Mepolizumab Treatment for Rhinovirus-induced Asthma Exacerbations (MATERIAL)
6 februari 2012 bijgewerkt door: Suzanne Bal, Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)
The Efficacy of Mepolizumab Treatment on Rhinovirus Induced Asthma Exacerbations
Asthma is a chronic inflammatory disorder of the airways characterized by lower respiratory tract (LRT) symptoms such as wheeze, cough and airway obstruction. Patients with asthma frequently suffer from exacerbations, which can be triggered by allergens and, in particular, viral respiratory infections. It has recently been shown that mepolizumab, a humanized monoclonal antibody that neutralizes interleukin(IL)-5, markedly reduces the exacerbation rate in asthma patients with eosinophilic airway inflammation. Previous studies have indicated that in a mixed population (eosinophilic and non eosinophilic) of mild asthma patients, mepolizumab did not have an impact on lung function and asthma symptom scores upon allergen provocation, although it did on markers such as sputum and blood eosinophils. Together, these observations led to the hypothesis that mepolizumab treatment reduces the exacerbation rate by limiting virus-induced asthma exacerbations.
The investigators hypothesize that neutralization of IL-5 during virus infection in patients with allergic asthma:
- Reduces virus-induced bronchial inflammation
- Attenuates virus-induced asthma symptoms, airflow limitation and bronchial hyperresponsiveness.
- Enhances cellular immune responses to the virus.
The aims of this study are to:
- To investigate whether IL-5 neutralization reduces the inflammatory response to viral airway infections in allergic asthma patients
- To investigate whether IL-5 neutralization prevents or reduces asthma symptoms during virus-induced asthma exacerbations
- To investigate whether IL-5 neutralization affects the cellular immune response to viral airway infections in allergic asthma patients
Studie Overzicht
Toestand
Onbekend
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
Mild allergic asthma subjects receive three times an infusion containing 750 mg of mepolizumab.
Two weeks after the third infusion, subjects will be experimentally infected with RV16.
One day before and six days after infection a bronchoscopy will be performed to collect bronchoalveolar lavage fluid and bronchial brushes.
Blood will be collected at each infusion and each bronchoscopy and at least 6 weeks after infection.
Lung function will be evaluated throughout the study.
Studietype
Ingrijpend
Inschrijving (Verwacht)
48
Fase
- Fase 3
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
-
-
-
Amsterdam, Nederland, 1105 AZ
- Werving
- Academic Medical Center
-
Hoofdonderzoeker:
- René Lutter, PhD
-
-
Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
18 jaar tot 50 jaar (Volwassen)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
Inclusion Criteria:
- Age between 18 - 50 years
- History of episodic chest tightness and wheezing
- Intermittent or mild persistent asthma according to the criteria by the Global Initiative for Asthma
- Non-smoking or stopped smoking more than 12 months ago and ≤ 5 pack years (PY)
- Clinically stable, no history of exacerbations within the last 6 weeks prior to the study
- Steroid-naïve or those patients who are currently not on corticosteroids and have not taken any corticosteroids by any dosing-routes within 2 weeks prior to the study. Occasional usage of inhaled short-acting beta2-agonists as rescue medication is allowed, prior and during the study
- Baseline FEV1 > 80% of predicted
- Airway hyperresponsiveness, indicated by a positive acetyl-ß-methylcholine bromide (MeBr) challenge with PC20 < 9.8 mg/ml
- Positive skin prick test (SPT) to one or more of the 12 common aeroallergen extracts, defined as a wheal with an average diameter of > 3mm
- No other clinically significant abnormality on medical history and clinical examination
Exclusion Criteria:
- Presence of antibodies directed against RV16 in serum (titer > 4), measured at visit 1
- History of clinical significant hypotensive episodes or symptoms of fainting, dizziness, or light-headedness
- Women who are pregnant, lactating or who have a positive urine pregnancy test at visit 1
- Chronic use of any other medication for treatment of lung disease other than short-acting beta2-agonists
- Participation in any clinical investigational drug treatment protocol within the preceding 3 months
- Ongoing use of tobacco products of any kind or previous usage with ≥ 6 total PY
- Concomitant disease or condition which could interfere with the conduct of the study, or for which the treatment might interfere with the conduct of the study, or which would, in the opinion of the investigator, pose an unacceptable risk to the patient
- People with young children (< 2 years)
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Preventie
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verdrievoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Placebo-vergelijker: Zoutoplossing
|
3 monthly intravenous infusions with saline
|
|
Experimenteel: Mepolizumab
|
3 monthly intravenous infusions of 750 mg
Andere namen:
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
FEV1
Tijdsspanne: 1 day prior and 6 days after RV16 challenge
|
Change in pre-bronchodilator FEV1 between day 70 and day 77, i.e. 1 day prior and 6 days after RV16 challenge.
|
1 day prior and 6 days after RV16 challenge
|
|
Questionnaire to score asthma and common cold complaints
Tijdsspanne: During 14 days following viral infection
|
During 14 days following viral infection
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Viral load
Tijdsspanne: Day 6 after viral infection
|
Viral load in nasal swab and bronchial brushes
|
Day 6 after viral infection
|
|
Sputum eosinophils
Tijdsspanne: Before and after mepolizumab infusion
|
Change in sputum eosinophils
|
Before and after mepolizumab infusion
|
|
Cell influx in bronchoalveolar lavage fluid
Tijdsspanne: 6 days after viral infection
|
Influx of neutrophils, eosinophils, macrophages, monocytes, T en B lymphocytes into the lungs
|
6 days after viral infection
|
|
Pro-inflammatory cytokines in bronchoalveolar lavage fluid
Tijdsspanne: 6 days after viral infection
|
Measurement of IL-6, IL-8 and IFN-y in bronchoaveolar lavage fluid
|
6 days after viral infection
|
|
Antibody production
Tijdsspanne: 6 weeks after infection
|
Anti RV-16 antibodies are measured in serum
|
6 weeks after infection
|
Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Onderzoekers
- Hoofdonderzoeker: René Lutter, PhD, Academic Medical Center, Respiratory Medicine
- Studie directeur: Elisabeth H Bel, MD, PhD, Academic Medical Center, Respiratory Medicine
- Studie directeur: Peter J Sterk, PhD, Academic Medical Center, Respiratory Medicine
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Algemene publicaties
- Haldar P, Brightling CE, Hargadon B, Gupta S, Monteiro W, Sousa A, Marshall RP, Bradding P, Green RH, Wardlaw AJ, Pavord ID. Mepolizumab and exacerbations of refractory eosinophilic asthma. N Engl J Med. 2009 Mar 5;360(10):973-84. doi: 10.1056/NEJMoa0808991. Erratum In: N Engl J Med. 2011 Feb 10;364(6):588.
- Nair P, Pizzichini MM, Kjarsgaard M, Inman MD, Efthimiadis A, Pizzichini E, Hargreave FE, O'Byrne PM. Mepolizumab for prednisone-dependent asthma with sputum eosinophilia. N Engl J Med. 2009 Mar 5;360(10):985-93. doi: 10.1056/NEJMoa0805435.
- Leckie MJ, ten Brinke A, Khan J, Diamant Z, O'Connor BJ, Walls CM, Mathur AK, Cowley HC, Chung KF, Djukanovic R, Hansel TT, Holgate ST, Sterk PJ, Barnes PJ. Effects of an interleukin-5 blocking monoclonal antibody on eosinophils, airway hyper-responsiveness, and the late asthmatic response. Lancet. 2000 Dec 23-30;356(9248):2144-8. doi: 10.1016/s0140-6736(00)03496-6.
- Message SD, Laza-Stanca V, Mallia P, Parker HL, Zhu J, Kebadze T, Contoli M, Sanderson G, Kon OM, Papi A, Jeffery PK, Stanciu LA, Johnston SL. Rhinovirus-induced lower respiratory illness is increased in asthma and related to virus load and Th1/2 cytokine and IL-10 production. Proc Natl Acad Sci U S A. 2008 Sep 9;105(36):13562-7. doi: 10.1073/pnas.0804181105. Epub 2008 Sep 3.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 januari 2012
Primaire voltooiing (Verwacht)
1 december 2013
Studie voltooiing (Verwacht)
1 maart 2014
Studieregistratiedata
Eerst ingediend
25 januari 2012
Eerst ingediend dat voldeed aan de QC-criteria
25 januari 2012
Eerst geplaatst (Schatting)
27 januari 2012
Updates van studierecords
Laatste update geplaatst (Schatting)
7 februari 2012
Laatste update ingediend die voldeed aan QC-criteria
6 februari 2012
Laatst geverifieerd
1 februari 2012
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- MATERIAL
Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .