Efficacy and Safety Study of Benralizumab in Adults and Adolescents Inadequately Controlled on Inhaled Corticosteroid Plus Long-acting β2 Agonist
2016年11月30日 更新者:AstraZeneca
A Multicentre, Randomized, Double-blind, Parallel Group, Placebocontrolled, Phase 3 Study to Evaluate the Efficacy and Safety of Benralizumab in Asthmatic Adults and Adolescents Inadequately Controlled on Inhaled Corticosteroid Plus Long-acting β2 Agonist (CALIMA)
The purpose of this study is to determine whether Benralizumab reduces the exacerbation rate in patients with a history of asthma exacerbations and uncontrolled asthma receiving ICS-LABA with or without oral corticosteroids and additional asthma controllers.
調査の概要
研究の種類
介入
入学 (実際)
2508
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
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Alabama
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Andalusia、Alabama、アメリカ
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Birmingham、Alabama、アメリカ
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Arizona
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Flagstaff、Arizona、アメリカ
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Glendale、Arizona、アメリカ
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Ciudad de Buenos Aires、アルゼンチン
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Concepción del Uruguay、アルゼンチン
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Corrientes、アルゼンチン
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Quebec、カナダ
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Alberta
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Sherwood Park、Alberta、カナダ
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British Columbia
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Vancouver、British Columbia、カナダ
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New Brunswick
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Moncton、New Brunswick、カナダ
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Ontario
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Burlington、Ontario、カナダ
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Hamilton、Ontario、カナダ
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Ottawa、Ontario、カナダ
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Toronto、Ontario、カナダ
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Quebec
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Montreal、Quebec、カナダ
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St Charles Borromee、Quebec、カナダ
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Goteborg、スウェーデン
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Luleå、スウェーデン
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Lund、スウェーデン
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Concepcion、チリ
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Quillota、チリ
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Santiago、チリ
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Talcahuano、チリ
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Valparaiso、チリ
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Viña del Mar、チリ
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Aschaffenburg、ドイツ
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Bamberg、ドイツ
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Berlin、ドイツ
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Bonn、ドイツ
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Frankfurt、ドイツ
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Frankfurt/Main、ドイツ
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Geesthacht、ドイツ
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Gelsenkirchen、ドイツ
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Hamburg、ドイツ
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Hannover、ドイツ
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Herford、ドイツ
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Leipzig、ドイツ
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Mainz、ドイツ
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München、ドイツ
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Neu-Isenburg、ドイツ
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Rostock、ドイツ
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Rüdersdorf、ドイツ
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Witten、ドイツ
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Iloilo City、フィリピン
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Lipa City、フィリピン
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Quezon City、フィリピン
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Aleksandrów Łódzki、ポーランド
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Białystok、ポーランド
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Bielsko Biala、ポーランド
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Bydgoszcz、ポーランド
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Bystra Śląska、ポーランド
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Gdańsk、ポーランド
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Gorzów Wlkp、ポーランド
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Karczew、ポーランド
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Katowice、ポーランド
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Kraków、ポーランド
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Lubin、ポーランド
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Lublin、ポーランド
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Ostrów Wielkopolski、ポーランド
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Poznań、ポーランド
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Ruda Slaska、ポーランド
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Rzeszów、ポーランド
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Skierniewice、ポーランド
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Szczecin、ポーランド
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Tarnów、ポーランド
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Toruń、ポーランド
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Trzebnica、ポーランド
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Warszawa、ポーランド
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Wieluń、ポーランド
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Wroclaw、ポーランド
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Wrocław、ポーランド
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Zabrze、ポーランド
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Łódź、ポーランド
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Łęczna、ポーランド
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Żnin、ポーランド
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Brasov、ルーマニア
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Bucharest、ルーマニア
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Constanta、ルーマニア
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Deva、ルーマニア
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Iasi、ルーマニア
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Timisoara、ルーマニア
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Asahi-shi、日本
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Chiyoda-ku、日本
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Chuo-ku、日本
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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
12年~75年 (子、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:
- Provision of informed consent prior to any study specific procedures
- Female and male aged 12 to 75 years, inclusively, at the time of Visit 1
- History of physician-diagnosed asthma requiring treatment with medium-to-high dose ICS (>250µg fluticasone dry powder formulation equivalents total daily dose) and a LABA, for at least 12 months prior to Visit 1.
- Documented treatment with ICS and LABA for at least 3 months prior to Visit 1 with or without oral corticosteroids and additional asthma controllers. The ICS and LABA can be parts of a combination product or given by separate inhalers. The ICS dose must be greater than or equal to 500 μg/day fluticasone propionate dry powder formulation or equivalent daily. For ICS/LABA combination preparations, the mid-strength approved maintenance dose in the local country will meet this ICS criterion.
Exclusion criteria:
- Clinically important pulmonary disease other than asthma (e.g. active lung infection, COPD, bronchiectasis, pulmonary fibrosis, cystic fibrosis, hypoventilation syndrome associated with obesity, lung cancer, alpha 1 anti-trypsin deficiency, and primary ciliary dyskinesia) or ever been diagnosed with pulmonary or systemic disease, other than asthma, that are associated with elevated peripheral eosinophil counts (e.g. allergic bronchopulmonary aspergillosis/mycosis, Churg- Strauss syndrome, hypereosinophilic syndrome)
Any disorder, including, but not limited to, cardiovascular, gastrointestinal, hepatic, renal, neurological, musculoskeletal, infectious, endocrine, metabolic, haematological, psychiatric, or major physical impairment that is not stable in the opinion of the Investigator and could:
- Affect the safety of the patient throughout the study
- Influence the findings of the studies or their interpretations
- Impede the patient's ability to complete the entire duration of study
- Acute upper or lower respiratory infections requiring antibiotics or antiviral medication within 30 days prior to the date informed consent is obtained or during the screening/run-in period
- Any clinically significant abnormal findings in physical examination, vital signs, haematology, clinical chemistry, or urinalysis during screening/run-in period, which in the opinion of the Investigator, may put the patient at risk because of his/her participation in the study, or may influence the results of the study, or the patient's ability to complete entire duration of the study
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:トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:ベンラリズマブ 30 mg 4 週間ごと
ベンラリズマブを4週間ごとに皮下投与
|
Benralizumab subcutaneously on study week 0 until study week 52 inclusive.
|
|
実験的:ベンラリズマブ 30 mg 8 週間ごと
ベンラリズマブを8週間ごとに皮下投与
|
Benralizumab subcutaneously on study week 0 until study week 52 inclusive.
|
|
プラセボコンパレーター:プラセボ
プラセボを皮下投与
|
Placebo subcutaneously on study week 0 until study week 52 inclusive.
|
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 |
|---|---|---|
|
Annual Asthma Exacerbation Rate in Adult and Adolescent Patients With Uncontrolled Asthma for Patients With Baseline Eosinophils >=300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
The annual exacerbation rate is based on unadjudicated annual exacerbation rate reported by the investigator in the eCRF.
|
Immediately following the first administration of study drug through Study Week 56.
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Annual Asthma Exacerbation Rate in Adult and Adolescent Patients With Uncontrolled Asthma for Patients With Baseline Eosinophils <300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
The annual exacerbation rate is based on unadjudicated annual exacerbation rate reported by the investigator in the eCRF.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Mean Change From Baseline to Week 56 in Pre-bronchodilator FEV1 (L) Value for Patients With Baseline Eosinophils >=300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
|
Mean Change From Baseline to Week 56 in Pre-bronchodilator FEV1 (L) Value for Patients With Baseline Eosinophils <300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
|
Mean Change From Baseline to Week 56 Asthma Symptoms Score for Patients With Baseline Eosinophils >=300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Asthma symptoms during night time and daytime are recorded by the patient each morning and evening in the asthma daily diary.
Symptom score values are from 0 (No asthma symptom) to 3 (unable to sleep because of asthma).
Baseline is defined as the average of data collected from the evening of study day -10 to the morning of study day 1.
Each timepoint is calculated as bi-weekly means based on daily diary data.
If more than 50% of scores are missing in a 14 day period then this is considered as missing.
Symptom score lower is better.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Mean Change From Baseline to Week 56 Asthma Symptoms Score for Patients With Baseline Eosinophils <300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Asthma symptoms during night time and daytime are recorded by the patient each morning and evening in the asthma daily diary.
Symptom score values are from 0 (No asthma symptom) to 3 (unable to sleep because of asthma).
Baseline is defined as the average of data collected from the evening of study day -10 to the morning of study day 1.
Each timepoint is calculated as bi-weekly means based on daily diary data.
If more than 50% of scores are missing in a 14 day period then this is considered as missing.
Symptom score lower is better.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Change in Asthma Rescue Medication Use
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Change from Baseline to Week 56 in number of Rescue medication use (puffs/day)
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Home Lung Function Assessments Based on PEF
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Change from Baseline to Week 56 in Home lung function (morning and evening Peak expiratory flow [PEF])
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Proportion of Nights With Awakening Due to Asthma
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Change from Baseline to Week 56 on Proportion of Nights with awakening due to asthma
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Mean Change From Baseline to Week 56 in ACQ-6 for Patients With Baseline Eosinophils >=300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
ACQ-6 contains one bronchodilator question and 5 symptom questions.
Questions are rated from 0 (totally controlled) to 6 (severely uncontrolled).
Mean ACQ-6 score is the average of the responses.
Mean scores of <=0.75 indicates well-controlled asthma, scores between 0.75 to <=1.5 indicate partly controlled asthma, and >1.5 indicates not well controlled asthma.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Mean Change From Baseline to Week 56 in ACQ-6 for Patients With Baseline Eosinophils <300/uL
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
ACQ-6 contains one bronchodilator question and 5 symptom questions.
Questions are rated from 0 (totally controlled) to 6 (severely uncontrolled).
Mean ACQ-6 score is the average of the responses.
Mean scores of <=0.75 indicates well-controlled asthma, scores between 0.75 to <=1.5 indicate partly controlled asthma, and >1.5 indicates not well controlled asthma.
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Number of Patients With >=1 Asthma Exacerbation
時間枠:Immediately following the first administration of study drug through Study Week 56
|
Immediately following the first administration of study drug through Study Week 56
|
|
|
Time to First Asthma Exacerbation
時間枠:Immediately following the first administration of study drug through Study Week 56
|
Immediately following the first administration of study drug through Study Week 56
|
|
|
Annual Rate of Asthma Exacerbation Resulting Emergency Room Visits and Hospitalizations
時間枠:Immediately following the first administration of study drug through Study Week 56.
|
Annual rate of asthma exacerbations that are associated with an emergency room visit or a hospitalization (adjudicated)
|
Immediately following the first administration of study drug through Study Week 56.
|
|
Pharmacokinetics of Benralizumab
時間枠:Baseline, Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, Week 56, Week 60
|
Mean PK Concentration at each visit
|
Baseline, Week 4, Week 8, Week 16, Week 24, Week 32, Week 40, Week 48, Week 56, Week 60
|
|
Immunogenicity of Benralizumab
時間枠:Pre-treatment until end of follow-up
|
Anti-drug antibodies (ADA) responses at baseline and post baseline.
Persistently positive is defined as positive at >=2 post-baseline assessments (with >=16 weeks between first and last positive) or positive at last post-baseline assessment.
Transiently positive is defined as having at least one post-baseline ADA positive assessment and not fulfilling the conditions of persistently positive.
|
Pre-treatment until end of follow-up
|
|
Extent of Exposure
時間枠:Immediately following the first administration of study drug through Study Week 56
|
Extent of exposure is defined as the duration of treatment in days
|
Immediately following the first administration of study drug through Study Week 56
|
|
Mean Change From Baseline to Week 56 in AQLQ(S)+12
時間枠:Immediately following the first administration of study drug through Study Week 56
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AQLQ(S)+12 overall score is defined as the average of all 32 questions in the AQLQ(S)+12 questionnaire.
AQLQ(S)+12 is a 7-point scale questionnaire, ranging from 7 (no impairment) to 1 (severe impairment).
Total or domain score change of >=0.5 are considered clinically meaningful.
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Immediately following the first administration of study drug through Study Week 56
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Change From Baseline to Week 56 in EQ-5D-5L VAS
時間枠:Immediately following the first administration of study drug through Study Week 56
|
EQ-5D-5L VAS is to rate current health status on a scale of 0-100, with 0 being the worst imaginable health state.
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Immediately following the first administration of study drug through Study Week 56
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Mean Work Productivity Loss Due to Asthma
時間枠:Immediately following the first administration of study drug through Study Week 56
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WPAI+CIQ (Work Productivity and Activity Impairment plus Classroom Impairment Questionnaire) contains 10 questions.
Work productivity loss is derived by sum of percentage of missed work due to asthma and product of percentage of actual working hours times degree of asthma affecting work productivity while working.
Percentage of missed work due to asthma is calculated by number of hours missed work due to asthma divided by total number of hours missed work plus number of hours actually worked.
This is only applicable to patients who were employed.
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Immediately following the first administration of study drug through Study Week 56
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Mean Productivity Loss Due to Asthma in Classroom
時間枠:Immediately following the first administration of study drug through Study Week 56
|
WPAI+CIQ (Work Productivity and Activity Impairment plus Classroom Impairment Questionnaire) contains 10 questions.
Classroom productivity loss is derived by sum of percentage of missed classes due to asthma and product of percentage of actual hours attending classes times degree of asthma affecting classroom productivity.
Percentage of missed classes due to asthma is calculated by number of hours missed classes due to asthma divided by total number of hours missed classes plus number of hours actually attending classes.
This is only applicable for patients who took classes.
|
Immediately following the first administration of study drug through Study Week 56
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Number of Participants That Utilized Health Care Resources
時間枠:Immediately following the first administration of study drug through Study Week 56
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Immediately following the first administration of study drug through Study Week 56
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Patient and Clinician Assessment of Response to Treatment
時間枠:Immediately following the first administration of study drug through Study Week 56
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CGIC (clinician global impression of change), and PGIC (patient global impression of change) are overall evaluation of response to treatment, conducted separately by investigator and patient using a 7-point rating scale, ranging from 1 (Very much Improved), to 7 (Very much Worse).
This endpoint was added after the second protocol amendment, thus not all patients had data to be analyzed.
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Immediately following the first administration of study drug through Study Week 56
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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
捜査官
- 主任研究者:Mark Fitzgerald, MD, PhD, Professor of Medicine、The Lung Centre, Gordon and Leslie Diamond Health Care Centre, Vancouver Canada
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
- Menzies-Gow A, Hoyte FL, Price DB, Cohen D, Barker P, Kreindler J, Jison M, Brooks CL, Papeleu P, Katial R. Clinical Remission in Severe Asthma: A Pooled Post Hoc Analysis of the Patient Journey with Benralizumab. Adv Ther. 2022 May;39(5):2065-2084. doi: 10.1007/s12325-022-02098-1. Epub 2022 Mar 14.
- Lugogo NL, Kreindler JL, Martin UJ, Cook B, Hirsch I, Trudo FJ. Blood eosinophil count group shifts and kinetics in severe eosinophilic asthma. Ann Allergy Asthma Immunol. 2020 Aug;125(2):171-176. doi: 10.1016/j.anai.2020.04.011. Epub 2020 Apr 22.
- Jackson DJ, Humbert M, Hirsch I, Newbold P, Garcia Gil E. Ability of Serum IgE Concentration to Predict Exacerbation Risk and Benralizumab Efficacy for Patients with Severe Eosinophilic Asthma. Adv Ther. 2020 Feb;37(2):718-729. doi: 10.1007/s12325-019-01191-2. Epub 2019 Dec 14.
- Chipps BE, Hirsch I, Trudo F, Alacqua M, Zangrilli JG. Benralizumab efficacy for patients with fixed airflow obstruction and severe, uncontrolled eosinophilic asthma. Ann Allergy Asthma Immunol. 2020 Jan;124(1):79-86. doi: 10.1016/j.anai.2019.10.006. Epub 2019 Oct 15.
- Chupp G, Lugogo NL, Kline JN, Ferguson GT, Hirsch I, Goldman M, Zangrilli JG, Trudo F. Rapid onset of effect of benralizumab on morning peak expiratory flow in severe, uncontrolled asthma. Ann Allergy Asthma Immunol. 2019 May;122(5):478-485. doi: 10.1016/j.anai.2019.02.016. Epub 2019 Feb 23.
- Bleecker ER, Wechsler ME, FitzGerald JM, Menzies-Gow A, Wu Y, Hirsch I, Goldman M, Newbold P, Zangrilli JG. Baseline patient factors impact on the clinical efficacy of benralizumab for severe asthma. Eur Respir J. 2018 Oct 18;52(4):1800936. doi: 10.1183/13993003.00936-2018. Print 2018 Oct.
- DuBuske L, Newbold P, Wu Y, Trudo F. Seasonal variability of exacerbations of severe, uncontrolled eosinophilic asthma and clinical benefits of benralizumab. Allergy Asthma Proc. 2018 Sep 4;39(5):345-349. doi: 10.2500/aap.2018.39.4162. Epub 2018 Aug 4.
- Chipps BE, Newbold P, Hirsch I, Trudo F, Goldman M. Benralizumab efficacy by atopy status and serum immunoglobulin E for patients with severe, uncontrolled asthma. Ann Allergy Asthma Immunol. 2018 May;120(5):504-511.e4. doi: 10.1016/j.anai.2018.01.030. Epub 2018 Feb 1.
- Ohta K, Adachi M, Tohda Y, Kamei T, Kato M, Mark Fitzgerald J, Takanuma M, Kakuno T, Imai N, Wu Y, Aurivillius M, Goldman M. Efficacy and safety of benralizumab in Japanese patients with severe, uncontrolled eosinophilic asthma. Allergol Int. 2018 Apr;67(2):266-272. doi: 10.1016/j.alit.2017.10.004. Epub 2017 Nov 8.
- FitzGerald JM, Bleecker ER, Nair P, Korn S, Ohta K, Lommatzsch M, Ferguson GT, Busse WW, Barker P, Sproule S, Gilmartin G, Werkstrom V, Aurivillius M, Goldman M; CALIMA study investigators. Benralizumab, an anti-interleukin-5 receptor alpha monoclonal antibody, as add-on treatment for patients with severe, uncontrolled, eosinophilic asthma (CALIMA): a randomised, double-blind, placebo-controlled phase 3 trial. Lancet. 2016 Oct 29;388(10056):2128-2141. doi: 10.1016/S0140-6736(16)31322-8. Epub 2016 Sep 5.
便利なリンク
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
2013年8月1日
一次修了 (実際)
2016年3月1日
研究の完了 (実際)
2016年3月1日
試験登録日
最初に提出
2013年7月31日
QC基準を満たした最初の提出物
2013年7月31日
最初の投稿 (見積もり)
2013年8月2日
学習記録の更新
投稿された最後の更新 (見積もり)
2017年1月25日
QC基準を満たした最後の更新が送信されました
2016年11月30日
最終確認日
2016年11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。