Study of Dexpramipexole Chronic Sinusitis With Nasal Polyps and Eosinophilia (CS201)
Primary Purpose
Chronic Sinusitis With Nasal Polyps and Eosinophilia
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
dexpramipexole
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Sinusitis With Nasal Polyps and Eosinophilia focused on measuring Sinusitis, Rhinosinusitis, CRS, CRSwNP, CSNP-E, Nasal polyps, Nasal polyposis, Eosinophilia, Asthma
Eligibility Criteria
Inclusion Criteria:
- Male or female >18 or <70 years of age
- Willing to practice effective contraception during the study and be willing and able to continue contraception for 1 month (females) or 3 months (males) after the last dose of study treatment
- Confirmed diagnosis of chronic sinusitis with nasal polyps
- Documented history of nasal eosinophilia
- Documented peripheral absolute eosinophil count >300 cells/μL
- Bilateral total polyp score of >4
- Sino-nasal outcome test (SNOT-22) score of >7
- Using an intranasal corticosteroid spray or irrigation (< 1000 μg/day beclomethasone or equivalent)
Exclusion Criteria:
- Acute sinusitis, concurrent nasal infection, or subjects who have had a nasal or upper respiratory tract infection within 2 weeks prior to baseline
- CT scan suggestive of allergic fungal rhinosinusitis
- Nasal septal deviation that would occlude at least one nostril
- Nasal surgery (including polypectomy) within 6 months prior to baseline
- History of more than 5 sinonasal surgeries requiring general anesthesia
- History of more than 2 sinonasal surgeries that changed the lateral wall of the nose
- History of cystic fibrosis, primary ciliary's dysfunction or Kartagener's syndrome
- History of diagnosis with a parasitic infection
- Hospitalization or emergency treatment for the treatment of asthma two or more times in the 12 months prior to baseline
- Hospitalization for an acute asthmatic attack within 4 weeks prior to baseline
- Forced expiratory volume (FEV1) of <60% of predicted normal range
- Treatment with a systemic corticosteroid or intra-polyp corticosteroid within 8 weeks prior to baseline or anticipated need for systemic corticosteroids during the study treatment period
- Utilization of rescue oral corticosteroids for asthma or chronic sinusitis exacerbation more than one time within the past 1 year
- Treatment with an investigational drug in the previous 30 days or 5-half-lives, whichever is longer
- Treatment with a monoclonal antibody therapy including omalizumab (Xolair®), within 5-half-lives
- Treatment with zileuton (Zyflo®) within 4 weeks of baseline
- Treatment with pramipexole (Mirapex®) within 4 weeks of baseline
- History of malignancy, including solid tumors and hematologic malignancies (except basal cell and squamous cell cancers of the skin that have been completely excised and cured)
- History of human immunodeficiency virus (HIV) or hepatitis B or C
- History of unstable or severe cardiac, hepatic, or renal disease, or other medically significant illness
- Medical or other condition likely to interfere with subject's ability to undergo study procedures, adhere to visit schedule or comply with study requirements
- Absolute neutrophil count <2000 cells/μL at screening, or any documented history of neutropenia
- Total IgE >1500 IU/ml at any visit prior to baseline
- Renal dysfunction, defined as an estimated glomerular filtration rate (eGFR) of ≤80 mg/dL at screening (estimation of creatinine clearance using the MDRD formula)
- History of long QT syndrome or arrhythmia
- Prolongation of QT/QTc interval (e.g., repeated demonstration of a QT/QTc interval >450 ms) at screening or pre-dose on day 1
Clinically important abnormalities in resting ECG that may interfere with the interpretation of QTc interval changes at screening or pre-dose on day 1, including any of the following:
- PR interval >210 ms;
- QRS >110 ms;
- Heart rate <45 bpm or >100 bpm (average of 3 assessments).
- Pregnant women or women breastfeeding
Sites / Locations
- ENT Associates of South Florida
- Johns Hopkins University
- Brigham and Women's Hospital
- Wake Research Associates
- University of Pennsylvania
- University of Pittsburgh School of Medicine
- University of Virginia
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
dexpramipexole
Arm Description
dexpramipexole 150 mg BID
Outcomes
Primary Outcome Measures
Ratio to Baseline in Peripheral Blood Eosinophil Counts After 6 Months of Treatment
Change in peripheral blood eosinophil (measured in cells/μL) from baseline to month 6 is presented as ratio to baseline.
Change From Baseline in Total Polyp Score (TPS) After 6 Months of Treatment
The change in Nasal Polyp Score (NPS) score after 6 months of treatment is presented. A blinded Central Endoscopy Rater determined the NPS for each nare on a scale of 0 to 4, and the bilateral NPS scores were added to generate the Total Polyp Score (TPS) on a scale of 0 to 8. A lower TPS corresponds to a lower polyp burden.
Secondary Outcome Measures
Number of Subjects With Potentially Clinically Significant Values in Clinical Laboratory Evaluations
Summary of subjects from the safety population who experienced potentially clinically significant values in hand serum chemistry results
Number of Subjects With Potentially Clinically Significant Values in Vital Signs and Weight
Summary of subjects from the safety population who experienced potentially clinically significant values or changes in vital signs or weight
Number of Subjects With Potentially Significant Values in Electrocardiogram Parameters
Summary of subjects from the safety population who experienced potentially significant values in electrocardiogram parameters
Ratio to Baseline in Peripheral Blood Eosinophil Counts After 3 Months of Treatment
Change in peripheral blood eosinophil (measured in cells/μL) from baseline to month 3 is presented as ratio to baseline.
Change From Baseline in TPS After 3 Months of Treatment
The change in Nasal Polyp Score (NPS) score after 3 months of treatment is presented. A blinded Central Endoscopy Rater determined the NPS for each nare on a scale of 0 to 4, and the bilateral NPS scores were added to generate the Total Polyp Score (TPS) on a scale of 0 to 8. A lower TPS corresponds to a lower polyp burden.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02217332
Brief Title
Study of Dexpramipexole Chronic Sinusitis With Nasal Polyps and Eosinophilia
Acronym
CS201
Official Title
Safety and Preliminary Efficacy of Dexpramipexole in Patients With Chronic Sinusitis With Nasal Polyps and Eosinophilia (CSNP-E)
Study Type
Interventional
2. Study Status
Record Verification Date
April 2021
Overall Recruitment Status
Completed
Study Start Date
August 2014 (undefined)
Primary Completion Date
December 14, 2016 (Actual)
Study Completion Date
January 20, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Knopp Biosciences
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Phase 2, open-label, multi-center study to evaluate the clinical effects of oral administration of dexpramipexole for 6 months in subjects with chronic sinusitis with nasal polyps and eosinophilia.
Detailed Description
This open-labelled study will evaluate the safety and preliminary efficacy of dexpramipexole for reducing the number of eosinophils in the peripheral blood and in improving nasal polyp score when administered to 20 subjects with chronic sinusitis with nasal polyps and eosinophilia.
Subjects will received dexpramipexole for up to 6 months and will have safety tests performed monthly and will have efficacy evaluations performed at month 1, month 3, and month 6 after beginning study drug.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Sinusitis With Nasal Polyps and Eosinophilia
Keywords
Sinusitis, Rhinosinusitis, CRS, CRSwNP, CSNP-E, Nasal polyps, Nasal polyposis, Eosinophilia, Asthma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
dexpramipexole
Arm Type
Experimental
Arm Description
dexpramipexole 150 mg BID
Intervention Type
Drug
Intervention Name(s)
dexpramipexole
Other Intervention Name(s)
KNS-760704, BIIB050, RPPX
Intervention Description
Dexpramipexole capsule-shaped film-coated tablets at the dose strength of 150 mg administered orally as 1 tablet twice daily (300 mg/day)
Primary Outcome Measure Information:
Title
Ratio to Baseline in Peripheral Blood Eosinophil Counts After 6 Months of Treatment
Description
Change in peripheral blood eosinophil (measured in cells/μL) from baseline to month 6 is presented as ratio to baseline.
Time Frame
Baseline and Month 6
Title
Change From Baseline in Total Polyp Score (TPS) After 6 Months of Treatment
Description
The change in Nasal Polyp Score (NPS) score after 6 months of treatment is presented. A blinded Central Endoscopy Rater determined the NPS for each nare on a scale of 0 to 4, and the bilateral NPS scores were added to generate the Total Polyp Score (TPS) on a scale of 0 to 8. A lower TPS corresponds to a lower polyp burden.
Time Frame
Baseline and Month 6
Secondary Outcome Measure Information:
Title
Number of Subjects With Potentially Clinically Significant Values in Clinical Laboratory Evaluations
Description
Summary of subjects from the safety population who experienced potentially clinically significant values in hand serum chemistry results
Time Frame
6 months
Title
Number of Subjects With Potentially Clinically Significant Values in Vital Signs and Weight
Description
Summary of subjects from the safety population who experienced potentially clinically significant values or changes in vital signs or weight
Time Frame
6 months
Title
Number of Subjects With Potentially Significant Values in Electrocardiogram Parameters
Description
Summary of subjects from the safety population who experienced potentially significant values in electrocardiogram parameters
Time Frame
6 months
Title
Ratio to Baseline in Peripheral Blood Eosinophil Counts After 3 Months of Treatment
Description
Change in peripheral blood eosinophil (measured in cells/μL) from baseline to month 3 is presented as ratio to baseline.
Time Frame
Baseline and Month 3
Title
Change From Baseline in TPS After 3 Months of Treatment
Description
The change in Nasal Polyp Score (NPS) score after 3 months of treatment is presented. A blinded Central Endoscopy Rater determined the NPS for each nare on a scale of 0 to 4, and the bilateral NPS scores were added to generate the Total Polyp Score (TPS) on a scale of 0 to 8. A lower TPS corresponds to a lower polyp burden.
Time Frame
Baseline and Month 3
Other Pre-specified Outcome Measures:
Title
Ratio to Baseline in Polyp Tissue Eosinophil Count After 6 Months of Treatment
Description
Change in polyp tissue eosinophil count measured as eosinophils/hpf (high powered field) from baseline to month 6 is presented as ratio to baseline.
Time Frame
Baseline and Month 6
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female >18 or <70 years of age
Willing to practice effective contraception during the study and be willing and able to continue contraception for 1 month (females) or 3 months (males) after the last dose of study treatment
Confirmed diagnosis of chronic sinusitis with nasal polyps
Documented history of nasal eosinophilia
Documented peripheral absolute eosinophil count >300 cells/μL
Bilateral total polyp score of >4
Sino-nasal outcome test (SNOT-22) score of >7
Using an intranasal corticosteroid spray or irrigation (< 1000 μg/day beclomethasone or equivalent)
Exclusion Criteria:
Acute sinusitis, concurrent nasal infection, or subjects who have had a nasal or upper respiratory tract infection within 2 weeks prior to baseline
CT scan suggestive of allergic fungal rhinosinusitis
Nasal septal deviation that would occlude at least one nostril
Nasal surgery (including polypectomy) within 6 months prior to baseline
History of more than 5 sinonasal surgeries requiring general anesthesia
History of more than 2 sinonasal surgeries that changed the lateral wall of the nose
History of cystic fibrosis, primary ciliary's dysfunction or Kartagener's syndrome
History of diagnosis with a parasitic infection
Hospitalization or emergency treatment for the treatment of asthma two or more times in the 12 months prior to baseline
Hospitalization for an acute asthmatic attack within 4 weeks prior to baseline
Forced expiratory volume (FEV1) of <60% of predicted normal range
Treatment with a systemic corticosteroid or intra-polyp corticosteroid within 8 weeks prior to baseline or anticipated need for systemic corticosteroids during the study treatment period
Utilization of rescue oral corticosteroids for asthma or chronic sinusitis exacerbation more than one time within the past 1 year
Treatment with an investigational drug in the previous 30 days or 5-half-lives, whichever is longer
Treatment with a monoclonal antibody therapy including omalizumab (Xolair®), within 5-half-lives
Treatment with zileuton (Zyflo®) within 4 weeks of baseline
Treatment with pramipexole (Mirapex®) within 4 weeks of baseline
History of malignancy, including solid tumors and hematologic malignancies (except basal cell and squamous cell cancers of the skin that have been completely excised and cured)
History of human immunodeficiency virus (HIV) or hepatitis B or C
History of unstable or severe cardiac, hepatic, or renal disease, or other medically significant illness
Medical or other condition likely to interfere with subject's ability to undergo study procedures, adhere to visit schedule or comply with study requirements
Absolute neutrophil count <2000 cells/μL at screening, or any documented history of neutropenia
Total IgE >1500 IU/ml at any visit prior to baseline
Renal dysfunction, defined as an estimated glomerular filtration rate (eGFR) of ≤80 mg/dL at screening (estimation of creatinine clearance using the MDRD formula)
History of long QT syndrome or arrhythmia
Prolongation of QT/QTc interval (e.g., repeated demonstration of a QT/QTc interval >450 ms) at screening or pre-dose on day 1
Clinically important abnormalities in resting ECG that may interfere with the interpretation of QTc interval changes at screening or pre-dose on day 1, including any of the following:
PR interval >210 ms;
QRS >110 ms;
Heart rate <45 bpm or >100 bpm (average of 3 assessments).
Pregnant women or women breastfeeding
Facility Information:
Facility Name
ENT Associates of South Florida
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33487
Country
United States
Facility Name
Johns Hopkins University
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21205
Country
United States
Facility Name
Brigham and Women's Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Wake Research Associates
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27612
Country
United States
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
University of Pittsburgh School of Medicine
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
12. IPD Sharing Statement
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Study of Dexpramipexole Chronic Sinusitis With Nasal Polyps and Eosinophilia
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