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A Study Evaluating the Effects of Lebrikizumab on Airway Eosinophilic Inflammation in Participants With Uncontrolled Asthma

Primary Purpose

Asthma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Lebrikizumab
Placebo
Inhaled corticposteroids (ICS)
Second Asthma Controller Medication
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asthma

Eligibility Criteria

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

Inclusion Criteria:

  • Asthma diagnosis for greater than or equal to (>/=) 12 months prior to Visit 1
  • Bronchodilator response demonstrated within the 12 months before Visit 1 or at Visit 1, 2, or 3 of screening
  • Pre-bronchodilator FEV1 of 40 percent (%) - 80% predicted at both Visits 2 and 3
  • On ICS therapy at a total daily dose of 500-2000 mcg of fluticasone propionate dry powder inhaler (DPI) or equivalent for >/= 6 months prior to Visit 1, with no changes within 4 weeks prior to Visit 1, and no anticipated changes throughout the study
  • On an eligible second controller medication (long-acting Beta-agonist [LABA), leukotriene receptor antagonist [LTRA], long-acting muscarinic antagonists [LAMAs] or theophylline) for 6 months prior to Visit 1, with no changes within 4 weeks prior to Visit 1, and no anticipated changes throughout the study
  • Uncontrolled asthma at Visit 1 and/or 2 and at Visit 3
  • Chest X-ray or computed tomography (CT) scan within 12 months prior to Visit 1 or chest X-ray during the screening period (prior to Visit 3) that confirms the absence of other clinically significant lung disease
  • Demonstrated adherence with controller medication during the screening period

Exclusion Criteria:

  • Maintenance oral corticosteroid therapy, defined as daily alternate-day oral corticosteroid maintenance therapy within 3 months prior to Visit 1
  • Treatment with systemic corticosteroids within 4 weeks prior to Visit 1 or during the screening period for any reason, including an acute exacerbation event
  • Any infection requiring hospital, intravenous (IV) or intramuscular (IM) antibiotic treatment or any respiratory infection within 4 weeks prior to Visit 1 or during screening. Any infection requiring oral antibiotic treatment with 2 weeks prior to Visit 1 or during screening, or any parasitic infection within 6 months prior to Visit 1 or during screening
  • Active tuberculosis requiring treatment within 12 months prior to Visit 1
  • Known immunodeficiency, including, but not limited to, human immunodeficiency virus (HIV) infection
  • History of interstitial lung disease, chronic obstructive pulmonary disease (COPD), or other clinically significant lung disease other than asthma
  • Known current malignancy or current evaluation for a potential malignancy
  • Unable to safely undergo elective flexible fiberoptic bronchoscopy
  • Clinically significant medical disease that is uncontrolled despite treatment, that is likely, in the opinion of the investigator, to impact the participant's ability to participate in the study, or to impact the study assessments
  • History of alcohol or drug abuse that would impair or risk the participant's full participation in the study, in the opinion of the investigator
  • Current smoker or history of smoking (greater than [>] 10 pack-years), or unwillingness to abstain from smoking for the duration of the study
  • Past and/or current use of any anti-interleukin (IL)-13 or anti-IL-4/IL-13 therapy, including lebrikizumab
  • Use of a licensed or investigational monoclonal antibody other than anti-IL-13, or anti IL-4/IL-13, including, but not limited to, omalizumab, anti-IL-5, or anti-IL-17, within 6 months or 5 drug half-lives prior to Visit 1 (whichever is longer) or during screening
  • Use of a systemic immunomodulatory or immunosuppressive therapy within 3 months or 5 drug half-lives prior to Visit 1 (whichever is longer) or during screening
  • Use of other investigational therapy within 4 weeks or 5 drug half-lives prior to Visit 1 (whichever is longer) or during screening
  • Initiation of or increase in allergen immunotherapy within 3 months prior to Visit 1 or during screening
  • Body mass index >38 kilograms per square meter (kg/m^2)
  • Body weight <40 kilograms (kg)
  • History of bronchial thermoplasty

Sites / Locations

  • University of Arizona
  • LAC-USC Medical Center
  • University of California Davis Health System; Division of Pulmonary and Critical Care Medicine
  • Yale School of Medicine
  • University of Miami School of Medicine - Sylvester at Deerfield
  • Northwestern University
  • University of Iowa Hospitals & Clinics; Internal Medicine
  • Brigham and Women's Hospital; Pulmonary Division
  • Washington University; Pediatrics
  • Duke University Medical Center
  • Wake Forest University Baptist Medical Center; Gastroenterology & Digestive Health
  • Pen Memory Center
  • Temple University Hospital ; Lung Center
  • University of Pittsburgh Medical Center Health System
  • UTMB Pathology Clinical Services
  • Baylor College of Medicine
  • University of Calgary
  • University of Alberta Hospital-SCC/WCM
  • VGH Research Pavilion
  • McMaster University Health Sciences Center
  • Hôpital Arnaud de Villeneuve
  • Groupe Hospitalier Sud - Hôpital Haut Lévêque
  • Connolly Hospital
  • Skånes Universitetssjukhus, Lund
  • Queen's University Belfast; NICRN Respiratory Research Office
  • Glenfield Hospital
  • St Mary's Hospital
  • The Medicines Evaluation Unit

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Lebrikizumab

Placebo

Arm Description

Participants with uncontrolled asthma on ICS therapy (not specified in the protocol) and a second controller medication, will receive SC injection of lebrikizumab on Days 1 and 8, and on Weeks 4 and 8.

Participants with uncontrolled asthma on ICS therapy (not specified in the protocol) and a second controller medication, will receive SC injection of lebrikizumab matching placebo on Days 1 and 8, and on Weeks 4 and 8.

Outcomes

Primary Outcome Measures

Relative Change From Baseline in the Number of Airway Submucosal Eosinophils per Surface Area of Basal Lamina (Cells per Square Millimeter [Cells/mm^2])

Secondary Outcome Measures

Absolute Change From Baseline in Number of Airway Submucosal Eosinophils per Surface Area of Basal Lamina (Cells/mm^2)
Relative Change From Baseline in the Number of Airway Epithelial Eosinophils per Surface Area of Basal Lamina (Cells/mm^2)
Absolute Change From Baseline in Number of Airway Epithelial Eosinophils per Surface Area of Basal Lamina (Cells/mm^2)
Relative Change From Baseline in Number of Airway Submucosal Eosinophils per Volume of Submucosa (Cells per Cubic Millimeter [Cells/mm^3])
Absolute Change From Baseline in Number of Airway Submucosal Eosinophils per Volume of Submucosa (Cells/mm^3)
Relative Change From Baseline in Number of Airway Epithelial Eosinophils per Volume of Epithelium (Cells/mm^3)
Absolute Change From Baseline in Number of Airway Epithelial Eosinophils per Volume of Epithelium (Cells/mm^3)
Change From Baseline in Blood Eosinophil Count
Change From Baseline in Immunoglobulin E (IgE) Levels
Change From Baseline in Serum Periostin Levels
Change From Baseline in Chemokine Ligand (CCL)-13 Levels
Change From Baseline in CCL-17 Levels
Change From Baseline in Lung Epithelial Cell Chloride Channel Accessory 1 (CLCA1) Gene Expression
Change From Baseline in Lung Epithelial Cell SerpinB2 Gene Expression at Week 12
Change From Baseline in Lung Epithelial Cell CCL-26 Gene Expression
Change From Baseline in Lung Epithelial Cell Nitric Oxide Synthase 2 (NOS2) Gene Expression
Change From Baseline in Lung Epithelial Cell Periostin (POSTN) Gene Expression
Relative Change From Baseline in Fractional Exhaled Nitric Oxide (FeNO)
Relative Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1)
Percentage of Participants With Treatment-Emergent Adverse Events
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Lebrikizumab
Serum Lebrikizumab Concentration at Week 12

Full Information

First Posted
March 26, 2014
Last Updated
September 4, 2017
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT02099656
Brief Title
A Study Evaluating the Effects of Lebrikizumab on Airway Eosinophilic Inflammation in Participants With Uncontrolled Asthma
Official Title
A Phase II, Randomized, Double-Blind, Placebo-Controlled Bronchoscopy Study to Evaluate the Effects of Lebrikizumab on Airway Eosinophilic Inflammation in Patients With Uncontrolled Asthma on Inhaled Corticosteroids and a Second Controller Medication
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
November 6, 2014 (Actual)
Primary Completion Date
October 13, 2016 (Actual)
Study Completion Date
October 13, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche

4. Oversight

5. Study Description

Brief Summary
This Phase II, randomized, double-blind, placebo-controlled, multicenter study will evaluate the effects of lebrikizumab on airway eosinophilic inflammation in participants with uncontrolled asthma who are using inhaled corticosteroid (ICS) treatment and a second controller medication. Enrolled participants will undergo a 3-week screening period during which assessments, including a bronchoscopy procedure, will be made. Participants will subsequently be randomized to receive lebrikizumab or placebo by subcutaneous (SC) injection on Day 1, Day 8, Week 4, and Week 8. Participants will continue their standard of care therapy throughout the study. End of treatment assessments will be taken at Week 12. Total study period, including screening and follow-up, is expected to last 23 weeks.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
64 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lebrikizumab
Arm Type
Experimental
Arm Description
Participants with uncontrolled asthma on ICS therapy (not specified in the protocol) and a second controller medication, will receive SC injection of lebrikizumab on Days 1 and 8, and on Weeks 4 and 8.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants with uncontrolled asthma on ICS therapy (not specified in the protocol) and a second controller medication, will receive SC injection of lebrikizumab matching placebo on Days 1 and 8, and on Weeks 4 and 8.
Intervention Type
Drug
Intervention Name(s)
Lebrikizumab
Other Intervention Name(s)
RO5490255
Intervention Description
Lebrikizumab will be administered by SC injection on Day 1, Day 8, Week 4, and Week 8.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Lebrikizumab matching placebo will be administered by SC injection on Day 1, Day 8, Week 4, and Week 8.
Intervention Type
Drug
Intervention Name(s)
Inhaled corticposteroids (ICS)
Intervention Description
Participants will continue their ICS controller therapy, as they are receiving prior to screening, throughout the study. Protocol does not specify any particular ICS.
Intervention Type
Drug
Intervention Name(s)
Second Asthma Controller Medication
Intervention Description
Participants will continue their asthma controller therapy, as they are receiving prior to screening, throughout the study.
Primary Outcome Measure Information:
Title
Relative Change From Baseline in the Number of Airway Submucosal Eosinophils per Surface Area of Basal Lamina (Cells per Square Millimeter [Cells/mm^2])
Time Frame
From Baseline to Week 12
Secondary Outcome Measure Information:
Title
Absolute Change From Baseline in Number of Airway Submucosal Eosinophils per Surface Area of Basal Lamina (Cells/mm^2)
Time Frame
From Baseline to Week 12
Title
Relative Change From Baseline in the Number of Airway Epithelial Eosinophils per Surface Area of Basal Lamina (Cells/mm^2)
Time Frame
From Baseline to Week 12
Title
Absolute Change From Baseline in Number of Airway Epithelial Eosinophils per Surface Area of Basal Lamina (Cells/mm^2)
Time Frame
From Baseline to Week 12
Title
Relative Change From Baseline in Number of Airway Submucosal Eosinophils per Volume of Submucosa (Cells per Cubic Millimeter [Cells/mm^3])
Time Frame
From Baseline to Week 12
Title
Absolute Change From Baseline in Number of Airway Submucosal Eosinophils per Volume of Submucosa (Cells/mm^3)
Time Frame
From Baseline to Week 12
Title
Relative Change From Baseline in Number of Airway Epithelial Eosinophils per Volume of Epithelium (Cells/mm^3)
Time Frame
From Baseline to Week 12
Title
Absolute Change From Baseline in Number of Airway Epithelial Eosinophils per Volume of Epithelium (Cells/mm^3)
Time Frame
Form Baseline to Week 12
Title
Change From Baseline in Blood Eosinophil Count
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Immunoglobulin E (IgE) Levels
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Serum Periostin Levels
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Chemokine Ligand (CCL)-13 Levels
Time Frame
From Baseline to Week 12
Title
Change From Baseline in CCL-17 Levels
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Lung Epithelial Cell Chloride Channel Accessory 1 (CLCA1) Gene Expression
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Lung Epithelial Cell SerpinB2 Gene Expression at Week 12
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Lung Epithelial Cell CCL-26 Gene Expression
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Lung Epithelial Cell Nitric Oxide Synthase 2 (NOS2) Gene Expression
Time Frame
From Baseline to Week 12
Title
Change From Baseline in Lung Epithelial Cell Periostin (POSTN) Gene Expression
Time Frame
From Baseline to Week 12
Title
Relative Change From Baseline in Fractional Exhaled Nitric Oxide (FeNO)
Time Frame
From Baseline to Week 12
Title
Relative Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1)
Time Frame
From Baseline to Week 12
Title
Percentage of Participants With Treatment-Emergent Adverse Events
Time Frame
From Baseline to Week 20
Title
Percentage of Participants With Anti-Therapeutic Antibodies (ATAs) to Lebrikizumab
Time Frame
Baseline up to Week 20 (assessed at Baseline, Weeks 8 and 20/dosing termination or early termination)
Title
Serum Lebrikizumab Concentration at Week 12
Time Frame
Predose (Hour 0) at Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Asthma diagnosis for greater than or equal to (>/=) 12 months prior to Visit 1 Bronchodilator response demonstrated within the 12 months before Visit 1 or at Visit 1, 2, or 3 of screening Pre-bronchodilator FEV1 of 40 percent (%) - 80% predicted at both Visits 2 and 3 On ICS therapy at a total daily dose of 500-2000 mcg of fluticasone propionate dry powder inhaler (DPI) or equivalent for >/= 6 months prior to Visit 1, with no changes within 4 weeks prior to Visit 1, and no anticipated changes throughout the study On an eligible second controller medication (long-acting Beta-agonist [LABA), leukotriene receptor antagonist [LTRA], long-acting muscarinic antagonists [LAMAs] or theophylline) for 6 months prior to Visit 1, with no changes within 4 weeks prior to Visit 1, and no anticipated changes throughout the study Uncontrolled asthma at Visit 1 and/or 2 and at Visit 3 Chest X-ray or computed tomography (CT) scan within 12 months prior to Visit 1 or chest X-ray during the screening period (prior to Visit 3) that confirms the absence of other clinically significant lung disease Demonstrated adherence with controller medication during the screening period Exclusion Criteria: Maintenance oral corticosteroid therapy, defined as daily alternate-day oral corticosteroid maintenance therapy within 3 months prior to Visit 1 Treatment with systemic corticosteroids within 4 weeks prior to Visit 1 or during the screening period for any reason, including an acute exacerbation event Any infection requiring hospital, intravenous (IV) or intramuscular (IM) antibiotic treatment or any respiratory infection within 4 weeks prior to Visit 1 or during screening. Any infection requiring oral antibiotic treatment with 2 weeks prior to Visit 1 or during screening, or any parasitic infection within 6 months prior to Visit 1 or during screening Active tuberculosis requiring treatment within 12 months prior to Visit 1 Known immunodeficiency, including, but not limited to, human immunodeficiency virus (HIV) infection History of interstitial lung disease, chronic obstructive pulmonary disease (COPD), or other clinically significant lung disease other than asthma Known current malignancy or current evaluation for a potential malignancy Unable to safely undergo elective flexible fiberoptic bronchoscopy Clinically significant medical disease that is uncontrolled despite treatment, that is likely, in the opinion of the investigator, to impact the participant's ability to participate in the study, or to impact the study assessments History of alcohol or drug abuse that would impair or risk the participant's full participation in the study, in the opinion of the investigator Current smoker or history of smoking (greater than [>] 10 pack-years), or unwillingness to abstain from smoking for the duration of the study Past and/or current use of any anti-interleukin (IL)-13 or anti-IL-4/IL-13 therapy, including lebrikizumab Use of a licensed or investigational monoclonal antibody other than anti-IL-13, or anti IL-4/IL-13, including, but not limited to, omalizumab, anti-IL-5, or anti-IL-17, within 6 months or 5 drug half-lives prior to Visit 1 (whichever is longer) or during screening Use of a systemic immunomodulatory or immunosuppressive therapy within 3 months or 5 drug half-lives prior to Visit 1 (whichever is longer) or during screening Use of other investigational therapy within 4 weeks or 5 drug half-lives prior to Visit 1 (whichever is longer) or during screening Initiation of or increase in allergen immunotherapy within 3 months prior to Visit 1 or during screening Body mass index >38 kilograms per square meter (kg/m^2) Body weight <40 kilograms (kg) History of bronchial thermoplasty
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
University of Arizona
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724-5030
Country
United States
Facility Name
LAC-USC Medical Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Facility Name
University of California Davis Health System; Division of Pulmonary and Critical Care Medicine
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Yale School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
University of Miami School of Medicine - Sylvester at Deerfield
City
Deerfield Beach
State/Province
Florida
ZIP/Postal Code
Suite 200
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
University of Iowa Hospitals & Clinics; Internal Medicine
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Facility Name
Brigham and Women's Hospital; Pulmonary Division
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Washington University; Pediatrics
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27705
Country
United States
Facility Name
Wake Forest University Baptist Medical Center; Gastroenterology & Digestive Health
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157-1045
Country
United States
Facility Name
Pen Memory Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Temple University Hospital ; Lung Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
University of Pittsburgh Medical Center Health System
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
UTMB Pathology Clinical Services
City
Galveston
State/Province
Texas
ZIP/Postal Code
77555-0743
Country
United States
Facility Name
Baylor College of Medicine
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
University of Calgary
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 2T9
Country
Canada
Facility Name
University of Alberta Hospital-SCC/WCM
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2S2
Country
Canada
Facility Name
VGH Research Pavilion
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 1L8
Country
Canada
Facility Name
McMaster University Health Sciences Center
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
Facility Name
Hôpital Arnaud de Villeneuve
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
Groupe Hospitalier Sud - Hôpital Haut Lévêque
City
Pessac
ZIP/Postal Code
33600
Country
France
Facility Name
Connolly Hospital
City
Dublin
ZIP/Postal Code
15
Country
Ireland
Facility Name
Skånes Universitetssjukhus, Lund
City
Lund
ZIP/Postal Code
221 85
Country
Sweden
Facility Name
Queen's University Belfast; NICRN Respiratory Research Office
City
Belfast
ZIP/Postal Code
BT9 7AB
Country
United Kingdom
Facility Name
Glenfield Hospital
City
Leicester
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Facility Name
St Mary's Hospital
City
London
ZIP/Postal Code
W2 1NY
Country
United Kingdom
Facility Name
The Medicines Evaluation Unit
City
Manchester
ZIP/Postal Code
M23 9QZ
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
32909660
Citation
Austin CD, Gonzalez Edick M, Ferrando RE, Solon M, Baca M, Mesh K, Bradding P, Gauvreau GM, Sumino K, FitzGerald JM, Israel E, Bjermer L, Bourdin A, Arron JR, Choy DF, Olsson JK, Abreu F, Howard M, Wong K, Cai F, Peng K, Putnam WS, Holweg CTJ, Matthews JG, Kraft M, Woodruff PG; CLAVIER Investigators. A randomized, placebo-controlled trial evaluating effects of lebrikizumab on airway eosinophilic inflammation and remodelling in uncontrolled asthma (CLAVIER). Clin Exp Allergy. 2020 Dec;50(12):1342-1351. doi: 10.1111/cea.13731. Epub 2020 Oct 4.
Results Reference
derived

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A Study Evaluating the Effects of Lebrikizumab on Airway Eosinophilic Inflammation in Participants With Uncontrolled Asthma

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