Study to Evaluate the Efficacy and Safety of MEDI9929 (AMG 157) in Adult Subjects With Inadequately Controlled, Severe Asthma

Asthma Clinical Trial

Official title:

A Phase 2 Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of MEDI9929 in Adult Subjects With Inadequately Controlled, Severe Asthma

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02054130
• Other study ID #: CD-RI-MEDI9929-1146
• Secondary ID: 2013-003269-33
• Status: Completed
• Phase: Phase 2
• Start date: December 13, 2013
• Est. completion date: March 1, 2017

Study information

• Verified date: November 2018
• Source: MedImmune LLC
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The primary objective of the study is to evaluate the effect of 3 dose levels of MEDI9929 (AMG 157) on asthma exacerbations in adult subjects with inadequately controlled, severe asthma.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 584
• Est. completion date: March 1, 2017
• Est. primary completion date: December 12, 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 75 Years

Eligibility

Inclusion Criteria:

• Age 18 through 75

• Body mass index (BMI) between 18-40 kg/m2 and weight greater than or equal 40 kg

• Documented physician-diagnosed asthma - Subjects must have received a physician-prescribed asthma controller regimen with medium- or high-dose inhaled corticosteroids (ICS) plus long acting ß2 agonist (LABA) -If on asthma controller medications in addition to ICS plus LABA, the dose of the other asthma controller medications (leukotriene receptor inhibitors, theophylline, secondary ICS, long-acting anti-muscarinics (LAMA), cromones, or maintenance oral prednisone or equivalent up to a maximum of 10 mg daily or 20 mg every other day for the maintenance treatment of asthma) must be stable. -Subjects must have a documented history of at least 2 asthma exacerbation events OR at least 1 severe asthma exacerbation resulting in hospitalization within the 12 months prior to first study visit.

Exclusion Criteria:

• Diagnosis of vocal cord dysfunction, reactive airways dysfunction syndrome, hyperventilation and panic attacks, or other mimics of asthma.

• Current smokers or subjects with a smoking history of = 10 pack years

• Former smokers with < 10 pack years must have stopped for at least 1 year to be eligible.

• Any concomitant respiratory disease that in the opinion of the investigator and/or medical monitor will interfere with the evaluation of the investigational product or interpretation of subject safety or study results (eg, chronic obstructive pulmonary disease, cystic fibrosis, pulmonary fibrosis, bronchiectasis, allergic bronchopulmonary aspergillosis, Churg-Strauss syndrome).

• Evidence of active liver disease.

• History of Cancer, except for basal cell carcinoma or insitu carcinoma of the cervix treated with apparent success with curative therapy or other malignancies are eligible provided that curative therapy was completed -Known history of active tuberculosis (TB)

• History of anaphylaxis to any biologic therapy

• Positive medical history for hepatitis B or C

• Subject with human immunodeficiency virus (HIV) or subject taking antiretroviral medications, as determined by medical history and/or subject's verbal report.

Related Conditions & MeSH terms

• Asthma

Intervention

Drug:
• Placebo
Participants received placebo matched to MEDI9929 subcutaneously once every 2 weeks from Day 1 to Week 50.
• MEDI9929 70 mg
Participants received 70 milligram (mg) of MEDI9929 subcutaneously once every 4 weeks from Day 1 to Week 48 along with subcutaneous placebo once every 4 weeks from Week 2 to Week 50.
• MEDI9929 210 mg
Participants received 210 mg of MEDI9929 subcutaneously once every 4 weeks from Day 1 to Week 48 along with subcutaneous placebo once every 4 weeks from Week 2 to Week 50.
• MEDI9929 280 mg
Participants received 280 mg of MEDI9929 subcutaneously once every 2 weeks from Day 1 to Week 50.

Locations

Country	Name	City	State
Bulgaria	Research Site	Plovdiv
Bulgaria	Research Site	Sofia
Bulgaria	Research Site	Sofia
Bulgaria	Research Site	Sofia
Bulgaria	Research Site	Sofia
Bulgaria	Research Site	Sofia
Bulgaria	Research Site	Velingrad
Czechia	Research Site	Brandys nad Labem
Czechia	Research Site	Hradec Kralove
Czechia	Research Site	Mlada Boleslav
Czechia	Research Site	Praha 4
Czechia	Research Site	Praha 8
Czechia	Research Site	Praha 8
Czechia	Research Site	Strakonice
Hungary	Research Site	Balassagyarmat
Hungary	Research Site	Budapest
Hungary	Research Site	Budapest
Hungary	Research Site	Budapest
Hungary	Research Site	Csorna
Hungary	Research Site	Debrecen
Hungary	Research Site	Farkasgyepü
Hungary	Research Site	Gödöllo
Hungary	Research Site	Komarom
Hungary	Research Site	Mateszalka
Hungary	Research Site	Nagykanizsa
Hungary	Research Site	Százhalombatta
Hungary	Research Site	Szeged
Hungary	Research Site	Torokbalint
Israel	Research Site	Ashkelon
Israel	Research Site	Haifa
Israel	Research Site	Jerusalem
Israel	Research Site	Kfar-Saba
Israel	Research Site	Petach Tikva
Israel	Research Site	Rehovot
Israel	Research Site	Tel Hashomer
Japan	Research Site	Chuo-ku
Japan	Research Site	Chuo-ku
Japan	Research Site	Chuo-ku
Japan	Research Site	Fujisawa-shi
Japan	Research Site	Kiyose-shi
Japan	Research Site	Kurume-shi
Japan	Research Site	Maebashi-shi
Japan	Research Site	Ora-gun
Japan	Research Site	Sagamihara-shi
Japan	Research Site	Saitama-Ken
Japan	Research Site	Sapporo-shi
Japan	Research Site	Taito-ku
Japan	Research Site	Toshima-ku
Japan	Research Site	Yokkaichi-shi
Latvia	Research Site	Daugavpils
Latvia	Research Site	Rezekne
Latvia	Research Site	Riga
Latvia	Research Site	Riga
Latvia	Research Site	Riga
Latvia	Research Site	Riga
Lithuania	Research Site	Kaunas
Lithuania	Research Site	Klaipeda
Lithuania	Research Site	Klaipeda
Serbia	Research Site	Belgrade
Serbia	Research Site	Kragujevac
Serbia	Research Site	Sremska Kamenica
Slovakia	Research Site	Bardejov
Slovakia	Research Site	Bratislava
Slovakia	Research Site	Ilava
Slovakia	Research Site	Kosice
Slovakia	Research Site	Levice
Slovakia	Research Site	Nove Zamky
Slovakia	Research Site	Poprad
Slovakia	Research Site	Spisska Nova Ves
Slovakia	Research Site	Sturovo
Slovakia	Research Site	Surany
Slovakia	Research Site	Topolcany
Slovakia	Research Site	Zvolen
South Africa	Research Site	Durban
South Africa	Research Site	Middelburg
South Africa	Research Site	Pretoria
South Africa	Research Site	Pretoria
Ukraine	Research Site	Dnipropetrovsk
Ukraine	Research Site	Ivano-Frankivsk
Ukraine	Research Site	Kyiv
Ukraine	Research Site	Kyiv
Ukraine	Research Site	Kyiv
Ukraine	Research Site	Mykolayiv
Ukraine	Research Site	Odessa
Ukraine	Research Site	Poltava
Ukraine	Research Site	Suprunivka Vil., Poltava Regio
Ukraine	Research Site	Vinnytsia
Ukraine	Research Site	Zaporizhzhya
Ukraine	Research Site	Zaporizhzhya
United States	Research Site	Baltimore	Maryland
United States	Research Site	Charlotte	North Carolina
United States	Research Site	Charlotte	North Carolina
United States	Research Site	Dublin	Ohio
United States	Research Site	Houston	Texas
United States	Research Site	Los Angeles	California
United States	Research Site	Los Angeles	California
United States	Research Site	Miami	Florida
United States	Research Site	New York	New York
United States	Research Site	New York	New York
United States	Research Site	Oklahoma City	Oklahoma
United States	Research Site	Oviedo	Florida
United States	Research Site	Peoria	Illinois
United States	Research Site	Richmond	Virginia
United States	Research Site	Rochester	Minnesota
United States	Research Site	Rock Hill	South Carolina
United States	Research Site	Savannah	Georgia
United States	Research Site	Spartanburg	South Carolina

Sponsors (2)

Lead Sponsor	Collaborator
MedImmune LLC	Amgen

Countries where clinical trial is conducted

United States,  Bulgaria,  Czechia,  Hungary,  Israel,  Japan,  Latvia,  Lithuania,  Serbia,  Slovakia,  South Africa,  Ukraine, 

References & Publications (1)

Corren J, Parnes JR, Wang L, Mo M, Roseti SL, Griffiths JM, van der Merwe R. Tezepelumab in Adults with Uncontrolled Asthma. N Engl J Med. 2017 Sep 7;377(10):936-946. doi: 10.1056/NEJMoa1704064. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Annualized Asthma Exacerbation Rate (AER) Through Week 52	Asthma exacerbation is defined as worsening of asthma that leads to any of the following: use of systemic corticosteroids for at least 3 days, an emergency department visit due to asthma that required systemic corticosteroids, and an inpatient hospitalization due to asthma. The annual AER was presented as the total number of exacerbations for the treatment group divided by the total duration of person follow-up.	Week 0 (Day 1) up to Week 52
Secondary	Reduction in AER on Subpopulations at Week 52	Asthma exacerbation is defined as worsening of asthma that leads to any of the following: use of systemic corticosteroids for at least 3 days, an emergency department visit due to asthma that required systemic corticosteroids, and an inpatient hospitalization due to asthma. Reduction in AER was evaluated in pre-specified subpopulations (blood eosinophil count [eosinophilic and non-eosinophilic], T helper cell 2 [Th2] status [high and low], Fraction of exhaled nitric oxide [FENO] [high and low], serum periostin [high and low], current post bronchodilator forced expiratory volume in 1 second [Post-BD FEV1] reversibility- yes, allergic and non-allergic) of asthma. The annual AER was presented as the total number of exacerbations for the treatment group divided by the total duration of person follow-up. Also, the high or low was determined using median value.	Week 52
Secondary	Change From Baseline in Pre-bronchodilator (Pre-BD) Forced Expiratory Volume in 1 Second (FEV1) and Forced Vital Capacity (FVC) at Week 52	Forced expiratory volume in 1 second and forced vital capacity measures taken before bronchodilator use were reported.	Baseline (Week 0 [Day 1]) to Week 52
Secondary	Change From Baseline in FEV1 on Subpopulations at Week 52	Forced expiratory volume in one second (FEV1) was evaluated in pre-specified subpopulations of asthma. The data presented in the below table for this outcome measure is for pre-bronchodilator FEV1.	Baseline and up to Week 52
Secondary	Change From Baseline in Post-bronchodilator (Post-BD) FEV1 and FVC at Week 52	Forced expiratory volume in 1 second and forced vital capacity measures taken after bronchodilator use were reported.	Baseline (Week 0 [Day 1]) to Week 52
Secondary	Change From Baseline in Overall Symptoms Score on Subpopulations at Week 52	Asthma symptoms during night time and daytime are recorded by the participant in the asthma daily diary. Overall symptom score is the average of scores of daytime severity, daytime frequency, and nighttime severity symptoms. The daytime frequency and severity items are scored from 0 to 4, where a higher score indicates greater frequency/severity and nighttime severity item is scored from 0 to 4 , where a higher score indicates greater severity. Overall symptom score ranges from 0 to 4, where lower score indicates better asthma symptom while, higher score indicates worse asthma symptom.	Baseline and up to Week 52
Secondary	Change From Baseline in Asthma Symptoms Measured by Asthma Daily Diary at Week 52	Asthma symptoms during night time and daytime are recorded by the participant in the asthma daily diary. Symptom score values for night time assessment is 0 (no asthma symptom) to 3 (unable to sleep because of asthma) and symptom score values for day time assessment is 0 (no asthma symptom) to 3 (unable to do normal activities due to asthma). Total asthma symptom score is the sum of the daytime and night time score (0 to 6). Lower score (0) is indicating better asthma symptom, while higher score (6) is indicating worse asthma symptom.	Baseline (Week 0 [Day 1]) and Week 52
Secondary	Change From Baseline in Asthma Symptoms Measured by Asthma Control Questionnaire (ACQ-6) Score at Week 52	The ACQ is a patient-reported questionnaire assessing asthma symptoms (ie, night-time waking, symptoms on waking, activity limitation, shortness of breath, wheezing) and daily rescue bronchodilator use and FEV1. The ACQ-6 is a shortened version of the ACQ that omits the FEV1 measurement from the original ACQ score. Questions are weighted equally and scored from 0 (totally controlled) to 6 (severely uncontrolled).	Baseline (Week 0 [Day 1]) and Week 52
Secondary	Rate of Severe Asthma Exacerbation Through Week 52	A severe asthma exacerbation is defined as an event that resulted in hospitalization. The severe AER was presented as the total number of exacerbations for the treatment group divided by the total duration of person follow-up.	Week 0 (Day 1) up to Week 52
Secondary	Time to First Asthma Exacerbation Through Week 52	Asthma exacerbation is defined as worsening of asthma that leads to use of systemic corticosteroids for at least 3 days, an emergency department visit due to asthma that required systemic corticosteroids, and an inpatient hospitalization due to asthma. Time to first asthma exacerbation was reported.	Week 0 (Day 1) through Week 52
Secondary	Time to First Severe Asthma Exacerbation Through Week 52	Asthma exacerbation is defined as worsening of asthma that leads to use of systemic corticosteroids for at least 3 days, an emergency department visit due to asthma that required systemic corticosteroids, and an inpatient hospitalization due to asthma. Time to first severe asthma exacerbations (hospitalization) were reported.	Week 0 (Day 1) through Week 52
Secondary	Number of Participants With at Least One Asthma Exacerbations Through Week 52	Asthma exacerbation is defined as worsening of asthma that leads to use of systemic corticosteroids for at least 3 days, an emergency department visit due to asthma that required systemic corticosteroids, and an inpatient hospitalization due to asthma.	Week 0 (Day 1) through Week 52
Secondary	Number of Participants With at Least One Severe Asthma Exacerbations Through Week 52	Asthma exacerbation is defined as worsening of asthma that leads to use of systemic corticosteroids for at least 3 days, an emergency department visit due to asthma that required systemic corticosteroids, and an inpatient hospitalization due to asthma. Participants with severe asthma exacerbations (hospitalization) were reported.	Week 0 (Day 1) through Week 52
Secondary	Change From Baseline in Asthma Quality of Life Questionnaire (Standardized Version) (AQLQ [S]) Overall Score at Week 52	The AQLQ(S) +12 is a 32-item questionnaire that measures the health-related quality of life experienced by asthma participants. The questionnaire comprises 4 separate domains (symptoms, activity limitations, emotional function, and environmental stimuli) scaled on a 7-point scale ranging from 7 (no impairment) to 1 (severe impairment).	Baseline (Week 0 [Day 1]) and Week 52
Secondary	Change From Baseline in European Quality of Life-5 Dimensions 5 Level Version (EQ-5D-5L) Health State Evaluation at Week 52	European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) is a standardized measure of health status of the participant. The first component is a descriptive system of the respondent's health comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive the health state index scores using the United Kingdom (UK) algorithm, with scores ranging from -0.594 to 1. A higher score indicates better health state. The second component is a self-perceived health score which is assessed using a visual analogue scale (VAS) that ranged from 0 to 100, where 0 indicated the worst health you can imagine and 100 indicated the best health you can imagine.	Baseline (Week 0 [Day 1]) and Week 52
Secondary	Total Amount of Study Drug Exposure	The total amount of study drug exposure (in milligram) for the entire study period was summarized.	Week 0 (Day 1) through Week 52
Secondary	Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)	An adverse event is any unfavourable and unintended signs (including abnormal laboratory findings), symptoms, or diseases temporally associated with use of medicinal product, whether or not considered related to medicinal product. Serious adverse event is any adverse event that resulted in death, life-threatening, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, is a congenital anomaly/birth defect in offspring of a study participant, is an important medical event that may jeopardize the participant or may require medical intervention. TEAEs are defined as events present at baseline that worsened in intensity after administration of study drug or events absent at baseline that emerged after administration of study drug, for the period until and including the follow-up period (Week 64).	Day 1 upto Week 64
Secondary	Number of Participants With TEAEs Related to Vital Sign Parameters	Adverse events observed in participants with clinically significant vital signs abnormalities were assessed.	Day 1 upto Week 64
Secondary	Number of Participants With TEAEs Related to Clinical Laboratory Evaluation	An abnormal laboratory finding which required an action or intervention by the investigator, or a finding judged by the investigator to represent a change beyond the range of normal physiologic fluctuation were reported as an adverse event. Laboratory evaluations of blood and urine samples were performed.	Day 1 upto Week 64
Secondary	Number of Participants With TEAEs Related to Electrocardiogram Evaluations	Adverse events observed in participants with clinically significant electrocardiogram abnormalities were assessed.	From the start of study drug administration upto Week 64
Secondary	Mean Serum Concentrations of MEDI9929	The mean serum concentrations of MEDI9929 was observed at specified timepoints.	Week 0 (Day 1) to Week 64
Secondary	Number of Participants With Positive Antibodies to MEDI9929	Blood samples for immunogenicity assessment included the determination of anti-drug antibodies (ADA) for MEDI9929. The number of participants with positive serum antibodies to MEDI9929 were presented.	Week 0 (Day 1) to Week 64

External Links

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