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Efficacy of an Anti-TSLP Monoclonal Antibody in the Management of Chronic Bronchial Disease Induced by Bronchiolitis Obliterans Syndrome in Allogeneic Hematopoietic Stem Cells Transplantation Recipients (IMMUNO-BOS)

14 sierpnia 2026 zaktualizowane przez: Hopital Foch

Allogeneic hematopoietic stem cell transplantation (HSCT) is burdened with a high morbidity and mortality rates. Graft versus host disease (GVHD) is the clinical manifestation of an immune conflict. The expression of GVHD in the bronchioles is responsible for bronchiolitis obliterans syndrome (BOS), defined by the appearance of an obstructive ventilatory disorder. BOS may affect up to 10% of allogeneic transplant recipients. Repeated aggression-repair phenomena of the bronchial epithelium lead to an irreversible fibrous remodeling. The management of BOS remains a therapeutic challenge. A number of patients worsen their ventilatory disorder despite the available treatments and progress to obstructive respiratory failure complicated by repeated bronchial exacerbations. When the patient is far from the allograft and in the absence of any sign of active extrathoracic GVHD, the mechanisms of aggravation of the ventilatory disorder are equivocal. It seems more likely that the bronchial disease evolves on its own due to a persistent local inflammation without any immunological conflict. In this case, it would be reasonable to model the management on that of severe bronchial diseases for which the logic of cortisone sparing is now permitted by the arrival of targeted biotherapies.

Since 2006, the therapeutic arsenal of bronchial inflammatory pathologies, mainly asthma, has been enriched with the class of targeted biotherapies. These therapies, targeting IgE (omalizumab), Th2 cytokines IL-5, IL-4, IL-13 (mepolizumab, benralizumab, dupilumab) and more recently the cytokine derived from the bronchial epithelium TSLP (tezepelumab), have shown effectiveness in reducing bronchial exacerbations, improving quality of life and reducing dependence on corticosteroids. TSLP is an alarmin that reflects bronchial epithelial involvement.

The objective of this study is to test the performance of an anti-TSLP biotherapy (tezepelumab) in the reduction of bronchial exacerbations in alloHSCT recipients suffering from obstructive bronchial disorders not supposed to be still related to an active GVHD.

Przegląd badań

Typ studiów

Interwencyjne

Zapisy (Szacowany)

36

Faza

  • Faza 2

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kopia zapasowa kontaktu do badania

Lokalizacje studiów

      • Besançon, Francja
        • Jeszcze nie rekrutacja
        • CHU de Besançon
        • Kontakt:
        • Główny śledczy:
          • Cindy BARNIG, Professor
      • Bordeaux, Francja
        • Jeszcze nie rekrutacja
        • Hopital Haut-Leveque - CHU Bordeaux
        • Kontakt:
        • Główny śledczy:
          • Elodie BLANCHARD, Doctor
      • Caen, Francja
        • Jeszcze nie rekrutacja
        • CHU Caen Normandie
        • Kontakt:
        • Główny śledczy:
          • Frederic RIVIERE, Doctor
      • Lille, Francja
        • Jeszcze nie rekrutacja
        • CHRU de Lille
        • Kontakt:
        • Główny śledczy:
          • Frederic WALLYN, Doctor
      • Paris, Francja
        • Jeszcze nie rekrutacja
        • Hôpital Saint-Louis APHP
        • Kontakt:
        • Główny śledczy:
          • Amira BENATTIA, Doctor
      • Suresnes, Francja, 92150
        • Rekrutacyjny
        • Foch Hospital
        • Kontakt:
        • Główny śledczy:
          • Hélène SALVATOR, Professor

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  1. Adult recipients, minimum age 18
  2. Recipient of an allogeneic bone marrow or haematopoietic stem cell transplant
  3. At more than 3 years after the date of the transplantation
  4. BOS defined by the occurrence of a new fixed obstructive ventilatory disorder after the allograft (accepted criteria: FEV1/FVC ≤70% and FEV1 < 75% pred value and decline of more than 10% over less than 2 years OR FEV1/FVC > 70% and FEV1 < 75% pred value and decline of FEV1 more than 10% over less than 2 years and Normal TLC > 80% OR decline of FEV1 more than 10% over less than 2 years and TLC > 120% and/or RV/TLC > 40%)
  5. Presenting an exacerbation profile: 2 or more moderate to severe bronchial exacerbations in the previous 12 months
  6. On optimal inhaled therapy comprising at least one long-acting bronchodilator and one inhaled corticosteroid for at least three months.
  7. Stable dose of systemic immunosuppressive regimen for the last 4 weeks
  8. Being covered by a national health insurance
  9. Signed consent form

Exclusion Criteria:

  1. Patients with an indication to increase their immunosuppressive treatment, in particular due to active GVH
  2. FEV1< 20% theorical value
  3. Being deprived of liberty or under guardianship
  4. Absence of signed consent
  5. Hypersensitivity (allergy) to tezelumab or to any of the excipients of TEZPIRE
  6. A helminth parasitic infection diagnosed within 6 months prior to Visit 1 that has not been treated with, or has failed to respond to, standard of care therapy
  7. Respiratory infection in the course of treatement (including acute bacterial and viral infection, long term treatment for fungal or non-tuberculosis mycobacteria)
  8. History of documented immune complex disease (Type III hypersensitivity reactions) following any biologic therapy
  9. Severe GVHD scleroderma-like manifestations of skin making subcutaneous injections of the investigational treatment impossible or overly difficult
  10. Pregnant, breastfeeding or lactating women

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Nie dotyczy
  • Model interwencyjny: Zadanie dla jednej grupy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Ramię 1
Participants will receive tezepelumab (TEZSPIRE®) 210 mg by subcutaneous injection once every 4 weeks for 12 months, starting with one injection on the day of enrollment. The investigational product is supplied as a pre-filled syringe containing 210 mg of tezepelumab in 1.91 mL (110 mg/mL). A total of 13 subcutaneous injections are planned during the study. The first injection at enrollment and injections at Visits 4, 7, 10 and 13 will be administered at the investigation center. Injections at Visits 2, 3, 5, 6, 8, 9, 11 and 12 will be administered at the participant's home by a nurse from the Libhéros network.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Change in the annualized number of bronchial exacerbations
Ramy czasowe: 13 months
Within-patient change in the annualized number of bronchial exacerbations between the 12-month period prior to treatment initiation and the 12-month treatment period
13 months

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Number of days alive and without bronchial exacerbation
Ramy czasowe: 13 months
Number of days during the study period during which the participant is alive and without bronchial exacerbation. Unit of measure: days.
13 months
Number of days alive and without hospitalization
Ramy czasowe: 13 months
Number of days during the study period during which the participant is alive and without hospitalization.
13 months
Change in corticosteroid regimen
Ramy czasowe: 13 months
Change in corticosteroid regimen, including inhaled and/or systemic corticosteroid therapy.
13 months
Change in Asthma Control Questionnaire 6 (ACQ-6) score
Ramy czasowe: 13 months
Change in the Asthma Control Questionnaire 6 (ACQ-6) score during the study period. Unit of measure: score, ranging from 0 to 6.
13 months
Change in Breathlessness, Cough and Sputum Scale (BCSS) score
Ramy czasowe: 13 months
Change in the Breathlessness, Cough and Sputum Scale (BCSS) total score during the study period. Unit of measure: score, ranging from 0 to 4.
13 months
Change in St George's Respiratory Questionnaire (SGRQ) score
Ramy czasowe: 13 months
Change in the St George's Respiratory Questionnaire (SGRQ) total score during the study period. Unit of measure: score, ranging from 0 to 100.
13 months
Change in forced expiratory volume in 1 second (FEV1)
Ramy czasowe: 13 months
Change in forced expiratory volume in 1 second (FEV1), measured by spirometry before and after bronchodilator administration. Unit of measure: liters (L).
13 months
Change in forced expiratory volume in 1 second (FEV1) percent predicted
Ramy czasowe: 13 months
Change in forced expiratory volume in 1 second (FEV1), expressed as a percentage of the predicted value and measured by spirometry before and after bronchodilator administration. Unit of measure: percent (%).
13 months
Change in forced vital capacity (FVC)
Ramy czasowe: 13 months
Change in forced vital capacity (FVC), measured by spirometry before and after bronchodilator administration. Unit of measure: liters (L).
13 months
Change in forced vital capacity (FVC) percent predicted
Ramy czasowe: 13 months
Change in forced vital capacity (FVC), expressed as a percentage of the predicted value and measured by spirometry before and after bronchodilator administration. Unit of measure: percent (%).
13 months
Change in FEV1/FVC ratio
Ramy czasowe: 13 months
Change in the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), measured by spirometry before and after bronchodilator administration. Unit of measure: ratio (L/L).
13 months
Change in FEV1/FVC ratio expressed as a percentage
Ramy czasowe: 13 months
Change in the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC), measured by spirometry before and after bronchodilator administration. Unit of measure: percent (%).
13 months
Change in total lung capacity (TLC)
Ramy czasowe: 13 months
Change in total lung capacity (TLC), measured by plethysmography before bronchodilator administration. Unit of measure: liters (L).
13 months
Change in total lung capacity (TLC) percent predicted
Ramy czasowe: 13 months
Change in total lung capacity (TLC), expressed as a percentage of the predicted value and measured by plethysmography before bronchodilator administration. Unit of measure: percent (%).
13 months
Change in residual volume (RV)
Ramy czasowe: 13 months
Change in residual volume (RV), measured by plethysmography before bronchodilator administration. Unit of measure: liters (L).
13 months
Change in residual volume (RV) percent predicted
Ramy czasowe: 13 months
Change in residual volume (RV), expressed as a percentage of the predicted value and measured by plethysmography before bronchodilator administration. Unit of measure: percent (%).
13 months
Change in TLC/RV ratio
Ramy czasowe: 13 months
Change in the ratio of total lung capacity (TLC) to residual volume (RV), measured by plethysmography before bronchodilator administration. Unit of measure: ratio (L/L).
13 months
Change in respiratory resistance at 5 Hz (R5)
Ramy czasowe: 13 months
Change in respiratory resistance at 5 Hz (R5), measured by inspiratory and expiratory oscillometry. Unit of measure: not specified in the protocol.
13 months
Change in respiratory resistance at 20 Hz (R20)
Ramy czasowe: 13 months
Change in respiratory resistance at 20 Hz (R20), measured by inspiratory and expiratory oscillometry. Unit of measure: not specified in the protocol.
13 months
Change in respiratory resistance difference between 20 Hz and 5 Hz (R20-R5)
Ramy czasowe: 13 months
Change in the difference between respiratory resistance at 20 Hz and 5 Hz (R20-R5), measured by inspiratory and expiratory oscillometry. Unit of measure: not specified in the protocol.
13 months
Change in respiratory reactance at 5 Hz (X5)
Ramy czasowe: 13 months
Change in respiratory reactance at 5 Hz (X5), measured by inspiratory and expiratory oscillometry. Unit of measure: not specified in the protocol.
13 months
Change in frequency of resonance (Fr)
Ramy czasowe: 13 months
Change in frequency of resonance (Fr), measured by inspiratory and expiratory oscillometry. Unit of measure: hertz (Hz).
13 months
Change in blood eosinophil count
Ramy czasowe: 13 months
Change in blood eosinophil count during the study period. Unit of measure: G/L.
13 months
Change in eosinophil count in induced sputum
Ramy czasowe: 13 months
Change in eosinophil count in induced sputum during the study period. Unit of measure: percent (%).
13 months
Change in blood total IgE level
Ramy czasowe: 13 months
Change in blood total IgE level during the study period. Unit of measure: kUI/L.
13 months
Annualized hospitalization rate per patient-year
Ramy czasowe: 13 months
Number of hospitalization events occurring during the study period, standardized per patient-year. Unit of measure: hospitalizations per patient-year.
13 months

Współpracownicy i badacze

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Sponsor

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

24 czerwca 2026

Zakończenie podstawowe (Szacowany)

1 stycznia 2029

Ukończenie studiów (Szacowany)

1 stycznia 2029

Daty rejestracji na studia

Pierwszy przesłany

27 lipca 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

14 sierpnia 2026

Pierwszy wysłany (Rzeczywisty)

18 sierpnia 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

18 sierpnia 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

14 sierpnia 2026

Ostatnia weryfikacja

1 sierpnia 2026

Więcej informacji

Terminy związane z tym badaniem

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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