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Efficacy of Dupilumab Added to Medium Dose Inhaled Corticosteroid/Long-acting Beta-agonist (ICS/LABA) in Comparison to ICS Dose Escalation to High Dose ICS/LABA in Adolescent and Adult Patients With Uncontrolled Asthma

Phase 4
Recruiting
Conditions
Asthma
Interventions
Drug: Matching Placebo
Drug: ICS/LABA
Registration Number
NCT06572228
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

This study is researching a drug called dupilumab. The study is focused on patients who have uncontrolled asthma. Asthma is a condition where the airways narrow and swell, making it difficult to breathe. Uncontrolled asthma means that patients are still having frequent symptoms while taking their current asthma medication.

The aim of the study is to see which regimen is more effective: taking dupilumab with an inhaled asthma medication or only taking a higher dose of the inhaled asthma medication. The type of asthma medication that will be used is a combination inhaled corticosteroid and long-acting beta-agonist (referred to as an ICS/LABA). Some patients may also receive an additional asthma medication called a long-acting muscarinic antagonist (referred to as a LAMA) if they are already receiving a LAMA.

The study is also looking at:

• What side effects may happen from taking dupilumab

Detailed Description

This study is a Phase 3b in Canada Minors will not be enrolled in Denmark

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
250
Inclusion Criteria
  1. Diagnosis of asthma for ≥12 months, based on the Global Initiative for Asthma (GINA) 2023 guidance document
  2. Existing treatment with medium dose ICS/LABA (>250 to 500 μg/day of fluticasone propionate DPI or equivalent, per GINA 2023 guidance document) for at least 3 months with a stable dose ≥1 month prior to visit 1
  3. Participants requiring a maximum of 3 controllers for their asthma will be considered eligible for this study
  4. Pre-bronchodilator FEV1, as defined in the protocol
  5. Reversibility of at least 12% and 200 mL in FEV1 after the administration of 200 to 400 μg albuterol/salbutamol at screening OR a documented history of ≥20% reduction in the FEV1, as defined in the protocol
  6. Demonstrated adherence to medium dose ICS/LABA on at least 80% of days during the run-in period
  7. ACQ-5 score ≥1.5 at screening (visit 1)
  8. History of ≥1 severe exacerbation(s) in the previous year before visit 1, but not in the 30 days immediately preceding visit 1
  9. Biomarker criteria: Baseline blood eosinophil count ≥300 cells/μL at visit 1 (~90% of population), as defined in the protocol

Key

Exclusion Criteria
  1. Diagnosis of chronic obstructive pulmonary disease (COPD) or other lung diseases which may impair lung function and interfere with treatment assessments
  2. Clinical evidence of lung disease(s) other than asthma or imaging (Chest X-ray, computed tomography (CT), magnetic resonance imaging [MRI]) with significant findings within 12 months of visit 1 and up to and including the baseline visit (visit 3)
  3. A participant who experiences a severe asthma exacerbation at any time from 1 month prior to the screening visit (visit 1) up to and including the baseline visit (visit 3), as defined in the protocol
  4. Weight is less than 30 kilograms
  5. Current smoker or cessation of smoking within 6 months prior to visit 1 or previous smoker with a smoking history ≥10 pack-years
  6. Severe concomitant illness(es) that, in the Investigator's judgment, would adversely affect the participant's participation in the study, as defined in the protocol
  7. Participants cannot be on systemic corticosteroids at any time from 1 month prior to the screening visit (visit 1) through the duration of the run-in period

NOTE: Other protocol-defined Inclusion/Exclusion criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dupilumab + ICS/LABAdupilumabRandomized 1:1
Dupilumab + ICS/LABAICS/LABARandomized 1:1
Placebo + ICS/LABAMatching PlaceboRandomized 1:1
Placebo + ICS/LABAICS/LABARandomized 1:1
Primary Outcome Measures
NameTimeMethod
Annualized severe asthma exacerbation rateBaseline through Week 52
Secondary Outcome Measures
NameTimeMethod
Change in FEV1: FVC ratioBaseline up to week 52
Annualized cumulative dose of systemic corticosteroid exposure to treat severe asthma exacerbationsBaseline to week 52
Proportion of participants achieving ACQ-5 <1.5At week 12
Change in pre-bronchodilator FEV1Baseline up to week 52
Change in percent predicted FEV1Baseline up to week 52
Change in forced expiratory flow (FEF) 25-75%Baseline up to week 52
Proportion of participants achieving a 0.5-point improvement minimal clinically important difference (MCID) in ACQ-5Up to week 52
Incidence of Treatment-emergent adverse event (TEAEs)Up to week 52
Change in pre-bronchodilator Forced expiratory volume in the first second (FEV1)Baseline to week 12
Change in peak expiratory flow (PEF)Baseline up to week 52
Change in post-bronchodilator FEV1Baseline up to week 52
Time to first severe exacerbation eventUp to week 52
Change in Asthma Control Questionnaire (ACQ-5)Baseline to week 12

The ACQ-5 has 5 items that assess the most common asthma symptoms: 1. Frequency in past week awoken by asthma during the night, 2. Severity of asthma symptoms in the morning, 3. Limitation of daily activities due to asthma, 4. Shortness of breath due to asthma and 5. Wheeze. Participants are asked to recall how their asthma has been during the previous week and to respond to the symptom questions on a 7-point scale (0=no impairment, 6=maximum impairment). The ACQ-5 global score is the mean of the 5 questions and, therefore, between 0 (totally controlled) and 6 (severely uncontrolled). Higher score indicates lower asthma control.

Change in forced vital capacity (FVC)Baseline up to week 52

Trial Locations

Locations (77)

Allergy Clinic NZOZ Homeo Medicus

🇵🇱

Bialystok, Poland

Fundacion de Investigacion (FDI) Clinical Research

🇵🇷

San Juan, Puerto Rico

Lekarze Specjaliści Małolepszy i Partnerzy

🇵🇱

Wroclaw, Poland

ALL-MED Specjalistyczna Opieka Medyczna Medyczny Instytut Badawczy

🇵🇱

Wroclaw, Poland

Lungenpraxis Hohenzollerndamm RCMS

🇩🇪

Berlin, Germany

POIS Sachsen GmbH iG

🇩🇪

Leipzig, Germany

IKF Pneumologie GmbH & Co. KG

🇩🇪

Mainz, Germany

Allianze pulmonary Research

🇵🇷

Guaynabo, Puerto Rico

Kern Research, Inc

🇺🇸

Bakersfield, California, United States

Modena Allergy & Asthma, Inc.

🇺🇸

La Jolla, California, United States

Antelope Valley Clinical Trials

🇺🇸

Lancaster, California, United States

Ark Clinical Research - Long Beach

🇺🇸

Long Beach, California, United States

Newport Native Md, Inc.

🇺🇸

Newport Beach, California, United States

Riviera Allergy Medical Center

🇺🇸

Redondo Beach, California, United States

Raffi Tachdjian MD inc

🇺🇸

Santa Monica, California, United States

Bensch Clinical Research

🇺🇸

Stockton, California, United States

Integrated Research of Inland, Inc.

🇺🇸

Upland, California, United States

Allianz Research Institute

🇺🇸

Westminster, California, United States

National Jewish Health

🇺🇸

Denver, Colorado, United States

St Francis Medical Institute

🇺🇸

Clearwater, Florida, United States

Florida Lung, Asthma and Sleep Specialists (FLASS) - Celebration

🇺🇸

Kissimmee, Florida, United States

Clinical Site Partners, LLC DBA Flourish Research

🇺🇸

Winter Park, Florida, United States

Treasure Valley Medical Research

🇺🇸

Boise, Idaho, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Sneeze Wheeze and Itch Associates

🇺🇸

Normal, Illinois, United States

Asthma and Allergy Center of Chicago

🇺🇸

River Forest, Illinois, United States

NorthShore University Health System

🇺🇸

Skokie, Illinois, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

Bluegrass Allergy Research

🇺🇸

Lexington, Kentucky, United States

Family Allergy and Asthma Research Institute

🇺🇸

Louisville, Kentucky, United States

Allergy & Asthma Specialists, P.S.C.

🇺🇸

Owensboro, Kentucky, United States

Paul A. Shapero, M.D.

🇺🇸

Bangor, Maine, United States

Massachusetts General Hospital

🇺🇸

Dover, Massachusetts, United States

Michigan Medicine

🇺🇸

Ann Arbor, Michigan, United States

Henry Ford Health System

🇺🇸

Detroit, Michigan, United States

Allergy and Asthma Center of Minnesota

🇺🇸

Maplewood, Minnesota, United States

Clinical Research Institute, Inc.

🇺🇸

Minneapolis, Minnesota, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Montana Medical Research

🇺🇸

Missoula, Montana, United States

The Asthma and Allergy Center

🇺🇸

Bellevue, Nebraska, United States

Henderson Clinical Trials

🇺🇸

Henderson, Nevada, United States

Certified Research Associates

🇺🇸

Cortland, New York, United States

New York Medical College

🇺🇸

Hawthorne, New York, United States

Rochester Regional Health - Alexander Park - Allergy, Immunology & Rheumatology

🇺🇸

Rochester, New York, United States

Cincinnati Childrens Hospital and Medical Center

🇺🇸

Cincinnati, Ohio, United States

Allergy, Asthma and Clinical Research Center

🇺🇸

Oklahoma City, Oklahoma, United States

Clinical Research Associates of Central PA

🇺🇸

DuBois, Pennsylvania, United States

Pulmonology Associates Inc.

🇺🇸

Wynnewood, Pennsylvania, United States

Dharma MD PA doing business as Southwest Family Medicine Associates

🇺🇸

Dallas, Texas, United States

Premier Pulmonary Critical Care and Sleep Medicine

🇺🇸

Denison, Texas, United States

Western Sky Medical Research

🇺🇸

El Paso, Texas, United States

PRCCI Clinical Research Center

🇵🇷

San Juan, Puerto Rico

Baylor College of Medicine - Section of Pulmonary and Critical Care

🇺🇸

Houston, Texas, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

Metroplex Pulmonary and Sleep Center, PA

🇺🇸

McKinney, Texas, United States

Lung Sleep Research Institute

🇺🇸

North Richland Hills, Texas, United States

South Texas Allegry & Asthma Medical Professionals (STAAMP) Research

🇺🇸

San Antonio, Texas, United States

Allergy & Asthma Care of Waco

🇺🇸

Waco, Texas, United States

Vancouver Clinic

🇺🇸

Vancouver, Washington, United States

The Lung Centre at Vancouver General Hospital

🇨🇦

Vancouver, British Columbia, Canada

Dynamic Drug Advancement Ltd.

🇨🇦

Ajax, Ontario, Canada

Evidence Based Medical Educator Inc.

🇨🇦

Toronto, Ontario, Canada

Inspiration Research Limited

🇨🇦

Toronto, Ontario, Canada

Dr. Syed Anees Medicine Professional Corporation

🇨🇦

Windsor, Ontario, Canada

Clinique de Specialisee en Allergie de la Capitale

🇨🇦

Quebec, Canada

Vejle Sygehus

🇩🇰

Vejle, South Denmark, Denmark

Copenhagen University Hospital - Hvidovre

🇩🇰

Hvidovre, Denmark

Lmu University Hospital

🇩🇪

Munich, Bavaria, Germany

Praxis fur Pneumologie am Duako

🇩🇪

Augsburg, Bayern, Germany

IKF Pneumologie Frankfurt GmbH & Co KG

🇩🇪

Frankfurt, Hessen, Germany

KPPK Studienzentrum

🇩🇪

Koblenz, Rheinland-Pfalz, Germany

Velocity Clinical Research Lubeck GmbH (Formerly KLB Gesundheitsforschung Lübeck GmbH)

🇩🇪

Lubeck, Schleswig-Holstein, Germany

Michał Bogacki - DOBROSTAN

🇵🇱

Wroclaw, Dolnoslaskie, Poland

Diamond Clinic sp zoo

🇵🇱

Krakow, Malopolska, Poland

Centrum Medyczne All-Med

🇵🇱

Kraków, Malopolskie, Poland

Centrum Medycyny Oddechowej Mroz SJ

🇵🇱

Białystok, Podlaskie, Poland

Uniwersyteckie Centrum Kliniczne, Budynek Centrum Medycyny Nieinwazyjnej

🇵🇱

Gdansk, Pomerania, Poland

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