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Study to Evaluate the Efficacy and Safety of Reslizumab Treatment in Patients With Moderate to Severe Asthma

2016年5月26日 更新者：Teva Branded Pharmaceutical Products R&D, Inc.

A 16-Week, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Reslizumab (3.0 mg/kg) Treatment in Patients With Moderate to Severe Asthma

The primary objective of the study is to characterize the efficacy of reslizumab treatment, at a dosage of 3.0 milligrams per kilogram (mg/kg) every 4 weeks for a total of 4 doses, in improving pulmonary function in relation to baseline blood eosinophil levels in patients with moderate to severe asthma, as assessed by the change from baseline to week 16 in forced expiratory volume in 1 second (FEV1).

調査の概要

状態

完了

条件

介入・治療

研究の種類

介入

入学 (実際)

511

段階

  • フェーズ 3

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

  • アメリカ
    • Alabama
      • Birmingham、Alabama、アメリカ
        • Investigational Site 861
      • Homewood、Alabama、アメリカ
        • Investigational Site 842
      • Jasper、Alabama、アメリカ
        • Investigational Site 887
    • Arizona
      • Tucson、Arizona、アメリカ
        • Investigational Site 809
      • Tucson、Arizona、アメリカ
        • Investigational Site 892
    • Arkansas
      • Little Rock、Arkansas、アメリカ
        • Investigational Site 846
    • California
      • Anaheim、California、アメリカ
        • Investigational Site 828
      • Fresno、California、アメリカ
        • Investigational Site 900
      • Huntington Beach、California、アメリカ
        • Investigational Site 862
      • Los Angeles、California、アメリカ
        • Investigational Site 852
      • Los Angeles、California、アメリカ
        • Investigational Site 909
      • Newport Beach、California、アメリカ
        • Investigational Site 864
      • Rancho Mirage、California、アメリカ
        • Investigational Site 812
      • Riverside、California、アメリカ
        • Investigational Site 808
      • Sacramento、California、アメリカ
        • Investigational Site 804
    • Colorado
      • Centennial、Colorado、アメリカ
        • Investigational Site 837
      • Denver、Colorado、アメリカ
        • Investigational Site 851
      • Wheat Ridge、Colorado、アメリカ
        • Investigational Site 832
    • Florida
      • Jacksonville、Florida、アメリカ
        • Investigational Site 855
      • Miami、Florida、アメリカ
        • Investigational Site 865
      • Miami、Florida、アメリカ
        • Investigational Site 881
    • Georgia
      • Albany、Georgia、アメリカ
        • Investigational Site 805
      • Stockbridge、Georgia、アメリカ
        • Investigational Site 870
    • Illinois
      • Chicago、Illinois、アメリカ
        • Investigational Site 816
      • Shiloh、Illinois、アメリカ
        • Investigational Site 824
    • Indiana
      • Evansville、Indiana、アメリカ
        • Investigational Site 883
      • Fort Wayne、Indiana、アメリカ
        • Investigational Site 878
    • Kansas
      • Lenexa、Kansas、アメリカ
        • Investigational Site 820
    • Kentucky
      • Owensboro、Kentucky、アメリカ
        • Investigational Site 873
    • Louisiana
      • Lafayette、Louisiana、アメリカ
        • Investigational Site 801
      • Mandeville、Louisiana、アメリカ
        • Investigational Site 877
    • Maryland
      • White Marsh、Maryland、アメリカ
        • Investigational Site 875
    • Massachusetts
      • Fall River、Massachusetts、アメリカ
        • Investigational Site 871
      • North Dartmouth、Massachusetts、アメリカ
        • Investigational Site 834
    • Michigan
      • Troy、Michigan、アメリカ
        • Investigational Site 889
    • Missouri
      • Rolla、Missouri、アメリカ
        • Investigational Site 838
      • St. Louis、Missouri、アメリカ
        • Investigational Site 818
      • St. Louis、Missouri、アメリカ
        • Investigational Site 841
    • New Mexico
      • Albuquerque、New Mexico、アメリカ
        • Investigational Site 857
    • New York
      • Newburgh、New York、アメリカ
        • Investigational Site 819
    • North Carolina
      • Charlotte、North Carolina、アメリカ
        • Investigational Site 844
    • Ohio
      • Middleburg Heights、Ohio、アメリカ
        • Investigational Site 845
    • Oklahoma
      • Tulsa、Oklahoma、アメリカ
        • Investigational Site 810
    • Oregon
      • Ashland、Oregon、アメリカ
        • Investigational Site 859
      • Portland、Oregon、アメリカ
        • Investigational Site 859
    • Pennsylvania
      • Jenkintown、Pennsylvania、アメリカ
        • Investigational Site 854
    • Rhode Island
      • Providence、Rhode Island、アメリカ
        • Investigational Site 843
    • South Carolina
      • Florence、South Carolina、アメリカ
        • Investigational Site 802
      • Orangeburg、South Carolina、アメリカ
        • Investigational Site 814
      • Spartanburg、South Carolina、アメリカ
        • Investigational Site 821
      • Spartanburg、South Carolina、アメリカ
        • Investigational Site 829
    • Tennessee
      • Knoxville、Tennessee、アメリカ
        • Investigational Site 850
      • Nashville、Tennessee、アメリカ
        • Investigational Site 803
    • Texas
      • Dallas、Texas、アメリカ
        • Investigational Site 880
      • Dickinson、Texas、アメリカ
        • Investigational Site 858
      • Live Oak、Texas、アメリカ
        • Investigational Site 869
      • Plano、Texas、アメリカ
        • Investigational Site 879
    • Utah
      • Salt Lake City、Utah、アメリカ
        • Investigational Site 847
      • West Jordan、Utah、アメリカ
        • Investigational Site 876
    • Virginia
      • Fairfax、Virginia、アメリカ
        • Investigational Site 840
      • Richmond、Virginia、アメリカ
        • Investigational Site 836
    • Washington
      • Seattle、Washington、アメリカ
        • Investigational Site 867
      • Spokane、Washington、アメリカ
        • Investigational Site 833
      • Vancouver、Washington、アメリカ
        • Investigational Site 904
    • Wisconsin
      • Greenfield、Wisconsin、アメリカ
        • Investigational Site 806
      • LaCrosse、Wisconsin、アメリカ
        • Investigational Site 823

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年～65年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

説明

Inclusion criteria:

Patients are included in the study if all of the following criteria are met:

  • The patient is a man or woman, 18 through 65 years of age, with a diagnosis of asthma.
  • The patient has an ACQ score of at least 1.5.
  • At screening, the patient has airway reversibility of at least 12% to beta-agonist administration.
  • The patient is currently taking fluticasone at a dosage of at least 440 µg daily (or equivalent). Patients' baseline asthma therapy regimens (including but not limited to inhaled corticosteroids, leukotriene antagonists, 5-lipoxygenase inhibitors, cromolyn) must be stable for 30 days before screening and continue without dosage changes throughout study.
  • Female patients must be surgically sterile, 2 years postmenopausal, or must have a negative beta-human chorionic gonadotropin (ßHCG) result for a pregnancy test at screening (serum) and baseline (urine).
  • Female patients of childbearing potential (not surgically sterile or 2 years postmenopausal), must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for 30 days after participation in the study. Acceptable methods of contraception include barrier method with spermicide, abstinence, intrauterine device (IUD), or steroidal contraceptive (oral, transdermal, implanted, and injected).
  • Written informed consent is obtained.
  • The patient is in reasonable health (except for diagnosis of asthma) as judged by the investigator, and as determined by a medical history, medical examination, electrocardiogram (ECG) evaluation, serum chemistry, hematology, urinalysis, and serology.
  • The patient must be willing and able to comply with study restrictions and to remain at the clinic for the required duration during the study period, and be willing to return to the clinic for the follow-up evaluation as specified in this protocol.

Exclusion Criteria:

Patients are excluded from participating in this study if 1 or more of the following criteria are met:

  • The patient has another confounding underlying lung disorder (eg, chronic obstructive pulmonary disease, pulmonary fibrosis, lung cancer). The patient has other pulmonary conditions with symptoms of asthma and blood eosinophilia (eg, Churg-Strauss syndrome, allergic bronchopulmonary aspergillosis).
  • The patient has a clinically meaningful comorbidity that would interfere with the study schedule or procedures, or compromise the patient's safety.
  • The patient has known hypereosinophilic syndrome (HES).
  • The patient is a current smoker (ie, has smoked within the last 6 months prior to screening).
  • The patient has a history of use of systemic immunosuppressive or immunomodulating agents (anti-immunoglobulin E [anti-IgE] mAb, methotrexate, cyclosporin, interferon-α, anti-tumor necrosis factor mAb, or omalizumab) within 6 months prior to study entry (randomization).
  • The patient is currently using or has used systemic corticosteroids (includes use of oral corticosteroids) within 30 days prior to the screening visit.
  • The patient is expected to be poorly compliant with study drug administration, study procedures, or visits.
  • The patient has any aggravating factors that are inadequately controlled, and thus would aggravate asthma symptoms (eg, gastroesophageal reflux disease).
  • The patient has participated in any investigative drug or device study within 30 days prior to screening.
  • The patient has participated in any investigative biologics study within 90 days prior to screening.
  • The patient has previously received reslizumab or other anti-hIL-5 mAbs (eg, mepolizumab).
  • The patient is a pregnant or lactating woman. (Any women becoming pregnant during the study will be withdrawn from the study.)
  • The patient has a current infection or disease that may preclude assessment of asthma.
  • The patient has a history of concurrent immunodeficiency (human immunodeficiency, acquired immunodeficiency syndrome, or congenital immunodeficiency).
  • The patient is suspected of current drug or alcohol abuse as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria.
  • The patient has presence of or suspected parasitic infestation/infection.
  • Patients may not have received any live attenuated vaccine within the 12-week period before study entry.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：ランダム化
  • 介入モデル：並列代入
  • マスキング：4倍

武器と介入

参加者グループ / アーム
介入・治療
プラセボコンパレーター：Placebo
Placebo intravenous injection every 4 weeks for a total of 4 doses.
薬：Placebo
Matching placebo administered by intravenous (iv) infusion by qualified study personnel every 4 weeks for 16 weeks (for a total of 4 doses).
実験的：Reslizumab 3.0 mg/kg
Reslizumab intravenous injection at a dosage of 3.0 mg/kg every 4 weeks for a total of 4 doses.
薬：Reslizumab
Reslizumab administered at a dosage of 3.0 mg/kg by intravenous (iv) infusion by qualified study personnel every 4 weeks for 16 weeks (for a total of 4 doses).
他の名前：
  • チンキル
  • ヒト化モノクローナル抗体
  • CEP-38072

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Week 16 in Full Analysis Set
時間枠：Baseline (Day 1), Week 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry.

Data represent the slope estimate of change from baseline in FEV1 (measured in liters) at Week 16 versus baseline eosinophil count (measured in 10^9/liter) by treatment group.
Baseline (Day 1), Week 16

二次結果の測定

結果測定
メジャーの説明
時間枠
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Over 16 Weeks Using Mixed Model for Repeated Measures
時間枠：Baseline (Day 1), Weeks 4, 8, 12, 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.

During study (Weeks 4, 8, 12 and 16) average value was calculated using a mixed effects model for repeated measures (MMRM) with treatment (reslizumab or placebo), blood eosinophil count at baseline, and the interaction of treatment and eosinophil count as a random effect.
Baseline (Day 1), Weeks 4, 8, 12, 16
Change From Baseline in Asthma Control Questionnaire (ACQ) Over 16 Weeks Using Mixed Model for Repeated Measures
時間枠：Baseline (Day 1), Weeks 4, 8, 12, 16

The ACQ score was measured using the ACQ-7. Six questions are-self assessments; the seventh item is the result of the patient's % predicted FEV1 measurement. Each item has 7 possible answers on a scale of 0 to 6, and the total score is the mean of all responses (the total scale is therefore 0-6). A score of 0 indicates good asthma control; higher scores indicate increasingly poorer asthma control. Negative change from baseline scores indicate improvement in asthma control.

During study (Weeks 4, 8, 12 and 16) average value was calculated from mixed model repeated measures (MMRM) with treatment, visit, treatment by visit interaction, history of asthma exacerbation in the previous year, height, baseline value, and sex as fixed factors, and patient as a random effect.
Baseline (Day 1), Weeks 4, 8, 12, 16
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Week 16 in FEV1 Subpopulation
時間枠：Baseline (Day 1), Week 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry.

As with the primary outcome, data represent the slope estimate of change from baseline in FEV1 (measured in liters) at Week 16 versus baseline eosinophil count (measured in 10^9/liter) by treatment group. However the FEV1 subpopulation includes participants with more impaired lung function (% predicted FEV1 <85% at baseline).
Baseline (Day 1), Week 16
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Weeks 4, 8, 12, and 16
時間枠：Baseline (Day 1), Weeks 4, 8, 12, and 16
FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (% Predicted FEV1) at Weeks 4, 8, 12, 16 and Endpoint
時間枠：Baseline (Day 1), Weeks 4, 8, 12, and 16
The percent predicted FEV1 is the ratio of the volume of air expired in the first second of a forced expiration to the patient's predicted FEV based on a similar population without asthma. Percent predicted lung function values were transcribed directly from the lung function report to the CRF, without any calculation by Teva. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in Forced Vital Capacity (FVC) at Weeks 4, 8, 12, and 16
時間枠：Baseline (Day 1), Weeks 4, 8, 12, and 16
The FVC is the volume of air that can be forcibly blown out after full inspiration, measured in liters. FV was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in the Forced Expiratory Flow at 25% to 75% of the Forced Vital Capacity (FEF25%-75%) at Weeks 4, 8, 12, and 16
時間枠：Baseline (Day 1), Weeks 4, 8, 12, and 16
The FEF25%-75% is the forced expiratory flow at 25% to 75% of the forced vital capacity. FEF25%-75% was measured using forced expiratory air spirometry. Positive change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12, and 16
Change From Baseline in Average Daily Use of Short-Acting Beta-Agonist Therapy (SABA) at Weeks 4, 8, 12, and 16
時間枠：Baseline (Day -2 to 1), Weeks 4, 8, 12, and 16
SABA are used for quick relief of asthma symptoms. The number of times SABA therapy was used was assessed using 3 day recall at scheduled visits. Participants were asked to recall whether SABAs were used within 3 days of the scheduled visit and, if so, how many puffs were used. Daily use was the average of those 3 days. Negative change from baseline scores indicate improvement in asthma control.
Baseline (Day -2 to 1), Weeks 4, 8, 12, and 16
Change From Baseline in Blood Eosinophil Counts at Weeks 4, 8, 12, 16, Follow-up (Week 28) and Endpoint
時間枠：Baseline (Day 1), Weeks 4, 8, 12, 16, Follow-up (Week 28)
Blood eosinophil counts were measured using a standard complete blood count with differential blood test at each scheduled visit. Follow-up was performed approximately 12 weeks after the 16 week treatment period. Endpoint is the last post-baseline assessment.
Baseline (Day 1), Weeks 4, 8, 12, 16, Follow-up (Week 28)
Change From Baseline in Asthma Control Questionnaire (ACQ) at Weeks 4, 8, 12 and 16
時間枠：Baseline (Day 1), Weeks 4, 8, 12 and 16
The ACQ score was measured using the ACQ-7. Six questions are self-assessments; the seventh item is the result of the patient's % predicted FEV1 measurement. Each item has 7 possible answers on a scale of 0 to 6, and the total score is the mean of all responses (the total scale is therefore 0-6). A score of 0 indicates good asthma control; higher scores indicate increasingly poorer asthma control. Negative change from baseline scores indicate improvement in asthma control.
Baseline (Day 1), Weeks 4, 8, 12 and 16
Participants With Treatment-Emergent Adverse Events
時間枠：Day 1 to Week 28
An adverse event was defined in the protocol as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= an inability to carry out usual activities. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical intervention to prevent the previously listed serious outcomes.
Day 1 to Week 28
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Abnormal Lab Values
時間枠：Week 4 to Week 16

Data represents participants with potentially clinically significant (PCS) abnormal serum chemistry, hematology, and urinalysis values during any of the lab tests conducted during the treatment period.

Significance criteria:

  • Blood urea nitrogen: >=10.71 mmol/L
  • Creatinine: >=177 μmol/L
  • Uric acid: M>=625, F>=506 μmol/L
  • Aspartate aminotransferase: >=3*upper limit of normal (ULN). Normal range is 10-43 U/L
  • Alanine aminotransferase: >=3*ULN. Normal range is 10-40 U/L
  • GGT = gamma-glutamyl transpeptidase: >= 3*ULN. Normal range is 4-49 U/L.
  • Total bilirubin: >=34.2 μmol/L
  • Creatinine phosphokinase: >5*ULN. Normal range is 24-207 U/L.
  • White blood cells: <=3.0 or >20 10^9/L
  • Hemoglobin: M<=115, F<=95 g/dL
  • Hematocrit: M<0.37, F<0.32 L/L
  • Platelets: <=75 10^9/L
  • Absolute neutrophil count: <=1.0 10^9/L
  • Urinalysis: blood, glucose, ketones and total protein: >=2 unit increase from baseline
Week 4 to Week 16
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Vital Signs Values
時間枠：Week 4 to Week 28

Data represents participants with potentially clinically significant (PCS) vital sign values during any of the treatment period exams.

Significance criteria

  • Heart rate - high: >100 and increase of >= 30 beats/minute (bpm)
  • Sitting systolic blood pressure - high: >160 and increase of >=30 mmHg
  • Sitting systolic blood pressure - low: <90 and decrease of >=30 mmHg
  • Sitting diastolic blood pressure - high: >100 and increase of >=12 mmHg
  • Sitting diastolic blood pressure - low: <50 and decrease of >=12 mmHg
  • Body temperature - high: >100.5° Fahrenheit or 38.1° Celsius and increase of >2°
  • Body temperature - low: <96.5° Fahrenheit or <35.8° Celsius
Week 4 to Week 28
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Electrocardiogram (ECG) Abnormalities
時間枠：Week 16 or endpoint
Counts represent the number of participants with potentially clinically significant ECG abnormalities as assessed by the investigator.
Week 16 or endpoint
Participants With a Positive Anti-Reslizumab Antibody Status During Study
時間枠：Screening (Week -3), Weeks 8 and 16

Counts of participants with a positive anti-drug antibody (ADA) response during treatment is offered for the experimental treatment arm. Blood samples were collected for determination of ADAs before study drug infusion at screening, weeks 8 and 16 or early withdrawal. Serum samples from patients who were treated with reslizumab were analyzed for ADA by Teva (Teva Biopharmaceuticals USA, Rockville, MD) using a validated homogeneous solution-based bridging enzyme-linked immunosorbent assay (ELISA).

Endpoint =week 16 or early withdrawal.

Counts represent the total number of participants at each time point with a positive immunogenicity test, and not 'new' participants with a positive test. An overall status of positive includes participants who had a positive ADA at any time point.
Screening (Week -3), Weeks 8 and 16

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Teva Branded Pharmaceutical Products R&D, Inc.

捜査官

  • スタディディレクター：Global Respiratory Clinical Research, M.D.、Sponsor's Medical Expert

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

一般刊行物

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始

2012年2月1日

一次修了 (実際)

2013年8月1日

研究の完了 (実際)

2013年8月1日

試験登録日

最初に提出

2012年1月3日

QC基準を満たした最初の提出物

2012年1月10日

最初の投稿 (見積もり)

2012年1月12日

学習記録の更新

投稿された最後の更新 (見積もり)

2016年6月27日

QC基準を満たした最後の更新が送信されました

2016年5月26日

最終確認日

2016年5月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • C38072/3084

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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