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Aspirin-exacerbated Respiratory DiseasePhase 2NCT03595488

Dupilumab for Aspirin-exacerbated Respiratory Disease

A Phase 2 study testing Dupilumab in people with Aspirin-exacerbated Respiratory Disease, run by Rochester General Hospital at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Subjects with physician-diagnosed aspirin-exacerbated respiratory disease (AERD) who remain unacceptably symptomatic with a SNOT 22 score > 18 despite routine medical therapy will be enrolled in this single center, single-blinded study assessing the efficacy of dupilumab in AERD. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Aspirin-exacerbated Respiratory Disease
What is being tested?
Dupilumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
11 participants
Where
1 siteUnited States
Study dates
5 Sep 2018to 11 Dec 2019
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Patients 18 years and older with a physician diagnosis of aspirin-exacerbated respiratory disease, as defined by a physician diagnosis of asthma, chronic rhinosinusitis with nasal polyposis, and a convincing clinical history of NSAID sensitivity
  • All subjects must have a SNOT 22 score ≥ 19 despite standard medical therapy. This minimal SNOT 22 was calculated by taking the range of SNOT 22 scores in studies of normal controls plus 8.9, which is the minimal clinically meaningful improvement in SNOT 22 score detected by patients.
  • Able to understand and willingness to sign informed consent
  • Able to comply with study procedures

Who cannot join

  • Patient < 18 years of age
  • Pregnancy or breast feeding
  • Current tobacco use
  • Significant, uncontrolled medical conditions
  • Ongoing malignancy or history of malignancy in remission within the past 12 months
  • Current treatment with immunosuppressive medications except chronic oral steroids
  • Currently increasing dose of aeroallergen immunotherapy (patients on stable dose of aeroallergen immunotherapy will be allowed to participate)
  • Treatment with omalizumab, reslizumab, mepolizumab within 4 months of enrollment

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Rochester Regional Health - Allergy/Immunology

    Rochester, New York, 14607

Other trials in United States

About this study

Official title: Dupilumab as add-on Therapy for Aspirin-exacerbated Respiratory Disease (AERD)

Subjects with physician-diagnosed aspirin-exacerbated respiratory disease (AERD) who remain unacceptably symptomatic with a SNOT 22 score > 18 despite routine medical therapy will be enrolled in this single center, single-blinded study assessing the efficacy of dupilumab in AERD.

Read the detailed description

This is a single blind, placebo controlled trial to be conducted in adult patients with AERD to determine the efficacy and safety of dupilumab in treating symptoms of chronic rhinosinusitis.

All subjects will be treated with the FDA-approved and the commercially available dose for adult atopic dermatitis of 300 mg every 2 weeks administered subcutaneously, based on the observed efficacy and safety of this dose. In addition to atopic dermatitis, this dose has also been shown to be efficacious in adult asthma.15 Patients will not be treated with a loading dose since other studies of dupilumab in asthma and chronic rhinosinusitis with nasal polyposis have not used a loading dose.

There will be a one month screening period to determine the patient's eligibility and establish symptom control and baseline parameters.

Patients will continue their background medications for chronic rhinosinusitis with nasal polyposis and asthma. These medications may include nasal corticosteroids, nasal antihistamines, systemic antihistamines, leukotriene receptor antagonists, 5 lipo-oxygenase inhibitors, inhaled corticosteroids, long-acting beta agonists, and long acting muscarinic antagonists. These controller medications will not be dispensed or supplied by the sponsor.

Being tested
Dupilumab

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • DupilumabDrug

    Also called Matching placebo

    dupilumab 300 mg subcutaneous injection every 2 weeks

Study groups in NCT03595488
Study groupRoleWhat they receive
Treatment armExperimentalSingle-blinded, Dupilumab or matching placebo will be administered to the patients at the study visits. At each study visit, a single dose of dupilumab or placebo will be dispensed to the patients to be administered at home. 300 mg/2 ml solution in a single-dose pre-filled syringe with needle shield given once every 2 weeks in a subcutaneous injection
Receives: Drug: Dupilumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. SNOT 22 Score

    This is a patient-reported outcome score for chronic rhinosinusitis with or without nasal polyposis

    Measured: From baseline to completion of study(7 months total)

Secondary outcomes (14)
  1. UPSIT

    Univ. of Pennsylvania smell identification test

    Measured: From baseline to completion of study( 7 months total)

  2. Lund Mackay score

    Objective score for CT sinus imaging, this is a widely used method for radiologic staging of chronic rhinosinusitis.

    Measured: From baseline to completion of study( 7 months total)

  3. ACT score

    Validated asthma control test, a series of 5 questions related to patient's asthma control over the previous 4 weeks.

    Measured: From baseline to completion of study( 7 months total)

  4. Asthma Mini-AQLQ, 15 questions to assess quality of life. This assessment takes approximately 4-5 minutes to complete the questions.

    Validated asthma quality of life score

    Measured: From baseline to completion of study( 7 months total)

  5. Change in FEV1

    Forced expiratory volume in first second from spirometry

    Measured: From baseline to completion of study( 7 months total)

  6. Change in FeNO

    Exhaled nitric oxide

    Measured: From baseline to completion of study( 7 months total)

  7. Eosinophil count

    Absolute eosinophil count

    Measured: From baseline to completion of study( 7 months total)

  8. Total serum IgE

    Total IgE

    Measured: From baseline to completion of study( 7 months total)

  9. Serum tryptase

    Biomarker

    Measured: From baseline to completion of study( 7 months total)

  10. Serum TARC (thymus and activation regulated cytokine)

    Biomarker

    Measured: From baseline to completion of study( 7 months total)

  11. Serum prostaglandin D2

    Biomarker

    Measured: From baseline to completion of study( 7 months total)

  12. 24 hour urinary leukotriene E4

    Biomarker

    Measured: From baseline to completion of study( 7 months total)

  13. To assess the safety and tolerability of dupilumab

    Adverse events

    Measured: From baseline to completion of study( 7 months total)

  14. To assess cumulative dose of systemic steroids

    Impact on systemic steroids

    Measured: From baseline to completion of study( 7 months total)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jul 2018
  2. Study start5 Sep 2018
  3. Primary completion11 Dec 2019
  4. Study completion11 Dec 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
11 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03595488
Sponsor's protocol ID
1828-A-18
Status last verified
Aug 2020
First submitted
29 Jun 2018
Last updated
26 Aug 2020
Results posted
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Rajan JP, Wineinger NE, Stevenson DD, White AA. Prevalence of aspirin-exacerbated respiratory disease among asthmatic patients: A meta-analysis of the literature. J Allergy Clin Immunol. 2015 Mar;135(3):676-81.e1. doi: 10.1016/j.jaci.2014.08.020. Epub 2014 Oct 3.

    PubMed 25282015
  • Mullol J, Picado C. Rhinosinusitis and nasal polyps in aspirin-exacerbated respiratory disease. Immunol Allergy Clin North Am. 2013 May;33(2):163-76. doi: 10.1016/j.iac.2012.11.002. Epub 2012 Dec 23.

    PubMed 23639706
  • Ta V, White AA. Survey-Defined Patient Experiences With Aspirin-Exacerbated Respiratory Disease. J Allergy Clin Immunol Pract. 2015 Sep-Oct;3(5):711-8. doi: 10.1016/j.jaip.2015.03.001. Epub 2015 Apr 7.

    PubMed 25858054
  • Berges-Gimeno MP, Simon RA, Stevenson DD. Long-term treatment with aspirin desensitization in asthmatic patients with aspirin-exacerbated respiratory disease. J Allergy Clin Immunol. 2003 Jan;111(1):180-6. doi: 10.1067/mai.2003.7.

    PubMed 12532116
  • Stevenson DD, Pleskow WW, Simon RA, Mathison DA, Lumry WR, Schatz M, Zeiger RS. Aspirin-sensitive rhinosinusitis asthma: a double-blind crossover study of treatment with aspirin. J Allergy Clin Immunol. 1984 Apr;73(4):500-7. doi: 10.1016/0091-6749(84)90361-0.

    PubMed 6368649
  • Swierczynska-Krepa M, Sanak M, Bochenek G, Strek P, Cmiel A, Gielicz A, Plutecka H, Szczeklik A, Nizankowska-Mogilnicka E. Aspirin desensitization in patients with aspirin-induced and aspirin-tolerant asthma: a double-blind study. J Allergy Clin Immunol. 2014 Oct;134(4):883-90. doi: 10.1016/j.jaci.2014.02.041. Epub 2014 Apr 24.

    PubMed 24767875
  • Fruth K, Pogorzelski B, Schmidtmann I, Springer J, Fennan N, Fraessdorf N, Boessert A, Schaefer D, Gosepath J, Mann WJ. Low-dose aspirin desensitization in individuals with aspirin-exacerbated respiratory disease. Allergy. 2013;68(5):659-65. doi: 10.1111/all.12131. Epub 2013 Mar 7.

    PubMed 23464577
  • Esmaeilzadeh H, Nabavi M, Aryan Z, Arshi S, Bemanian MH, Fallahpour M, Mortazavi N. Aspirin desensitization for patients with aspirin-exacerbated respiratory disease: A randomized double-blind placebo-controlled trial. Clin Immunol. 2015 Oct;160(2):349-57. doi: 10.1016/j.clim.2015.05.012. Epub 2015 Jun 14.

    PubMed 26083948
  • Waldram JD, White AA. A survey of aspirin desensitization practices among allergists and fellows in training in the United States. J Allergy Clin Immunol Pract. 2016 Nov-Dec;4(6):1253-1255. doi: 10.1016/j.jaip.2016.06.016. Epub 2016 Jul 21. No abstract available.

    PubMed 27452889
  • Samuelsson B, Dahlen SE, Lindgren JA, Rouzer CA, Serhan CN. Leukotrienes and lipoxins: structures, biosynthesis, and biological effects. Science. 1987 Sep 4;237(4819):1171-6. doi: 10.1126/science.2820055.

    PubMed 2820055
  • Laidlaw TM, Boyce JA. Aspirin-Exacerbated Respiratory Disease--New Prime Suspects. N Engl J Med. 2016 Feb 4;374(5):484-8. doi: 10.1056/NEJMcibr1514013. No abstract available.

    PubMed 26840139
  • Bachert C, Zhang N. Chronic rhinosinusitis and asthma: novel understanding of the role of IgE 'above atopy'. J Intern Med. 2012 Aug;272(2):133-43. doi: 10.1111/j.1365-2796.2012.02559.x.

    PubMed 22640264
  • Patou J, Gevaert P, Van Zele T, Holtappels G, van Cauwenberge P, Bachert C. Staphylococcus aureus enterotoxin B, protein A, and lipoteichoic acid stimulations in nasal polyps. J Allergy Clin Immunol. 2008 Jan;121(1):110-5. doi: 10.1016/j.jaci.2007.08.059. Epub 2007 Nov 5.

    PubMed 17980412
  • Wenzel S, Ford L, Pearlman D, Spector S, Sher L, Skobieranda F, Wang L, Kirkesseli S, Rocklin R, Bock B, Hamilton J, Ming JE, Radin A, Stahl N, Yancopoulos GD, Graham N, Pirozzi G. Dupilumab in persistent asthma with elevated eosinophil levels. N Engl J Med. 2013 Jun 27;368(26):2455-66. doi: 10.1056/NEJMoa1304048. Epub 2013 May 21.

    PubMed 23688323
  • Wenzel S, Castro M, Corren J, Maspero J, Wang L, Zhang B, Pirozzi G, Sutherland ER, Evans RR, Joish VN, Eckert L, Graham NM, Stahl N, Yancopoulos GD, Louis-Tisserand M, Teper A. Dupilumab efficacy and safety in adults with uncontrolled persistent asthma despite use of medium-to-high-dose inhaled corticosteroids plus a long-acting beta2 agonist: a randomised double-blind placebo-controlled pivotal phase 2b dose-ranging trial. Lancet. 2016 Jul 2;388(10039):31-44. doi: 10.1016/S0140-6736(16)30307-5. Epub 2016 Apr 27.

    PubMed 27130691

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Dupilumab in people with Aspirin-exacerbated Respiratory Disease, run by Rochester General Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Aug 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

SNOT 22 Score (time frame: From baseline to completion of study(7 months total)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03595488, which also lists 27 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Aug 2020.

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