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AsthmaPhase 3DIRECTIONNCT03927157

Study to Evaluate Tezepelumab in Adults With Severe Uncontrolled Asthma

A Phase 3 study testing Experimental: Tezepelumab in people with Asthma, run by AstraZeneca at 72 sites in 3 countries.

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

A Regional, Multicentre, Randomized, Double-Blind, Placebo Controlled, Parallel Group, Phase 3 Study to Evaluate the Efficacy and Safety of Tezepelumab in Adults with Severe Uncontrolled Asthma Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Asthma
What is being tested?
Experimental: Tezepelumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
405 participants
Where
72 sitesin 3 countries
Study dates
14 Jun 2019to 13 Aug 2024
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age. 18-80
  • Documented physician-diagnosed asthma for at least 12 months
  • Participants who have received a physician-prescribed asthma controller medication with medium or high dose ICS for at least 6 months.
  • Documented treatment with a total daily dose of either medium or high dose ICS (≥ 500 µg fluticasone propionate dry powder formulation equivalent total daily dose) for at least 3 months.
  • At least one additional maintenance asthma controller medication is required according to standard practice of care and must be documented for at least 3 months.
  • Morning pre-BD FEV1 <80% predicted normal
Show all 9Show fewer
  • Evidence of asthma as documented by either: Documented historical reversibility of FEV1 ≥12% and ≥200 mL in the previous 12 months OR Post-BD (albuterol/salbutamol) reversibility of FEV1 ≥12% and ≥200 mL during screening.
  • Documented history of at least 2 asthma exacerbation events within 12 months, and at least one of the exacerbations should occur during the treatment of medium-to-high dose ICS.
  • ACQ-6 score ≥1.5 at screening and on day of randomization

Who cannot join

  • Pulmonary disease other than asthma.
  • History of cancer.
  • History of a clinically significant infection.
  • Current smokers or participants with smoking history ≥10 pack-yrs.
  • History of chronic alcohol or drug abuse within 12 months.
  • Hepatitis B, C or HIV.
Show all 9Show fewer
  • Pregnant or breastfeeding.
  • History of anaphylaxis following any biologic therapy.
  • participant randomized in the current study or previous tezepelumab studies.

Trial locations and contacts

72 sites in 3 countries.

72 sites in 3 countries

China62 sites
  • Research Site

    Baotou, 14010

  • Research Site

    Beijing, 1000096

  • Research Site

    Beijing, 100020

  • Research Site

    Beijing, 100029

  • Research Site

    Beijing, 100070

  • Research Site

    Beijing, 100730

  • Research Site

    Beijing, 100853

  • Research Site

    Changchun, 130021

  • Research Site

    Changsha, 410008

  • Research Site

    Changsha, 410011

  • Research Site

    Chengdu, 610041

  • Research Site

    Chongqing, 400000

  • Research Site

    Chongqing, 400016

  • Research Site

    Chongqing, 400038

  • Research Site

    Fuzhou, 350001

  • Research Site

    Guangzhou, 510080

  • Research Site

    Guangzhou, 510120

  • Research Site

    Guangzhou, 510515

  • Research Site

    Guangzhou

  • Research Site

    Guiyang, 550004

  • Research Site

    Haikou, 570311

  • Research Site

    Hangzhou, 310020

  • Research Site

    Hefei, 133500

  • Research Site

    Hengyang, 421001

  • Research Site

    Hohhot, 010017

  • Research Site

    Hohhot, 10050

  • Research Site

    Huzhou, 313003

  • Research Site

    Jinan, 250013

  • Research Site

    Jinhua, 321000

  • Research Site

    Kunming, 650032

  • Research Site

    Lanzhou, 730000

  • Research Site

    Linhai, 317000

  • Research Site

    Linyi, CN-276003

  • Research Site

    Nanchang, 330006

  • Research Site

    Nanjing, 2100008

  • Research Site

    Nanjing, 210009

  • Research Site

    Nanjing, 210029

  • Research Site

    Nanning, 530007

  • Research Site

    Quanzhou, 362000

  • Research Site

    Shanghai, 200025

  • Research Site

    Shanghai, 200032

  • Research Site

    Shanghai, 200050

  • Research Site

    Shengyang, 110004

  • Research Site

    Shenyang, 110015

  • Research Site

    Shenzhen, 518035

  • Research Site

    Shijiazhuang, 050000

  • Research Site

    Tianjin, 300192

  • Research Site

    Ürümqi, 830054

  • Research Site

    Weifang, 261041

  • Research Site

    Wenzhou, 325027

  • Research Site

    Wuhan, 430022

  • Research Site

    Wuhan, 430030

  • Research Site

    Wuhan, 430033

  • Research Site

    Xi'an, 710004

  • Research Site

    Xining, 810007

  • Research Site

    Xuzhou, 221000

  • Research Site

    Xuzhou, 221009

  • Research Site

    Yangzhou, 225001

  • Research Site

    Zhengzhou, 450000

  • Research Site

    Zhuhai, 519099

  • Research Site

    Zibo, 255036

  • Research Site

    Zunyi, 563100

Other trials in China

South Korea8 sites
  • Research Site

    Cheongju-si, 28644

  • Research Site

    Daegu, 42415

  • Research Site

    Jeonju, 54907

  • Research Site

    Seoul, 03312

  • Research Site

    Seoul, 03722

  • Research Site

    Seoul, 05505

  • Research Site

    Seoul, 06591

  • Research Site

    Suwon, 16499

Other trials in South Korea

Philippines2 sites
  • Research Site

    Iloilo City, 5000

  • Research Site

    Quezon City, 1100

Other trials in Philippines

About this study

Official title: A Regional, Multicentre, Randomized, Double-Blind, Placebo Controlled, Parallel Group, Phase 3 Study to Evaluate the Efficacy and Safety of Tezepelumab in Adults With Severe Uncontrolled Asthma

A Regional, Multicentre, Randomized, Double-Blind, Placebo Controlled, Parallel Group, Phase 3 Study to Evaluate the Efficacy and Safety of Tezepelumab in Adults with Severe Uncontrolled Asthma

Read the detailed description

This is a regional, multicentre, randomized, double-blind, placebo controlled, parallel group, phase 3 study designed to evaluate the efficacy and safety of 210 mg Q4W (SC) of tezepelumab in adults with severe, uncontrolled asthma on medium to high-dose ICS and at least one additional asthma controller medication with or without OCS. Approximately 396 participants will be randomized regionally (China/non-China). Participants will receive tezepelumab, or placebo, administered via subcutaneous injection at the study site, over a 52-week treatment period. The study also includes a post-treatment follow-up period of 12 weeks

Conditions
Asthma
Being tested
Experimental: Tezepelumab, Placebo
Keywords
Asthma, Uncontrolled Asthma, Severe Uncontrolled Asthma
Medical subject headings
Asthma

What participants receive

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

  • Experimental: TezepelumabBiological

    Also called Tezepelumab

    Tezepelumab subcutaneous injection

  • PlaceboOther

    Placebo subcutaneous injection

Study groups in NCT03927157
Study groupRoleWhat they receive
TezepelumabExperimentalTezepelumab: Tezepelumab subcutaneous injection
Receives: Biological: Experimental: Tezepelumab
PlaceboPlacebo comparatorPlacebo: Placebo subcutaneous injection
Receives: Other: Placebo

What is being measured

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

  1. Annual Asthma Exacerbation Rate (AERR)

    The annual exacerbation rate is based on exacerbations reported by the investigator in the eCRF over 52 weeks

    Measured: Randomization to Week 52

Secondary outcomes (18)
  1. Mean Change From Baseline in Pre-dose/Pre-bronchodilator (Pre-BD) Forced Expiratory Volume in 1 Second (FEV1) at Week 52

    Mean change from baseline in FEV1 as compared to placebo at Week 52. FEV1 is defined as the volume of air exhaled from the lungs in the first second of a forced expiration.

    Measured: Randomization to Week 52

  2. Mean Change From Baseline in Standardized Asthma Quality of Life Questionnaire for 12 Years and Older (AQLQ(S)+12) Total Score at Week 52

    Mean change from baseline in AQLQ(S)+12 as compared to placebo at Week 52. The AQLQ(S)+12 is a questionnaire that measures the health-related quality of life experienced by asthma participants. The total 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).

    Measured: Randomization to Week 52

  3. Mean Change From Baseline in Asthma Control Questionnaire-6 (ACQ-6) Score at Week 52

    Mean change from baseline in ACQ-6 as compared to placebo at Week 52. The ACQ-6 captures asthma symptoms and short-acting β2-agonist use via subject-report. Questions are weighted equally and scored from 0 (totally controlled) to 6 (severely uncontrolled). The ACQ-6 score is the mean of the responses.

    Measured: Randomization to Week 52

  4. Mean Change From Baseline in Weekly Mean Daily Asthma Symptom Diary Score at Week 52

    Mean change from baseline in Asthma Symptom Diary score as compared to placebo at Week 52. The Asthma Symptom Diary comprises of 10 items (5 items in the morning; 5 items in the evening). Asthma symptoms during night time and daytime are recorded by the patient each morning and evening in the daily diary. A daily ASD score is the mean of the 10 items. A higher value indicates a worse outcome. Responses for all 10 items are required to calculate the daily ASD score; otherwise, it is treated as missing. For the 7-day average asthma symptom score, scoring is done with no imputation using the mean of at least 4 of the 7 daily ASD scores as a mean weekly item score. The 7-day average ASD score ranges from 0 to 4.

    Measured: Randomization to Week 52

  5. Time to First Asthma Exacerbation

    Time to the first occurrence of asthma exacerbation post randomization, presented as number of participants with at least one asthma exacerbation reported in the eCRF

    Measured: Randomization to Week 52

  6. Mean Change From Baseline in Fractional Exhaled Nitric Oxide at Week 52

    Mean change from baseline in FENO (ppb) at week 52 to assess the effect of 210 mg of tezepelumab SC Q4W on biomarkers

    Measured: Randomization to Week 52

  7. Number of Participants With Asthma Specific Resource Utilization Over 52 Weeks

    Number of participants with asthma specific resource utilization (e.g. unscheduled physician visits, unscheduled phone calls to physicians, use of other asthma medications) over 52 weeks.

    Measured: Randomization to Week 52

  8. Pharmacokinetics of Tezepelumab

    Mean serum trough PK concentrations taken pre-dose at each scheduled visit to evaluate the pharmacokinetics (PK) of tezepelumab

    Measured: Baseline, Week 24, Week 52, Week 64

  9. Mean Change From Baseline in EQ-5D-5L VAS Score at Week 52

    Mean change from baseline in EQ-5D-5L VAS at week 52. EQ-5D-5L visual analogue scale (VAS) allows participants to rate current health status on a scale of 0-100, with 0 being the worst imaginable health state.

    Measured: At Week 52

  10. Mean Change From Baseline in Blood Eosinophils (Cells/uL) at Week 52

    Mean change from baseline in blood eosinophil counts at week 52 to assess the effect of 210 mg of tezepelumab SC Q4W on biomarkers.

    Measured: Randomization to Week 52

  11. Mean Change From Baseline in Total Serum IgE (IU/mL) at Week 52

    Mean change from baseline in IgE at week 52 to assess the effect of 210 mg of tezepelumab SC Q4W on biomarkers.

    Measured: Randomization to Week 52

  12. Mean Change From Baseline in Night Time Awakenings (Percentage) at Week 52

    Mean change from baseline in night time awakenings due to asthma at Week 52. Night time awakenings percentage is defined as number of nights with awakenings due to asthma and requiring rescue medication divided by number of nights with available data and multiplied by 100%. At least 4 out of 7 days of data is required to calculate a weekly mean.

    Measured: Randomization to Week 52

  13. Immunogenicity of Tezepelumab

    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 the first and the 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. Treatment boosted ADA defined as baseline positive ADA that was boosted to a 4 fold or higher level following treatment. Treatment emergent ADA defined as sum of treatment induced ADA and treatment boosted ADA.

    Measured: Baseline to Week 64

  14. Mean Change From Baseline in Daily Rescue Medication Use (Weekly Means) at Week 52

    Daily rescue medication use is defined as: Number of night inhaler puffs + 2 x [number of night nebulizer times] + number of daytime inhaler puffs + 2 x [number of day nebulizer times]. Weekly means are calculated using at least 4 of 7 days of daily rescue medication use.

    Measured: Randomization to Week 52

  15. Mean Change From Baseline in Home Based Morning Peak Expiratory Flow (PEF) at Week 52

    Mean change from baseline in home based morning PEF (L/min) at Week 52. Home PEF testing was performed by participant in the morning upon awakening and in the evening at bedtime using an electronic, hand-held spirometer. Weekly means are calculated using at least 4 of the 7 days of PEF data.

    Measured: Randomization to Week 52

  16. Mean Change From Baseline in Home Based Evening Peak Expiratory Flow (PEF) at Week 52

    Mean change from baseline in home based evening PEF (L/min) at Week 52. Home PEF testing was performed by participant in the morning upon awakening and in the evening at bedtime using an electronic, hand-held spirometer. Weekly means are calculated using at least 4 of the 7 days of PEF data.

    Measured: Randomization to Week 52

  17. Annual Asthma Exacerbation Rate Resulting in Emergency Room Visit or Hospitalization

    The annual exacerbation rate is based on exacerbations reported by the investigator that are associated with an emergency room visit, urgent care visit, or a hospitalization (where urgent care visit was captured as an emergency room visit on the eCRF).

    Measured: Randomization to Week 52

  18. Proportion of Participants Who Had no Asthma Exacerbations

    The proportion of participants who had no asthma exacerbations is presented as the percentage of participants with no exacerbations. This is defined as participants who meet both the following criteria: (1) completed the 52 week treatment period and (2) did not report an exacerbation during this period.

    Measured: Randomization to Week 52

Timeline

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

  1. First posted25 Apr 2019
  2. Study start14 Jun 2019
  3. Primary completion24 May 2024
  4. Study completion13 Aug 2024

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomized in a 1:1 ratio to either tezepelumab or matching placebo both administered subcutaneously.
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
405 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03927157
Sponsor's protocol ID
D5180C00021
Acronym
DIRECTION
Status last verified
Jun 2025
First submitted
23 Apr 2019
Last updated
1 Jul 2025
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Experimental: Tezepelumab in people with Asthma, run by AstraZeneca at 72 sites in 3 countries.

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 9 inclusion and 9 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 1 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 72 sites in China, South Korea, Philippines. 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. Some participants in this study may receive a placebo. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 1 Jul 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Annual Asthma Exacerbation Rate (AERR) (time frame: Randomization to Week 52). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 1 Jul 2025.

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