OPN-375 Efficacy and Safety in Adolescents With Bilateral Nasal Polyps

September 22, 2023 updated by: Optinose US Inc.

16-Week Randomized Double-Blind Placebo Controlled Parallel-Group Multicenter Study Evaluating the Efficacy and Safety of OPN-375 186 μg Twice a Day in Adolescents With Bilateral Nasal Polyps Followed With 12-Week Open-Label Treatment Phase

This is a 16-Week Randomized, Double-Blind, Placebo Controlled, Parallel-Group, Multicenter Study Evaluating the Efficacy and Safety of OPN-375 186 μg Twice a Day (BID) in Adolescents with Bilateral Nasal Polyps followed by a 12-Week Open-Label Treatment Phase. The total planned number of subjects is approximately 120 adolescents (12-17 years of age) who will be randomly assigned to receive 1 of 2 study treatments using a 2:1 ratio (OPN-375 186 μg: Placebo). For the PK sub-study, up to 14 subjects will be enrolled to obtain 10 completers.

Study Overview

Status

Recruiting

Intervention / Treatment

Detailed Description

The primary objective of this study is to evaluate the efficacy of intranasal administration of OPN-375 186 μg Twice a Day (BID) versus placebo in adolescents with bilateral nasal polyposis and nasal congestion by analyzing the reduction of nasal congestion/obstruction symptoms at the end of Week 4 measured by the 7-day average instantaneous morning diary symptom scores and the reduction in total polyp grade at Week 16 as determined by a nasal polyp grading scale score measured using a 0 to 6 point severity grading scale.

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Alabama
      • Birmingham, Alabama, United States, 35209
    • Arizona
      • Gilbert, Arizona, United States, 85234
        • Recruiting
        • Arizona Allergy and Immunology Research
        • Contact:
      • Gilbert, Arizona, United States, 85234
    • California
      • Bakersfield, California, United States, 93301
        • Recruiting
        • Kern Research
        • Contact:
      • Fresno, California, United States, 93720
        • Recruiting
        • Central California Clinical Research
        • Contact:
      • Orange, California, United States, 92868
        • Recruiting
        • Children's Hospital of Orange County
        • Contact:
      • Redwood City, California, United States, 94063
      • Roseville, California, United States, 95661
        • Recruiting
        • Sacramento ENT
        • Contact:
    • Colorado
    • Connecticut
      • New Haven, Connecticut, United States, 06519
        • Recruiting
        • Yale School of Medicine, Section of Otolaryngology
        • Contact:
    • Florida
      • Jacksonville, Florida, United States, 32207
        • Recruiting
        • Nemours Children's Specialty Care
        • Contact:
    • Georgia
      • Atlanta, Georgia, United States, 30322
        • Recruiting
        • Children's Healthcare of Atlanta
        • Contact:
    • Illinois
      • Chicago, Illinois, United States, 60612
        • Recruiting
        • Rush University Medical Center - Department of Otorhinolaryngology
        • Contact:
      • Chicago, Illinois, United States, 60657
    • Kentucky
      • Louisville, Kentucky, United States, 40205
    • Louisiana
      • New Orleans, Louisiana, United States, 70121
        • Recruiting
        • Ochsner Medical Center, Otorhinolaryngology Department
        • Contact:
    • Minnesota
      • Minneapolis, Minnesota, United States, 55102
    • Missouri
      • Columbia, Missouri, United States, 65212
    • New York
      • Rochester, New York, United States, 14642
    • North Carolina
      • Charlotte, North Carolina, United States, 28204
        • Recruiting
        • Allergy Asthma & Immunology Research Institute
        • Contact:
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73120
        • Recruiting
        • Allergy, Asthma & Clinical Research Center
        • Contact:
      • Tulsa, Oklahoma, United States, 74136
        • Recruiting
        • Vital Prospects Clinical Research Institute, P.C.
        • Contact:
    • South Carolina
      • Charleston, South Carolina, United States, 29425
        • Recruiting
        • MUSC Department of Otolaryngology, Head and Neck Surgery
        • Contact:
      • Orangeburg, South Carolina, United States, 29118
        • Recruiting
        • Carolina ENT
        • Contact:
    • Texas
      • San Antonio, Texas, United States, 78229
        • Recruiting
        • STAAMP Research
        • Contact:
    • Utah
      • Salt Lake City, Utah, United States, 84132
    • Virginia
      • Norfolk, Virginia, United States, 23507
        • Recruiting
        • Eastern Virginia Medical School - Otolaryngology
        • Contact:
    • Washington
    • West Virginia
      • Morgantown, West Virginia, United States, 26506
        • Recruiting
        • West Virginia University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

12 years to 17 years (Child)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Male or female subjects aged 12 to 17 years, inclusive, at time of Visit 1 (Screening).
  2. Female subjects, if sexually active, must:

    1. be practicing an effective method of birth control (e.g., prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, double-barrier method [e.g., condoms, diaphragm, or cervical cap with spermicidal foam, cream, or gel], or male partner sterilization) before entry and throughout the study, or
    2. be surgically sterile, (have had a hysterectomy or bilateral oophorectomy, tubal ligation, or otherwise be incapable of pregnancy), or
    3. or agree to abstinence.
  3. Ability to read and speak English
  4. All female subjects not documented to be infertile (e.g., infertility due to congenital abnormality or surgical sterilization) must have a negative serum or urine beta-human chorionic gonadotropin (β-hCG) at Visit 1 (Screening) and a negative urine pregnancy test at the Visit 2 (Day 1/Randomization/Baseline)
  5. Must have bilateral nasal polyposis with a grade of 1 to 3 in each of the nasal cavities as determined by a nasal polyp grading scale score measured by nasoendoscopy at Visit 1 (Screening)
  6. Must report at least mild symptoms of nasal congestion/obstruction as demonstrated by an average morning nasal congestion/obstruction score of at least 1.0 over the last 7 days of the run-in period (Subjects not meeting this inclusion criterion may be re-screened once after at least 4 weeks.)
  7. Subjects with comorbid asthma must be stable, defined as no exacerbations (e.g., no emergency room visits, hospitalization, or oral or parenteral steroid use) within the 3 months before Visit 1 (Screening). Subjects who received inhaled corticosteroids are required to be on no more than a moderate dosage regimen as defined by 2005 Global Initiative for Asthma Guidelines (GINA) for 1 month before Visit 1 (Screening) and to be expected to remain on it throughout the study. Visit 1 (Screening)
  8. Must be able to cease treatment with intranasal medications including, but not limited to, intranasal oxymetazoline or any other decongestants, intranasal antihistamines, intranasal steroids, intranasal sodium cromolyn, nasal atropine, nasal ipratropium bromide, as well as inhaled corticosteroids (except permitted doses listed above for asthma) at Visit 1 (Screening). (Note: intranasal antibiotics and saline are permissible)
  9. If taking oral antihistamines, must be on a stable regimen for at least 2 weeks prior to the Visit 1 (Screening), and agree to not change the dose of these medications until after Visit 3 (Week 4) of the study.
  10. Subject (with assistance from parent or legal guardian if needed) must demonstrate the ability to correctly complete the daily diary during the run-in period to be eligible for randomization.
  11. Must demonstrate correct use of the demo exhalation delivery system (EDS).
  12. Must be capable, in the opinion of the investigator, of providing assent and the appropriate parent(s) or guardian must provide an informed consent to participate in the study.

Exclusion Criteria:

  1. Pregnancy or lactation
  2. Has a history of cystic fibrosis
  3. Have used XHANCE® (fluticasone propionate) nasal spray within the past 2 months
  4. Inability to achieve bilateral nasal airflow for any reason, including nasal septum deviation
  5. Inability to examine both nasal cavities for any reason, including severe nasal septum deviation
  6. Have history of nasal septum erosion, ulceration or perforation or evidence of such lesion on Visit 1 (Screening) nasal examination/nasoendoscopy
  7. Other significant nasal pathology or abnormal anatomy
  8. Has had any episode of epistaxis with frank bleeding in the 3 months before Visit 1 (Screening)
  9. History of more than 5 sinus or nasal surgeries for either nasal polyps or nasal/sinus inflammation (lifetime) Visit 1 (Screening)
  10. Have had any surgery on the nasal septum
  11. History of sinus or nasal surgery within 6 months before Visit 1 (Screening)
  12. History of any surgical procedure that prevents the ability to accurately to diagnose or grade polyps if the subject requires nasoendoscopy
  13. Current, ongoing rhinitis medicamentosa (rebound rhinitis)
  14. Have significant oral structural abnormalities (e.g., a cleft palate)
  15. History of Churg-Strauss syndrome or dyskinetic ciliary syndromes
  16. Purulent nasal infection (recent fever or symptoms of lethargy), acute sinusitis, or upper respiratory tract infection within 2 weeks before Visit 1 (Screening). Potential subjects presenting with one of these infections may be rescreened after 4 weeks
  17. Have an allergy, hypersensitivity, or contraindication to corticosteroids or steroids
  18. Have an allergy or hypersensitivity to any excipients in study drug
  19. Exposure to any glucocorticoid treatment with potential for systemic effects (e.g., oral or parenteral steroids, high dose topical steroids) within 1 month before Visit 1 (Screening); except as noted in inclusion criteria for subjects with comorbid asthma
  20. Currently receiving Nucala (mepolizumab), Cinquair (reslizumab), Dupixent (dupilumab), or Omalizumab (Xolair®) (note patients should not be removed from their therapy for the sole purpose of study participation)
  21. Have nasal or oral candidiasis
  22. Have taken a potent CYP3A4-inhibitor within 14 days before Visit 1 (Screening)
  23. Any serious or unstable concurrent disease, psychiatric disorder, or any significant concomitant medical condition that, in the opinion of the investigator could confound the results of the study or could interfere with the subject's participation or compliance in the study, or pose a specific risk to the subject due to study participation
  24. History or current diagnosis of glaucoma or ocular hypertension (intraocular pressure >21 mmHg)
  25. History of intraocular pressure elevation on any form of steroid therapy
  26. Current diagnosis of the presence (in either eye) of a cataract of Grade 1 or greater as defined on the Eye Examination Worksheet OR, less than a Grade 1 cataract with associated visual impairment
  27. A recent (within 1 year of Visit 1 (Screening) clinically significant history of drug or alcohol use, abuse, or dependence)
  28. Positive urine drug screen at Visit 1 (Screening) for stimulants, opioids, or cocaine
  29. Have participated in an investigational drug clinical trial within 30 days of Visit 1 (Screening)
  30. Parents, guardian or caregivers of the subject who are employees of the investigator or study center, with direct involvement in the proposed study or other studies under the direction of that investigator or study center, as well as family members of the employees or the investigator

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: OPN-375 186 μg BID

Double-Blind Treatment Phase: OPN-375 186 μg BID x 16 weeks

Open-Label Extension Phase: OPN-375 186 μg BID x 12 weeks

OPN-375, BID
Placebo Comparator: Placebo
Double-Blind Treatment Phase: Matching Placebo BID x 16 weeks
OPN-375, BID

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in nasal congestion/obstruction symptoms (mild, moderate, severe) at the end of Week 4
Time Frame: 4 Weeks
Change in nasal congestion/obstruction symptoms at the end of Week 4 measured by the 7-day average instantaneous morning (AM) diary symptom scores (ADS7-IA). The nasal symptom scale is what is used to score the nasal congestion/obstruction score, which is recorded in the diary. Nasal symptom scale is graded on a scale of 0=no symptom, 1=mild symptom, 2=moderate symptom, 3=severe symptom.
4 Weeks
Mean change from baseline at Week 16 in total polyp grade
Time Frame: 16 Weeks
Change in total polyp grade (sum of scores from both nasal cavities) at Week 16 as determined by a nasal polyp grading scale score measured using a 0 to 6 point severity grading scale, with 0 (no polyps) to 3 (severe polyps) points per nostril
16 Weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in bilateral polyp grade over time
Time Frame: 16 Weeks
nasal polyp grading scale score measured using a 0 to 6 point severity grading scale, with 0 (no polyps) to 3 (severe polyps) points per nostril
16 Weeks
Percentage of subjects with a ≥1 point improvement in polyp grade
Time Frame: 16 Weeks
nasal polyp grading scale score measured using a 0 to 6 point severity grading scale, with 0 (no polyps) to 3 (severe polyps) points per nostril
16 Weeks
Percentage of subject with a grade of 0 on at least one side of the nose
Time Frame: 16 Weeks
nasal polyp grading scale score measured using a 0 to 6 point severity grading scale, with 0 (no polyps) to 3 (severe polyps) points per nostril
16 Weeks
Change in diary symptom scores for the symptoms of nasal congestion/obstruction, measured as instantaneous and reflective scores for the morning and the afternoon (AM and PM scores)
Time Frame: 16 Weeks
The Nasal Symptom Scale is graded on a scale of 0 (no symptom) to 3 (Severe symptom)
16 Weeks
Change in diary symptom scores for the symptoms of rhinorrhea, measured as instantaneous and reflective scores for the morning and the afternoon (AM and PM scores)
Time Frame: 16 Weeks
The Nasal Symptom Scale is graded on a scale of 0 (no symptom) to 3 (Severe symptom)
16 Weeks
Change in diary symptom scores for the symptoms of facial pain or pressure, measured as instantaneous and reflective scores for the morning and the afternoon (AM and PM scores)
Time Frame: 16 Weeks
The Nasal Symptom Scale is graded on a scale of 0 (no symptom) to 3 (Severe symptom)
16 Weeks
Change in diary symptom scores for the sense of smell, measured as instantaneous and reflective scores for the morning and the afternoon (AM and PM scores)
Time Frame: 16 Weeks
Sense of smell will be scored on a scale from 0 (normal) to 3 (absent, no sense of smell)
16 Weeks
The proportions of subjects who have reductions in the AM and PM, instantaneous and reflective, average nasal congestion/obstruction symptom scores by 0.5 or more points from baseline to the end of the double-blind treatment phase
Time Frame: 16 Weeks
The Nasal Symptom Scale is graded on a scale of 0 (no symptom) to 3 (Severe symptom)
16 Weeks
Subjects will assess their global impression of change since starting the study drug using the PGIC scale
Time Frame: 16 Weeks
Subject global impression of change will be assessed using a subject-completed PGIC scale, with a single question rated from 1=very much improved to 7=very much worse
16 Weeks
Subjects will assess their change in quality of life since starting the study drug using the quality of life questionnaire (SN-5).
Time Frame: 16 Weeks
Quality of life assessment using the SN-5 Questionnaire, a subject/parent-completed questionnaire that consists of 5 specific symptoms-related questions (answered on a 7-point Likert scale on the frequency of symptoms, 1=none of the time, 7=all of the time), and 1 general overall quality of life question (answered on a visual analog scale from 0 to 10, worst to best).
16 Weeks
Proportion of subjects eligible for surgical intervention (independent of actual surgery performed)
Time Frame: Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)

The assessment criteria are as follows:

  • Subject has had moderate symptoms of congestion from nasal polyposis for at least 3 months.
  • Subject continues to suffer from at least moderate symptoms despite use of topical steroids at conventional doses for at least 6 weeks.
  • Subject continues to suffer from at least moderate symptoms despite use (or previous use) of saline lavage for at least 6 weeks.
  • Subject has endoscopically visualized bilateral nasal polyposis of at least moderate severity (nasal polyp grading score > 2 in at least 1 nostril). Also assess each subject's eligibility for surgery based on specific of criteria (see Section 12) independent of whether the subject actually undergoes surgery.
Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Assessment of safety from physical examination-measuring weight
Time Frame: Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety from physical examination-weight measured in kg or lb
Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety from physical examination-measuring height
Time Frame: Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety from physical examination-height measured in cm or in
Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety by recording the severity of AEs
Time Frame: 16 Weeks
Assessment of safety by measuring severity of AEs using scale with 1=mild, 2=moderate, 3=severe
16 Weeks
Assessment of safety by nasal examination
Time Frame: 16 Weeks
Assessed in nasal examination worksheet which includes recording the presence of any epistaxis, septal erosion/perforation, ulceration/erosion of area other than septum. If present, the nostril location is also recorded, along with severity, and if there is any relation to an injury or trauma
16 Weeks
Assessment of safety by ocular examination-visual acuity
Time Frame: Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety by performing visual acuity test assessment using eye chart. Separate recording for each eye in the form of a fraction, 20/...
Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety by ocular examination-Intraocular Pressure
Time Frame: Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety by averaging intraocular pressure measurement of 2 or 3 measurements to determine if it is >21mmHg
Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety by ocular examination-Cataract Evaluation
Time Frame: Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Cataracts should be again assessed present or absent, If cataract is diagnosed, cataract type per localization should be specified and cataract should be graded 1=mild, 2=moderate, 3=pronounced, 4=severe
Visit 1 (Screening) and Visit 6 (Week 16/ End of Double-Blind/Early Termination)
Assessment of safety measuring vital signs (blood pressure)
Time Frame: 16 Weeks
Includes systolic and diastolic blood pressure measurements in millimeter of mercury (mmHg)
16 Weeks
Assessment of safety measuring vital signs (pulse)
Time Frame: 16 Weeks
measure pulse in beats per minute (bpm)
16 Weeks
Assessment for safety from the collection of information for concomitant medications usage
Time Frame: 16 Weeks
16 Weeks
Assessment of pharmacokinetics - AUC(0-t) (pg*hr/mL)
Time Frame: 8 hours, 1 to 2 weeks before randomization
PK Laboratory to determine the concentrations of fluticasone propionate [AUC(0-t) (pg*hr/mL) measurement] in human plasma using high performance liquid chromatography (HPLC) with mass spectrometric detection. Approximately 5 mL of blood is collected from each subject at 10 different timepoints over an 8-hour period, for a total of 50 mL. The timepoints are: Pre-dose; 5 minutes, 10 minutes, 15 minutes, 30 minutes, 1 hour, 1.5 hours, 3 hours, 6 hours and 8 hours post-dose.
8 hours, 1 to 2 weeks before randomization
Assessment of pharmacokinetics - AUC(0-∞) (pg*hr/mL)
Time Frame: 8 hours, 1 to 2 weeks before randomization
PK Laboratory to determine the concentrations of fluticasone propionate [AUC(0-∞) (pg*hr/mL) measurement] in human plasma using high performance liquid chromatography (HPLC) with mass spectrometric detection. Approximately 5 mL of blood is collected from each subject at 10 different timepoints over an 8-hour period, for a total of 50 mL. The timepoints are: Pre-dose; 5 minutes, 10 minutes, 15 minutes, 30 minutes, 1 hour, 1.5 hours, 3 hours, 6 hours and 8 hours post-dose.
8 hours, 1 to 2 weeks before randomization
Assessment of pharmacokinetics - AUCex (%)
Time Frame: 8 hours, 1 to 2 weeks before randomization
PK Laboratory to determine the concentrations of fluticasone propionate [AUCex (%) measurement] in human plasma using high performance liquid chromatography (HPLC) with mass spectrometric detection. Approximately 5 mL of blood is collected from each subject at 10 different timepoints over an 8-hour period, for a total of 50 mL. The timepoints are: Pre-dose; 5 minutes, 10 minutes, 15 minutes, 30 minutes, 1 hour, 1.5 hours, 3 hours, 6 hours and 8 hours post-dose.
8 hours, 1 to 2 weeks before randomization
Assessment of pharmacokinetics - Cmax (pg/mL)
Time Frame: 8 hours, 1 to 2 weeks before randomization
PK Laboratory to determine the concentrations of fluticasone propionate [Cmax (pg/mL) measurement] in human plasma using high performance liquid chromatography (HPLC) with mass spectrometric detection. Approximately 5 mL of blood is collected from each subject at 10 different timepoints over an 8-hour period, for a total of 50 mL. The timepoints are: Pre-dose; 5 minutes, 10 minutes, 15 minutes, 30 minutes, 1 hour, 1.5 hours, 3 hours, 6 hours and 8 hours post-dose.
8 hours, 1 to 2 weeks before randomization
Assessment of pharmacokinetics - tmax (h)
Time Frame: 8 hours, 1 to 2 weeks before randomization
PK Laboratory to determine the concentrations of fluticasone propionate [tmax (h) measurement] in human plasma using high performance liquid chromatography (HPLC) with mass spectrometric detection. Approximately 5 mL of blood is collected from each subject at 10 different timepoints over an 8-hour period, for a total of 50 mL. The timepoints are: Pre-dose; 5 minutes, 10 minutes, 15 minutes, 30 minutes, 1 hour, 1.5 hours, 3 hours, 6 hours and 8 hours post-dose.
8 hours, 1 to 2 weeks before randomization
Assessment of pharmacokinetics - t1/2 (h)
Time Frame: 8 hours, 1 to 2 weeks before randomization
PK Laboratory to determine the concentrations of fluticasone propionate [t1/2 (h) measurement] in human plasma using high performance liquid chromatography (HPLC) with mass spectrometric detection. Approximately 5 mL of blood is collected from each subject at 10 different timepoints over an 8-hour period, for a total of 50 mL. The timepoints are: Pre-dose; 5 minutes, 10 minutes, 15 minutes, 30 minutes, 1 hour, 1.5 hours, 3 hours, 6 hours and 8 hours post-dose.
8 hours, 1 to 2 weeks before randomization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Study Chair: John Messina, Optinose US Inc.
  • Study Director: Kim Koob, Optinose US Inc.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 31, 2018

Primary Completion (Estimated)

March 1, 2026

Study Completion (Estimated)

March 1, 2026

Study Registration Dates

First Submitted

October 23, 2018

First Submitted That Met QC Criteria

November 16, 2018

First Posted (Actual)

November 20, 2018

Study Record Updates

Last Update Posted (Actual)

September 26, 2023

Last Update Submitted That Met QC Criteria

September 22, 2023

Last Verified

September 1, 2023

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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