Effect of Mepolizumab on Decrease of Systemic Corticosteroids in Patients With Severe Eosinophilic Asthma (Mepolizumab)
Effet du Mepolizumab Sur la décroissance de la corticothérapie systémique Chez Des Patients Avec un Asthme éosinophilique sévère Etude Observationnelle, Suivi de Cohorte Via Une ATU Nominative
The primary objective of the study is to measure the effect of mepolizumab on declines in oral corticosteroid therapy (prednisolone or prednisone) in patients with severe eosinophilic asthma.
Asthma is a chronic inflammatory disease of the airways that affects 5 to 10% of adults and children. Despite current treatments that are often effective, 10% of patients are not controlled by inhaled therapies. These severe asthma require regular use of systemic corticosteroids in 30 to 40% of cases. In this context, the use of glucocorticoids is associated with many more or less serious adverse effects, but still affecting the patient's quality of life. Several treatments have already been proven to save systemic steroids (theophylline, anti-leukotrienes, golimumab ...). On the other hand, none is currently recommended because of a risk / benefit ratio that is too high.
Mepolizumab is a human monoclonal antibody that binds to and inactivates interleukin 5. It has recently been shown to be effective in reducing the daily dose of oral corticosteroids and in reducing exacerbations in these patients with severe eosinophilic asthma. It also reduces the number of eosinophils in the blood and sputum and improves the quality of life.
Patients will receive a subcutaneous injection of 100mg mepolizumab every 4 weeks for one year, for a total of 12 injections.
In France, this treatment was subject to a Temporary Authorization for Nominative Use in severe eosinophilic asthma and is reserved for hospital use.
The injections will be done in HDJ Pneumology CHU Grenoble Alpes and patients will be followed monthly during injections and one month after the end of injections.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Contacts and Locations
Study Locations
-
-
-
La Tronche, France, 38700
- University Hospital Grenoble
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Severe eosinophilic asthma
- Patient on inhaled therapy with inhaled corticosteroid and long-acting bronchodilator for at least 6 months
- Patient under oral corticosteroid therapy (prednisolone or prednisone) for at least 6 months and unmodified in the last 4 weeks before the first injection
- Patient able to provide informed and written consent
- Obtaining the temporary authorization for nominative use for mepolizumab
Exclusion Criteria:
- Chronic pulmonary pathology other than asthma
- Active neoplasia
- Active liver disease
- Serious and uncontrolled cardiovascular pathology (LVEF less than 30%, NYHA IV, ...)
- Other eosinophilic pathology (Churg & Strauss syndrome, parasitic infection, ...)
- Hypersensitivity to mepolizumab or excipient
- Immunity disorders
- Patient not affiliated to a social security system
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
mepolizumab
Patients will receive a subcutaneous injection of mepolizumab 100 mg every 4 weeks for one year, for a total of 12 injections
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Effect of mepolizumab on declines in oral corticosteroid therapy (prednisolone or prednisone) in patients with severe eosinophilic asthma.
Time Frame: 13 months
|
Rate of decrease in systemic corticosteroids between the day of the first injection and one month after the last injection.
|
13 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Asthma control
Time Frame: Every month during 13 months
|
Asthma Control Questionnaire (ACT)
|
Every month during 13 months
|
|
Improving quality of life
Time Frame: Every month during 13 months
|
Asthma Quality of Life Questionnaire (AQLQ)
|
Every month during 13 months
|
|
Improvement of respiratory functional explorations, Forced Expiratory Volume
Time Frame: Every month during 13 months
|
Forced Expiratory Volume
|
Every month during 13 months
|
|
Decrease in the number of exacerbations
Time Frame: Assessed every month during 13 months
|
An exacerbation is defined as an episode of progressive degradation, over a few days, of one or more clinical signs, as well as functional parameters of bronchial obstruction.
|
Assessed every month during 13 months
|
|
Improvement of respiratory functional explorations
Time Frame: Every month during 13 months
|
Vital Capacity
|
Every month during 13 months
|
|
Improvement of respiratory functional explorations
Time Frame: Every month during 13 months
|
Forced Vital Capacity
|
Every month during 13 months
|
|
Improvement of respiratory functional explorations
Time Frame: Every month during 13 months
|
FEV/FVC
|
Every month during 13 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Margaux Isnard, Resident, University Hospital, Grenoble
- Study Chair: Laure Geneletti, Resident, University Hospital, Grenoble
- Study Chair: Audrey Lehmann, Ph, University Hospital, Grenoble
- Study Chair: Pierrick Bedouch, PhD, University Hospital, Grenoble
- Study Chair: Sébastien Chanoine, University Hospital, Grenoble
Publications and helpful links
General Publications
- Bel EH, Wenzel SE, Thompson PJ, Prazma CM, Keene ON, Yancey SW, Ortega HG, Pavord ID; SIRIUS Investigators. Oral glucocorticoid-sparing effect of mepolizumab in eosinophilic asthma. N Engl J Med. 2014 Sep 25;371(13):1189-97. doi: 10.1056/NEJMoa1403291. Epub 2014 Sep 8.
- Ortega HG, Liu MC, Pavord ID, Brusselle GG, FitzGerald JM, Chetta A, Humbert M, Katz LE, Keene ON, Yancey SW, Chanez P; MENSA Investigators. Mepolizumab treatment in patients with severe eosinophilic asthma. N Engl J Med. 2014 Sep 25;371(13):1198-207. doi: 10.1056/NEJMoa1403290. Epub 2014 Sep 8. Erratum In: N Engl J Med. 2015 Apr 30;372(18):1777.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 38RC16.137
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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