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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01287039
Other study ID # C38072/3082
Secondary ID
Status Completed
Phase Phase 3
First received
Last updated
Start date April 2011
Est. completion date March 2014

Study information

Verified date November 2021
Source Teva Branded Pharmaceutical Products R&D, Inc.
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a Phase 3, multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy, safety, and immunogenicity of treatment with reslizumab in patients with eosinophilic asthma.


Description:

Demonstrate the efficacy of reslizumab, at a dose of 3 mg/kg administered iv every 4 weeks over 12 months, as assessed by the reduction in frequency of clinical asthma exacerbations (CAEs) during 12 months. An exacerbation event will be considered a CAE if the patient meets either or both of the criteria listed below and this is corroborated with at least 1 other measurement to indicate the worsening of clinical signs and symptoms of asthma: - use of systemic, or an increase in the use of inhaled, corticosteroid treatment for 3 or more days - asthma-related emergency treatment The above criteria must be corroborated with at least 1 other measurement to indicate worsening in the clinical signs and symptoms of asthma.


Recruitment information / eligibility

Status Completed
Enrollment 489
Est. completion date March 2014
Est. primary completion date December 2013
Accepts healthy volunteers No
Gender All
Age group 12 Years to 75 Years
Eligibility Inclusion Criteria: - The patient is male or female, 12 through 75 years of age, with a previous diagnosis of asthma. - The patient has had at least 1 asthma exacerbation requiring oral, intramuscular (im), or intravenous (iv) corticosteroid use for at least 3 days over the past 12 months before screening. - The patient has a current blood eosinophil level of at least 400/µl. - The patient has airway reversibility of at least 12% to beta-agonist administration. - The patient has an ACQ score of at least 1.5 at the screening and baseline (before the 1st dose of study drug) visits. - The patient is taking inhaled fluticasone at a dosage of at least 440 µg, or equivalent, daily. Chronic oral corticosteroid use (no more than 10 mg/day prednisone or equivalent) is allowed. If a patient is on a stable dose, eg, 2 weeks or more of oral corticosteroid treatment at the time of study enrollment, the patient must remain on this dose throughout the study. The patient's baseline asthma therapy regimen (including but not limited to inhaled corticosteroids, oral corticosteroids up to a maximum of 10 mg of prednisone daily or equivalent, leukotriene antagonists, 5-lipooxygenase inhibitors, or cromolyn) must be stable for 30 days prior to screening and baseline, and must continue without dosage changes throughout study. - All female patients must be surgically sterile, 2 years postmenopausal, or must have a negative pregnancy test ß-human chorionic gonadotropin [ß-HCG]) at screening (serum) and baseline (urine). - Female patients of childbearing potential (not surgically sterile or 2 years postmenopausal), must use a medically accepted method of contraception and must agree to continue use of this method for the duration of the study and for 30 days after participation in the study. - Written informed consent is obtained. Patients 12 through 17 years old must provide assent. - The patient is in reasonable health (except for diagnosis of asthma) as judged by the investigator, and as determined by a medical history, medical examination, ECG evaluation (at screening), serum chemistry, hematology, and urinalysis. - Other criteria apply; please contact the investigator for more information. Exclusion Criteria: - The patient has a clinically meaningful co-morbidity that would interfere with the study schedule or procedures, or compromise the patient's safety. - The patient has known hypereosinophilic syndrome. - The patient has another confounding underlying lung disorder (eg, chronic obstructive pulmonary disease, pulmonary fibrosis, or lung cancer). Patients with pulmonary conditions with symptoms of asthma and blood eosinophilia (eg, Churg-Strauss syndrome, allergic bronchopulmonary aspergillosis) will also be excluded. - The patient is a current smoker (ie, has smoked within the last 6 months prior to screening). - The patient is using systemic immunosuppressive or immunomodulating or other biologic agents (including, but not limited to, anti-IgE mAb, methotrexate, cyclosporin, interferon-a, or anti-tumor necrosis factor [anti TNF] mAb) within 6 months prior to screening. - The patient has previously received an anti-hIL-5 monoclonal antibody (eg, reslizumab, mepolizumab, or benralizumab). - The patient has any aggravating medical factors that are inadequately controlled (eg, rhinitis, gastroesophageal reflux disease, and uncontrolled diabetes). - The patient has participated in any investigative drug or device study within 30 days prior to screening. - The patient has participated in any investigative biologics study within 6 months prior to screening. - Female patients who are pregnant, nursing, or, if of childbearing potential, and not using a medically accepted, effective method of birth control (eg, barrier method with spermicide, abstinence, IUD, or steroidal contraceptive [oral, transdermal, implanted, and injected]) are excluded from this study. NOTE: Partner sterility alone is not considered an acceptable form of birth control. - Other criteria apply; please contact the investigator for more information.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Reslizumab
Patients were administered intravenously over 15 to 30 minutes reslizumab at a dosage of 3.0 mg/kg at baseline and once every 4 weeks relative to baseline over 48 weeks for a total of 13 doses.
Placebo
Matching placebo (20 mM sodium acetate, 7% sucrose), administered intravenously (iv) once every 4 weeks over 52 weeks, for a total of 13 doses administered. Each patient received a specific volume of placebo to match the volume of reslizumab on the basis of the patient's body weight.

Locations

Country Name City State
Australia Teva Investigational Site 641 Clayton
Australia Teva Investigational Site 644 Daw Park
Australia Teva Investigational Site 642 Frankston
Australia Teva Investigational Site 645 Liverpool
Australia Teva Investigational Site 643 Nedlands Western Australia
Belgium Teva Investigational Site 261 Bruxelles
Belgium Teva Investigational Site 264 Bruxelles
Belgium Teva Investigational Site 260 Gent
Belgium Teva Investigational Site 262 Jambes
Belgium Teva Investigational Site 263 Liège
Chile Teva Investigational Site 160 Rancagua
Chile Teva Investigational Site 163 Santiago
Chile Teva Investigational Site 164 Santiago
Chile Teva Investigational Site 165 Santiago
Chile Teva Investigational Site 161 Temuco
Chile Teva Investigational Site 162 Valdivia
Chile Teva Investigational Site 166 Valparaiso
Colombia Teva Investigational Site 185 Bogota
Colombia Teva Investigational Site 181 Bogotá
Colombia Teva Investigational Site 182 Cali
Colombia Teva Investigational Site 180 Floridablanca
Czechia Teva Investigational Site 284 Breclav
Czechia Teva Investigational Site 287 Brno
Czechia Teva Investigational Site 286 Liberec
Czechia Teva Investigational Site 280 Olomouc
Czechia Teva Investigational Site 281 Olomouc
Czechia Teva Investigational Site 285 Olomouc
Czechia Teva Investigational Site 283 Tabor
Denmark Teva Investigational Site 301 Hvidovre
Denmark Teva Investigational Site 300 Odense
Hungary Teva Investigational Site 401 Balassagyarmat
Hungary Teva Investigational Site 400 Miskolc
Hungary Teva Investigational Site 404 Mosonmagyaróvár
Hungary Teva Investigational Site 403 Sopron
Hungary Teva Investigational Site 405 Törökbálint
Israel Teva Investigational Site 423 Ashkelon
Israel Teva Investigational Site 430 Beer-Sheva
Israel Teva Investigational Site 431 Haifa
Israel Teva Investigational Site 432 Haifa
Israel Teva Investigational Site 425 Jerusalem
Israel Teva Investigational Site 428 Jerusalem
Israel Teva Investigational Site 429 Jerusalem
Israel Teva Investigational Site 426 Kfar Saba
Israel Teva Investigational Site 422 Petach Tikva
Israel Teva Investigational Site 427 Ramat Gan
Israel Teva Investigational Site 433 Ramat Gan
Israel Teva Investigational Site 421 Rehovot
Israel Teva Investigational Site 420 Tel-Aviv
Malaysia Teva Investigational Site 705 Batu Caves
Malaysia Teva Investigational Site 700 Kuala Lumpur
Malaysia Teva Investigational Site 702 Kuala Lumpur
Malaysia Teva Investigational Site 703 Kuantan
Malaysia Teva Investigational Site 701 Penang
Malaysia Teva Investigational Site 704 Taiping
New Zealand Teva Investigational Site 723 Auckland
New Zealand Teva Investigational Site 722 Christchurch
New Zealand Teva Investigational Site 726 Christchurch
New Zealand Teva Investigational Site 724 Dunedin
New Zealand Teva Investigational Site 727 Hamilton
New Zealand Teva Investigational Site 720 Tauranga
New Zealand Teva Investigational Site 721 Wellington
Philippines Teva Investigational Site 744 Governor Mangubat Drive, Dasma
Philippines Teva Investigational Site 742 Manila
Philippines Teva Investigational Site 740 Quezon City
Philippines Teva Investigational Site 741 Quezon City
Philippines Teva Investigational Site 743 Quezon City
Philippines Teva Investigational Site 745 Quezon City
Poland Teva Investigational Site 507 Bialystok
Poland Teva Investigational Site 509 Bydgoszcz
Poland Teva Investigational Site 501 Bystra
Poland Teva Investigational Site 500 Ostrow Wielkopolski
Poland Teva Investigational Site 511 Poznan
Poland Teva Investigational Site 502 Sopot
Poland Teva Investigational Site 504 Tarnow
Russian Federation Teva Investigational Site 545 Barnaul
Russian Federation Teva Investigational Site 551 Kazan
Russian Federation Teva Investigational Site 549 Kemerovo
Russian Federation Teva Investigational Site 550 Nizhniy Novgorod
Russian Federation Teva Investigational Site 553 Novosibirsk
Russian Federation Teva Investigational Site 555 Novosibirsk
Russian Federation Teva Investigational Site 542 St. Petersburg
Russian Federation Teva Investigational Site 552 Tomsk
Russian Federation Teva Investigational Site 546 Yaroslavl
South Africa Teva Investigational Site 581 Cape Town
South Africa Teva Investigational Site 584 Cape Town
South Africa Teva Investigational Site 586 Cape Town
South Africa Teva Investigational Site 587 Centurion
South Africa Teva Investigational Site 582 Durban
South Africa Teva Investigational Site 585 Durban
South Africa Teva Investigational Site 580 Johannesburg
South Africa Teva Investigational Site 589 Johannesburg
South Africa Teva Investigational Site 583 Pretoria
South Africa Teva Investigational Site 588 Pretoria
Sweden Teva Investigational Site 602 Göteborg
Sweden Teva Investigational Site 604 Göteborg
Sweden Teva Investigational Site 603 Linköping
Sweden Teva Investigational Site 601 Malmö
Thailand Teva Investigational Site 780 Bangkok
Thailand Teva Investigational Site 782 Bangkok
Thailand Teva Investigational Site 783 Bangkok
Thailand Teva Investigational Site 781 Muang
Thailand Teva Investigational Site 784 Nakhon Ratchasima
United States Teva Investigational Site 66 Altoona Pennsylvania
United States Teva Investigational Site 63 Boerne Texas
United States Teva Investigational Site 51 Boston Massachusetts
United States Teva Investigational Site 64 Boys Town Nebraska
United States Teva Investigational Site 60 Bronx New York
United States Teva Investigational Site 31 Cincinnati Ohio
United States Teva Investigational Site 34 Colorado Springs Colorado
United States Teva Investigational Site 62 Columbus Ohio
United States Teva Investigational Site 52 DeBary Florida
United States Teva Investigational Site 72 Houston Texas
United States Teva Investigational Site 49 Lexington Kentucky
United States Teva Investigational Site 61 Los Angeles California
United States Teva Investigational Site 65 Louisville Kentucky
United States Teva Investigational Site 33 Madison Wisconsin
United States Teva Investigational Site 55 Miami Florida
United States Teva Investigational Site 35 Missoula Montana
United States Teva Investigational Site 32 Nashville Tennessee
United States Teva Investigational Site 50 Oklahoma City Oklahoma
United States Teva Investigational Site 37 Orange California
United States Teva Investigational Site 38 Richmond Virginia
United States Teva Investigational Site 68 Rochester New York
United States Teva Investigational Site 74 Saint Louis Missouri
United States Teva Investigational Site 56 San Diego California
United States Teva Investigational Site 58 Scottsdale Arizona
United States Teva Investigational Site 18 Valrico Florida
United States Teva Investigational Site 30 Winston-Salem North Carolina

Sponsors (1)

Lead Sponsor Collaborator
Teva Branded Pharmaceutical Products R&D, Inc.

Countries where clinical trial is conducted

United States,  Australia,  Belgium,  Chile,  Colombia,  Czechia,  Denmark,  Hungary,  Israel,  Malaysia,  New Zealand,  Philippines,  Poland,  Russian Federation,  South Africa,  Sweden,  Thailand, 

Outcome

Type Measure Description Time frame Safety issue
Primary Frequency of Clinical Asthma Exacerbations (CAEs) During 12 Months of Treatment An exacerbation event was considered a CAE if the patient met either or both of the criteria listed below and this was corroborated with at least 1 other measurement to indicate the worsening of clinical signs and symptoms of asthma:
use of systemic, or an increase in the use of inhaled, corticosteroid treatment for 3 or more days; or an increased 2 or more fold for at least 3 or more days for patient's already on corticosteroids.
asthma-related emergency treatment, such as an unscheduled visit to the physician's office or emergency room for nebulizer treatment or other urgent treatment to prevent worsening of asthma symptoms, or an asthma-related hospitalization CAEs were adjudicated by committee to assure consistency.
Adjusted CAE rate and confidence intervals were based on Negative Binomial regression model adjusted for stratification factors.
Results are offered as adjusted means.
Day 1 to Week 52
Primary Frequency of Each of the Two Criteria for Clinical Asthma Exacerbations (CAEs) An exacerbation event was considered a CAE if the patient met either or both of the criteria listed below and this was corroborated with at least 1 other measurement to indicate the worsening of clinical signs and symptoms of asthma:
use of systemic, or an increase in the use of inhaled, corticosteroid treatment for 3 or more days; or an increased 2 or more fold for at least 3 or more days for patient's already on corticosteroids.
asthma-related emergency treatment, such as an unscheduled visit to the physician's office or emergency room for nebulizer treatment or other urgent treatment to prevent worsening of asthma symptoms, or an asthma-related hospitalization.
CAEs were adjudicated by committee to assure consistency. Adjusted CAE rate and confidence intervals for the two criteria were based on Negative Binomial regression model adjusted for stratification factors.
Results are offered as adjusted means.
Day 1 to Week 52
Secondary Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Over 16 Weeks Using Mixed Model for Repeated Measures FEV1 is a standard measurement of air movement in the lungs of patients with asthma obtained from pulmonary function tests. It is the volume of air expired in the first second of a forced expiration using a spirometer. Positive change from baseline scores indicate improvement in asthma control.
The during treatment (Weeks 4, 8, 12 and 16) average FEV1 was estimated using a mixed-effect model for repeated measures (MMRM) with fixed effects (treatment, stratification factors, sex, visit, interaction of treatment and visit), covariates (height, baseline value), and patient as the random effect for the repeated measurements.
Day 1 (baseline, pre-dose), Weeks 4, 8, 12 and 16
Secondary Change From Baseline in Asthma Quality of Life Questionnaire (AQLQ) to Week 16 The AQLQ is a 32-item instrument administered as a self-assessment (Juniper et al 1992). The questionnaire is divided into 4 domains: activity limitation, symptoms, emotional function, and environmental stimuli. Patients were asked to recall their experiences during the last 2 weeks and to respond to each question on a 7-point scale (1=severe impairment, 7=no impairment). The overall AQLQ score is the mean of all 32 responses. Five of the activity questions were "patient-specific," which means that each patient identified and scored 5 activities in which the patient was limited by asthma; these 5 activities were identified at the first visit and retained for all subsequent follow-up visits.
Positive change from baseline scores indicate improvement in quality of life.
Day 1 (baseline, pre-dose), Week 16
Secondary Change From Baseline in Asthma Control Questionnaire (ACQ) Over 16 Weeks Using Mixed Model for Repeated Measures The ACQ is a 7-item instrument that measures asthma control (Juniper et al 1999). Six questions are self-assessments; the seventh item, completed by a member of the study staff, is the result of the patient's FEV1 measurement. Each item has 7 possible answers on a scale of 0 to 6, and the total score is the mean of all responses (the total scale is therefore 0-6). A higher score is an indication of poorer asthma control. The during treatment (Weeks 4, 8, 12 and 16) average ACQ was estimated using a mixed-effect model for repeated measures (MMRM) with fixed effects (treatment, stratification factors, sex, visit, interaction of treatment and visit), covariates (height, baseline value), and patient as the random effect for the repeated measurements.
Negative change from baseline scores indicate improvement in asthma control.
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16
Secondary Kaplan-Meier Estimates for Time to First Clinical Asthma Exacerbation (CAE) An exacerbation event was considered a CAE if the patient met either or both of the criteria listed below and this was corroborated with at least 1 other measurement to indicate the worsening of clinical signs and symptoms of asthma:
use of systemic, or an increase in the use of inhaled, corticosteroid treatment for 3 or more days; or an increased 2 or more fold for at least 3 or more days for patient's already on corticosteroids.
asthma-related emergency treatment, such as an unscheduled visit to the physician's office or emergency room for nebulizer treatment or other urgent treatment to prevent worsening of asthma symptoms, or an asthma-related hospitalization.
CAEs were adjudicated by committee to assure consistency. The distributions were compared by a log rank test stratified by baseline usage of oral corticosteroid (yes or no) and geographical region (US or other).
Day 1 to Day 478 (longest treatment time plus 2 weeks)
Secondary Change From Baseline in Asthma Symptom Utility Index (ASUI) Over 16 Weeks Using Mixed Model for Repeated Measures The ASUI is an 11-item instrument designed to assess the frequency and severity of asthma symptoms and side effects, weighted by patient preferences (Revicki et al 1998). ASUI is a utility score that ranges from 0 to 1, with higher values indicating better asthma control; info obtained from questionnaire about asthma symptoms.
The during treatment (Weeks 4, 8, 12 and 16) average ASUI was estimated using a mixed-effect model for repeated measures (MMRM) with fixed effects (treatment, stratification factors, sex, visit, interaction of treatment and visit), covariates (height, baseline value), and patient as the random effect for the repeated measurements.
Positive change from baseline values indicate improvement in asthma symptoms. Information was obtained from questionnaire about asthma symptoms.
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16
Secondary Change From Baseline in Short-Acting Beta-Agonist (SABA) Use Over 16 Weeks Using Mixed Model for Repeated Measures SABA are used for quick relief of asthma symptoms. To measure SABA use, at each clinical visit patients were asked to recall their usage of SABA therapy within the last 3 days of the scheduled visit. If usage was confirmed, the number of puffs used was recorded. For the purpose of summaries, an average daily usage was evaluated by dividing the total number of puffs recorded over 3 days by 3.
The during treatment (Weeks 4, 8, 12 and 16) SABA use was estimated using a mixed-effect model for repeated measures (MMRM) with fixed effects (treatment, stratification factors, sex, visit, interaction of treatment and visit), covariates (height, baseline value), and patient as the random effect for the repeated measurements.
Negative change from baseline scores indicate improvement in asthma control.
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16
Secondary Change From Baseline in Blood Eosinophil Count Over 16 Weeks and 52 Weeks Using Mixed Model for Repeated Measures Blood eosinophil counts were measured using a standard complete blood count (CBC) with differential blood test at each scheduled visit, and from all patients experiencing a serious adverse event, an adverse event leading to withdrawal, or an exacerbation of asthma symptoms.
The during treatment average eosinophil counts were estimated using a mixed-effect model for repeated measures (MMRM) with fixed effects (treatment, stratification factors, sex, visit, interaction of treatment and visit), covariates (height, baseline value), and patient as the random effect for the repeated measurements.
Negative change from baseline values correlate to reduced asthma severity.
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 or early withdrawal
Secondary Participants With Treatment-Emergent Adverse Events An adverse event was defined in the protocol as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= an inability to carry out usual activities. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical intervention to prevent the previously listed serious outcomes. Day 1 (post-dose) to Week 65. The last postbaseline value for approximately 20 patients in each
Secondary Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Abnormal Lab Values Data represents participants with potentially clinically significant (PCS) abnormal serum chemistry, hematology, and urinalysis values.
Significance criteria:
Blood urea nitrogen: >=10.71 mmol/L
Uric acid: M>=625, F>=506 µmol/L
Aspartate aminotransferase: >=3*upper limit of normal (ULN). Normal range is 10-43 U/L
Alanine aminotransferase: >=3*ULN. Normal range is 10-40 U/L
GGT = gamma-glutamyl transpeptidase: >= 3*ULN. Normal range is 5-49 U/L.
Bilirubin: >=34.2 µmol/L
White blood cells: <=3.0 or >20 10^9/L
Hemoglobin: M<=115, F<=95 g/dL
Hematocrit: M<0.37, F<0.32 L/L
Neutrophils: <=1.0 10^9/L
Eosinophils: >10.0 %
Platelets: <75 or >=700 10^9/L
Urinalysis: blood, glucose, ketones and total protein: >=2 unit increase from baseline
Week 4 to Week 65. The last postbaseline value for approximately 20 patients in each
Secondary Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Vital Signs Values Data represents participants with potentially clinically significant (PCS) vital sign values.
Significance criteria
Sitting pulse - high 12-17 yr: >100 and increase of >= 30 beats/minute (bpm)
Sitting pulse - low >=18 yr: <50 and decrease of >=30 bpm
Sitting pulse - high >=18 yr: >100 and increase of >=30 bpm
Sitting systolic blood pressure - low >=18 yr: <90 and decrease of >=30 mmHg
Sitting systolic blood pressure - high >=18 yr: >160 and increase of >=30 mmHg
Sitting diastolic blood pressure - low 12-17 yr: <55 and decrease of >=12 mmHg
Sitting diastolic blood pressure - low >=18 yr: <50 and decrease of >=12 mmHg
Sitting diastolic blood pressure - high >=18 yr: >100 and increase of >=12 mmHg
Respiratory rate >=18 yr: >24 and increase of >=10 breaths/minute
Body temperature - low 12-17 yr: <96.5° Fahrenheit or <35.8° Celsius
Body temp - low >=18 yr: <96.5° F or <35.8° C
Body temp - high >=18 yr: >100.5° Fahrenheit
Week 4 to Week 65. The last postbaseline value for approximately 20 patients in each
Secondary Participants With a Positive Anti-Reslizumab Antibody Status During Study The immunogenicity of reslizumab was assessed by measuring for the presence of anti-reslizumab antibodies at baseline, weeks 16, 32, 48, and 52 or early withdrawal. Blood samples for anti-reslizumab antibodies assessment were also obtained from all patients (inside or outside of the US) experiencing a serious adverse event, an adverse event leading to withdrawal, or an exacerbation of asthma symptoms. Weeks 16, 32, 48 and 52
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