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Eosinophilic Airway Inflammation and Mepolizumab

Primary Purpose

Asthma

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
mepolizumab
Sponsored by
University of Wisconsin, Madison
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Asthma focused on measuring asthma, allergic inflammation, interleukin-5

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Males or females age 18 to 50 yrs,
  • History of asthma based upon presence of asthma symptoms such as cough, shortness of breath, wheeze or chest tightness,
  • positive skin-prick test to a House Dust Mite extract,
  • Forced expiratory volume at one second >70% predicted pre-albuterol, > 80% predicted post albuterol
  • >12% increase in Forced expiratory volume at one second following inhaled albuterol (180 µg) and/or
  • airway responsiveness to methacholine (PC20 <8mg/ml).
  • > 20% immediate drop in FEV1 following inhaled antigen challenge.
  • Safety laboratory assessments within normal ranges (labs to include complete blood count with differential, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, Prothrombin time, Partial Thromboplastin Time, and platelet count)
  • Female subjects of child-bearing potential must have a negative urine pregnancy test (urine HCG) within 48 hours of the methacholine challenge at Visit 2 and agree to use a reliable method of birth control for the duration of the study (reliable methods of birth control can include abstinence, barrier methods, oral contraceptives, injection contraceptives or skin absorption contraceptives).
  • In the opinion of the investigator, capable and willing to grant written informed consent and cooperate with study procedures and requirements.

Exclusion Criteria:

  • Use of inhaled or systemic corticosteroids or leukotriene inhibitors within 1 month of screening.
  • Treatment with Omalizumab (anti-IgE) within 9 months of screening visit
  • Concomitant use of any other monoclonal antibody
  • Respiratory infection within 4 weeks of study
  • Unstable asthma as indicated by self-report of increased symptoms or increased beta-agonist use over the previous 2 weeks.
  • Female subjects who are pregnant, nursing or have a pregnancy planned during the course of study
  • Current smokers (defined as smoked within the last year) or a former smoker with a history of >5 pack years.
  • Major health problems such as heart disease, type I and II diabetes or lung diseases other than asthma. Decisions regarding this criteria will be based upon the judgment of the investigator.
  • Previous malignancy.
  • Medication other than for asthma, allergies or contraception and that the investigator feels may interfere with the conduct of study (e.g. monoamine oxidase inhibitors and B-adrenergic antagonists in any form)
  • Known history of allergic reaction to previous antibody administration.
  • Prior treatment with an anti-interleukin-5 monoclonal antibody,
  • Use of an investigational drug within 30 days of entering the study,
  • History of noncompliance with medical regimens or subjects who are considered unreliable.

Sites / Locations

  • University of Wisconsin- Madison

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Mepolizumab

Arm Description

up to 3 monthly doses of 750mg i.v. mepolizumab

Outcomes

Primary Outcome Measures

The Primary Endpoint of the Study is the Percent of Eosinophils in the Bronchoalveolar Lavage Fluid After Segmental Allergen Challenge, Before and After Mepolizumab Administration (Bronchoscopy #2 vs. Bronchoscopy #4).
Percent of eosinophils was determined in the bronchoalveolar lavage fluid collected from the participant after segmental allergen challenge. This was done via differential cell count using Hema-3 stain. Cell differentials were determined by counting a total of 1000 cells on two cytospin preparations. The percent eosinophils were done before and after administration of mepolizumab for a specified amount of time (up to 3 months of administration).

Secondary Outcome Measures

Effect of Mepolizumab on Bronchoalveolar Lavage Fluid Concentrations of IL-5 Cytokine Before and After Mepolizumab
IL-5 was measured via ELISA on bronchoalveolar lavage fluid before and after mepolizumab administration (up to 3 months of administration). Fluid was prepared in LowCross-Buffer to minimize potential matrix effects. A 1/2 dilution of 1X bronchoalveolar fluid was used for IL-5 detection. Data are expressed as pg/mL and are extrapolated to 1X.

Full Information

First Posted
December 4, 2008
Last Updated
March 27, 2019
Sponsor
University of Wisconsin, Madison
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1. Study Identification

Unique Protocol Identification Number
NCT00802438
Brief Title
Eosinophilic Airway Inflammation and Mepolizumab
Official Title
Eosinophilic Airway Inflammation: Relationship to Remodeling and Modulation by Mepolizumab
Study Type
Interventional

2. Study Status

Record Verification Date
March 2019
Overall Recruitment Status
Completed
Study Start Date
June 1, 2008 (Actual)
Primary Completion Date
March 1, 2013 (Actual)
Study Completion Date
March 1, 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Wisconsin, Madison

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
A drug (mepolizumab) that reduces allergic inflammation will affect the function of allergy cells called eosinophils which are produced by the body in response to allergen exposure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma
Keywords
asthma, allergic inflammation, interleukin-5

7. Study Design

Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
38 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Mepolizumab
Arm Type
Experimental
Arm Description
up to 3 monthly doses of 750mg i.v. mepolizumab
Intervention Type
Biological
Intervention Name(s)
mepolizumab
Other Intervention Name(s)
anti-interleukin 5
Intervention Description
up to three monthly doses of 750mg i.v. mepolizumab
Primary Outcome Measure Information:
Title
The Primary Endpoint of the Study is the Percent of Eosinophils in the Bronchoalveolar Lavage Fluid After Segmental Allergen Challenge, Before and After Mepolizumab Administration (Bronchoscopy #2 vs. Bronchoscopy #4).
Description
Percent of eosinophils was determined in the bronchoalveolar lavage fluid collected from the participant after segmental allergen challenge. This was done via differential cell count using Hema-3 stain. Cell differentials were determined by counting a total of 1000 cells on two cytospin preparations. The percent eosinophils were done before and after administration of mepolizumab for a specified amount of time (up to 3 months of administration).
Time Frame
before and after up to 3 months of Mepo.
Secondary Outcome Measure Information:
Title
Effect of Mepolizumab on Bronchoalveolar Lavage Fluid Concentrations of IL-5 Cytokine Before and After Mepolizumab
Description
IL-5 was measured via ELISA on bronchoalveolar lavage fluid before and after mepolizumab administration (up to 3 months of administration). Fluid was prepared in LowCross-Buffer to minimize potential matrix effects. A 1/2 dilution of 1X bronchoalveolar fluid was used for IL-5 detection. Data are expressed as pg/mL and are extrapolated to 1X.
Time Frame
before and after up to 3 months of Mepo

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females age 18 to 50 yrs, History of asthma based upon presence of asthma symptoms such as cough, shortness of breath, wheeze or chest tightness, positive skin-prick test to a House Dust Mite extract, Forced expiratory volume at one second >70% predicted pre-albuterol, > 80% predicted post albuterol >12% increase in Forced expiratory volume at one second following inhaled albuterol (180 µg) and/or airway responsiveness to methacholine (PC20 <8mg/ml). > 20% immediate drop in FEV1 following inhaled antigen challenge. Safety laboratory assessments within normal ranges (labs to include complete blood count with differential, blood urea nitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, Prothrombin time, Partial Thromboplastin Time, and platelet count) Female subjects of child-bearing potential must have a negative urine pregnancy test (urine HCG) within 48 hours of the methacholine challenge at Visit 2 and agree to use a reliable method of birth control for the duration of the study (reliable methods of birth control can include abstinence, barrier methods, oral contraceptives, injection contraceptives or skin absorption contraceptives). In the opinion of the investigator, capable and willing to grant written informed consent and cooperate with study procedures and requirements. Exclusion Criteria: Use of inhaled or systemic corticosteroids or leukotriene inhibitors within 1 month of screening. Treatment with Omalizumab (anti-IgE) within 9 months of screening visit Concomitant use of any other monoclonal antibody Respiratory infection within 4 weeks of study Unstable asthma as indicated by self-report of increased symptoms or increased beta-agonist use over the previous 2 weeks. Female subjects who are pregnant, nursing or have a pregnancy planned during the course of study Current smokers (defined as smoked within the last year) or a former smoker with a history of >5 pack years. Major health problems such as heart disease, type I and II diabetes or lung diseases other than asthma. Decisions regarding this criteria will be based upon the judgment of the investigator. Previous malignancy. Medication other than for asthma, allergies or contraception and that the investigator feels may interfere with the conduct of study (e.g. monoamine oxidase inhibitors and B-adrenergic antagonists in any form) Known history of allergic reaction to previous antibody administration. Prior treatment with an anti-interleukin-5 monoclonal antibody, Use of an investigational drug within 30 days of entering the study, History of noncompliance with medical regimens or subjects who are considered unreliable.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nizar N Jarjour, MD
Organizational Affiliation
University of Wisconsin, Madison
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Wisconsin- Madison
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53792-9988
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
28862877
Citation
Kelly EA, Esnault S, Liu LY, Evans MD, Johansson MW, Mathur S, Mosher DF, Denlinger LC, Jarjour NN. Mepolizumab Attenuates Airway Eosinophil Numbers, but Not Their Functional Phenotype, in Asthma. Am J Respir Crit Care Med. 2017 Dec 1;196(11):1385-1395. doi: 10.1164/rccm.201611-2234OC.
Results Reference
derived

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Eosinophilic Airway Inflammation and Mepolizumab

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