Effectiveness and Safety Study of Tezepelumab in Adults & Adolescent Participants With Severe Asthma in the United States (PASSAGE)

A Multicenter, Single-arm, Open-label, Post-Authorization, Phase 4 Effectiveness and Safety Study of Tezepelumab in Adult and Adolescent Participants With Severe Asthma Including Several Under-Studied Populations in the United States (PASSAGE)

To asses effectiveness and safety of tezepelumab in adult and adolescent participants with severe asthma including several under-studied populations in the United States.

Study Overview

• Status: Recruiting
• Conditions: Asthma
• Intervention / Treatment: Drug: Tezepelumab

Detailed Description

This is a multicenter, single-arm, open-label, Post-authorization, Phase 4 study to assess the effectiveness of tezepelumab in the United States (US) among a real-world population of adults and adolescent participants with asthma requiring medium-dose to high-dose inhaled corticosteroids (ICS), with additional controller(s) for at least 12 months with documented history of at least 2 asthma exacerbations during the year prior to enrolment. The total duration of the study for each participant will be approximately 56 weeks. Approximately 400 participants will be enrolled. Participants will receive tezepelumab via subcutaneous injection at the study site, over a 48-week treatment period. The study also includes a post-dosing follow-up period from Weeks 48 to 52.

• Study Type: Interventional
• Enrollment (Estimated): 400
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: AstraZeneca Clinical Study Information Center; Phone Number: 1-877-240-9479; Email: information.center@astrazeneca.com

Study Locations

• United States
  • Alabama
    • Hoover, Alabama, United States, 35244
      • Withdrawn
      • Research Site
    • Mobile, Alabama, United States, 36608
      • Withdrawn
      • Research Site
  • Arizona
    • Gilbert, Arizona, United States, 85234
      • Withdrawn
      • Research Site
  • California
    • La Jolla, California, United States, 92093
      • Not yet recruiting
      • Research Site
    • Long Beach, California, United States, 90815
      • Recruiting
      • Research Site
    • Rancho Mirage, California, United States, 92270
      • Recruiting
      • Research Site
    • Westminster, California, United States, 92683
      • Recruiting
      • Research Site
    • Whittier, California, United States, 90603
      • Recruiting
      • Research Site
  • Colorado
    • Colorado Springs, Colorado, United States, 80907
      • Recruiting
      • Research Site
  • Connecticut
    • New Haven, Connecticut, United States, 06510
      • Recruiting
      • Research Site
  • District of Columbia
    • Washington, District of Columbia, United States, 20037
      • Recruiting
      • Research Site
  • Illinois
    • Chicago, Illinois, United States, 60611
      • Recruiting
      • Research Site
  • Kentucky
    • Lexington, Kentucky, United States, 40509
      • Recruiting
      • Research Site
  • Louisiana
    • New Orleans, Louisiana, United States, 70112
      • Recruiting
      • Research Site
  • Maryland
    • Upper Marlboro, Maryland, United States, 20772
      • Recruiting
      • Research Site
    • White Marsh, Maryland, United States, 21162
      • Withdrawn
      • Research Site
  • Michigan
    • Ann Arbor, Michigan, United States, 48109
      • Recruiting
      • Research Site
    • Ypsilanti, Michigan, United States, 48197
      • Recruiting
      • Research Site
  • Minnesota
    • Saint Paul, Minnesota, United States, 55109
      • Recruiting
      • Research Site
  • Missouri
    • Saint Louis, Missouri, United States, 63110
      • Recruiting
      • Research Site
  • Nebraska
    • Lincoln, Nebraska, United States, 68505
      • Recruiting
      • Research Site
    • Omaha, Nebraska, United States, 68114
      • Recruiting
      • Research Site
  • New York
    • Bronx, New York, United States, 10465
      • Withdrawn
      • Research Site
    • Hollis, New York, United States, 11423
      • Recruiting
      • Research Site
    • Horseheads, New York, United States, 14845
      • Withdrawn
      • Research Site
    • Rochester, New York, United States, 14642
      • Recruiting
      • Research Site
    • Valhalla, New York, United States, 10595
      • Recruiting
      • Research Site
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27514
      • Recruiting
      • Research Site
    • Durham, North Carolina, United States, 27709
      • Withdrawn
      • Research Site
    • Wilmington, North Carolina, United States, 28401
      • Recruiting
      • Research Site
  • Ohio
    • Cincinnati, Ohio, United States, 45229
      • Withdrawn
      • Research Site
    • Toledo, Ohio, United States, 43617
      • Recruiting
      • Research Site
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73120
      • Recruiting
      • Research Site
  • Pennsylvania
    • Altoona, Pennsylvania, United States, 16602
      • Recruiting
      • Research Site
    • Philadelphia, Pennsylvania, United States, 19140
      • Recruiting
      • Research Site
  • Rhode Island
    • Warwick, Rhode Island, United States, 02886
      • Withdrawn
      • Research Site
  • South Carolina
    • Greenville, South Carolina, United States, 29607
      • Recruiting
      • Research Site
  • Tennessee
    • Hendersonville, Tennessee, United States, 37075
      • Recruiting
      • Research Site
  • Texas
    • Dallas, Texas, United States, 75246
      • Withdrawn
      • Research Site
    • Fort Worth, Texas, United States, 76107
      • Recruiting
      • Research Site
    • McKinney, Texas, United States, 75069
      • Recruiting
      • Research Site
    • San Antonio, Texas, United States, 78229
      • Recruiting
      • Research Site
  • Virginia
    • Charlottesville, Virginia, United States, 22903
      • Recruiting
      • Research Site
  • Washington
    • Vancouver, Washington, United States, 98664
      • Recruiting
      • Research Site
  • Wisconsin
    • Madison, Wisconsin, United States, 53792
      • Withdrawn
      • Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 12 years to 130 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male or female participant must be 12 years of age or older, at the time of signing the informed consent form or assent.
• Documented physician-diagnosed asthma for at least 12 months prior to enrollment and confirmed by the Investigator not to be due to alternative diagnoses.
• Documented treatment with medium- to high dose ICS as per Global Initiative for Asthma (GINA) guidelines (GINA 2021) for at least 12 months prior to enrollment.
• Use of additional asthma maintenance controller medication(s) in addition to ICS for at least 12 months prior to enrollment. The additional maintenance controller medication may be contained in a combination product (eg, ICS/ long-acting β-agonist (LABA)).
• Documented history of at least 2 asthma exacerbations during the 12 months prior to enrollment.
• Physician decision that participant is eligible for treatment with tezepelumab according to the approved United States product insert (USPI).
• Currently receiving care from specialist physicians (eg, pulmonologists and/or allergists).
• Provision of signed and dated written informed consent form.

Exclusion Criteria:

• Any contraindication to tezepelumab as per the US approved product label or in the opinion of the Investigator.
• Comorbid diagnosis of severe or very severe chronic obstructive pulmonary disease (COPD) per GOLD guidelines (GOLD 2021).
• Use of biologics that are approved for the treatment of asthma within 4 months or 5 half- lives (whichever is longer) prior to enrollment.
• Participation in an interventional clinical trial for asthma within 12 months prior to enrollment.
• Judgment by the Investigator that the participant is unlikely to comply with study procedures, restrictions, and requirements.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Tezepelumab; Participants will be receiving 210 mg of tezepelumab every 4 weeks (Q4W) from Week 0 until Week 48.	Drug: Tezepelumab; Participants will be receiving subcutaneous injection of tezepelumab.; Other Names: AMG 157 or MEDI9929

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Annualized asthma exacerbation rate (AAER)	Asthma exacerbation will be defined by worsening of asthma symptoms that leads to temporary bolus/burst of systemic corticosteroids for at least 3 consecutive days, or an emergency department (ED) or urgent care visit due to asthma that required systemic corticosteroid (SCS), and/or inpatient hospitalization (≥24 hours) due to asthma. The AAER is based on exacerbations reported by the investigator over 52 weeks. The exacerbation rate will be compared between the 12 month period before (baseline period) and the 12 month period after initiation of tezepelumab (up to study Week 52 - study period).	Baseline period up to study Week 52
Proportion of participants with asthma exacerbations	The proportion of participants with asthma exacerbations in the 12 month periods before (baseline period) and after initiation of tezepelumab (study period) (up to study Week 52 - study period) will be assessed.	Baseline period up to study Week 52
Proportion of participants who completed the 52 -week study period with any reduction in total number of asthma exacerbations	The proportion of participants who completed the 52 -week study period following tezepelumab initiation with any reduction, at least 50% reduction, and 100% reduction in total number of asthma exacerbations will be assessed.	Baseline period up to study Week 52
Cumulative asthma exacerbation days	The cumulative asthma exacerbation days over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed.	Baseline period up to study Week 52

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pre-bronchodilator (pre-BD) forced expiratory volume in 1 second (FEV1)	Lung function (FEV1) will be measured pre-bronchodilator (pre-BD) by spirometry test.	Baseline (Week 0), Week 24, Week 52
Change from baseline in pre-bronchodilator FEV1	Change from baseline in pre-bronchodilator FEV1 will be assessed as lung function parameters after initiation of tezepelumab.	Baseline (Week 0), Week 24, Week 52
Asthma Control Questionnaire (ACQ-6)	The ACQ-6 is a shortened version of the ACQ that assesses the adequacy of asthma control and change in asthma control which occurs spontaneously or as a result of treatment. ACQ assesses symptoms and rescue bronchodilator use. Questions are weighted equally and scored from 0 (totally controlled) to 6 (severely uncontrolled). The mean ACQ-6 score is the mean of the responses.	Baseline (Week 0), Week 24, Week 52
Asthma Impairment and Risk Questionnaire (AIRQ)	The Asthma Impairment and Risk Questionnaire (AIRQ) is a PRO tool intended to identify participants 12 years and older whose health may be at risk because of uncontrolled asthma. It has 10 questions that ask about respiratory symptoms, activity limitation, sleep, rescue medication use, social activities, exercise, difficulty controlling asthma, and exacerbations. All items have a yes/no response option and the tool is scored by summing the total number of 'yes' responses. This sum score is used to assess level of asthma control where: 0-1 is well controlled, 2-4 is not well controlled, and 5-10 is very poorly controlled. Thus, a higher score indicates worse control status.	Baseline (Week 0), Week 24, Week 52
St. George's Respiratory Questionnaire (SGRQ)	The SGRQ is a 50-item PRO instrument developed to measure the health status of participants with airway obstruction diseases. The questionnaire is divided into 2 parts: part 1 consists of 8 items pertaining to the severity of respiratory symptoms in the preceding 4 weeks; part 2 consists of 42 items related to the daily activity and psychosocial impacts of the individual's respiratory condition. The SGRQ yields a total score and 3 components scores (symptoms, activity, and impacts). The total score indicates the impact of disease on overall health status. This total score is expressed as a percentage of overall impairment, in which 100 represents the worst possible health status and 0 indicates the best possible health status. Likewise, the domain scores range from 0 to 100, with higher scores indicative of greater impairment.	Baseline (Week 0), Week 24, Week 52
Change from baseline in ACQ-6 score	Change from baseline in ACQ-6 score will be assessed.	Baseline (Week 0), Week 24, Week 52
Change from baseline in AIRQ score	Change from baseline in AIRQ score will be assessed.	Baseline (Week 0), Week 24, Week 52
Change from baseline in SGRQ score	Change from baseline in SGRQ score will be assessed.	Baseline (Week 0), Week 24, Week 52
Proportion of AIRQ responders	AIRQ responders is defined as participants who achieve ≥1 minimum clinically important difference (MCID).	Baseline (Week 0), Week 24, Week 52
Proportion of SGRQ responders	SGRQ responders is defined as participants who achieve ≥1 minimum clinically important difference (MCID).	Baseline (Week 0), Week 24, Week 52
Time to first asthma exacerbation	The time to first exacerbation after initiation of tezepelumab will be assessed.	Week 0 to Week 52
Rate of asthma exacerbations associated with hospitalizations	The rate of asthma exacerbations associated with hospitalization over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed.	Baseline period up to study Week 52
Rate of asthma exacerbations associated with emergency department /urgent care (ED/UC) visits	The rate of asthma exacerbations associated with ED/UC visits over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed.	Baseline period up to study Week 52
Rate of asthma exacerbations associated with hospitalizations or ED/UC visits over	The rate of asthma exacerbations associated with hospitalizations or ED/UC visits over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed.	Baseline period up to study Week 52
Proportion of participants with asthma exacerbations associated with hospitalizations or ED/UC visits	The proportion of participants with asthma exacerbations associated with hospitalizations or ED/UC visits in in the 12-month periods before (baseline period) and after initiation of tezepelumab (study period) (up to study Week 52) will be assessed.	Baseline period up to study Week 52
Cumulative asthma exacerbation days associated with hospitalizations or ED/UC visits	The cumulative asthma exacerbation days associated with hospitalizations or ED/UC over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed.	Baseline period up to study Week 52
Proportion of pre-BD FEV1 responders	Proportion of pre-BD FEV1 responders is defined as participants who achieve either at least 5% or 100 mL improvement from baseline.	Baseline (Week 0), Week 24, Week 52
Proportion of ACQ-6 responders	ACQ-6 responders are defined as participants who achieve >=1 clinically important difference (MCID).	Baseline (Week 0), Week 24, Week 52
Proportion of participants who require any systemic corticosteroid (SCS) use	Proportion of participants who require any SCS use in the 12-month periods before (baseline period) and after initiation of tezepelumab (up to study Week 52 -study period) will be assessed.	Baseline period up to study Week 52
Cumulative annualized SCS dose	Cumulative annualized SCS dose in the 12-month periods before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed.	Baseline period up to study Week 52
Proportion of participants who require longer-term (>30 consecutive days) SCS use	Proportion of participants who require longer-term (>30 consecutive days) SCS use in the 12-month periods before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed.	Baseline period up to study Week 52
Number and type of asthma-related healthcare resource utilization (HRU)	Number and type of asthma-related HRU in the 12-month period before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed.	Baseline period up to study Week 52
Duration of asthma-related hospitalizations	Duration of asthma-related hospitalization in the 12-month period before (baseline period) and after initiation of tezepelumab (up to study Week 52-study period) will be assessed.	Baseline period up to study Week 52
AAER for asthma exacerbations (subgroups of participants)	The AAER based on asthma exacerbations in the 12-month period before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed in the following subgroups of participants: Blood eosinophil count (BEC) ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Proportion of participants with asthma exacerbations (subgroups of participants)	The proportion of participants with asthma exacerbations in the 12-month period before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Proportion of participants who completed the 52 -week study with any reduction in total number of asthma exacerbations (subgroups of participants)	The proportion of participants who completed the 52 -week study period following tezepelumab initiation with any reduction, at least 50% reduction, and 100% reduction in total number of asthma exacerbations will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Week 0 to Week 52
Cumulative asthma exacerbation days (subgroups of participants)	The cumulative asthma exacerbation days over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Rate of asthma exacerbations associated with hospitalizations (subgroups of participants)	The rate of asthma exacerbations associated with hospitalization over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Rate of asthma exacerbations associated with emergency department urgent care (ED/UC) visits (subgroups of participants)	The rate of asthma exacerbations associated with ED/UC visits over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Rate of asthma exacerbations associated with hospitalizations or ED/UC visits over (subgroups of participants)	The rate of asthma exacerbations associated with hospitalizations or ED/UC visits over 52 weeks before (baseline period) and after initiation of tezepelumab (study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Number and type of asthma-related HRU (subgroups of participants)	Number and type of asthma related HRU in the 12-month period before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52
Duration of asthma-related hospitalizations (subgroups of participants)	Duration of asthma-related hospitalization in the 12- month period before (baseline period) and after initiation of tezepelumab (up to study Week 52- study period) will be assessed in the following subgroups of participants: BEC ≥300 cells/microliter; BEC <300 cells/microliter; With a clinically-relevant allergy to a perennial aeroallergen; Without a clinically-relevant allergy to a perennial aeroallergen; Participants who identify as Black/African American; Adolescents (12-17 years); Comorbid diagnosis of mild to moderate COPD; Significant smoking history (≥10 pack-years of smoking).	Baseline period up to study Week 52

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of participants with serious adverse events, adverse events that lead to tezepelumab treatment discontinuation, and adverse events of special interest	The safety and tolerability of tezepelumab will be assessed.	Week 0 to Week 52

Collaborators and Investigators

• Sponsor: AstraZeneca
• Collaborators: Parexel
• Investigators: Principal Investigator: Njira Lugogo., MD., University of Michigan Health. Michigan, USA

Study record dates

Study Major Dates

• Study Start (Actual): April 29, 2022
• Primary Completion (Estimated): July 8, 2025
• Study Completion (Estimated): July 8, 2025

Study Registration Dates

• First Submitted: March 17, 2022
• First Submitted That Met QC Criteria: April 7, 2022
• First Posted (Actual): April 14, 2022

Study Record Updates

• Last Update Posted (Actual): April 11, 2024
• Last Update Submitted That Met QC Criteria: April 10, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: Inhaled corticosteroids (ICS); Post-Authorization; Baseline Blood eosinophil count (BEC); long-acting- β2 Agonist (LABA); Real-world participant population
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Immune System Diseases; Lung Diseases; Hypersensitivity, Immediate; Bronchial Diseases; Lung Diseases, Obstructive; Respiratory Hypersensitivity; Hypersensitivity; Asthma
• Other Study ID Numbers: D5180C00032

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

IPD Plan Description

Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All requests will be evaluated as per the AZ disclosure commitment:

https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

• IPD Sharing Time Frame: AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
• IPD Sharing Access Criteria: When a request has been approved AstraZeneca will provide access to the de-identified individual patient-level data in an approved sponsored tool. Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No