Effects of Mepolizumab Compared to Placebo on Airway Physiology in Patients With Eosinophilic Asthma: MEMORY Study (MEMORY)
Primary Purpose
Asthma
Status
Terminated
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
Mepolizumab
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Asthma focused on measuring eosinophilic asthma, mepolizumab, treatment
Eligibility Criteria
Inclusion Criteria:
- Patients must be able to give written informed consent prior to participation in the study, which will include the ability to comply with the requirements and restrictions listed in the consent form.
- Male or female patients at least 18 years
- Physician-diagnosis of asthma and evidence of asthma as documented by either reversibility of airflow obstruction (FEV1 ≥ 12% or 200 ml) demonstrated at visit 1 or visit 2 .
- ICS dose must be ≥ 1000 μg/day BDP or equivalent daily with or without maintenance oral corticosteroids.
- Treatment in the past 12 months with an additional controller medication for at least 3 successive months, e.g., long-acting beta-2-agonist (LABA), leukotriene receptor antagonist (LTRA), or theophylline.
- Persistent airflow obstruction as indicated by a pre-bronchodilator FEV1 < 80% predicted recorded at Visit 1 or < 90% for patients on oral corticosteroids.
- An elevated peripheral blood eosinophil level of ≥ 300/µL that is related to asthma or ≥ 150/µL in patients treated with oral corticosteroids as maintenance therapy demonstrated at visit 1 or in the previous 12 months
- Confirmed history of two or more exacerbations requiring treatment with systemic corticosteroids (intramuscular, intravenous, or oral), in the 12 months prior to visit 1, despite the use of high-dose inhaled corticosteroids. For patients receiving maintenance corticosteroids, the corticosteroid treatment for the exacerbations must have been a two-fold increase or greater in the dose.
Exclusion Criteria:
- Current smokers or former smokers with a smoking history of ≥ 10 pack years (number of pack years = (number of cigarettes per day / 20) x number of years smoked). Patients who have not smoked for ≥ 6 months before visit 1 and have < 10 pack years can be included into the study.
- Presence of a clinically important lung condition other than asthma. This includes current infection, bronchiectasis, pulmonary fibrosis, bronchopulmonary aspergillosis, or diagnoses of emphysema or chronic bronchitis (chronic obstructive pulmonary disease other than asthma) or a history of lung cancer.
- Patients who have received omalizumab [Xolair] within 130 days of Visit 1.
- Patients who have received any biological to treat inflammatory disease within 5 half-lives of visit 1
Sites / Locations
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Pneumologie
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Mepolizumab
Placebo
Arm Description
100 mg SC every 4 weeks for 13 injections
Amount of Placebo corresponding to mepolizumab dose SC every 4 weeks for 13 injections
Outcomes
Primary Outcome Measures
mean change from baseline in pre- and post-bronchodilator FVC at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator forced vital capacity (FVC) at visit 10 (week 24) and at time of response
mean change from baseline in pre- and post-bronchodilator FEV1 at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 second (FEV1) at visit 10 (week 24) and at time of response
mean change from baseline in pre- and post-bronchodilator RV at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator residual volume (RV) at visit 10 (week 24) and at time of response
mean change from baseline in pre- and post-bronchodilator TLC at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator total lung capacity (TLC) at visit 10 (week 24) and at time of response
mean change from baseline in pre- and post-bronchodilator airway resistance at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator airway resistance at visit 10 (week 24) and at time of response
mean change from baseline in pre- and post-bronchodilator IC at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator inspiratory capacity (IC) at visit 10 (week 24) and at time of response
mean change from baseline in pre- and post-bronchodilator CO diffusion capacity at visit 10 (week 24) and at time of response
The primary outcome is the mean change from baseline in pre- and post-bronchodilator CO diffusion capacity at visit 10 (week 24) and at time of response
Secondary Outcome Measures
Mean change from baseline in pre- and post-bronchodilator forced vital capacity (FVC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Mean change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 second (FEV1) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Mean change from baseline in pre- and post-bronchodilator residual volume (RV) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Mean change from baseline in pre- and post-bronchodilator total lung capacity (TLC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Mean change from baseline in pre- and post-bronchodilator airway resistance over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Mean change from baseline in pre- and post-bronchodilator inspiratory capacity (IC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Mean change from baseline in pre- and post-bronchodilator CO diffusion capacity over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Exercise tolerance in a subgroup of patients: Mean change from baseline in exercise endurance time
Mean change from baseline in exercise endurance time during a sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment.
Exercise tolerance in a subgroup of patients: Mean change from baseline in inspiratory capacity (IC)
Mean change from baseline in inspiratory capacity (IC) at rest and at peak during sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment.
Exercise tolerance in a subgroup of patients: Mean change from baseline in exertional dyspnea and leg discomfort (Borg CR10 Scale®)
Mean change from baseline in exertional dyspnea and leg discomfort (Borg CR10 Scale®) during sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment
Time to clinical response and time to change of baseline parameters of clinical Response: sence of smell
Time to clinical response and time to change of baseline parameters of clinical Response: sense of taste
Time to clinical response and time to change of baseline parameters of clinical Response: lung volume
Time to clinical response and time to change of baseline parameters of clinical Response: CO Diffusion capacity
Time to clinical response and time to change of baseline parameters of clinical Response: FEV1 reversibility
Time to clinical response and time to change of baseline parameters of clinical Response: exhaled NO (eNO)
Time to clinical response and time to change of baseline parameters of clinical Response: blood eosinophils
Time to clinical response and time to change of baseline parameters of clinical Response: eosinophilic cationic Protein (ECP)
Time to clinical response and time to change of baseline parameters of clinical Response: blood periostin
Mean change from baseline in Asthma Control Questionnaire (ACQ)
Mean change from baseline in Asthma Quality of Life Questionnaire (AQLQ)
Mean change from baseline in St. George´s Respiratory Questionnaire (SQRG)
Mean change from baseline in Dyspnoe Index (BDI/TDI)
Mean change from baseline in fatique
Mean change from baseline in number of days off school/work over the 48-week treatment period
Time to first clinically significant exacerbation requiring oral or systemic corticosteroids, hospitalization, and/or emergency department (ED) visits
Frequency of clinically significant exacerbations
Time to first exacerbation requiring hospitalization or emergency department (ED) visit
Frequency of exacerbations requiring hospitalization (including intubation and admittance to an intensive care unit (ICU)) or ED visits
GETE rating by physician and patient at time of response and over the 52-week treatment period at pre-specified timepoints (1, 3, 6, 9 and 12 months)
Mean change in proportion of patients with nasal polyps, chronic sinusitis and loss of smell and taste
Clinical response to mepolizumab in relation to asthma parameters which potentially predict clinical response
Clinical response to mepolizumab in relation to asthma parameters which potentially predict clinical response (age at onset and duration of asthma, prior asthma medication, presence of nasal polyps, sense of smell and taste, allergic sensitization (skin prick test, total and specific IgE against aeroallergens and Staph. aureus enterotoxin), reversibility of airflow obstruction, eNO, blood eosinophils, eosinophilic cationic protein (ECP), blood periostin, ANA, ANCA, ECP.
Routine safety assessment (AE and SAE reporting, withdrawals, pregnancy, hematological and clinical chemistry parameters, ECG and vital signs (pulse rate and systolic and diastolic blood pressure))
Routine safety assessments are incorporated throughout and/or at the end of treatment period including AE and SAE reporting, withdrawals, pregnancy, hematological and clinical chemistry parameters, ECG and vital signs (pulse rate and systolic and diastolic blood pressure).
Full Information
NCT ID
NCT02594332
First Posted
August 31, 2015
Last Updated
July 11, 2017
Sponsor
Johannes Gutenberg University Mainz
Collaborators
GlaxoSmithKline
1. Study Identification
Unique Protocol Identification Number
NCT02594332
Brief Title
Effects of Mepolizumab Compared to Placebo on Airway Physiology in Patients With Eosinophilic Asthma: MEMORY Study
Acronym
MEMORY
Official Title
A Randomized, Double-blind, Placebo-controlled, Mono-center Study to Evaluate the Effects of Mepolizumab on Airway Physiology in Patients With Eosinophilic Asthma: the MEMORY Study
Study Type
Interventional
2. Study Status
Record Verification Date
July 2017
Overall Recruitment Status
Terminated
Why Stopped
recruitment problems
Study Start Date
November 17, 2015 (Actual)
Primary Completion Date
May 22, 2017 (Actual)
Study Completion Date
May 22, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Johannes Gutenberg University Mainz
Collaborators
GlaxoSmithKline
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of the MEMORY trial is to compare the effects of mepolizumab with Placebo on airway physiology in patients with eosinophilic asthma
Detailed Description
Asthma with eosinophilic inflammation in the airways and/or blood eosinophilia is associated with clinical severity including the risk of exacerbations and relevant comorbidities (e.g. nasal polyposis). Interleukin-5 (IL-5) is a cytokine essential for eosinophil trafficking and survival. Clinical trials of blocking IL-5 with anti-IL-5 antibodies (mepolizumab and reslizumab) in patients with uncontrolled eosinophilic asthma resulted in an improvement in exacerbation rate and oral corticosteroid use. In some studies with mepolizumab and reslizumab there was a beneficial effect on lung function (FEV1). In addition, many patients described a profound impact on asthma symptoms and quality of life in personal reports which is not uniformly reflected in clinical trials.
The MEMORY trial is the first to primarily evaluate the effect of mepolizumab treatment on pulmonary function in patients with severe eosinophilic asthma. Importantly, using spirometry and bodyplethysmography will allow to evaluate additional parameters beyond FEV1 that more closely mirror the pathophysiological changes and functional aspects of airflow limitation in asthma in real life, e.g. airway resistance, hyperinflation and diffusion capacity. The proposed trial will answer the important questions: if, and if so, which parameters of airway (patho-) physiology as assessed by bodyplethysmography best reflect clinical response to mepolizumab therapy in patients with severe eosinophilic asthma. In addition, the time course to clinical response will be assessed. Equally important, there is only a loose correlation between FEV1 and parameters of asthma control and asthma-related quality of life. This is why another new and important aspect of this trial is to carefully monitor asthma control and asthma quality in life in correlation with lung function changes beyond FEV1. Finally, it is tempting to speculate that the proposed trial will contribute to the question how to best define clinical response to mepolizumab.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma
Keywords
eosinophilic asthma, mepolizumab, treatment
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
29 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Mepolizumab
Arm Type
Experimental
Arm Description
100 mg SC every 4 weeks for 13 injections
Arm Title
Placebo
Arm Type
Experimental
Arm Description
Amount of Placebo corresponding to mepolizumab dose SC every 4 weeks for 13 injections
Intervention Type
Drug
Intervention Name(s)
Mepolizumab
Intervention Description
100 mg SC every 4 weeks for 13 injections
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
mean change from baseline in pre- and post-bronchodilator FVC at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator forced vital capacity (FVC) at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Title
mean change from baseline in pre- and post-bronchodilator FEV1 at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 second (FEV1) at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Title
mean change from baseline in pre- and post-bronchodilator RV at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator residual volume (RV) at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Title
mean change from baseline in pre- and post-bronchodilator TLC at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator total lung capacity (TLC) at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Title
mean change from baseline in pre- and post-bronchodilator airway resistance at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator airway resistance at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Title
mean change from baseline in pre- and post-bronchodilator IC at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator inspiratory capacity (IC) at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Title
mean change from baseline in pre- and post-bronchodilator CO diffusion capacity at visit 10 (week 24) and at time of response
Description
The primary outcome is the mean change from baseline in pre- and post-bronchodilator CO diffusion capacity at visit 10 (week 24) and at time of response
Time Frame
week 24 and time of response
Secondary Outcome Measure Information:
Title
Mean change from baseline in pre- and post-bronchodilator forced vital capacity (FVC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Mean change from baseline in pre- and post-bronchodilator forced expiratory volume in 1 second (FEV1) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Mean change from baseline in pre- and post-bronchodilator residual volume (RV) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Mean change from baseline in pre- and post-bronchodilator total lung capacity (TLC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Mean change from baseline in pre- and post-bronchodilator airway resistance over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Mean change from baseline in pre- and post-bronchodilator inspiratory capacity (IC) over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Mean change from baseline in pre- and post-bronchodilator CO diffusion capacity over the 48-week treatment period at prespecified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 months
Title
Exercise tolerance in a subgroup of patients: Mean change from baseline in exercise endurance time
Description
Mean change from baseline in exercise endurance time during a sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment.
Time Frame
1, 3, 6, 9 and 12 month
Title
Exercise tolerance in a subgroup of patients: Mean change from baseline in inspiratory capacity (IC)
Description
Mean change from baseline in inspiratory capacity (IC) at rest and at peak during sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment.
Time Frame
1, 3, 6, 9 and 12 month
Title
Exercise tolerance in a subgroup of patients: Mean change from baseline in exertional dyspnea and leg discomfort (Borg CR10 Scale®)
Description
Mean change from baseline in exertional dyspnea and leg discomfort (Borg CR10 Scale®) during sub-maximal constant-load cycle ergometry test after 1, 3, 6, 9 and 12 months of treatment
Time Frame
1, 3, 6, 9 and 12 month
Title
Time to clinical response and time to change of baseline parameters of clinical Response: sence of smell
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: sense of taste
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: lung volume
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: CO Diffusion capacity
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: FEV1 reversibility
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: exhaled NO (eNO)
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: blood eosinophils
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: eosinophilic cationic Protein (ECP)
Time Frame
52 weeks
Title
Time to clinical response and time to change of baseline parameters of clinical Response: blood periostin
Time Frame
52 weeks
Title
Mean change from baseline in Asthma Control Questionnaire (ACQ)
Time Frame
52 weeks
Title
Mean change from baseline in Asthma Quality of Life Questionnaire (AQLQ)
Time Frame
52 weeks
Title
Mean change from baseline in St. George´s Respiratory Questionnaire (SQRG)
Time Frame
52 weeks
Title
Mean change from baseline in Dyspnoe Index (BDI/TDI)
Time Frame
52 weeks
Title
Mean change from baseline in fatique
Time Frame
52 weeks
Title
Mean change from baseline in number of days off school/work over the 48-week treatment period
Time Frame
48 weeks
Title
Time to first clinically significant exacerbation requiring oral or systemic corticosteroids, hospitalization, and/or emergency department (ED) visits
Time Frame
52 weeks
Title
Frequency of clinically significant exacerbations
Time Frame
52 weeks
Title
Time to first exacerbation requiring hospitalization or emergency department (ED) visit
Time Frame
52 weeks
Title
Frequency of exacerbations requiring hospitalization (including intubation and admittance to an intensive care unit (ICU)) or ED visits
Time Frame
52 weeks
Title
GETE rating by physician and patient at time of response and over the 52-week treatment period at pre-specified timepoints (1, 3, 6, 9 and 12 months)
Time Frame
1, 3, 6, 9 and 12 month
Title
Mean change in proportion of patients with nasal polyps, chronic sinusitis and loss of smell and taste
Time Frame
52 weeks
Title
Clinical response to mepolizumab in relation to asthma parameters which potentially predict clinical response
Description
Clinical response to mepolizumab in relation to asthma parameters which potentially predict clinical response (age at onset and duration of asthma, prior asthma medication, presence of nasal polyps, sense of smell and taste, allergic sensitization (skin prick test, total and specific IgE against aeroallergens and Staph. aureus enterotoxin), reversibility of airflow obstruction, eNO, blood eosinophils, eosinophilic cationic protein (ECP), blood periostin, ANA, ANCA, ECP.
Time Frame
52 weeks
Title
Routine safety assessment (AE and SAE reporting, withdrawals, pregnancy, hematological and clinical chemistry parameters, ECG and vital signs (pulse rate and systolic and diastolic blood pressure))
Description
Routine safety assessments are incorporated throughout and/or at the end of treatment period including AE and SAE reporting, withdrawals, pregnancy, hematological and clinical chemistry parameters, ECG and vital signs (pulse rate and systolic and diastolic blood pressure).
Time Frame
52 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients must be able to give written informed consent prior to participation in the study, which will include the ability to comply with the requirements and restrictions listed in the consent form.
Male or female patients at least 18 years
Physician-diagnosis of asthma and evidence of asthma as documented by either reversibility of airflow obstruction (FEV1 ≥ 12% or 200 ml) demonstrated at visit 1 or visit 2 .
ICS dose must be ≥ 1000 μg/day BDP or equivalent daily with or without maintenance oral corticosteroids.
Treatment in the past 12 months with an additional controller medication for at least 3 successive months, e.g., long-acting beta-2-agonist (LABA), leukotriene receptor antagonist (LTRA), or theophylline.
Persistent airflow obstruction as indicated by a pre-bronchodilator FEV1 < 80% predicted recorded at Visit 1 or < 90% for patients on oral corticosteroids.
An elevated peripheral blood eosinophil level of ≥ 300/µL that is related to asthma or ≥ 150/µL in patients treated with oral corticosteroids as maintenance therapy demonstrated at visit 1 or in the previous 12 months
Confirmed history of two or more exacerbations requiring treatment with systemic corticosteroids (intramuscular, intravenous, or oral), in the 12 months prior to visit 1, despite the use of high-dose inhaled corticosteroids. For patients receiving maintenance corticosteroids, the corticosteroid treatment for the exacerbations must have been a two-fold increase or greater in the dose.
Exclusion Criteria:
Current smokers or former smokers with a smoking history of ≥ 10 pack years (number of pack years = (number of cigarettes per day / 20) x number of years smoked). Patients who have not smoked for ≥ 6 months before visit 1 and have < 10 pack years can be included into the study.
Presence of a clinically important lung condition other than asthma. This includes current infection, bronchiectasis, pulmonary fibrosis, bronchopulmonary aspergillosis, or diagnoses of emphysema or chronic bronchitis (chronic obstructive pulmonary disease other than asthma) or a history of lung cancer.
Patients who have received omalizumab [Xolair] within 130 days of Visit 1.
Patients who have received any biological to treat inflammatory disease within 5 half-lives of visit 1
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephanie Korn, MD
Organizational Affiliation
Johannes Gutenberg University Mainz
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Pneumologie
City
Mainz
ZIP/Postal Code
55131
Country
Germany
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Effects of Mepolizumab Compared to Placebo on Airway Physiology in Patients With Eosinophilic Asthma: MEMORY Study
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