 1 diabetes. All samples were tested using the a-Gliatest® IgG and the comparator test kit. The results of the studies are summarized in Table 19.

Table 19 Results of Method Comparison Study for a-Gliatest® IgG

|                                       |          | Aeskulisa® Glia G (K052439)<br>(Cut-off = 15 AU/mL) |          |       |
|---------------------------------------|----------|-----------------------------------------------------|----------|-------|
|                                       |          | Positive                                            | Negative | Total |
| α-Gliatest® IgG<br>(Cut-off 50 AU/mL) | Positive | 52                                                  | 15       | 67    |
|                                       | Negative | 14                                                  | 117      | 131   |
|                                       | Total    | 66                                                  | 132      | 198   |

Positive Agreement = 78.8% (95% C.I. 67.0% - 87.9%) Negative Agreement = 88.6 % (95% C.I. 82.0% - 93.5%) Overall Agreement = 85.4% (95% C.I. 79.6% - 90.0%)

#### α-GliaPep® IgA 11.2.3

A method comparison study was performed which compared the a-GliaPep® IgA to a comparator test using 179 clinical samples within the linearity range of the assay. These samples consist of clinically-diagnosed celiac positive (clinical history and/or biospy) and negative samples. The negative samples were obtained from healthy blood donors, IBD patients, IBS patients, patients affected by food intolerances, patients with autoimmune disorders, patients with infectious diseases and patients with Type 1 diabetes. All samples were tested using a-GliaPep® IgA and the comparator test kit. The results of the studies are summarized in Table 20.

{13}------------------------------------------------

|                                     |          | Aeskulisa® Glia A (K052439)<br>(Cut-off = 15 AU/mL) |          |       |
|-------------------------------------|----------|-----------------------------------------------------|----------|-------|
|                                     |          | Positive                                            | Negative | Total |
| α-GliaPep® IgA<br>(Cut-off 8 AU/mL) | Positive | 36                                                  | 11       | 47    |
|                                     | Negative | 14                                                  | 118      | 132   |
|                                     | Total    | 50                                                  | 129      | 179   |

Table 20 Results of Method Comparison Study for α-GliaPep® IgA

Positive % Agreement = 72.0% (95% C.I. 57.5% - 83.8%) Negative % Agreement = 91.5% (95% C.I. 85.3% - 95.7%) Overall % Agreement = 86.0% (95% C.I. 80.1% - 90.8%)

#### a-GliaPep® IgG 11.2.4

The a-GliaPep® IgG test was tested in comparison to the predicate, using 201 clinical samples within the linearity range of the assay. These samples consist of 57 clinically-diagnosed celiac positive (clinical history and/or biospy), which include 10 total IgA-deficient celiac patients, and 146 negative samples. The negative samples were ontained from healthy blood donors, IBD patients, IBS patients, patients affected by food intolerances, patients with autoimmune disorders, patients with infectious diseases and patients with Type 1 diabetes. All samples were tested using the a-GliaPep® IgG and the comparator test kit. The results of the studies are summarized in Table 21.

| Aeskulisa® Glia G (K052439)<br>(Cut-off = 15 AU/mL) |          |          |       |     |
|-----------------------------------------------------|----------|----------|-------|-----|
|                                                     | Positive | Negative | Total |     |
| α-GliaPep® IgG<br>(Cut-off 10 AU/mL)                | Positive | 50       | 16    | 66  |
|                                                     | Negative | 13       | 122   | 135 |
|                                                     | Total    | 63       | 138   | 201 |

Table 21 Results of Method Comparison Study for a-GliaPep® IgG

Positive % Agreement = 79.4% (95% C.I. 67.3% - 88.5%) Negative % Agreement = 88.4% (95% C.I. 81.9% - 93.2%) Overall % Agreement = 85.6% (95% C.I. 79.9% - 90.1%)

{14}------------------------------------------------

#### 11.3 Clinical Studies

#### α-Gliatest® IgA 11.3.1

For the a-Gliatest® IgA, the clinical study included 262 clinical samples, of which 114 are positive celiac patients and 148 are negative samples from disease control patients with autoimmune disorders, infectious diseases, IBD, IBS and Type 1 diabetes. The celiac patient samples were diagnosed with clinical findings and/or confirmed with biopsy. Table 22 demonstrates the clincal performance of the a-Gliatest® IgA.

|                                      |          | Celiac Disease |          |       |
|--------------------------------------|----------|----------------|----------|-------|
|                                      |          | Positive       | Negative | Total |
| a-Gliatest® IgA<br>(Cut-off 8 AU/mL) | Positive | 79             | 36       | 115   |
|                                      | Negative | 35             | 112      | 147   |
|                                      | Total    | 114            | 148      | 262   |

Table 22 Clinical Study Results of a-Gliatest® IgA

Specificity = 75.7% (95% C.I. 67.9% - 82.3%)

For the a-Gliatest IgA assay, 196 healthy blood donor samples were also tested, of which six samples (3.1%) tested positive.

#### a-Gliatest® IgG 11.3.2

For the a-Gliatest® IgG, the clinical study included 285 clinical samples, of which 127 are positive celiac patients, 10 are total IgA-deficient celiac patients and 148 are negative samples from disease control patients with autoimmune disorders, infectious diseases, IBD, IBS and Type 1 diabetes. The positive celiac patient samples were diagnosed with clinical findings and confirmed with biopsy. Table 23 demonstrates the clinical performance of the a-Gliatest® IgG assay.

Table 23 Clinical Study Results of a-Gliatest® IgG

|                                       |          | Celiac Disease |          |       |
|---------------------------------------|----------|----------------|----------|-------|
|                                       |          | Positive       | Negative | Total |
| α-Gliatest® IgG<br>(Cut-off 50 AU/mL) | Positive | 109            | 17       | 126   |
|                                       | Negative | 28             | 131      | 159   |
|                                       | Total    | 137            | 148      | 285   |

Sensitivity = 79.6% (95% C.I. 71.8% - 86.0%)

Specificity = 88.5% (95% C.I. 82.2% - 93.2%)

For the a-Gliatest IgG assay, 196 healthy blood donor samples were also tested, of which 10 samples (5.1%) tested positive.

{15}------------------------------------------------

#### α-GliaPep® IgA 11.3.3

For the a-GliaPep® IgA, the clinical study included 241 clinical samples, of which 93 are positive celiac patients and 148 are negative samples from disease control patients with autoimmune disorders, infectious diseases, IBD, IBS and Type 1 diabetes. The celiac patient samples were diagnosed with clinical findings and confirmed with biopsy. Table 24 demonstrates the clincal performance of the a-GliaPep® IgA.

|                                     |          | Celiac Disease |          |       |
|-------------------------------------|----------|----------------|----------|-------|
|                                     |          | Positive       | Negative | Total |
| α-Gliapep® IgA<br>(Cut-off 8 AU/mL) | Positive | 74             | 10       | 84    |
|                                     | Negative | 19             | 138      | 157   |
|                                     | Total    | 93             | 148      | 241   |

| Table 24 Clinical Study Results of a-GliaPep® IgA |  |  |
|---------------------------------------------------|--|--|
|                                                   |  |  |

Sensitivity = 79.6% (95% C.I. 69.9% - 87.2%) Specificity = 93.2% (95% C.I. 87.9% - 96.7%)

For the a-GliaPep IgA assay, 145 healthy blood donor samples were also tested, of which five samples (3.5%) tested positive.

#### a-GliaPep® IgG 11.3.4

For the a-GliaPep® IgG, the clinical study included 253 clinical samples, of which 95 are positive celiac patients, 10 are total IgA-deficient celiac patients and 148 are negative samples from disease control patients with autoimmune disorders, infectious diseases, IBD, IBS and Type 1 diabetes patient samples. The positive celiac patient samples were diagnosed with clinical findings (31.6%) and confirmed with biopsy (68.4%). Table 25 demonstrates the clinical performance of the a-GliaPep® IgG assay.

Table 25 Clinical Study Results of a-GliaPep® IgG

|                                       |          | Celiac Disease |          |       |
|---------------------------------------|----------|----------------|----------|-------|
|                                       |          | Positive       | Negative | Total |
| α-Gliatest® IgG<br>(Cut-off 50 AU/mL) | Positive | 95             | 22       | 117   |
|                                       | Negative | 10             | 126      | 136   |
|                                       | Total    | 105            | 148      | 253   |

Sensitivity = 90.5% (95% C.1. 83.2% - 95.3%) Specificity = 85.1% (95% C.I. 78.4% - 90.4%)

For the a-GliaPep IgG assay, 145 healthy blood donor samples were also tested, of which 13 samples (9.0%) tested positive.

{16}------------------------------------------------

#### 11.4 Expected Results

The expected result in the normal population is negative. However, the incidence of celiac disease in the normal population is about 1%. Some apparently healthy individuals may test positive for the anti-gliadin antibodies (AGA).

#### 12 Conclusion

The submitted material in this 510(k) Premarket Notification is sufficient to support a substantial equivalence decision with the legally marketed predicate devices.

{17}------------------------------------------------

Image /page/17/Picture/0 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo features a stylized depiction of a human figure in profile, with three overlapping faces suggesting a sense of community and support. The text "DEPARTMENT OF HEALTH & HUMAN SERVICES • USA" is arranged in a circular pattern around the figure, emphasizing the department's role within the United States government. The logo is simple, yet conveys a sense of care and service.

### DEPARTMENT OF HEALTH & HUMAN SERVICES

### Public Health Service

Food and Drug Administration 10903 New Hampshire Avenue Document Control Center - WO66-G609 Silver Spring, MD 20993-002

# DEC 1 4 2012

Grifols USA, LLC C/O Ms. Catherine L. Wong Director, Regulatory Affairs 2410 Lillyvale Avenue Los Angeles. CA 90032

Re: k113377

Trade/Device Name: α-Gliatest® IgA, α-Gliatest® IgG, α-GliaPep® IgA, α-GliaPep® IgG Regulation Number: 21 CFR §866.5750

Regulation Name: Radioallergosorbent (RAST) Immunological Test System Regulatory Class: Class II

Product Code: MST

Dated: November 27, 2012

Received: November 28, 2012

### Dear Ms. Wong:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 tó 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting (reporting of medical

{18}------------------------------------------------

### Page 2 - Ms. Catherine L. Wong

device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please go to http://www.fda.gov/AboutFDA/CentersOffices/CDRH/CDRHOffices/ucm115809.htm for the Center for Devices and Radiological Health's (CDRH's) Office of Compliance. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to

http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 796-7100 or at its Internet address http://www.fda.gov/MedicalDevices/Resourcesfor You/Industry/default.htm.

Sincerely yours,

Reena Philip -S

for Maria M. Chan, Ph.D.

Director

Division of Immunology and Hematology Devices Office of In Vitro Diagnostics and Radiological Health (OIR)

Center for Devices and Radiological Health

{19}------------------------------------------------

#### Indication for Use Statement for α-Gliatest® IgA 1.

510(k) Number (if known): K113377

Device Name: α-Gliatest® IgA

Indication for Use:

The a-Gliatest IgA is intended for the semi-quantitative determination of IgA antibodies directed against gliadin in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Prescription Use _ X (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OIVD)

NZP misar Pampoic

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) k113377

{20}------------------------------------------------

#### Indication for Use Statement for a-Gliatest® IgG 2.

510(k) Number (if known): K113377

Device Name: α-Gliatest ® IgG

Indication for Use:

The a-Gliatest® IgG is intended for the semi-quantitative determination of IgG antibodies directed against gliadin in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Prescription Use X (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OIVD)

NZP Nisar Pampori

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K113377

{21}------------------------------------------------

#### Indication for Use Statement for α-GliaPep® IgA 3.

510(k) Number (if known): K113377

Device Name: α-GliaPep ® IgA

Indication for Use:

The a-GliaPep® IgA is intended for the semi-quantitative determination of IgA antibodies directed against deamidated gliadin peptide in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Prescription Use _ X (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use _ (21 CFR Part 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OIVD)

NZGnisar Painpori

Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K113377

{22}------------------------------------------------

#### Indication for Use Statement for x-GliaPep® IgG 4.

510(k) Number (if known): K113377

Device Name: α-GliaPep® IgG

Indication for Use:

The a-GliaPep® IgG is intended for the semi-quantitative determination of IgG antibodies directed against deamidated gliadin peptide in human serum. The assay is an aid in the diagnosis of celiac disease and should be used in conjunction with other serological tests and clinical findings.

Prescription Use _ X (21 CFR Part 801 Subpart D) And/Or

Over the Counter Use (21 CFR Part 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE; CONTINUE ON ANOTHER PAGE IF NEEDED) Concurrence of CDRH, Office of In Vitro Diagnostic Device Evaluation and Safety (OIVD)

NZ-P. Nisar Pampori

Division Sign-Off Office of In Vitro Diagnostic Device Evaluation and Safety

510(k) K113377

---

**Source:** [https://fda.innolitics.com/submissions/IM/subpart-f%E2%80%94immunological-test-systems/MST/K113377](https://fda.innolitics.com/submissions/IM/subpart-f%E2%80%94immunological-test-systems/MST/K113377)

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