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Mepolizumab Treatment for Rhinovirus-induced Asthma Exacerbations (MATERIAL)

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:

  1. Reduces virus-induced bronchial inflammation
  2. Attenuates virus-induced asthma symptoms, airflow limitation and bronchial hyperresponsiveness.
  3. Enhances cellular immune responses to the virus.

The aims of this study are to:

  1. To investigate whether IL-5 neutralization reduces the inflammatory response to viral airway infections in allergic asthma patients
  2. To investigate whether IL-5 neutralization prevents or reduces asthma symptoms during virus-induced asthma exacerbations
  3. To investigate whether IL-5 neutralization affects the cellular immune response to viral airway infections in allergic asthma patients

研究概览

详细说明

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.

研究类型

介入性

注册 (预期的)

48

阶段

  • 第三阶段

联系人和位置

本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。

学习地点

      • Amsterdam、荷兰、1105 AZ
        • 招聘中
        • Academic Medical Center
        • 首席研究员:
          • René Lutter, PhD

参与标准

研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 至 50年 (成人)

接受健康志愿者

不

有资格学习的性别

全部

描述

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)

学习计划

本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。

研究是如何设计的?

设计细节

  • 主要用途:预防
  • 分配:随机化
  • 介入模型:并行分配
  • 屏蔽:三倍

武器和干预

参与者组/臂
干预/治疗
安慰剂比较:盐水
3 monthly intravenous infusions with saline
实验性的:Mepolizumab
3 monthly intravenous infusions of 750 mg
其他名称:
  • Mepolizumab, SB240563

研究衡量的是什么?

主要结果指标

结果测量
措施说明
大体时间
FEV1
大体时间: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
大体时间:During 14 days following viral infection
During 14 days following viral infection

次要结果测量

结果测量
措施说明
大体时间
Viral load
大体时间:Day 6 after viral infection
Viral load in nasal swab and bronchial brushes
Day 6 after viral infection
Sputum eosinophils
大体时间:Before and after mepolizumab infusion
Change in sputum eosinophils
Before and after mepolizumab infusion
Cell influx in bronchoalveolar lavage fluid
大体时间: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
大体时间: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
大体时间:6 weeks after infection
Anti RV-16 antibodies are measured in serum
6 weeks after infection

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

调查人员

  • 首席研究员:René Lutter, PhD、Academic Medical Center, Respiratory Medicine
  • 研究主任:Elisabeth H Bel, MD, PhD、Academic Medical Center, Respiratory Medicine
  • 研究主任:Peter J Sterk, PhD、Academic Medical Center, Respiratory Medicine

出版物和有用的链接

负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2012年1月1日

初级完成 (预期的)

2013年12月1日

研究完成 (预期的)

2014年3月1日

研究注册日期

首次提交

2012年1月25日

首先提交符合 QC 标准的

2012年1月25日

首次发布 (估计)

2012年1月27日

研究记录更新

最后更新发布 (估计)

2012年2月7日

上次提交的符合 QC 标准的更新

2012年2月6日

最后验证

2012年2月1日

更多信息

此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.

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