Open-Label Extension Study of Omalizumab in Patients With Chronic Rhinosinusitis With Nasal Polyps
Overview
- Phase
- Phase 3
- Intervention
- Omalizumab
- Conditions
- Nasal Polyps
- Sponsor
- Hoffmann-La Roche
- Enrollment
- 249
- Locations
- 79
- Primary Endpoint
- Change From Baseline in Average Daily Nasal Congestion Score (NCS)
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
The overall purpose of this study is to evaluate the safety, efficacy, and durability of response of omalizumab in an open-label setting in adult participants with chronic rhinosinusitis with nasal polyps who completed the double-blind, placebo-controlled, Phase III studies GA39688 (NCT03280550) or GA39855 (NCT03280537). Participants will be eligible for enrollment in the study at, or within 28 days after, the Week 24 visit of Studies GA39688/GA39855. After enrollment into this open-label extension (OLE) study, participants will receive 28 weeks of dosing of omalizumab before entering a 24-week off-treatment observation phase of the study. Baseline in this OLE study is defined as the last pre-treatment measurement prior to randomization in Studies GA39688/GA39855 (i.e., baseline of Studies GA39688/GA39855). The data that will be reported from baseline to Week 24 inclusive will come from Studies GA39688/GA39855.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Ability to comply with the study protocol, in the investigator's judgment
- •Participation in Study GA39688 or GA39855, including completion of endoscopy and other assessments at Week 24, without discontinuation of study drug
- •Completion of eDiary daily assessments for at least 4 out of 7 days in the week prior to the Week 24 visit of Study GA39688 or GA39855
- •For women of childbearing potential: agreement to remain abstinent or use acceptable contraceptive methods during the treatment period and for 60 days after the last dose of study drug
Exclusion Criteria
- •Anaphylaxis/hypersensitivity related to study drug in Study GA39688 or GA39855
- •Serious adverse events related to study drug in Study GA39688 or GA39855 that the investigator or Sponsor determines may jeopardize the patient's safety if he or she continues in the study
- •Uncontrolled epistaxis within Study GA39688 or GA39855
- •Pregnant or breastfeeding, or intending to become pregnant during the study or within 60 days after the last dose of omalizumab
- •Any serious medical condition or abnormality in clinical laboratory tests that, in the investigator's judgment, precludes the patient's safe participation in and completion of the study
Arms & Interventions
Cohort A: Study GA39688 Omalizumab
Participants who received omalizumab once every 2 weeks (Q2W) or once every 4 weeks (Q4W) in Study GA39688 will continue to receive omalizumab at Week 24 at the same dosing schedule.
Intervention: Omalizumab
Cohort A: Study GA39688 Placebo
Participants who received placebo Q2W or Q4W in Study GA39688 will start receiving omalizumab Q2W or Q4W at Week 24 at the same dosing schedule.
Intervention: Omalizumab
Cohort A: Study GA39688 Placebo
Participants who received placebo Q2W or Q4W in Study GA39688 will start receiving omalizumab Q2W or Q4W at Week 24 at the same dosing schedule.
Intervention: Placebo
Cohort B: Study GA39855 Omalizumab
Participants who received omalizumab Q2W or Q4W in Study GA39855 will continue to receive omalizumab at Week 24 at the same dosing schedule.
Intervention: Omalizumab
Cohort B: Study GA39855 Placebo
Participants who received placebo Q2W or Q4W in Study GA39855 will start receiving omalizumab Q2W or Q4W at Week 24 at the same dosing schedule.
Intervention: Omalizumab
Cohort B: Study GA39855 Placebo
Participants who received placebo Q2W or Q4W in Study GA39855 will start receiving omalizumab Q2W or Q4W at Week 24 at the same dosing schedule.
Intervention: Placebo
Outcomes
Primary Outcomes
Change From Baseline in Average Daily Nasal Congestion Score (NCS)
Time Frame: Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76
The Nasal Congestion Score (NCS) was assessed daily by the participant via an electronic diary as the response to the following question: Is your nose blocked? The four available response options were scored from 0 (no symptoms) to 3 (severe symptoms): 0 = Not at all; 1 = Mild; 2 = Moderate; and 3 = Severe. For each study day, a score was calculated using an average of the prior 7 days among the available days within the pre-specified window (For Week 24: Study Days 155 to 186), excluding the study day itself, if a value had been recorded by the participant on at least 4 of the prior 7 days; otherwise, the 7-day prior average for that study day was to be considered missing. One calculated (non-missing) 7-day prior average was selected for analysis according to the study day with nearest proximity to Week 24 (Study Day 168), with the earlier selected in the case of a tie. Baseline was defined as the (non-missing) 7-day interval ending on the latest day prior to randomization.
Percentage of Participants With Adverse Events Leading to Discontinuation of Omalizumab
Time Frame: From Start to End (Weeks 24 to 76) of OLE Study
A serious adverse event was defined as any adverse event that met any of the following criteria: was fatal; was life-threatening; required or prolonged inpatient hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect in a neonate/infant born to a mother exposed to the study drug; or, was a significant medical event in the investigator's judgment. Multiple occurrences of the same serious adverse event in one individual were counted once.
Change From Baseline in Nasal Polyp Score (NPS)
Time Frame: Baseline, Weeks 4, 8, 16, 24, 36, 52, 64, and 76
Total NPS ranges from 0 to 8 (sum of 0-4 for left and right nasal passage scores per the following criteria), with a lower score indicating smaller-sized nasal polyps: 0 = No polyps; 1 = Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate; 2 = Polyps reaching below the lower border of the middle turbinate (modified to accommodate those with a middle turbinectomy, such that polyp must have reached the top of the inferior turbinate.); 3 = Large polyps reaching the lower border of the inferior turbinate or polyps medial to the middle turbinate; and 4 = Large polyps causing complete obstruction of the inferior nasal cavity. Two blinded primary independent expert readers reviewed every post-screening recorded video endoscopy for a given participant to determine total NPS. A third reader chose one of the two scores to be used for analysis in cases where there was any discrepancy in total NPS assigned between the two primary readers.
Percentage of Participants With Adverse Events (AE) and Serious Adverse Events (SAE)
Time Frame: From Start to End (Weeks 24 to 52) of OLE Study
A serious adverse event was defined as any adverse event that met any of the following criteria: was fatal; was life-threatening; required or prolonged inpatient hospitalization; resulted in persistent or significant disability/incapacity; was a congenital anomaly/birth defect in a neonate/infant born to a mother exposed to the study drug; or, was a significant medical event in the investigator's judgment. Multiple occurrences of the same serious adverse event in one individual were counted once.
Secondary Outcomes
- Change From Baseline in Average Daily Total Nasal Symptom Score (TNSS)(Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76)
- Change From Baseline in Loss of Sense of Smell Score(Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76)
- Change From Baseline in European Quality of Life 5-Dimension 5-Level Questionnaire (EQ-5D-5L) Visual Analogue Scale (VAS) Score(Baseline, Weeks 16, 24, 36, 52, 64, and 76)
- Percentage of Participants With a Clinically Significant Change From Baseline in Laboratory Values(Baseline, Weeks 36, 52, 64, and 76)
- Change From Baseline in Average Daily Posterior Rhinorrhea Score(Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76)
- Change From Baseline in Average Daily Anterior Rhinorrhea Score(Baseline, Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56, 60, 64, 68, 72, and 76)
- Change From Baseline in Health-Related Quality of Life (HRQoL) as Assessed by the Total Sino-Nasal Outcome Test (SNOT)-22 Score(Baseline, Weeks 4, 8, 16, 24, 36, 52, 64, and 76)
- Percentage of Participants Reporting "No Problem" in the European Quality of Life 5-Dimension 5-Level Questionnaire (EQ-5D-5L) Subdomains(Baseline, Weeks 16, 24, 36, 52, 64 and 76)
- Change From Baseline in Asthma Quality of Life Questionnaire (AQLQ) Score (in Participants With Comorbid Asthma Only)(Baseline, Weeks 16, 24, 36, 52, 64, and 76)
- Change From Baseline in Sense of Smell, as Assessed by The University of Pennsylvania Smell Identification Test (UPSIT) Score(Baseline, Weeks 8, 16, 24, 36, 52, 64, and 76)
- Minimum Serum Concentrations (Ctrough) of Omalizumab at Specified Timepoints(Predose at Weeks 36, 52, 64, and 76)
- Serum Concentration of Total Immunoglobulin E (IgE)(Predose at Weeks 36, 52, 64, and 76)
- Serum Concentration of Free IgE(Predose at Weeks 36, 52, 64, and 76)