Uno studio per valutare l'efficacia della remibrutinib rispetto al dupilumab ai primi punti dei tempi negli adulti con orticaria spontanea cronica inadeguatamente controllata da H1-antihistamins di seconda generazione (RECLAIM)
Uno studio di fase 3B di fase 3b, multicentrico, randomizzato, doppio in doppio manichino, per valutare l'efficacia della remibrutinib rispetto al dupilumab ai primi punti dei tempi negli adulti con orticaria spontanea cronica inadeguatamente controllata da anticistamini H1 di seconda generazione
This is a US, multi-center, randomized, double-blind, double-dummy, Phase 3b study to evaluate efficacy of remibrutinib (25 mg twice daily [b.i.d.] by mouth [p.o.]) compared to dupilumab (600 mg loading dose administered subcutaneously (s.c.) followed by 300 mg every 2 weeks s.c.) at early timepoints (4 weeks and earlier), when administered as an add-on treatment to second generation H1-antihistamines (sgH1-AH) (standard label dose as background therapy) in adult US participants with moderate to severe chronic spontaneous urticaria (CSU) inadequately controlled by sgH1-AHs.
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
This study consists of a screening period (up to 4 weeks), a core treatment period (12 weeks double-blind, double-dummy), an optional open-label extension [OLE] period, and safety follow-up period.
Screening period: participants will have a screening period of a minimum of 7 days up to a maximum of 28 days to establish eligibility for the study. Participants meeting all the inclusion criteria and none of the exclusion criteria will be eligible to participate in the study.
Core treatment period (double-blind, double-dummy): approximately, 400 participants diagnosed with CSU inadequately controlled by sgH1-AH will be randomized in this study. Participants will be stratified based on prior exposure to anti-IgE biologics.
Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib and placebo solution for injection or dupilumab and remibrutinib matching placebo, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit.
Additionally, all participants will be on a stable, standard label dose of a sgH1-AH ("background therapy") throughout the entire core treatment period (starting a minimum of 7 days prior to randomization until the end of Week 12). To treat unbearable symptoms of CSU, participants will be allowed to add more of the same sgH1-AH on an as-needed basis ("rescue therapy"). The total maximum daily dose of sgH1-AH (background plus rescue) should not exceed 4 tablets/day (4-fold the standard label dose).
Optional open-label extension [OLE] period: At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional OLE safety period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).
Safety follow-up period:
- For participants who do not enter the OLE period: there will be a safety follow-up for 12 weeks with safety follow-up phone calls at Week 16 and Week 24 (Week 24 will be end of study).
- For participants who enter the OLE period: there will be 2 options at the end of Week 24:
- If remibrutinib is commercially available: participants will discontinue study treatment, perform their EOT visit and receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
- If remibrutinib is not commercially available, participants may continue on remibrutinib 25 mg b.i.d. until its commercial availability and return for site visits for safety follow up and treatment dispensation every 3 months. When remibrutinib becomes commercially available, the participant will be contacted for a site visit to complete the EOT visit and will receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
Tipo di studio
Tipo di studio
Iscrizione (Effettivo)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
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Alabama
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Birmingham, Alabama, Stati Uniti, 35209
- Allervie Clinical Research
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Birmingham, Alabama, Stati Uniti, 35244
- Cahaba Derm and skin hlth ctr 27
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Arizona
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Litchfield Park, Arizona, Stati Uniti, 85340
- Research Solutions of Arizona
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Payson, Arizona, Stati Uniti, 85541
- Peak Dermatology
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Phoenix, Arizona, Stati Uniti, 85032
- Premier Allergy Asthma And Immunology
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Scottsdale, Arizona, Stati Uniti, 85254
- Orso Health
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Arkansas
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Little Rock, Arkansas, Stati Uniti, 72205
- Acuro Research Inc
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California
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Fountain Valley, California, Stati Uniti, 92708
- First OC Dermatology
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Fremont, California, Stati Uniti, 95438
- Ctr for Dermatology Clinical Res
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Huntington Beach, California, Stati Uniti, 92647
- Allergy and Asthma Specialists Group
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Long Beach, California, Stati Uniti, 90808
- Orso Health
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Long Beach, California, Stati Uniti, 90815
- Ark Clinical Research
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Los Angeles, California, Stati Uniti, 90045
- Dermatology Research Associates
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Los Angeles, California, Stati Uniti, 90025
- California Allergy and Asthma Medical Group
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Napa, California, Stati Uniti, 94558
- One Of A Kind Clinical Research
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Palo Alto, California, Stati Uniti, 94304
- Stanford University Medical Center
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Pomona, California, Stati Uniti, 91767
- Empire Clinical Research
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Redwood City, California, Stati Uniti, 94063
- Allergy and Asthma Consultants
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Rocklin, California, Stati Uniti, 95765
- Norcal Clinical Research
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Rolling Hills Estates, California, Stati Uniti, 90274
- Peninsula Research Associates
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Sacramento, California, Stati Uniti, 95815
- Integrative Skin Science and Res
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Sacramento, California, Stati Uniti, 95817
- UC Davis Neuromuscular Research Center
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San Diego, California, Stati Uniti, 92123
- Therapeutics Clinical Research
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Santa Monica, California, Stati Uniti, 90403
- Dermatology Institute and Skin Care
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Upland, California, Stati Uniti, 91786
- Integrated Research of Inland Inc
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Walnut Creek, California, Stati Uniti, 94598
- Allergy and Asthma Clin Res Inc
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Colorado
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Aurora, Colorado, Stati Uniti, 80045
- University of Colorado Hospital - Aurora
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Colorado Springs, Colorado, Stati Uniti, 80909
- Colorado ENT and Allergy
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Colorado Springs, Colorado, Stati Uniti, 80907
- Asthma and Allergy Associates P C
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District of Columbia
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Washington D.C., District of Columbia, Stati Uniti, 20059
- Howard University Hospital Division of Geriatrics
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Florida
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Aventura, Florida, Stati Uniti, 33180
- Florida Ctr Allergy Asthma Research
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Boca Raton, Florida, Stati Uniti, 33486
- Skin Care Research Inc
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Doral, Florida, Stati Uniti, 33172
- Omnicure Clinical Research
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Fort Lauderdale, Florida, Stati Uniti, 33308
- FXM Clinical Research Ft Laud
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Hollywood, Florida, Stati Uniti, 33021
- Skin Care Research LLC
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Jacksonville, Florida, Stati Uniti, 32216
- Jacksonville Center for Clinical Research
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Miami, Florida, Stati Uniti, 33176
- Miami Dade Medical Research
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Miami, Florida, Stati Uniti, 33125
- University of MiamiHealth System
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Miami, Florida, Stati Uniti, 33175
- FXM Clinical Res Miami LLC
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Miramar, Florida, Stati Uniti, 33027
- Eminat LLC
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North Miami Beach, Florida, Stati Uniti, 33162
- Ziaderm Research LLC
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Panama, Florida, Stati Uniti, 32405
- AllerVie Health
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Sarasota, Florida, Stati Uniti, 34233
- Sarasota Clinical Research
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Sweetwater, Florida, Stati Uniti, 33172
- Lenus Research and Med Group LLC
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Tampa, Florida, Stati Uniti, 33613
- Asthma Allergy Immunology Clin Res
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Winter Park, Florida, Stati Uniti, 32789
- Conquest Research
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Georgia
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Columbus, Georgia, Stati Uniti, 31904
- AllerVie Clin Res Columbus GA
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Cumming, Georgia, Stati Uniti, 30040
- Cleaver Medical Group
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Douglasville, Georgia, Stati Uniti, 30135
- Southeast Dermatology Specialists
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Savannah, Georgia, Stati Uniti, 31406
- Aeroallergy Research Laboratories
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Idaho
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Meridian, Idaho, Stati Uniti, 83642
- The Allergy Group-Meridian Clinic
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Illinois
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Chicago, Illinois, Stati Uniti, 60612
- Rush University Medical Center
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Chicago, Illinois, Stati Uniti, 60611
- NW Uni C and T Sciences Ins
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Normal, Illinois, Stati Uniti, 61761
- Midwest Allergy Sinus Asthma SC
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O'Fallon, Illinois, Stati Uniti, 62269
- Clinical Res Ctr of S Illinois
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River Forest, Illinois, Stati Uniti, 60305
- Asthma and Allergy Center of Chicago S C
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Skokie, Illinois, Stati Uniti, 60077
- Endeavor Health Clinical Trials Center
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Wheaton, Illinois, Stati Uniti, 60189
- Accellacare Duly Health and Care
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Indiana
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Evansville, Indiana, Stati Uniti, 47715
- Deaconess Clin Allerg Res Inst
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New Albany, Indiana, Stati Uniti, 47150
- Southern IN Clinical Trials
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Iowa
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Ames, Iowa, Stati Uniti, 50010
- McFarland Clinic PC
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Kentucky
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Bowling Green, Kentucky, Stati Uniti, 42104
- Equity Medical LLC
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Louisville, Kentucky, Stati Uniti, 40215
- Family Allergy And Asthma Rsch Inst
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Owensboro, Kentucky, Stati Uniti, 42301
- Allergy and Asthma Specialist P S C
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Louisiana
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Baton Rouge, Louisiana, Stati Uniti, 70816
- Ochsner Health Center
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Lafayette, Louisiana, Stati Uniti, 70508
- Velocity Clinical Research
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Maryland
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Baltimore, Maryland, Stati Uniti, 21236
- Chesapeake Clinical Research Inc
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Baltimore, Maryland, Stati Uniti, 21205
- Johns Hopkins U School of Med
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Chevy Chase, Maryland, Stati Uniti, 20815
- Institute for Asthma and Allergy PC
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Massachusetts
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Boston, Massachusetts, Stati Uniti, 02111
- Boston Specialists LLC
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Michigan
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Ann Arbor, Michigan, Stati Uniti, 48106-0525
- ClinSite Inc
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Caledonia, Michigan, Stati Uniti, 49316
- Derm Institute West Michigan PLLC
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Detroit, Michigan, Stati Uniti, 48202
- Henry Ford Hospital
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Troy, Michigan, Stati Uniti, 48084
- Somerset Skin Centre
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Troy, Michigan, Stati Uniti, 48084
- Revival Research Institute
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Minnesota
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Minneapolis, Minnesota, Stati Uniti, 55455
- University of Minnesota
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Minneapolis, Minnesota, Stati Uniti, 55402
- Clinical Research Institute
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Rochester, Minnesota, Stati Uniti, 55905
- Mayo Clinic - Rochester
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Missouri
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Columbia, Missouri, Stati Uniti, 65201
- ENT and Allergy Center of Missouri
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St Louis, Missouri, Stati Uniti, 63141
- The Clinical Research Center
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St Louis, Missouri, Stati Uniti, 63141
- Washington University
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Nebraska
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Lincoln, Nebraska, Stati Uniti, 68510
- Somnos Clinical Research
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Nevada
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Las Vegas, Nevada, Stati Uniti, 89144
- Las Vegas Dermatology
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Las Vegas, Nevada, Stati Uniti, 89128
- Allergy and Asthma Center of Las Vegas
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New Jersey
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Hamilton, New Jersey, Stati Uniti, 08619
- Circuit Clinical Mercer Algy Pulm
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Little Silver, New Jersey, Stati Uniti, 07739
- Allergy Asthma Assoc Monmouth
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Ocean Township, New Jersey, Stati Uniti, 07712
- Allergy Partners of New Jersey PC
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New York
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The Bronx, New York, Stati Uniti, 10467
- Montefiore Medical Center
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The Bronx, New York, Stati Uniti, 10455
- Equity Medical
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North Carolina
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Asheville, North Carolina, Stati Uniti, 28801
- Allergy Partners Of West NC
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Chapel Hill, North Carolina, Stati Uniti, 27516
- UNC DermatologyandSkinCancer Ctr
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Ohio
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Cincinnati, Ohio, Stati Uniti, 45231
- Bernstein Clinical Research Center
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Columbus, Ohio, Stati Uniti, 43213
- CR Services Acquisition US
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Fairborn, Ohio, Stati Uniti, 45324
- Wright State University
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Toledo, Ohio, Stati Uniti, 43617
- Toledo Institute of Clinical Research
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Oklahoma
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Oklahoma City, Oklahoma, Stati Uniti, 73118
- Unity Clinical Research
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Tulsa, Oklahoma, Stati Uniti, 74136
- Vital Prospects Clinical Research Institute
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Oregon
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Portland, Oregon, Stati Uniti, 97239
- Oregon Health Sciences University
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Portland, Oregon, Stati Uniti, 97223
- Oregon Medical Research Center
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Pennsylvania
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Pittsburgh, Pennsylvania, Stati Uniti, 15213
- University of Pittsburgh Medical Center
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Pittsburgh, Pennsylvania, Stati Uniti, 15241
- Allergy and Clinical Immunology Associates
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South Carolina
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Greenville, South Carolina, Stati Uniti, 29607
- Allergic Disease and Asthma Center
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Greenville, South Carolina, Stati Uniti, 29601
- Tribe Clinical Research LLC
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North Charleston, South Carolina, Stati Uniti, 29420
- National Allergy and Asthma Research LLS
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North Charleston, South Carolina, Stati Uniti, 29406
- Charleston ENT and Allergy
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Tennessee
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Goodlettsville, Tennessee, Stati Uniti, 37072-2301
- Goodlettsville Dermatology Research
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Murfreesboro, Tennessee, Stati Uniti, 37130
- International Clinical Research Tennessee LCC
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Texas
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Arlington, Texas, Stati Uniti, 76011
- Arlington Center for Dermatology
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Austin, Texas, Stati Uniti, 78759
- Orion Clinical Research
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Bellaire, Texas, Stati Uniti, 77401
- Bellaire Dermatology Associates
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Dallas, Texas, Stati Uniti, 75230
- Reveal Research Institute
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Dallas, Texas, Stati Uniti, 75231
- Pharma Research and Amp Consult
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El Paso, Texas, Stati Uniti, 79924
- Western Sky Medical Research
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Houston, Texas, Stati Uniti, 77030
- Center for Clinical Studies
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Kerrville, Texas, Stati Uniti, 78028
- Sante Clinical Research
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San Antonio, Texas, Stati Uniti, 78229
- Andante Research
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San Antonio, Texas, Stati Uniti, 78213
- RFSA Dermatology
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Utah
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Murray, Utah, Stati Uniti, 84107
- University Of Utah
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Sandy City, Utah, Stati Uniti, 84093
- Allergy Associates of Utah
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Virginia
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Vienna, Virginia, Stati Uniti, 22182
- Forefront Dermatology
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Washington
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Bellingham, Washington, Stati Uniti, 98225
- Bellingham Asthma Allergy and Immunology
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
- Adults ≥ 18 years of age at the time of signing the informed consent
- CSU duration for ≥ 6 months prior to screening (defined as the onset of CSU determined by the Investigator based on all available supporting documentation)
- Diagnosis of CSU inadequately controlled by sgH1-AH at the time of randomization, defined as:
- The presence of itch and hives for ≥ 6 consecutive weeks prior to screening despite the use of sgH1-AH during the 7 days prior to randomization (Day 1):
- UAS7 score (range, 0-42) ≥ 16, and
- ISS7 score (range, 0-21) ≥ 6, and
- HSS7 score (range, 0-21) ≥ 6
- Documentation of hives within 3 months before randomization (either at screening and/or at randomization); or documented in the participants medical history
- Willing and able to complete an Urticaria Patient Daily Diary (UPDD) for the duration of the study and adhere to the study protocol
- Participants must not have had more than one missing UPDD entry (either morning or evening) in the 7 days prior to randomization (Day 1)
Exclusion Criteria:
- Previous use of remibrutinib or other bruton's tyrosine kinase (BTK) inhibitors
- Previous use of dupilumab
- Evidence of clinically significant cardiovascular (such as but not limited to myocardial infarction, unstable ischemic heart disease, NYHA Class III/IV left ventricular failure, arrhythmia and uncontrolled hypertension within 12 months prior to Visit 1), neurological, psychiatric, pulmonary, renal, hepatic (past history or current), endocrine or metabolic disorder, or immunodeficiency that, in the investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant.
- Evidence of hematological disorders (including coagulation disorders or significant bleeding risk)
- History or evidence of gastrointestinal disease (including gastrointestinal bleeding, e.g., in association with use of nonsteroidal anti-inflammatory drugs (NSAID), that was clinically relevant (e.g., where intervention was indicated or requiring hospitalization or blood transfusion)
- Requirement for anti-platelet medication, except for acetylsalicylic acid up to 100 mg/d or clopidogrel up to 75 mg/d. The use of dual anti-platelet therapy (e.g., acetylsalicylic acid + clopidogrel) is prohibited.
- Requirement for anticoagulant medication (for example, warfarin or Novel Oral Anti-Coagulants [NOAC])
- History or current hepatic disease including but not limited to acute or chronic hepatitis, cirrhosis or hepatic failure or hepatic parameters at screening: Aspartate Aminotransferase (AST)/ Alanine Aminotransferase (ALT) levels more than 1.5x ULN or International Normalized Ratio (INR) > 1.5 at screening
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Triplicare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: Treatment group 1: Remibrutinib + Placebo
Remibrutinib tablet (25 mg b.i.d. p.o.) + placebo solution for injection in pre-filled syringe (2 s.c. injections at baseline and then 1 s.c. injection every other week [Weeks 2-10]) |
Film-coated tablet, oral administration, 25 mg b.i.d. Solution for injection in pre-filled syringe every 2 weeks |
|
Comparatore attivo: Treatment group 2: Dupilumab + remibrutinib matching placebo
Dupilumab pre-filled syringe (600 mg loading dose [2 x 300 mg dupilumab s.c. injection] at baseline visit followed by dupilumab 300 mg s.c. injection every other week [Weeks 2-10]) + remibrutinib matching placebo tablet (1 tablet b.i.d. p.o.) |
Film-coated tablet, oral administration, b.i.d. Solution for injection in pre-filled syringe 600 mg loading dose followed by 300 mg dose every 2 weeks |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Absolute change from baseline in Weekly Urticaria Activity Score (UAS7) at Week 4
Lasso di tempo: Baseline, Week 4
|
The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit. |
Baseline, Week 4
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Improvement of severity of hives, assessed as absolute change from baseline in HSS7 score at Week 4
Lasso di tempo: Baseline, Week 4
|
The hives (wheals) severity score, defined by number of hives, will be recorded by the participant twice daily in their eCOA device, on a scale of 0 (none) to 3. A weekly score (HSS7) is derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score is therefore 0 - 21. |
Baseline, Week 4
|
|
Improvement of severity of itch, assessed as absolute change from baseline in ISS7 score at Week 4
Lasso di tempo: Baseline, Week 4
|
The severity of the itch will be recorded by the participant twice daily in their eCOA device, on a scale of 0 (none) to 3 (severe). A weekly score (ISS7) is derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score is therefore 0 - 21. |
Baseline, Week 4
|
|
Improvement of UAS7, assessed as absolute change from baseline in UAS7 score at Week 1
Lasso di tempo: Baseline, Week 1
|
The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit. |
Baseline, Week 1
|
|
Percentage of participants with UAS7 ≤ 6 at Week 4
Lasso di tempo: Week 4
|
Percentage of participants who achieved UAS7 ≤ 6 at Week 4. The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit. |
Week 4
|
|
Percentage of participants with UAS7=0 at Week 4
Lasso di tempo: Week 4
|
Percentage of participants who achieved UAS7 = 0 at Week 4. The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit. |
Week 4
|
|
Percentage of participants with UAS7 ≤ 6 at Week 2
Lasso di tempo: Week 2
|
Percentage of participants who achieved UAS7 ≤ 6 at Week 2. The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit. |
Week 2
|
Collaboratori e investigatori
Sponsor
Sponsor
Pubblicazioni e link utili
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
- Processi patologici
- Malattia cronica
- Attributi della malattia
- Malattie del sistema immunitario
- Ipersensibilità, immediata
- Ipersensibilità
- Malattie della pelle
- Orticaria
- Malattie della pelle, vascolari
- Condizioni patologiche, segni e sintomi
- Malattie della pelle e del tessuto connettivo
- Orticaria cronica
- Terapie
- Rotte della somministrazione di droga
- Terapia farmacologica
- Iniezioni
- Dupilumab
- remibrutinib
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- CLOU064AUS02
Piano per i dati dei singoli partecipanti (IPD)
Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?
Descrizione del piano IPD
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Informazioni su farmaci e dispositivi, documenti di studio
Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti
Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .