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Effects of Mepolizumab Compared to Placebo on Airway Physiology in Patients With Eosinophilic Asthma: MEMORY Study (MEMORY)

11 luglio 2017 aggiornato da: PD Dr. Stephanie Korn, Johannes Gutenberg University Mainz

A Randomized, Double-blind, Placebo-controlled, Mono-center Study to Evaluate the Effects of Mepolizumab on Airway Physiology in Patients With Eosinophilic Asthma: the MEMORY Study

The purpose of the MEMORY trial is to compare the effects of mepolizumab with Placebo on airway physiology in patients with eosinophilic asthma

Panoramica dello studio

Stato

Terminato

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Asthma with eosinophilic inflammation in the airways and/or blood eosinophilia is associated with clinical severity including the risk of exacerbations and relevant comorbidities (e.g. nasal polyposis). Interleukin-5 (IL-5) is a cytokine essential for eosinophil trafficking and survival. Clinical trials of blocking IL-5 with anti-IL-5 antibodies (mepolizumab and reslizumab) in patients with uncontrolled eosinophilic asthma resulted in an improvement in exacerbation rate and oral corticosteroid use. In some studies with mepolizumab and reslizumab there was a beneficial effect on lung function (FEV1). In addition, many patients described a profound impact on asthma symptoms and quality of life in personal reports which is not uniformly reflected in clinical trials.

The MEMORY trial is the first to primarily evaluate the effect of mepolizumab treatment on pulmonary function in patients with severe eosinophilic asthma. Importantly, using spirometry and bodyplethysmography will allow to evaluate additional parameters beyond FEV1 that more closely mirror the pathophysiological changes and functional aspects of airflow limitation in asthma in real life, e.g. airway resistance, hyperinflation and diffusion capacity. The proposed trial will answer the important questions: if, and if so, which parameters of airway (patho-) physiology as assessed by bodyplethysmography best reflect clinical response to mepolizumab therapy in patients with severe eosinophilic asthma. In addition, the time course to clinical response will be assessed. Equally important, there is only a loose correlation between FEV1 and parameters of asthma control and asthma-related quality of life. This is why another new and important aspect of this trial is to carefully monitor asthma control and asthma quality in life in correlation with lung function changes beyond FEV1. Finally, it is tempting to speculate that the proposed trial will contribute to the question how to best define clinical response to mepolizumab.

Tipo di studio

Interventistico

Iscrizione (Effettivo)

29

Fase

  • Fase 3

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

      • Mainz, Germania, 55131
        • Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Pneumologie

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. Patients must be able to give written informed consent prior to participation in the study, which will include the ability to comply with the requirements and restrictions listed in the consent form.
  2. Male or female patients at least 18 years
  3. Physician-diagnosis of asthma and evidence of asthma as documented by either reversibility of airflow obstruction (FEV1 ≥ 12% or 200 ml) demonstrated at visit 1 or visit 2 .
  4. ICS dose must be ≥ 1000 μg/day BDP or equivalent daily with or without maintenance oral corticosteroids.
  5. Treatment in the past 12 months with an additional controller medication for at least 3 successive months, e.g., long-acting beta-2-agonist (LABA), leukotriene receptor antagonist (LTRA), or theophylline.
  6. Persistent airflow obstruction as indicated by a pre-bronchodilator FEV1 < 80% predicted recorded at Visit 1 or < 90% for patients on oral corticosteroids.
  7. An elevated peripheral blood eosinophil level of ≥ 300/µL that is related to asthma or ≥ 150/µL in patients treated with oral corticosteroids as maintenance therapy demonstrated at visit 1 or in the previous 12 months
  8. Confirmed history of two or more exacerbations requiring treatment with systemic corticosteroids (intramuscular, intravenous, or oral), in the 12 months prior to visit 1, despite the use of high-dose inhaled corticosteroids. For patients receiving maintenance corticosteroids, the corticosteroid treatment for the exacerbations must have been a two-fold increase or greater in the dose.

Exclusion Criteria:

  1. Current smokers or former smokers with a smoking history of ≥ 10 pack years (number of pack years = (number of cigarettes per day / 20) x number of years smoked). Patients who have not smoked for ≥ 6 months before visit 1 and have < 10 pack years can be included into the study.
  2. Presence of a clinically important lung condition other than asthma. This includes current infection, bronchiectasis, pulmonary fibrosis, bronchopulmonary aspergillosis, or diagnoses of emphysema or chronic bronchitis (chronic obstructive pulmonary disease other than asthma) or a history of lung cancer.
  3. Patients who have received omalizumab [Xolair] within 130 days of Visit 1.
  4. Patients who have received any biological to treat inflammatory disease within 5 half-lives of visit 1

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Quadruplicare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Mepolizumab
100 mg SC every 4 weeks for 13 injections
100 mg SC every 4 weeks for 13 injections
Sperimentale: Placebo
Amount of Placebo corresponding to mepolizumab dose SC every 4 weeks for 13 injections

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
mean change from baseline in pre- and post-bronchodilator FVC at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator forced vital capacity (FVC) at visit 10 (week 24) and at time of response
week 24 and time of response
mean change from baseline in pre- and post-bronchodilator FEV1 at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 second (FEV1) at visit 10 (week 24) and at time of response
week 24 and time of response
mean change from baseline in pre- and post-bronchodilator RV at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator residual volume (RV) at visit 10 (week 24) and at time of response
week 24 and time of response
mean change from baseline in pre- and post-bronchodilator TLC at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator total lung capacity (TLC) at visit 10 (week 24) and at time of response
week 24 and time of response
mean change from baseline in pre- and post-bronchodilator airway resistance at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator airway resistance at visit 10 (week 24) and at time of response
week 24 and time of response
mean change from baseline in pre- and post-bronchodilator IC at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator inspiratory capacity (IC) at visit 10 (week 24) and at time of response
week 24 and time of response
mean change from baseline in pre- and post-bronchodilator CO diffusion capacity at visit 10 (week 24) and at time of response
Lasso di tempo: week 24 and time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator CO diffusion capacity at visit 10 (week 24) and at time of response
week 24 and time of response

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Mean change from baseline in pre- and post-bronchodilator forced vital capacity (FVC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Mean change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 second (FEV1) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Mean change from baseline in pre- and post-bronchodilator residual volume (RV) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Mean change from baseline in pre- and post-bronchodilator total lung capacity (TLC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Mean change from baseline in pre- and post-bronchodilator airway resistance over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Mean change from baseline in pre- and post-bronchodilator inspiratory capacity (IC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Mean change from baseline in pre- and post-bronchodilator CO diffusion capacity over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 months
1, 3, 6, 9 and 12 months
Exercise tolerance in a subgroup of patients: Mean change from baseline in exercise endurance time
Lasso di tempo: 1, 3, 6, 9 and 12 month
Mean change from baseline in exercise endurance time during a sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment.
1, 3, 6, 9 and 12 month
Exercise tolerance in a subgroup of patients: Mean change from baseline in inspiratory capacity (IC)
Lasso di tempo: 1, 3, 6, 9 and 12 month
Mean change from baseline in inspiratory capacity (IC) at rest and at peak during sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment.
1, 3, 6, 9 and 12 month
Exercise tolerance in a subgroup of patients: Mean change from baseline in exertional dyspnea and leg discomfort (Borg CR10 Scale®)
Lasso di tempo: 1, 3, 6, 9 and 12 month
Mean change from baseline in exertional dyspnea and leg discomfort (Borg CR10 Scale®) during sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment
1, 3, 6, 9 and 12 month
Time to clinical response and time to change of baseline parameters of clinical Response: sence of smell
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: sense of taste
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: lung volume
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: CO Diffusion capacity
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: FEV1 reversibility
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: exhaled NO (eNO)
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: blood eosinophils
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: eosinophilic cationic Protein (ECP)
Lasso di tempo: 52 weeks
52 weeks
Time to clinical response and time to change of baseline parameters of clinical Response: blood periostin
Lasso di tempo: 52 weeks
52 weeks
Mean change from baseline in Asthma Control Questionnaire (ACQ)
Lasso di tempo: 52 weeks
52 weeks
Mean change from baseline in Asthma Quality of Life Questionnaire (AQLQ)
Lasso di tempo: 52 weeks
52 weeks
Mean change from baseline in St. George´s Respiratory Questionnaire (SQRG)
Lasso di tempo: 52 weeks
52 weeks
Mean change from baseline in Dyspnoe Index (BDI/TDI)
Lasso di tempo: 52 weeks
52 weeks
Mean change from baseline in fatique
Lasso di tempo: 52 weeks
52 weeks
Mean change from baseline in number of days off school/work over the 48-week treatment period
Lasso di tempo: 48 weeks
48 weeks
Time to first clinically significant exacerbation requiring oral or systemic corticosteroids, hospitalization, and/or emergency department (ED) visits
Lasso di tempo: 52 weeks
52 weeks
Frequency of clinically significant exacerbations
Lasso di tempo: 52 weeks
52 weeks
Time to first exacerbation requiring hospitalization or emergency department (ED) visit
Lasso di tempo: 52 weeks
52 weeks
Frequency of exacerbations requiring hospitalization (including intubation and admittance to an intensive care unit (ICU)) or ED visits
Lasso di tempo: 52 weeks
52 weeks
GETE rating by physician and patient at time of response and over the 52-week treatment period at pre-specified timepoints (1, 3, 6, 9 and 12 months)
Lasso di tempo: 1, 3, 6, 9 and 12 month
1, 3, 6, 9 and 12 month
Mean change in proportion of patients with nasal polyps, chronic sinusitis and loss of smell and taste
Lasso di tempo: 52 weeks
52 weeks
Clinical response to mepolizumab in relation to asthma parameters which potentially predict clinical response
Lasso di tempo: 52 weeks
Clinical response to mepolizumab in relation to asthma parameters which potentially predict clinical response (age at onset and duration of asthma, prior asthma medication, presence of nasal polyps, sense of smell and taste, allergic sensitization (skin prick test, total and specific IgE against aeroallergens and Staph. aureus enterotoxin), reversibility of airflow obstruction, eNO, blood eosinophils, eosinophilic cationic protein (ECP), blood periostin, ANA, ANCA, ECP.
52 weeks
Routine safety assessment (AE and SAE reporting, withdrawals, pregnancy, hematological and clinical chemistry parameters, ECG and vital signs (pulse rate and systolic and diastolic blood pressure))
Lasso di tempo: 52 weeks
Routine safety assessments are incorporated throughout and/or at the end of treatment period including AE and SAE reporting, withdrawals, pregnancy, hematological and clinical chemistry parameters, ECG and vital signs (pulse rate and systolic and diastolic blood pressure).
52 weeks

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Collaboratori

Investigatori

  • Investigatore principale: Stephanie Korn, MD, Johannes Gutenberg University Mainz

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

17 novembre 2015

Completamento primario (Effettivo)

22 maggio 2017

Completamento dello studio (Effettivo)

22 maggio 2017

Date di iscrizione allo studio

Primo inviato

31 agosto 2015

Primo inviato che soddisfa i criteri di controllo qualità

2 novembre 2015

Primo Inserito (Stima)

3 novembre 2015

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

13 luglio 2017

Ultimo aggiornamento inviato che soddisfa i criteri QC

11 luglio 2017

Ultimo verificato

1 luglio 2017

Maggiori informazioni

Termini relativi a questo studio

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INDECISO

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 .

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