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Study to Assess the Efficacy and Safety of Omalizumab Treatment on ICS Reduction for Severe IgE-mediated Asthma (MEXIC)

2019年6月24日 更新者:Novartis Pharmaceuticals

Multicentric, Open-label, Randomized, Parallel--group Study to Evaluate the Efficacy and Safety of Omalizumab in a 12- Month Period, in Patients With Severe IgE-mediated Asthma Inadequately Controlled With High Doses of Corticosteroids.

Assess efficacy and safety of omalizumab treatment during 12 months in order to reduce the use of inhaled corticosteroid (ICS) in pediatric and adult participants with severe Immunoglobulin E (IgE)-mediated asthma inadequately controlled with high doses of corticosteroids.

調査の概要

詳細な説明

This was a multicentric, open label, randomized, parallel-group study with a 12-month treatment period. Participants were assigned to one of the 2 treatment groups, omalizumab plus budesonide/formoterol or budesonide/formoterol alone.

The study comprised 4 phases:

During the 4-week run-in phase adult participants received budesonide 800 mg and formoterol 24 mg. If a participant complied with all inclusion and exclusion criteria and had received the according-to-age run-in proposed doses during the last month, the participant continued to the stable-steroid phase.

During the 16-week stable-steroid phase, adult and pediatric eligible participants were randomized to one of the two treatment groups.

During the 8-week steroid-reduction phase, adult and pediatric participants reduced 25% of the budesonide baseline dose every 2 weeks, depending of the asthma control, until they reached a 100% reduction of the baseline dose. The clinical control of asthma was defined according to criteria (GINA 2012).

研究の種類

介入

入学 (実際)

112

段階

  • フェーズ 4

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

    • Chiapas
      • Tuxtla Gutierrez、Chiapas、メキシコ、29030
        • Novartis Investigative Site
    • Distrito Federal
      • Mexico、Distrito Federal、メキシコ、14050
        • Novartis Investigative Site
      • Mexico、Distrito Federal、メキシコ、06760
        • Novartis Investigative Site
      • Mexico、Distrito Federal、メキシコ、03100
        • Novartis Investigative Site
      • Mexico、Distrito Federal、メキシコ、03020
        • Novartis Investigative Site
      • Mexico、Distrito Federal、メキシコ、06090
        • Novartis Investigative Site
      • Mexico、Distrito Federal、メキシコ、04700
        • Novartis Investigative Site
      • Mexico、Distrito Federal、メキシコ、04980
        • Novartis Investigative Site
      • Mexico City、Distrito Federal、メキシコ、14000
        • Novartis Investigative Site
    • Edo. De México
      • Mexico、Edo. De México、メキシコ、53910
        • Novartis Investigative Site
    • Estado De Mexico
      • Nezahualcoyotl、Estado De Mexico、メキシコ、57730
        • Novartis Investigative Site
    • Hidalgo
      • Pachuca de Soto、Hidalgo、メキシコ、42090
        • Novartis Investigative Site
    • Jalisco
      • Guadalajara、Jalisco、メキシコ、44600
        • Novartis Investigative Site
      • Guadalajara、Jalisco、メキシコ、44500
        • Novartis Investigative Site
      • Guadalajara、Jalisco、メキシコ、44620
        • Novartis Investigative Site
      • Guadalajara、Jalisco、メキシコ、44690
        • Novartis Investigative Site
      • Guadaljara、Jalisco、メキシコ、44500
        • Novartis Investigative Site
    • Nayarit
      • Tepic、Nayarit、メキシコ、63000
        • Novartis Investigative Site
    • Nuevo León
      • Monterrey、Nuevo León、メキシコ、64020
        • Novartis Investigative Site
      • Monterrey、Nuevo León、メキシコ、64718
        • Novartis Investigative Site
    • Yucatán
      • Mérida、Yucatán、メキシコ、97070
        • Novartis Investigative Site

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

6年~55年 (子、大人)

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

  • Male and female between 6 and 55 years old. If female, participant of childbearing potential must use a safe and efficacious birth control method.
  • Asthma is considered as not well-controlled if participant has 3 or more of the following conditions:

    1. Persistent day symptoms with current therapy twice at week or more, (siblings, dyspnea, cough, chest pain, thoracic oppression).
    2. One or more night-time awakenings over the last 4 weeks.
    3. Any limitation of age-appropriated habitual activities.
    4. Need of rescue medication (short acting β2 agonist) for two or more occasions per week during the last 4 weeks before screening and 2 consecutive weeks within the 4 weeks before selection.
    5. Peak expiratory flow (PEF) or VEF1 <80% predicted or personal best (if known) this is not mandatory for pediatric participants (under 18 years old).
  • Despite continuous treatment with high-dose inhaled corticosteroids (ICS) or oral corticosteroids (OCS) (CSO≥ 1 mg/kg/day) with or without controllers (As per GINA 2012 definition), the subject is receiving high doses of ICS (budesonide or its equivalent) and a long-acting β2-agonists(LABA) (formoterol) for the past 12 weeks at visit 0.
  • At last one documented asthma exacerbation (defined as increase asthma symptoms requiring systemic corticosteroid rescue therapy) that requires visits to the emergency room or to be hospitalized in the past 12 months. It is also considered asthma exacerbation a non-planned visit that required rescue medication (β2-agonists and/or steroid nebulization every 20 minutes or β2-agonists inhaler shots every 20 minutes).
  • Positive skin test or in vitro reactivity to a perennial aeroallergen, documented during the 12 months previous screening.
  • IgE total concentration ranging from 30 to 1500 UI/ml.
  • Body weight between 20 to 150 kg Exclusion Criteria
  • Pregnant or lactating female or without safe and efficacious birth control method if of childbearing potential.
  • Currently smokers or history of smoking 10 or more packs per year.
  • Ex-smokers with a history of more than 10 years of smoking. As an exception, a participant with this criterion will be considered as eligible if the FEV1 reversibility of the first spirometry reaches 12%.
  • Active lung disease other than asthma.
  • Use of methotrexate, gold salts, troleandomycin, cyclosporine, immunosuppressants, gammaglobulin or any other type of monoclonal antibody used during the 6 months prior to the initial visit.
  • Use of omalizumab during the 4 months prior to de screening visit.
  • History of renal disease, cardiovascular disease, metabolic disease, hematologic disease, gastrointestinal disease, as well as immunodeficiency or cerebrovascular disease currently under treatment but not-controlled.
  • History of hepatic, neurologic, oncologic or autoimmune disease.
  • Participant under suspicion of having cancer.
  • Participants with history of hypersensitivity to sucrose, histidine, polysorbate 20 as well as to monoclonal antibodies or gammaglobulin.
  • Hypersensitivity to omalizumab or its excipients.
  • Abnormal values of the blood chemistry laboratory tests, over 2 times the upper limit normal, that are considered clinically significant.
  • Underage participant or any participant under vulnerable conditions who does not live with their parents or legal guardian.

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:なし(オープンラベル)

武器と介入

参加者グループ / アーム
介入・治療
実験的:Omalizumab + budesonide and formoterol
Participants will receive Omalizumab every 2 or 4 weeks depending on IgE level and body weight and will also receive budesonide and formoterol according to maximum daily dose.
Subcutaneous injection dose according to the IgE level and body weight.
Budesonide (400 μg, 200 μg or 100 μg) tablets taken orally according to maximum daily dose.
Formoterol 12ug tablets taken orally according to maximum daily dose.
Budesonide (400 μg, 200 μg or 100 μg). Patients were instructed to take the inhaled budesonide doses every 12 hours following the specific administration instructions as per the manufactures' prescription information.
Formoterol 12ug. Patients were instructed to take the inhaled formoterol doses every 12 hours following the specific administration instructions as per the manufactures' prescription information.
アクティブコンパレータ:Budesonide and formoterol
Participants will receive budesonide and formoterol according to maximum daily dose.
Budesonide (400 μg, 200 μg or 100 μg) tablets taken orally according to maximum daily dose.
Formoterol 12ug tablets taken orally according to maximum daily dose.
Budesonide (400 μg, 200 μg or 100 μg). Patients were instructed to take the inhaled budesonide doses every 12 hours following the specific administration instructions as per the manufactures' prescription information.
Formoterol 12ug. Patients were instructed to take the inhaled formoterol doses every 12 hours following the specific administration instructions as per the manufactures' prescription information.

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
The Mean Prescribed Budesonide Dose (μg) at Baseline
時間枠:Baseline
prescribed budesonide dose (in μg) at Baseline in intention to treat population and in intention to treat population
Baseline

二次結果の測定

結果測定
メジャーの説明
時間枠
Number of Hospital Admissions Due to Asthma Exacerbation
時間枠:12 month treatment duration
A hospital admission is defined as admissions to hospital involving a stay of at least 24 hours.
12 month treatment duration
Days Missed in School/Work Due to Asthma Exacerbation Episodes
時間枠:12 month treatment duration
Participants /parent/legal guarding reported number of missed days of school or work at each study visit via diaries.
12 month treatment duration
Control of Asthma Symptoms- Daytime Symptoms
時間枠:12 month treatment duration
The clinical control of asthma was defined according to the following criteria (GINA 2012): 1-Daytime symptoms: none or less than twice a week 2-Limitations of daily activities: none 3-Nocturnal symptoms or awakening because of asthma: none 4-Need of relief or rescue medication: none or less than twice a week 5-Lung function (PEF or FEV1) without administration of bronchodilator: normal
12 month treatment duration
Control of Asthma Symptoms
時間枠:12 month treatment duration
The clinical control of asthma was defined according to the following criteria (GINA 2012): 1-Daytime symptoms: none or less than twice a week 2-Limitations of daily activities: none 3-Nocturnal symptoms or awakening because of asthma: none 4-Need of relief or rescue medication: none or less than twice a week 5-Lung function (PEF or FEV1) without administration of bronchodilator: normal
12 month treatment duration
Control of Asthma Symptoms- Rescue Medication Use
時間枠:12 month treatment duration
The clinical control of asthma was defined according to the following criteria (GINA 2012): 1-Daytime symptoms: none or less than twice a week 2-Limitations of daily activities: none 3-Nocturnal symptoms or awakening because of asthma: none 4-Need of relief or rescue medication: none or less than twice a week 5-Lung function (PEF or FEV1) without administration of bronchodilator: normal
12 month treatment duration
Participants Requiring Oral Systemic Corticosteroids During the 12 Month Study Duration
時間枠:12 month treatment duration
Number of days of concomitant medications use reported by participants at all visits via diaries.
12 month treatment duration
Asthma Control Questionnaire (ACQ) at Baseline
時間枠:Baseline
The Asthma Control Questionnaire (ACQ) has six questions to be answered by the participants, each with a 7 point scale (0-good control, 6-poor control), and one question where the actual pre-bronchodilator Forced expiratory volume in 1 second (FEV1) value expressed in % of predicted FEV1 was classified to scores from 0 (> 95% of predicted) to 6 (< 50% of predicted). The overall score is the average of the 7 questions; a minimum overall score of 0 = good control of asthma whereas a maximum overall score of 6 = poor control of asthma.
Baseline
Asthma Quality of Life Questionnaire (AQLQ) at Baseline
時間枠:Baseline
The quality of life will be measured by the standardized version of the Asthma Quality of Life Questionnaire (AQLQ[S]) score for adults and the pediatric version of the AQLQ(S) for pediatric participants (PAQLQ[S]) . The AQLQ(S) and PAQLQ(S0 contain 4 domains (activity limitations, symptoms, emotional function, and environmental stimuli), with a total of 32 items; each item is measured in a 7-point Likert scale of 1 to 7 (1 = severe impairment, 7 = no impairment). All items are weighted equally. Mean score is calculated across all items within each domain and the overall score is the mean score of the 32 items.
Baseline

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

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 (実際)

2013年11月11日

一次修了 (実際)

2015年8月6日

研究の完了 (実際)

2016年1月8日

試験登録日

最初に提出

2013年7月29日

QC基準を満たした最初の提出物

2013年7月30日

最初の投稿 (見積もり)

2013年7月31日

学習記録の更新

投稿された最後の更新 (実際)

2019年7月2日

QC基準を満たした最後の更新が送信されました

2019年6月24日

最終確認日

2019年6月1日

詳しくは

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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