To evaluate the efficacy of dupilumab compared to placebo on a background of mometasone furoate nasal spray (MFNS) in reducing nasal congestion/obstruction (NC) severity and endoscopic nasal polyp score (NPS) in patients with bilateral nasal…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
bilaterale nasale polyposis
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Change from baseline at Week 24:
* Nasal congestion/obstruction (NC) symptom severity score based on the patient
daily morning (AM) assessment.
* Nasal polyp score, as assessed by central video recordings of nasal
endoscopy.
Secondary outcome
Efficacy key secondary
- Change in following parameters from baseline at week 24
* total symptom score at Week 24: composite severity score consisting of the
patient daily AM assessed nasal congestion, decreased/loss of sense of smell,
anterior/posterior rhinorrhea.
* UPSIT smell test
* severity of decreased/loss of smell
* opacification of sinuses assessed by CT scans
* sino-nasal outcome test (SNOT-22)
- Proportion of patients during study treatment receiving oral corticosteroids
for nasal polyposis and/or planned to undergo surgery for nasal polyps.
Background summary
Polyps are generally comprised of eosinophilic infiltrate and associated with a
Th2 orchestrated inflammatory state characterized by high IgE, increased Th2
cytokines such as IL 5 and IL 13, and decreased T regulatory function.
Dupilumab prevents IL 4 and IL 13 binding and activation of their respective
receptors involved in signaling pathways that play key roles in the
pathophysiology of nasal polyposis. A Phase 2a study in patients with NP and
symptoms of sinusitis, demonstrated efficacy of dupilumab with improvements in
endoscopic, radiographic and clinical measures of disease as well as
improvements in lung function and disease control in patients with comorbid
asthma. Dupilumab may provide an effective treatment for patients suffering
from nasal polyposis despite maximal treatment with available therapy.
Study objective
To evaluate the efficacy of dupilumab compared to placebo on a background of
mometasone furoate nasal spray (MFNS) in reducing nasal congestion/obstruction
(NC) severity and endoscopic nasal polyp score (NPS) in patients with bilateral
nasal polyposis (NP).
Study design
A randomized, double-blind, placebo controlled, parallel group, multi-center
study
Intervention
Biweekly subcutaneous injections with dupilumab (300 mg) or or placebo for 24
weeks
Study burden and risks
Risks and burdens related to blood collection, CT scan, subcutaneous injections
for both groups. Possible side events of study medication for dupilumab group.
Further burden for the patient is related to the increased frequency of
visiting the hospital for treatment of their nasal polyps.
Kampenringweg 45E
Gouda 2803 PE
NL
Kampenringweg 45E
Gouda 2803 PE
NL
Listed location countries
Age
Inclusion criteria
Patients with bilateral sinonasal polyposis that despite prior treatment with systemic corticosteroids (SCS) anytime within the past 2 years; and/or have a medical contraindication / intolerance to SCS, and/or had prior surgery for NP at the screening visit, have:;-An endoscopic bilateral NPS of at least 5 out of a maximum score of 8 (with a minimum score of 2 in each nasal cavity).;-Ongoing symptoms (for at least 8 weeks prior to V1) of nasal congestion / blockage / obstruction with moderate or severe symptom severity (score 2 or 3) at V1 and a weekly average severity of greater than 1 at the time of randomization (V2), and another symptom such as loss of smell, rhinorrhea (anterior/posterior).;-Signed written informed consent.
Exclusion criteria
-Patients <18 years of age.;-Patient who has previously been treated in dupilumab studies.;-Patient who has taken:;-Biologic therapy/systemic immunosuppressant to treat inflammatory disease or autoimmune disease (eg, rheumatoid arthritis, inflammatory bowel disease, primary biliary cirrhosis, systemic lupus erythematosus, multiple sclerosis, etc.) within 2 months before V1 or 5 half-lives, whichever is longer.;-Any experimental monoclonal antibody (mAB) within 5 half-lives or within 6 months before V1 if the half-life is unknown.;-Anti-immunoglobulin E (IgE) therapy (omalizumab) within 130 days prior to V1.;-Leukotriene antagonists/modifiers unless patient is on a continuous treatment for at least 30 days prior to V1.;-Initiation of allergen immunotherapy within 3 months prior to V1 or a plan to begin therapy or change its dose during the run-in period or the randomized treatment period.;-Patients who have undergone any intranasal and/or sinus surgery (including polypectomy) within 6 months prior to V1.;-Patients who have had a sinonasal or sinus surgery changing the lateral wall structure of the nose making impossible the evaluation of NPS.;-Patients with conditions/concomitant diseases making them nonevaluable at V1 or for the primary efficacy endpoint such as:;-Antrochoanal polyps.;-Nasal septal deviation that would occlude at least one nostril.;-Acute sinusitis, nasal infection or upper respiratory infection.;-Ongoing rhinitis medicamentosa.;-Allergic granulomatous angiitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener*s granulomatosis), Young*s syndrome, Kartagener*s syndrome or other dyskinetic ciliary syndromes, concomitant cystic fibrosis.;-Radiologic suspicion, or confirmed invasive or expansive fungal rhinosinusitis.;-Patients with nasal cavity malignant tumor and benign tumors (eg, papilloma, blood boil etc).;-Patients with forced expiratory volume in 1 second (FEV1) 50% or less (of predicted normal).;-Patients receiving concomitant treatment prohibited in the study.;-Treatment with a live (attenuated) vaccine within 12 weeks before the baseline visit.;-History of human immunodeficiency virus (HIV) infection or positive HIV serology at screening.;-Positive with hepatitis B surface antigen (HBsAg) or hepatitis C antibody at the screening visit.;-Active chronic or acute infection requiring systemic treatment within 2 weeks before the baseline visit.;-Known or suspected history of immunosuppression.;-Pregnant or breastfeeding women, or women planning to become pregnant or breastfeed during the study.;-Women unwilling to use adequate birth control, if of reproductive potential and sexually active.;Note: The information listed above is not intended to contain all considerations relevant to a;patient's potential participation in this clinical trial therefore not all inclusion/exclusion criteria are;listed.
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
EudraCT | EUCTR2015-003101-42-NL |
Other | IND105379 |
CCMO | NL58914.018.16 |