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Mild AsthmaPhase 4DARWINNCT06563102

Study to Investigate Changes in Airway Inflammation, Symptoms, and Rescue Therapy Utilization With AIRSUPRA Compared to Albuterol as Needed in Adults With Mild Asthma

A Phase 4 study testing Albuterol/Budesonide and Albuterol in people with Mild Asthma, run by AstraZeneca at 16 sites 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

The purpose of this study is to compare the efficacy and safety of albuterol/budesonide to albuterol in changes in airway inflammation, asthma symptoms, and rescue therapy utilization in adults with mild asthma. Study details include: The study duration will be up to 15 weeks. The treatment duration will be 12 weeks. Read more about this study

Who is it for?
Ages 18 to 120 years
Conditions the study is for
Mild Asthma
What is being tested?
Albuterol/Budesonide and Albuterol
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
101 participants
Where
16 sitesUnited States
Study dates
11 Sep 2024to 24 Feb 2026
Phase
Phase 4
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 120 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Informed Consent
  • 1 Capable of giving signed informed consent as described in the protocol which included compliance with the requirements and restrictions listed in the ICF and protocol
  • Type of Participant and Disease Characteristics 3 Diagnosis of asthma, by a prescribing health care professional 4 ≥ 2 prescriptions for a SABA inhaler in the past 12 months prior to Visit 1 (and the expectation that the participant will probably use their rescue inhaler ≥ 2 days per week as this is required at Visit 2 for randomization following the Lead-in Period) 5 FeNO ≥ 25 ppb at Visit 1
  • Sex and Contraceptive/Barrier Requirements 7 Female participants: Females must be not of childbearing potential or using a form of birth control as defined below:
  • Females not of childbearing potential are defined as females who are either permanently sterilized (hysterectomy, bilateral oophorectomy, or bilateral salpingectomy), or who are postmenopausal. The following age-specific requirements apply:
  • Females < 50 years old would be considered postmenopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatment and in the absence of any alternative medical cause, as judged by the investigator.
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  • Females ≥ 50 years old would be considered postmenopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatment.
  • Female participants of childbearing potential must use a highly effective form of birth control. A highly effective method of contraception is defined as one that can achieve a failure rate of less than 1% per year when used consistently and correctly. Females of childbearing potential who are sexually active with a non-sterilized male partner must agree to use one highly effective method of birth control, as defined below, from enrolment throughout the study and until at least 14 days after last dose of study intervention. Cessation of contraception after this point should be discussed with a responsible physician. Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception. Female condom and male condom should not be used together.
  • All females of childbearing potential must have a negative pregnancy test result at Visit 1.
  • Females < 50 years old would be considered postmenopausal if they have been amenorrhoeic for 12 months or more following cessation of exogenous hormonal treatment and in the absence of any alternative medical cause, as judged by the investigator.
  • Highly effective birth control methods are listed below:
  • Total sexual abstinence is an acceptable method provided it is the usual lifestyle of the participant (defined as refraining from heterosexual intercourse during the entire period of risk associated with the study treatments).
  • Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation:
  • Oral
  • Intravaginal
  • Transdermal
  • Progestogen-only hormonal contraception associated with inhibition of ovulation:
  • Oral
  • Injectable
  • Implantable
  • Intrauterine device or intrauterine hormone-releasing system
  • Bilateral tubal occlusion
  • Male partner sterilization/vasectomy with documentation of azoospermia prior to the female participant's entry into the study, and this male is the sole partner for that participant. The documentation on male sterility can come from the site personnel's review of participant's medical records, medical examination and/or semen analysis or medical history interview provided by her or her partner.
  • 8 Negative pregnancy test (urine) for female participants of childbearing potential at Visit 1.
  • Randomization Criteria 5.1.1 at Visit 2 (Week 0)
  • Symptoms requiring rescue medication use for a minimum of 2 days per week for the last 14 days during the Lead-in Period (minimum 4 uses total)
  • At least 80% overall compliance rate for performing daily FeNO and spirometry assessments and completing the twice-daily asthma symptom and rescue medication use diary during the Lead-in Period.

Who cannot join

  • Medical Conditions
  • Any significant disease or disorder, or evidence of drug/substance abuse which in the investigator's opinion would pose a risk to participant safety, interfere with the conduct of study, have an impact on the study results, or make it undesirable for the participant to participate in the study.
  • Medical history of life-threatening asthma including intubation and intensive care unit admission.
  • Medical conditions (other than allergic rhinitis) or medications that will influence FeNO, as judged by the investigator.
  • Concurrent respiratory disease: presence of a known pre-existing, clinically important lung condition other than asthma (eg, cystic fibrosis, idiopathic pulmonary fibrosis, pulmonary arterial hypertension, chronic obstructive pulmonary disease).
  • Any disease state or procedure that is likely to necessitate the use of oral/systemic corticosteroids during the Treatment Period, other than asthma.
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  • Malignancy: a current malignancy or previous history of cancer in remission for less than 12 months prior to Visit 1 (participants with treated localized squamous cell or basal cell carcinoma of the skin will not be excluded, whereas participants who had melanoma will be excluded). Participants with a history/treatment of malignancy, and which in the investigator's opinion could compromise the safety of the participant.
  • Other concurrent medical conditions: participants who have known, pre-existing, clinically significant cardiovascular (including clinically significant cardiac arrhythmia and participants with known QT interval corrected for heart rate using the Fridericia formula > 480 ms), endocrine, autoimmune, metabolic, neurological, renal, gastrointestinal, hepatic, haematological or any other system abnormalities that are uncontrolled with standard treatment.
  • Current smokers: previous smokers are allowed to be included provided that they stopped smoking > 12 months prior to Visit 1 AND have a smoking history of ≤ 10 pack-years (includes tobacco, e-cigarettes, vapes, marijuana, etc.).
  • Alcohol/substance abuse: a history (or suspected history) of alcohol misuse or substance abuse within 2 years prior to Visit 1.
  • Prior/Concomitant Therapy
  • Use of ICS-containing therapy for maintenance or rescue at enrolment. Other therapies for maintenance of asthma control are allowed (leukotriene receptor antagonists and/or antihistamines, for example), but not LAMA or LABA.
  • Use of any systemic or inhaled corticosteroid within 4 weeks of Visit 1
  • Planned use of a nebulizer during the study (between Visits 1 and 5)
  • Prior/Concurrent Clinical Study Experience
  • Participation in another clinical study with any marketed or investigational anti-allergic or immunosuppressant biologic drug within 4 months or 5 half-lives (whichever is longer) prior to Visit 1.
  • Participation in another clinical study with a non-biologic investigational product or new formulation of a marketed non-biologic drug during the last 30 days prior to Visit 1.
  • Other Exclusions
  • Participants with a known hypersensitivity to the study drugs or any of the excipients of the products.
  • Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site).
  • Previous randomization in the present study.
  • For women only: currently pregnant (confirmed with positive pregnancy test), breastfeeding or planned pregnancy during the study.
  • Planned hospitalization during the study that would interfere with study objectives as judged by the investigator.

Trial locations and contacts

16 sites in 1 country.

16 sites in 1 country

United States16 sites
  • Research Site

    Boise, Idaho, 83706

  • Research Site

    Cape Coral, Florida, 33990

  • Research Site

    Columbus, Georgia, 31904

  • Research Site

    El Paso, Texas, 79903

  • Research Site

    Houston, Texas, 77030

  • Research Site

    Lake Worth, Florida, 33462

  • Research Site

    Lancaster, California, 93534

  • Research Site

    North Charleston, South Carolina, 29420

  • Research Site

    Oklahoma City, Oklahoma, 73120

  • Research Site

    Phoenix, Arizona, 85040

  • Research Site

    Plainfield, Indiana, 46168

  • Research Site

    Riverdale, New Jersey, 07457

  • Research Site

    San Diego, California, 92123

  • Research Site

    St Louis, Missouri, 63141

  • Research Site

    Tucson, Arizona, 85715

  • Research Site

    Waco, Texas, 76712

Other trials in United States

About this study

Official title: A 12-week, Randomized, Double-Blind, Phase 4 Study Evaluating the Effect of AIRSUPRA Compared to Albuterol Administered as Needed on Changes in Airway Inflammation, Symptoms, and Rescue Therapy Utilization in Adults With Mild Asthma

The purpose of this study is to compare the efficacy and safety of albuterol/budesonide to albuterol in changes in airway inflammation, asthma symptoms, and rescue therapy utilization in adults with mild asthma.

Study details include:

  • The study duration will be up to 15 weeks.
  • The treatment duration will be 12 weeks.
  • The visit frequency will be once every 4 weeks, with 3 clinic visits and 2 video calls in total.
Read the detailed description

DARWIN is a randomized, active-comparator, double-blind, parallel-group, Phase IV study evaluating the effect of albuterol/budesonide (AIRSUPRA) compared to albuterol administered as-needed in response to symptoms on changes in airway inflammation, asthma symptoms, and rescue therapy utilization in adults with mild asthma.

Approximately 15 sites in the United States of America will enroll adult participants with mild asthma who use albuterol as a rescue inhaler and who do not take ICS as maintenance therapy.

The study will be divided in 2 periods (Lead-in Period and Treatment Period) and the total duration of the study for each participant could be up to 15 weeks, with a visit frequency of once every 4 weeks:

  • Lead-In Period: Up to 3 weeks
  • Treatment Period: 12 weeks
Conditions
Mild Asthma
Being tested
Albuterol/Budesonide, Albuterol
Keywords
Respiratory Hypersensitivity, Asthma
Medical subject headings
Respiratory Hypersensitivity, Asthma

What participants receive

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

  • Albuterol/BudesonideCombination product

    Also called AIRSUPRA, BDA MDI HFA

    Oral Inhalation. Rescue medication. Unit dose strength of 80 μg budesonide and 90 μg albuterol per actuation

  • AlbuterolCombination product

    Also called AS MDI

    Oral Inhalation. Rescue medication. Unit dose strength of 90μg albuterol per actuation.

Study groups in NCT06563102
Study groupRoleWhat they receive
Group 1 - Participants randomized to receive albuterol/budesonideExperimentalParticipants will be randomized based on Visit 1 FeNO levels (< 50 ppb / ≥ 50 ppb) and geographic region. Participants who are randomized to receive albuterol/budesonide for as-needed rescue therapy will be compared to participants randomized to receive albuterol for as-needed rescue therapy.
Receives: Combination Product: Albuterol/Budesonide
Group 2 - Participants randomized to receive albuterolActive comparatorParticipants will be randomized based on Visit 1 FeNO levels (< 50 ppb / ≥ 50 ppb) and geographic region. Participants who are randomized to receive albuterol/budesonide for as-needed rescue therapy will be compared to participants randomized to receive albuterol for as-needed rescue therapy.
Receives: Combination Product: Albuterol

What is being measured

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

  1. Change from baseline to maximum value of daily morning FeNO

    Change from baseline to maximum value of daily morning FeNO over 12 weeks of treatment in the albuterol/budesonide group compared to the albuterol group.

    Measured: Daily over 12 weeks

Secondary outcomes (5)
  1. Change from baseline in FeNO on high inflammation days

    Change from baseline in FeNO on high inflammation days in the albuterol/budesonide group compared to the albuterol group. A high inflammation day is a day in which the FeNO value is ≥ 20 ppb above baseline.

    Measured: Daily over 12 weeks

  2. Number of days with high inflammation (annualized rate)

    Number of days with high inflammation in the albuterol/budesonide group compared to the albuterol group. A high inflammation day is a day in which the FeNO value is ≥ 20 ppb above baseline.

    Measured: Daily over 12 weeks

  3. Number of days with daily morning FeNO measurements ≥ 50 ppb (annualized rate)

    Number of days with FeNO >= 50 ppb in the albuterol/budesonide group compared to the albuterol group.

    Measured: Daily over 12 weeks

  4. Number of days with daily morning FeNO measurements ≥ 25 ppb (annualized rate)

    Number of days with FeNO >= 25 ppb in the albuterol/budesonide group compared to the albuterol group.

    Measured: Daily over 12 weeks

  5. Mean absolute difference in daily morning FeNO over 12 weeks of randomized treatment

    Mean daily change in FeNO from the median of the individual's daily FeNO measures over 12 weeks in the albuterol/budesonide group compared to the albuterol group.

    Measured: Daily over 12 weeks

Timeline

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

  1. First posted20 Aug 2024
  2. Study start11 Sep 2024
  3. Primary completion24 Feb 2026
  4. Study completion24 Feb 2026

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
At Visit 2 (Week 0), participants who demonstrated ≥ 80% compliance with all at-home study procedures during the last 14 days of the Lead-in Period, and who have used their albuterol rescue inhaler at least 2 days per week during the last 14 days of the Lead-in Period (≥ 4 uses total) will be randomized to continue the study and provided with study drug. Randomization will be stratified by Visit 1 FeNO level (\< 50 ppb / ≥ 50 ppb) and geographic region. Both albuterol/budesonide and albuterol will be supplied in identical inhalers and the maximum daily dose is the same for the 2 IMPs (6 doses, ie, 12 inhalations/day).
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
101 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06563102
Sponsor's protocol ID
D6930C00018
Acronym
DARWIN
Status last verified
Feb 2026
First submitted
19 Aug 2024
Last updated
27 Feb 2026
Results posted
No
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 Vivli.org. All requests 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 approved.

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Albuterol/Budesonide and Albuterol in people with Mild Asthma, run by AstraZeneca at 16 sites 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 27 inclusion and 23 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 27 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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?

Change from baseline to maximum value of daily morning FeNO (time frame: Daily over 12 weeks). 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 27 Feb 2026.

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