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A Study to Evaluate the Efficacy and Safety of Reslizumab in Patients With Eosinophilic Asthma

Primary Purpose

Eosinophilic Asthma

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Reslizumab
Placebo
Sponsored by
Teva Branded Pharmaceutical Products R&D, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Eosinophilic Asthma

Eligibility Criteria

12 Years - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • The patient is male or female, 12 through 75 years of age, with a previous diagnosis of asthma. Patients 12 through 17 years of age are excluded from participating in Germany, India, Argentina, and Korea; patients 66 through 75 years of age are excluded from participating in India and Korea.
  • 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 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 dose of 10 mg prednisone daily or equivalent, leukotriene antagonists, 5-lipoxygenase inhibitors, or cromolyn) must be stable for 30 days prior to screening and baseline and must continue without dosage changes throughout the 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. Acceptable methods of contraception include barrier method with spermicide, abstinence, intrauterine device (IUD), or steroidal contraceptive (oral, transdermal, implanted, and injected). NOTE: Partner sterility alone is not acceptable for inclusion in the study.
  • Written informed consent is obtained. Patients 12 through 17 years old, where participating, 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.
  • The patient must be willing and able to understand and comply with study restrictions, requirements, and procedures, as specified by the study center, and to remain at the study center for the required duration during the study period, and willing to return to the study center for the follow-up evaluation as specified in this protocol.
  • Patients who experience an asthma exacerbation during the screening period will be considered to have failed screening and cannot be randomly assigned to study drug. Patients may be rescreened 1 time only.

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, immunomodulating, or other biologic agents (including, but not limited to, anti-immunoglobulin E (IgE) mAb, methotrexate, cyclosporin, interferon-α, 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.
  • Other exclusion criteria apply.

Sites / Locations

  • Teva Investigational Site 48
  • Teva Investigational Site 41
  • Teva Investigational Site 59
  • Teva Investigational Site 47
  • Teva Investigational Site 28
  • Teva Investigational Site 53
  • Teva Investigational Site 27
  • Teva Investigational Site 25
  • Teva Investigational Site 57
  • Teva Investigational Site 46
  • Teva Investigational Site 40
  • Teva Investigational Site 67
  • Teva Investigational Site 44
  • Teva Investigational Site 69
  • Teva Investigational Site 45
  • Teva Investigational Site 121
  • Teva Investigational Site 126
  • Teva Investigational Site 123
  • Teva Investigational Site 120
  • Teva Investigational Site 150
  • Teva Investigational Site 143
  • Teva Investigational Site 140
  • Teva Investigational Site 144
  • Teva Investigational Site 145
  • Teva Investigational Site 142
  • Teva Investigational Site 104
  • Teva Investigational Site 102
  • Teva Investigational Site 105
  • Teva Investigational Site 343
  • Teva Investigational Site 342
  • Teva Investigational Site 341
  • Teva Investigational Site 360
  • Teva Investigational Site 361
  • Teva Investigational Site 362
  • Teva Investigational Site 366
  • Teva Investigational Site 371
  • Teva Investigational Site 365
  • Teva Investigational Site 369
  • Teva Investigational Site 370
  • Teva Investigational Site 372
  • Teva Investigational Site 367
  • Teva Investigational Site 368
  • Teva Investigational Site 363
  • Teva Investigational Site 364
  • Teva Investigational Site 381
  • Teva Investigational Site 380
  • Teva Investigational Site 382
  • Teva Investigational Site 682
  • Teva Investigational Site 680
  • Teva Investigational Site 681
  • Teva Investigational Site 683
  • Teva Investigational Site 686
  • Teva Investigational Site 685
  • Teva Investigational Site 205
  • Teva Investigational Site 203
  • Teva Investigational Site 204
  • Teva Investigational Site 207
  • Teva Investigational Site 209
  • Teva Investigational Site 202
  • Teva Investigational Site 223
  • Teva Investigational Site 220
  • Teva Investigational Site 221
  • Teva Investigational Site 222
  • Teva Investigational Site 225
  • Teva Investigational Site 226
  • Teva Investigational Site 227
  • Teva Investigational Site 229
  • Teva Investigational Site 523
  • Teva Investigational Site 524
  • Teva Investigational Site 520
  • Teva Investigational Site 521
  • Teva Investigational Site 522
  • Teva Investigational Site 543
  • Teva Investigational Site 544
  • Teva Investigational Site 554
  • Teva Investigational Site 556
  • Teva Investigational Site 558
  • Teva Investigational Site 559
  • Teva Investigational Site 557
  • Teva Investigational Site 541
  • Teva Investigational Site 540
  • Teva Investigational Site 563
  • Teva Investigational Site 561
  • Teva Investigational Site 560
  • Teva Investigational Site 562
  • Teva Investigational Site 764
  • Teva Investigational Site 765
  • Teva Investigational Site 760
  • Teva Investigational Site 761
  • Teva Investigational Site 763
  • Teva Investigational Site 621
  • Teva Investigational Site 629
  • Teva Investigational Site 635
  • Teva Investigational Site 630
  • Teva Investigational Site 620
  • Teva Investigational Site 633
  • Teva Investigational Site 622
  • Teva Investigational Site 623
  • Teva Investigational Site 624
  • Teva Investigational Site 625
  • Teva Investigational Site 628
  • Teva Investigational Site 626
  • Teva Investigational Site 631
  • Teva Investigational Site 632

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Reslizumab 3.0 mg/kg

Arm Description

Placebo administered intravenously once every 4 weeks ( +-7 days) for a total of 13 doses.

Reslizumab 3.0 mg/kg administered intravenously once every 4 weeks ( +-7 days) for a total of 13 doses.

Outcomes

Primary Outcome Measures

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.
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.

Secondary Outcome Measures

Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) At Week 16
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.
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. During study (Weeks 4, 8, 12 and 16) average value used a mixed effect model for repeated measures (MMRM) with treatment group, visit, treatment and visit interaction, and stratification factors as fixed effects and participant as a random effect. Covariates for baseline values were also included in the model; for pulmonary function test analyses, covariates for height and sex were included as well. Positive change from baseline scores indicate improvement in asthma control.
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.
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.
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).
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.
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) average 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.
Change From Baseline in Blood Eosinophil Count Over 16 Weeks and 52 Weeks Using Mixed Model for Repeated Measures
The blood eosinophil counts were measured using a standard complete blood count (CBC) with differential blood test. Results of all differential blood tests conducted after randomization were blinded. The during treatment average eosinophil count 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. The 'over 16 weeks' value used data from Weeks 4, 8, 12 and 16. The 'over 52 weeks' value used all the during study time points listed in the Time Frame field. Negative change from baseline values correlate to reduced asthma severity.
Participants With Treatment-Emergent Adverse Events TEAE)
An adverse event (AE) 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.
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Abnormal Lab Values
Data represents participants with potentially clinically significant (PCS) abnormal serum chemistry, hematology (except for eosinophil values), and urinalysis values. Significance criteria: Blood urea nitrogen: >=10.71 mmol/L Creatinine: >=177 μmol/L Urate: M>=625, F>=506 μmol/L Aspartate aminotransferase (AST): >=3*upper limit of normal (ULN) Alanine aminotransferase (ALT): >=3*ULN GGT = gamma-glutamyl transpeptidase: >= 3*ULN Total bilirubin: >=34.2 μmol/L White blood cells (low): <=3.0*10^9/L White blood cells (high): >=20*10^9/L Hemoglobin (age >=18 years): M<=115, F<=95 g/dL Hematocrit (age >=18 years): M<0.37, F<0.32 L/L Eosinophils/leukocytes: >=10.0% Platelets: <=75*10^9/L Neutrophils: <=1.0*10^9/L Urinalysis: blood, ketones, glucose, and protein: >=2 unit increase from baseline
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): >100 and increase of >= 30 beats/minute Sitting systolic blood pressure (low): <90 and decrease of >= 30 mmHg Sitting systolic blood pressure (high): >160 and increase of >= 30 mmHg Sitting diastolic blood pressure (low): <50 and decrease of >=12 mmHg (if 12-17 years old: <55 and decrease of >=12 mmHg 0 Sitting diastolic blood pressure (high): >100 and increase of >=12 mmHg Respiratory rate (low): <6 breaths/minute Respiratory rate (high): >24 and increase of >=10 breaths/minute Body temperature (low): <35.8° Celsius Body temperature (high): >=38.1 and increase of >=1.1° Celsius
Participants With a Positive Anti-Reslizumab Antibody Status During Study
Counts of participants with a positive anti-drug antibody (ADA) response during treatment is offered for the experimental treatment arm. Blood samples were collected for determination of ADAs before study drug infusion.

Full Information

First Posted
January 25, 2011
Last Updated
November 6, 2021
Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01285323
Brief Title
A Study to Evaluate the Efficacy and Safety of Reslizumab in Patients With Eosinophilic Asthma
Official Title
A 12-Month, Double-Blind, Placebo-Controlled, Parallel-Group Study to Evaluate the Efficacy and Safety of Reslizumab (3.0 mg/kg) in the Reduction of Clinical Asthma Exacerbations in Patients (12-75 Years of Age) With Eosinophilic Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
March 2011 (undefined)
Primary Completion Date
April 2014 (Actual)
Study Completion Date
April 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The primary objective of this study is to determine whether reslizumab is more effective than placebo in reducing the number of clinical asthma exacerbations (CAEs) in patients with eosinophilic asthma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Eosinophilic Asthma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
464 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo administered intravenously once every 4 weeks ( +-7 days) for a total of 13 doses.
Arm Title
Reslizumab 3.0 mg/kg
Arm Type
Experimental
Arm Description
Reslizumab 3.0 mg/kg administered intravenously once every 4 weeks ( +-7 days) for a total of 13 doses.
Intervention Type
Drug
Intervention Name(s)
Reslizumab
Other Intervention Name(s)
Cinquil, humanized monoclonal antibody, CEP-38072
Intervention Description
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.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo (acetate sucrose buffer), administered intravenously (iv) once every 4 weeks for a total of 13 doses.
Primary Outcome Measure Information:
Title
Frequency of Clinical Asthma Exacerbations (CAEs) During 12 Months of Treatment
Description
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.
Time Frame
Day 1 to Month 12
Title
Frequency of Each of the Two Criteria for Clinical Asthma Exacerbations (CAEs)
Description
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.
Time Frame
Day 1 to Month 12
Secondary Outcome Measure Information:
Title
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) At Week 16
Description
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.
Time Frame
Day 1 (baseline, pre-dose), Week 16
Title
Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Over 16 Weeks Using Mixed Model for Repeated Measures
Description
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. During study (Weeks 4, 8, 12 and 16) average value used a mixed effect model for repeated measures (MMRM) with treatment group, visit, treatment and visit interaction, and stratification factors as fixed effects and participant as a random effect. Covariates for baseline values were also included in the model; for pulmonary function test analyses, covariates for height and sex were included as well. Positive change from baseline scores indicate improvement in asthma control.
Time Frame
Day 1 (baseline, pre-dose), Weeks 4, 8, 12 and 16
Title
Change From Baseline in Asthma Quality of Life Questionnaire (AQLQ) to Week 16
Description
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.
Time Frame
Day 1 (baseline, pre-dose), Week 16
Title
Change From Baseline in Asthma Control Questionnaire (ACQ) Over 16 Weeks Using Mixed Model for Repeated Measures
Description
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.
Time Frame
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16
Title
Kaplan-Meier Estimates for Time to First Clinical Asthma Exacerbation (CAE)
Description
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).
Time Frame
Day 1 to Day 526 (longest treatment time plus 2 weeks)
Title
Change From Baseline in Asthma Symptom Utility Index (ASUI) Over 16 Weeks Using Mixed Model for Repeated Measures
Description
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.
Time Frame
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16
Title
Change From Baseline in Short-Acting Beta-Agonist (SABA) Use Over 16 Weeks Using Mixed Model for Repeated Measures
Description
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) average 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.
Time Frame
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16
Title
Change From Baseline in Blood Eosinophil Count Over 16 Weeks and 52 Weeks Using Mixed Model for Repeated Measures
Description
The blood eosinophil counts were measured using a standard complete blood count (CBC) with differential blood test. Results of all differential blood tests conducted after randomization were blinded. The during treatment average eosinophil count 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. The 'over 16 weeks' value used data from Weeks 4, 8, 12 and 16. The 'over 52 weeks' value used all the during study time points listed in the Time Frame field. Negative change from baseline values correlate to reduced asthma severity.
Time Frame
Day 1 (baseline, pre-dose), Weeks 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52 or early withdrawal
Title
Participants With Treatment-Emergent Adverse Events TEAE)
Description
An adverse event (AE) 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.
Time Frame
Day 1 (post-dose) to Week 65. The endpoint for adverse events was the last postbaseline observation, which included the 90 day follow-up visit.
Title
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Abnormal Lab Values
Description
Data represents participants with potentially clinically significant (PCS) abnormal serum chemistry, hematology (except for eosinophil values), and urinalysis values. Significance criteria: Blood urea nitrogen: >=10.71 mmol/L Creatinine: >=177 μmol/L Urate: M>=625, F>=506 μmol/L Aspartate aminotransferase (AST): >=3*upper limit of normal (ULN) Alanine aminotransferase (ALT): >=3*ULN GGT = gamma-glutamyl transpeptidase: >= 3*ULN Total bilirubin: >=34.2 μmol/L White blood cells (low): <=3.0*10^9/L White blood cells (high): >=20*10^9/L Hemoglobin (age >=18 years): M<=115, F<=95 g/dL Hematocrit (age >=18 years): M<0.37, F<0.32 L/L Eosinophils/leukocytes: >=10.0% Platelets: <=75*10^9/L Neutrophils: <=1.0*10^9/L Urinalysis: blood, ketones, glucose, and protein: >=2 unit increase from baseline
Time Frame
Week 4 to Week 52
Title
Participants With Treatment-Emergent Potentially Clinically Significant (PCS) Vital Signs Values
Description
Data represents participants with potentially clinically significant (PCS) vital sign values. Significance criteria Sitting pulse (high): >100 and increase of >= 30 beats/minute Sitting systolic blood pressure (low): <90 and decrease of >= 30 mmHg Sitting systolic blood pressure (high): >160 and increase of >= 30 mmHg Sitting diastolic blood pressure (low): <50 and decrease of >=12 mmHg (if 12-17 years old: <55 and decrease of >=12 mmHg 0 Sitting diastolic blood pressure (high): >100 and increase of >=12 mmHg Respiratory rate (low): <6 breaths/minute Respiratory rate (high): >24 and increase of >=10 breaths/minute Body temperature (low): <35.8° Celsius Body temperature (high): >=38.1 and increase of >=1.1° Celsius
Time Frame
Week 4 to Week 52
Title
Participants With a Positive Anti-Reslizumab Antibody Status During Study
Description
Counts of participants with a positive anti-drug antibody (ADA) response during treatment is offered for the experimental treatment arm. Blood samples were collected for determination of ADAs before study drug infusion.
Time Frame
Baseline visit (prior to reslizumab exposure), Weeks 16, 32, 48 and 52

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient is male or female, 12 through 75 years of age, with a previous diagnosis of asthma. Patients 12 through 17 years of age are excluded from participating in Germany, India, Argentina, and Korea; patients 66 through 75 years of age are excluded from participating in India and Korea. 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 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 dose of 10 mg prednisone daily or equivalent, leukotriene antagonists, 5-lipoxygenase inhibitors, or cromolyn) must be stable for 30 days prior to screening and baseline and must continue without dosage changes throughout the 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. Acceptable methods of contraception include barrier method with spermicide, abstinence, intrauterine device (IUD), or steroidal contraceptive (oral, transdermal, implanted, and injected). NOTE: Partner sterility alone is not acceptable for inclusion in the study. Written informed consent is obtained. Patients 12 through 17 years old, where participating, 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. The patient must be willing and able to understand and comply with study restrictions, requirements, and procedures, as specified by the study center, and to remain at the study center for the required duration during the study period, and willing to return to the study center for the follow-up evaluation as specified in this protocol. Patients who experience an asthma exacerbation during the screening period will be considered to have failed screening and cannot be randomly assigned to study drug. Patients may be rescreened 1 time only. 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, immunomodulating, or other biologic agents (including, but not limited to, anti-immunoglobulin E (IgE) mAb, methotrexate, cyclosporin, interferon-α, 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. Other exclusion criteria apply.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Expert, MD
Organizational Affiliation
Teva Branded Pharmaceutical Products R&D, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Teva Investigational Site 48
City
Mobile
State/Province
Alabama
Country
United States
Facility Name
Teva Investigational Site 41
City
Fresno
State/Province
California
Country
United States
Facility Name
Teva Investigational Site 59
City
Long Beach
State/Province
California
Country
United States
Facility Name
Teva Investigational Site 47
City
Denver
State/Province
Colorado
Country
United States
Facility Name
Teva Investigational Site 28
City
Waterbury
State/Province
Connecticut
Country
United States
Facility Name
Teva Investigational Site 53
City
Clearwater
State/Province
Florida
Country
United States
Facility Name
Teva Investigational Site 27
City
Miami
State/Province
Florida
Country
United States
Facility Name
Teva Investigational Site 25
City
Lawrenceville
State/Province
Georgia
Country
United States
Facility Name
Teva Investigational Site 57
City
Metairie
State/Province
Louisiana
Country
United States
Facility Name
Teva Investigational Site 46
City
Bangor
State/Province
Maine
Country
United States
Facility Name
Teva Investigational Site 40
City
Saint Louis
State/Province
Missouri
Country
United States
Facility Name
Teva Investigational Site 67
City
Fort Mill
State/Province
South Carolina
Country
United States
Facility Name
Teva Investigational Site 44
City
Dallas
State/Province
Texas
Country
United States
Facility Name
Teva Investigational Site 69
City
El Paso
State/Province
Texas
Country
United States
Facility Name
Teva Investigational Site 45
City
San Antonio
State/Province
Texas
Country
United States
Facility Name
Teva Investigational Site 121
City
Ciudad Autonoma de Buenos Aire
Country
Argentina
Facility Name
Teva Investigational Site 126
City
Ciudad Autonoma de Buenos Aire
Country
Argentina
Facility Name
Teva Investigational Site 123
City
Rosario-Santa Fe
Country
Argentina
Facility Name
Teva Investigational Site 120
City
San Miguel De Tucuman - Tucuma
Country
Argentina
Facility Name
Teva Investigational Site 150
City
Florianopolis
Country
Brazil
Facility Name
Teva Investigational Site 143
City
Porto Alegre, RS
Country
Brazil
Facility Name
Teva Investigational Site 140
City
Porto Alegre
Country
Brazil
Facility Name
Teva Investigational Site 144
City
Porto Alegre
Country
Brazil
Facility Name
Teva Investigational Site 145
City
Porto Alegre
Country
Brazil
Facility Name
Teva Investigational Site 142
City
Santo André, São Paulo
Country
Brazil
Facility Name
Teva Investigational Site 104
City
Newmarket
Country
Canada
Facility Name
Teva Investigational Site 102
City
Pointe-Claire
Country
Canada
Facility Name
Teva Investigational Site 105
City
Windsor
Country
Canada
Facility Name
Teva Investigational Site 343
City
Grenoble
Country
France
Facility Name
Teva Investigational Site 342
City
Marseille
Country
France
Facility Name
Teva Investigational Site 341
City
Montpellier
Country
France
Facility Name
Teva Investigational Site 360
City
Bad Wörishofen
Country
Germany
Facility Name
Teva Investigational Site 361
City
Berlin
Country
Germany
Facility Name
Teva Investigational Site 362
City
Berlin
Country
Germany
Facility Name
Teva Investigational Site 366
City
Berlin
Country
Germany
Facility Name
Teva Investigational Site 371
City
Bochum
Country
Germany
Facility Name
Teva Investigational Site 365
City
Dresden
Country
Germany
Facility Name
Teva Investigational Site 369
City
Frankfurt
Country
Germany
Facility Name
Teva Investigational Site 370
City
Hamburg
Country
Germany
Facility Name
Teva Investigational Site 372
City
Koblenz
Country
Germany
Facility Name
Teva Investigational Site 367
City
Leipzig
Country
Germany
Facility Name
Teva Investigational Site 368
City
Leipzig
Country
Germany
Facility Name
Teva Investigational Site 363
City
Mainz
Country
Germany
Facility Name
Teva Investigational Site 364
City
Mainz
Country
Germany
Facility Name
Teva Investigational Site 381
City
Alexandroupolis
Country
Greece
Facility Name
Teva Investigational Site 380
City
Athens
Country
Greece
Facility Name
Teva Investigational Site 382
City
Heraklion, Crete
Country
Greece
Facility Name
Teva Investigational Site 682
City
Gwangju
Country
Korea, Republic of
Facility Name
Teva Investigational Site 680
City
Seoul
Country
Korea, Republic of
Facility Name
Teva Investigational Site 681
City
Seoul
Country
Korea, Republic of
Facility Name
Teva Investigational Site 683
City
Seoul
Country
Korea, Republic of
Facility Name
Teva Investigational Site 686
City
Seoul
Country
Korea, Republic of
Facility Name
Teva Investigational Site 685
City
Suwon
Country
Korea, Republic of
Facility Name
Teva Investigational Site 205
City
Ciudad De México
Country
Mexico
Facility Name
Teva Investigational Site 203
City
Distrito Federal
Country
Mexico
Facility Name
Teva Investigational Site 204
City
Guadalajara, JAL
Country
Mexico
Facility Name
Teva Investigational Site 207
City
Mexico City
Country
Mexico
Facility Name
Teva Investigational Site 209
City
Monterrey
Country
Mexico
Facility Name
Teva Investigational Site 202
City
Tijuana, B.C.
Country
Mexico
Facility Name
Teva Investigational Site 223
City
Cercado De Lima, Lima
Country
Peru
Facility Name
Teva Investigational Site 220
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 221
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 222
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 225
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 226
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 227
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 229
City
Lima
Country
Peru
Facility Name
Teva Investigational Site 523
City
Bucharest
Country
Romania
Facility Name
Teva Investigational Site 524
City
Bucharest
Country
Romania
Facility Name
Teva Investigational Site 520
City
Cluj-Napoca
Country
Romania
Facility Name
Teva Investigational Site 521
City
Iasi
Country
Romania
Facility Name
Teva Investigational Site 522
City
Targu Mures
Country
Romania
Facility Name
Teva Investigational Site 543
City
Moscow
Country
Russian Federation
Facility Name
Teva Investigational Site 544
City
Moscow
Country
Russian Federation
Facility Name
Teva Investigational Site 554
City
Moscow
Country
Russian Federation
Facility Name
Teva Investigational Site 556
City
Moscow
Country
Russian Federation
Facility Name
Teva Investigational Site 558
City
Moscow
Country
Russian Federation
Facility Name
Teva Investigational Site 559
City
Moscow
Country
Russian Federation
Facility Name
Teva Investigational Site 557
City
Novosibirsk
Country
Russian Federation
Facility Name
Teva Investigational Site 541
City
St. Petersburg
Country
Russian Federation
Facility Name
Teva Investigational Site 540
City
St.Petersburg
Country
Russian Federation
Facility Name
Teva Investigational Site 563
City
Bradejov
Country
Slovakia
Facility Name
Teva Investigational Site 561
City
Levice
Country
Slovakia
Facility Name
Teva Investigational Site 560
City
Spisska Nova Ves
Country
Slovakia
Facility Name
Teva Investigational Site 562
City
Topolcany
Country
Slovakia
Facility Name
Teva Investigational Site 764
City
Kaohsiung
Country
Taiwan
Facility Name
Teva Investigational Site 765
City
Taichung
Country
Taiwan
Facility Name
Teva Investigational Site 760
City
Taipei
Country
Taiwan
Facility Name
Teva Investigational Site 761
City
Taipei
Country
Taiwan
Facility Name
Teva Investigational Site 763
City
Taoyuan
Country
Taiwan
Facility Name
Teva Investigational Site 621
City
Dnipropetrovsk
Country
Ukraine
Facility Name
Teva Investigational Site 629
City
Donetsk
Country
Ukraine
Facility Name
Teva Investigational Site 635
City
Donetsk
Country
Ukraine
Facility Name
Teva Investigational Site 630
City
Ivano-Frankivsk
Country
Ukraine
Facility Name
Teva Investigational Site 620
City
Kharkiv
Country
Ukraine
Facility Name
Teva Investigational Site 633
City
Kharkiv
Country
Ukraine
Facility Name
Teva Investigational Site 622
City
Kyiv
Country
Ukraine
Facility Name
Teva Investigational Site 623
City
Kyiv
Country
Ukraine
Facility Name
Teva Investigational Site 624
City
Kyiv
Country
Ukraine
Facility Name
Teva Investigational Site 625
City
Kyiv
Country
Ukraine
Facility Name
Teva Investigational Site 628
City
Ternopil
Country
Ukraine
Facility Name
Teva Investigational Site 626
City
Vinnytsya
Country
Ukraine
Facility Name
Teva Investigational Site 631
City
Zaporizhzhia
Country
Ukraine
Facility Name
Teva Investigational Site 632
City
Zaporizhzhia
Country
Ukraine

12. IPD Sharing Statement

Citations:
PubMed Identifier
31626990
Citation
Nair P, Bardin P, Humbert M, Murphy KR, Hickey L, Garin M, Vanlandingham R, Chanez P. Efficacy of Intravenous Reslizumab in Oral Corticosteroid-Dependent Asthma. J Allergy Clin Immunol Pract. 2020 Feb;8(2):555-564. doi: 10.1016/j.jaip.2019.09.036. Epub 2019 Oct 15.
Results Reference
derived
PubMed Identifier
31262379
Citation
Carr WW, McDonald M, Meizlik P. Effect of intravenously administered reslizumab on spirometric lung age in patients with moderate-to-severe eosinophilic asthma. Allergy Asthma Proc. 2019 Jul 1;40(4):240-249. doi: 10.2500/aap.2019.40.4225.
Results Reference
derived
PubMed Identifier
30964365
Citation
Han S, Kim S, Kim H, Suh HS. Cost-utility analysis of reslizumab for patients with severe eosinophilic asthma inadequately controlled with high-dose inhaled corticosteroids and long-acting beta2-agonists in South Korea. Curr Med Res Opin. 2019 Sep;35(9):1597-1605. doi: 10.1080/03007995.2019.1605159. Epub 2019 May 16.
Results Reference
derived
PubMed Identifier
30346831
Citation
Bateman ED, Djukanovic R, Castro M, Canvin J, Germinaro M, Noble R, Garin M, Buhl R. Predicting Responders to Reslizumab after 16 Weeks of Treatment Using an Algorithm Derived from Clinical Studies of Patients with Severe Eosinophilic Asthma. Am J Respir Crit Care Med. 2019 Feb 15;199(4):489-495. doi: 10.1164/rccm.201708-1668OC.
Results Reference
derived
PubMed Identifier
30193936
Citation
Weinstein SF, Katial RK, Bardin P, Korn S, McDonald M, Garin M, Bateman ED, Hoyte FCL, Germinaro M. Effects of Reslizumab on Asthma Outcomes in a Subgroup of Eosinophilic Asthma Patients with Self-Reported Chronic Rhinosinusitis with Nasal Polyps. J Allergy Clin Immunol Pract. 2019 Feb;7(2):589-596.e3. doi: 10.1016/j.jaip.2018.08.021. Epub 2018 Sep 5.
Results Reference
derived
PubMed Identifier
28159511
Citation
Brusselle G, Germinaro M, Weiss S, Zangrilli J. Reslizumab in patients with inadequately controlled late-onset asthma and elevated blood eosinophils. Pulm Pharmacol Ther. 2017 Apr;43:39-45. doi: 10.1016/j.pupt.2017.01.011. Epub 2017 Jan 31.
Results Reference
derived
PubMed Identifier
25736990
Citation
Castro M, Zangrilli J, Wechsler ME, Bateman ED, Brusselle GG, Bardin P, Murphy K, Maspero JF, O'Brien C, Korn S. Reslizumab for inadequately controlled asthma with elevated blood eosinophil counts: results from two multicentre, parallel, double-blind, randomised, placebo-controlled, phase 3 trials. Lancet Respir Med. 2015 May;3(5):355-66. doi: 10.1016/S2213-2600(15)00042-9. Epub 2015 Feb 23. Erratum In: Lancet Respir Med. 2015 Apr;3(4):e15. Lancet Respir Med. 2016 Oct;4(10 ):e50.
Results Reference
derived

Learn more about this trial

A Study to Evaluate the Efficacy and Safety of Reslizumab in Patients With Eosinophilic Asthma

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