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Clinical and Biological Effects of Anti-IgE (Omalizumab) in Patients With Bilateral Nasal Polyposis and Asthma

11 de julio de 2011 actualizado por: University Hospital, Ghent

This pilot study is a double-blinded, randomized controlled, two-centre trial in which subjects will receive 4 to 8 (subcutaneous administered) doses of medication (Omalizumab or placebo) (dose and dosing interval calculated on body weight and baseline total serum IgE). During the treatment period and follow-up, the clinical efficacy of the treatment will be assessed by evaluation of symptoms, Quality of Life questionnaire, morning Peak Expiratory Flow measurement, smell test, nasal endoscopy, CT-scan, peak nasal inspiratory flow and spirometry. Biological activity will be evaluated by measuring peripheral and local (in serum, in nasal secretions, biopsies) markers of inflammation.

Study hypothesis

  1. Evaluation of the efficacy and safety of anti-IgE (Omalizumab) in patients with nasal polyposis and comorbid asthma.
  2. Exploration of anti-IgE effects on local and systemic metabolism of IgE in nasal polyposis
  3. Clinical assessment of the IgE theory in the pathogenesis of nasal polyps

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Tipo de estudio

Intervencionista

Inscripción (Actual)

23

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

      • Ghent, Bélgica, 9000
        • University Hospital, Ghent
      • Leuven, Bélgica, 3000
        • UZ Gasthuisberg

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Subjects must be at least 18 years of age, of either gender and any race.
  • Subjects must have a diagnosis of bilateral nasal polyps at screening and baseline that have recurred after surgical resection or nasal polyps that are grades 3 or 4 in both nares using the scoring system described in table 5. Bilateral nasal polyposis is defined as sinus symptoms for more than 3 months, bilateral opacity on CT-scan imaging and visible nasal polyps at endoscopy.

Subjects must have a diagnosis of asthma for more than 2 years. Subjects must be in good health, free of any clinically significant disease that would interfere with the study schedule or procedures or compromise his/her safety.

  • Subjects must be willing to give informed consent and adhere to visit schedules, medication restrictions, and agree to perform daily diary entries.
  • Subjects must be free of any upper respiratory tract infection within two weeks prior to inclusion.
  • Clinical laboratory tests must be within normal limits or clinically acceptable for the investigator.
  • Non-pregnant women of childbearing potential must use a medically acceptable, adequate form of birth control. This includes: a) hormonal contraceptive as prescribed by a physician (eg, oral combined, hormonal implant, depot injectable); b) medically prescribed Intra-Uterine Device (IUD); c) condom in combination with a spermicide; d) monogamous relationship with a male partner who has had a vasectomy or is using a condom plus spermicide during the study. They must have started this birth control method at least three months prior to screening (with the exception of condom in combination with a spermicide), and they must agree to continue its use for at least 3 months after last dosing. Women of childbearing potential who are not currently sexually active must agree and consent to using a double-barrier method should they become sexually active during the course of this study. Women who are surgically sterilized or are at least one year postmenopausal are considered not to be of childbearing potential. However, all female subjects must have a urine pregnancy test prior to treatment, which must be negative. A monthly-control pregnancy test is requested.
  • Male subjects must agree to use an adequate form of birth control from first dosing to at least 3 months after last dosing. They must either agree to use a condom with spermicide or agree to have sexual relations only with women using medically acceptable forms of birth control as described above.

Exclusion Criteria:

  • Women must not be pregnant, breast feeding, or premenarcheal.
  • Patients younger than 18 years old.
  • Subjects with history of systemic reactions to the study medication.
  • Subjects with prohibited medication at screening without full wash-out period.
  • Subjects with acute sinusitis, concurrent nasal infection, or subjects who have had a nasal or upper respiratory tract infection within two weeks of the inclusion are excluded.
  • Subjects with cystic fibrosis, primary ciliary's dysfunction or Kartagener's syndrome by history are excluded.
  • Subjects must not have ever been diagnosed with a parasitic infection.
  • Subjects must not have ever been diagnosed with cancer
  • Subjects must not have a medical history of Human Immunodeficiency Virus (HIV) or hepatitis B or C. Testing will not be done at screening.
  • Subjects must not have had an acute asthmatic attack requiring admission to a hospital (excluding emergency room visits which resulted in direct discharge without hospitalization) within the four weeks prior to screening.
  • Subjects must not have received specific immunotherapy within the previous three months.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Triple

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador de placebos: Placebo
Placebo
Comparador activo: Omalizumab

Omalizumab (Xolair(R)) is a recombinant DNA-derived humanized IgG1 monoclonal antibody that selectively binds to human IgE. Molecular weight is approximately 149 kilodaltons. Xolair(R) is a sterile, white, preservative-free, lyophilized powder contained in a single-use vial, reconstituted with Sterile Water For Injection (SWFI), and administered as subcutaneous (SC) injection.

Xolair(R) will be administered subcutaneously in a dose of 75 to 375mg every 2 to 4 weeks. Doses (mg) and dosing frequency are determined by total serum IgE level (IU/ml) measured at the start of treatment and body weight (kg). During this 20-week during trial patients will receive 4 or 8 doses of omalizumab.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Effect of Omalizumab on nasal polyp size and evolution of nasal polyps
Periodo de tiempo: At every study visit starting from week 0 until week 20
Nasal examination at all visits by endoscopy of each nasal fossa. Polyps will be graded by the Modified DAVOS score
At every study visit starting from week 0 until week 20

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Effect of Omalizumab on rhinosinusitis symptoms:nasal discharge, nasal congestion, postnasal drip scores: Subject's Diary
Periodo de tiempo: At screening visit, baseline visit and at week 0, 4, 8, 12, 16, 20
Dispense / collect / review diary
At screening visit, baseline visit and at week 0, 4, 8, 12, 16, 20
Effect of Omalizumab on asthma symptom scores including cough, wheeze, dyspnoea: Subject's Diary.
Periodo de tiempo: At screening visit, baseline visit and at week 0, 4, 8, 12, 16, 20
Dispense / collect / review diary
At screening visit, baseline visit and at week 0, 4, 8, 12, 16, 20
Effect of Omalizumab on sinus computed tomography (CT)-scan score : Sinus CT-scan evaluation
Periodo de tiempo: Visit before dosing and at week 16
Sinus CT-scan evaluation
Visit before dosing and at week 16
Effect of Omalizumab on smell: UPSIT (University of Pennsylvania Smell Identification Test)
Periodo de tiempo: Baseline visit and at week 10
Olfactory test
Baseline visit and at week 10
Effect of Omalizumab on Rhinitis specific Quality of Life: Rhinosinusitis Outcome Measure (RSOM-31)
Periodo de tiempo: At baseline visit
At baseline visit
Effect of Omalizumab on asthma related Quality of life: Asthma Quality of Life Questionnaire (AQLQ)
Periodo de tiempo: At baseline visit
At baseline visit
Effect of Omalizumab on overall Quality of Life: The Short Form (36) Health Survey (SF-36)
Periodo de tiempo: At baseline visit
At baseline visit
Effect of Omalizumab on peak nasal inspiratory flow
Periodo de tiempo: On screening visit, baseline visit and on week 4,8,12, 16 and 20
On screening visit, baseline visit and on week 4,8,12, 16 and 20
Effect of Omalizumab and Forced Expiratory Volume in 1 second (FEV1): spirometry
Periodo de tiempo: At screening visit, baseline visit and week 16 and 20
At screening visit, baseline visit and week 16 and 20
Effect of Omalizumab on diverse inflammatory mediators in serum, in nasal fluid (eosinophilic cationic protein (ECP), Interleukin-2 receptor (IL-2R), Sol Interleukin-5 receptor, soluble Cluster of differentiation 23 (sCD23), tryptase)
Periodo de tiempo: At screening visit, baseline visit and week 4, 8, 12, 16 and 20
At screening visit, baseline visit and week 4, 8, 12, 16 and 20
Evaluation of adverse events, directly or by general physical examination, blood sampling , review of concomitant medication or symptom scores.
Periodo de tiempo: week 2, 4, 6, 8, 10, 12, 14, 16, 20
week 2, 4, 6, 8, 10, 12, 14, 16, 20

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Paul Van Cauwenberge, PhD, MD, University Hospital, Ghent, Belgium

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de diciembre de 2006

Finalización primaria (Actual)

1 de octubre de 2008

Finalización del estudio (Actual)

1 de diciembre de 2009

Fechas de registro del estudio

Enviado por primera vez

7 de julio de 2011

Primero enviado que cumplió con los criterios de control de calidad

11 de julio de 2011

Publicado por primera vez (Estimar)

13 de julio de 2011

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

13 de julio de 2011

Última actualización enviada que cumplió con los criterios de control de calidad

11 de julio de 2011

Última verificación

1 de julio de 2011

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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