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Bronchial AsthmaPhase 3NAPNCT04607629

An Efficacy and Safety Study of Genolar® and Xolar® in the Persistent Atopic Bronchial Asthma

A Phase 3 study testing Genolar® + Symbicort® and Xolair® + Symbicort® in people with Bronchial Asthma, run by AO GENERIUM at 24 sites in Russia.

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

This is a randomized, double-blind, comparative, parallel-group study of the efficacy and safety of Genolar® and Xolair® in the treatment of persistent atopic bronchial asthma of moderate and severe course, whose symptoms are insufficiently controlled by the 4-step treatment GINA (2017) Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Bronchial Asthma
What is being tested?
Genolar® + Symbicort® and Xolair® + Symbicort®
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
192 participants
Where
24 sitesRussia
Study dates
20 Jun 2018to 13 Dec 2019
Phase
Phase 3
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 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men and women of the ages between 18 and 75 at the time of the Informed Consent Form signature.
  • A documented diagnosis of bronchial asthma for ≥1 year before the Screening;
  • 4th stage of asthma treatment according to GINA (2017) ≥2 months before the Screening;
  • The FEV1 value measured ≥4 hours after the last inhalation of short-acting β2-agonists or ≥12 hours after the last inhalation of long-acting β2-agonists is in the range of ≥40% and ≤80% of the proper value;
  • A positive test result for the obstruction reversibility, which is defined as an increase in FEV1 > 12% and > 200 ml from the baseline value, which is measured if inhaled short-acting β2-agonists are withdrawn for ≥4 hours or long-acting β2-agonists ≥12 hours, after 10-15 minutes after inhalation 200-400 mcg salbutamol or equivalent.
  • OR
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  • Daily PEF variability for 2 weeks before randomization is >10%, which is defined as the PEF amplitude between the maximum and minimum values during the day, expressed as an average daily PEF percentage and averaged over 2 weeks: ([maximum per day value - minimum per day value] / average of the maximum and minimum values per day), averaged over 2 weeks and multiplied by 100%;
  • Insufficiently controlled asthma at the Screening despite the correct inhaler use and good adherence to the 4th stage of bronchial asthma treatment (GINA 2017); and the lack of asthma control reasons are not in concomitant diseases, for example, allergic rhinitis. Insufficiently controlled asthma is defined as ≥1.5 points on the ACQ-5 asthma control questionnaire (Asthma Control Questionnaire);
  • Atopy for common environmental allergens confirmed at the Screening, or documented atopy for common environmental allergens in history.

Who cannot join

  • The initial concentration of total IgE and body weight do not correspond to the range in the dosing table for omalizumab dose-ranging.
  • Asthma resistant to glucocorticosteroids (inhaled, oral or parenteral).
  • Current smokers, smoker's index (pack / years) >10. Smoker's index (pack / years) = number of cigarettes smoked per day × smoking experience (years) / 20.
  • Asthma exacerbation during the 4 weeks before randomization.
  • Asthma treatment regimen changes during the Introductory trial period during which the basic therapeutic drug Symbicort Turbuhaler was admitted, until the first injection of study drugs.
  • Skipped the basic inhalations with Symbicort® Turbuhaler® during the introductory period of the trial more than 20%.
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  • Patients with severe medical conditions that in the view of the investigator prohibits participation in the study.
  • Pregnant or nursing (lactating) women.
  • Monoclonal antibodies administration within 1 year before taking omalizumab.
  • Hypersensitivity to any of the used study drug, to their components, history of an undesirable drug reaction.
  • A history of autoimmune disease.

Trial locations and contacts

24 sites in 1 country.

24 sites in 1 country

Russia24 sites
  • State Budgetary Healthcare Institution of the Arkhangelsk Region "The First City Clinical Hospital named after E.E. Volosevich"

    Arkhangelsk, 163001

  • Regional State Budgetary Healthcare Institution "Regional Clinical Hospital"

    Barnaul, 656024

  • State Autonomous Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Hospital named after S.V. Belyaev"

    Kemerovo, 650066

  • Municipal budgetary health care institution "Krasnodar City Clinical Emergency Hospital"

    Krasnodar, 350042

  • Joint Stock Company "Outpatient clinic" Medical Regional United System of Contracts"

    Moscow, 109544

  • Federal State Budgetary Institution "Research Institute of Pulmonology of the Federal Medical and Biological Agency"

    Moscow, 115682

  • State Budgetary Institution of Health of the City of Moscow "City Polyclinic No. 52 of the Department of Healthcare of the City of Moscow"

    Moscow, 117546

  • Federal State Budgetary Educational Institution of Further Professional Education "Russian Medical Academy of Continuous Professional Education" of the Ministry of Health of the Russian Federation

    Moscow, 123995

  • State Budgetary Institution of Health of the Novosibirsk Region "City Clinical Hospital No. 2

    Novosibirsk, 630051

  • State Budgetary Healthcare Institution of the Novosibirsk Region "State Novosibirsk Regional Clinical Hospital"

    Novosibirsk, 630087

  • Limited Liability Company "MDP-Medical Group"

    Odintsovo, Moscow Oblast, 143005

  • Budgetary health care institution of the Omsk region "City Clinical Hospital No. 1 named after AN Kabanov"

    Omsk, 644112

  • State Budgetary Healthcare Institution of the Perm Territory "Clinical Medical and Sanitary Unit No. 1

    Perm, Perm Territory, 614077

  • State Budgetary Institution of Health Care of the Leningrad Region "Center for Occupational Pathology"

    Saint Petersburg, Sankt-Peterburg, 195271

  • St. Petersburg State Budgetary Healthcare Institution "Vvedenskaya City Clinical Hospital"

    Saint Petersburg, 191180

  • Limited Liability Company "Medical Technologies" LLC "Medical Technologies"

    Saint Petersburg, 192148

  • St. Petersburg State Budgetary Healthcare Institution "City Consultative and Diagnostic Center No. 1"

    Saint Petersburg, 194354

  • Limited Liability Company "Baltic Medicine" LLC "Baltic Medicine"

    Saint Petersburg, 194356

  • Regional State Budgetary Healthcare Institution "Clinical Hospital No. 1"

    Smolensk, 214006

  • Federal State Budgetary Educational Institution of Higher Education "Siberian State Medical University" of the Ministry of Health of the Russian Federation

    Tomsk, 634050

  • State Budgetary Healthcare Institution "Republican Clinical Hospital named after G.G. Kuvatov"

    Ufa, Bashkortostan Republic, 450005

  • State Budgetary Healthcare Institution of the Vladimir Region "Regional Clinical Hospital"

    Vladimir, 600023

  • Budgetary healthcare institution of the Voronezh region "Voronezh Regional Clinical Hospital No. 1"

    Voronezh, 394066

  • Budgetary Public Health Facility of the Sverdlovsk Region "Sverdlovsk Regional Clinical Hospital No. 1

    Yekaterinburg, 620102

Other trials in Russia

About this study

Official title: A Comparative Study of Efficacy and Safety of Genolar® and Xolar® in Treating Patients With Moderate to Severe Persistent Atopic Bronchial Asthma Inadequately Controlled With Stage 4 GINA (2017) Treatment

This is a randomized, double-blind, comparative, parallel-group study of the efficacy and safety of Genolar® and Xolair® in the treatment of persistent atopic bronchial asthma of moderate and severe course, whose symptoms are insufficiently controlled by the 4-step treatment GINA (2017)

Read the detailed description

There is an increasing incidence of bronchial asthma (BA) and other allergic diseases around the world. Bronchial asthma suffers from 4 to 10% of the world population, in Russian Federation, the incidence of BA across the adult population ranges from 2.2 to 5-7%, in the child population is about 10%.

Severe BA is associated not only with frequent hospitalizations and increased mortality but also with high treatment costs.

As to it, there is a hot button issue of developing new drugs for treating patients not to be achieved effectively with standard therapy. Considering the leading pathogenesis role of IgE-mediated allergy, the use of drugs to block IgE makes it possible to control the disease at the earliest allergic reaction phase of the development. It was shown that the IgE elimination from the mast cells and basophils surface reduced the severity of acute allergic reactions, reduced the allergen-induced late phase of the immune response and infiltration with inflammatory cells. These anti-IgE antibodies effects have been shown in various studies.

Genolar® (omalizumab) (JSC "GENERIUM", the Russian Federation) is a humanized recombinant monoclonal antibody selectively binding to immunoglobulin (IgE) and is a biosimilar of Xolar® ("Novartis Pharma AG", Switzerland).

This III phase study is aimed to compare the effectiveness, safety and immunogenicity of Genolar® (JSC "GENERIUM", Russia) and Xolair® to register of the drug Genolar® (JSC "GENERIUM", the Russian Federation), a lyophilizate for subcutaneous administration, in the Russian Federation.

The study included patients (n = 192) aged 18 to 75 years with moderate to severe persistent atopic bronchial asthma. The diagnosis was documented for ≥1 year. The symptoms of the disease were insufficiently controlled by therapy corresponding to the 4th stage of treatment (GINA, 2017) during ≥2 months before screening. With block randomization, the patients were divided into two groups in a 2: 1 ratio: in group 1 - 127 patients received treatment with Genolar® for 52 weeks ± 3 days, in group 2 - 64 patients received treatment with Xolair® for 26 weeks ± 3 days. The study consisted of a screening period, an induction period for basic treatment standardizing with the using inhaled budesonide + formoterol, a comparative period of treatment with the studied drugs (Genolar® vs. Xolair®) for 26 weeks ± 3 days, and an additional period of continuing treatment with Genolar® for 26 ± 1 week for its long-term immunogenicity study.

Being tested
Genolar® + Symbicort®, Xolair® + Symbicort®
Keywords
omalizumab, humanized monoclonal antibodies, safety, bronchial asthma, equivalence, biosimilar, anti-allergic agents, anti-asthmatic agents, respiratory system agents, hypersensitivity, immune system diseases, urticaria, immunogenicity
Medical subject headings
Asthma, Hypersensitivity, Immune System Diseases, Urticaria

What participants receive

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

  • Genolar® + Symbicort®Biological

    Also called omalizumab & (budesonide+formoterol), GNR-044 & (budesonide+formoterol)

    The experimental drug dose and administration frequency were determined based on baseline IgE concentration (IU / ml) measured before treatment and current body weight (kg). Depending on the initial IgE concentration and body weight the recommended drug dose was from 75 to 600 mg once in 2 or 4 weeks. The experimental drug Genolar® and the reference drug Xolair® were administered subcutaneously for 26 weeks. Budesonide + formoterol inhalation (dosed powder for inhalation, each delivered dose contains 320 μg budesonide and formoterol fumarate dihydrate 9 μg)) 1 inhalation 2 times a day.

  • Xolair® + Symbicort®Biological

    Also called omalizumab & (budesonide+formoterol)

    The experimental drug dose and administration frequency were determined based on baseline IgE concentration (IU / ml) measured before treatment and current body weight (kg). Depending on the initial IgE concentration and body weight the recommended drug dose was from 75 to 600 mg once in 2 or 4 weeks. The experimental drug Genolar® and the reference drug Xolair® were administered subcutaneously for 26 weeks. Budesonide + formoterol inhalation (dosed powder for inhalation, each delivered dose contains 320 μg budesonide and formoterol fumarate dihydrate 9 μg)) 1 inhalation 2 times a day.

Study groups in NCT04607629
Study groupRoleWhat they receive
Genolar® + Symbicort®Experimentalomalizumab \& inhalation of budesonide+formoterol
Receives: Biological: Genolar® + Symbicort®
Xolair® + Symbicort®Active comparatoromalizumab \& inhalation of budesonide+formoterol
Receives: Biological: Xolair® + Symbicort®

What is being measured

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

  1. Patients proportion with an investigator rating "excellent" or "good" on the Global Evaluation of Treatment Effectiveness (GETE) scale after 26 weeks of comparative treatment

    Global evaluation of treatment effectiveness (GETE) is a validated tool and has been used to evaluate the clinical response to omalizumab in patients with moderate to severe allergic asthma (IgE-mediated).

    Measured: In 26 weeks after comparative treatment beginning (Genolar® vs. Xolair®)

Secondary outcomes (6)
  1. The number of bronchial asthma exacerbations per patient for 26-week period of comparative treatment

    An exacerbation is defined as the patient needs to use oral or intravenous glucocorticosteroids (prednisolone) or to increase the dose of inhaled corticosteroids ≥2 times due to an exacerbation of asthma symptoms and a fall in peak expiratory flow (PEF) or forced expectorant volume for 1 sec (FEV1) resistant to treatment with inhalation drugs

    Measured: For 26 weeks after comparative treatment start (Genolar® vs. Xolair®)

  2. Mean PEF change in every 4 weeks compared to PEF baseline in patients treated with Genolar® and Xolar® for 26 weeks of comparative treatment

    PEF measures how much air patient can breathe out using the greatest effort. It is used in the monitoring and treatment of asthma to determine treatment efficacy

    Measured: Every 4 weeks for 26 weeks of comparative treatment (Genolar® vs. Xolair®)

  3. FEV1 changes from FEV1 baseline at each visit over 26 weeks of comparative treatment (Genolar® vs. Xolair®)

    FEV1 is the amount of air that can be forcefully exhaled in one second. Clinically, the percentage of predicted FEV1 appears to be a valid marker for the degree of airway obstruction with asthma and other respiratory conditions. Together with asthma symptoms and use of inhaled short-acting beta2-agonists, FEV1 is used to classify the severity of asthma and treatment efficacy

    Measured: At the screening, for the Introductory trial period during which the basic therapeutic drug Symbicort Turbuhaler was admitted, before the comparative treatment beginning, in 8, 16, 26 weeks of comparative treatment (Genolar® vs. Xolair®)

  4. Patients proportion with an ACQ-5 Asthma Control Questionnaire score ≤0.75 after 26 weeks of treatment

    ACQ is a patient-reported tool to assess asthma control in patient ≥ 6 years of age. ACQ was used to evaluate asthma control in patients and treatment efficacy

    Measured: At the screening, before the comparative treatment start, upon 26 weeks of comparative treatment (Genolar® vs. Xolair®) completion

  5. Number of days without asthma symptoms during the 26-week period of comparison treatment (Genolar® vs. Xolair®)

    A day without asthma symptoms

    Measured: For 26 weeks of comparative treatment (Genolar® vs. Xolair®)

  6. Neutralizing antibody rate

    long-term immunogenicity study of Genolar®

    Measured: Baseline, in 6, 26, 52 weeks of treatment

Timeline

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

  1. First posted29 Oct 2020
  2. Study start20 Jun 2018
  3. Primary completion29 Apr 2019
  4. Study completion13 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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Interventional
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
192 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04607629
Sponsor's protocol ID
OMA-BA-III
Other IDs
№189. eff.data 25 Apr 2018
Acronym
NAP
Status last verified
Oct 2020
First submitted
15 Oct 2020
Last updated
29 Oct 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: NAP

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Genolar® + Symbicort® and Xolair® + Symbicort® in people with Bronchial Asthma, run by AO GENERIUM at 24 sites in Russia.

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 11 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 29 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in Russia. 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 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?

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?

Patients proportion with an investigator rating "excellent" or "good" on the Global Evaluation of Treatment Effectiveness (GETE) scale after 26 weeks of comparative treatment (time frame: In 26 weeks after comparative treatment beginning (Genolar® vs. Xolair®)). 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 29 Oct 2020.

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