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An Imaging Study Using PET/CT to Characterize the Effect of Intravenous Reslizumab on Airway Inflammation (DEAR)

Primary Purpose

Asthma

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Reslizumab
Fludeoxyglucose F 18 (FDG)
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 Asthma

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Male or female, 18 through 50 years of age.
  • Females that are either surgically sterile, are 2 years postmenopausal, or have a negative pregnancy test at screening.
  • Females of childbearing potential (not surgically sterile or 2 years postmenopausal), have to use a medically accepted method of contraception and have to agree to continue to use of this method for the duration of the study and for 5 months after study drug administration.
  • Participants with less that 10-pack year history of smoking.
  • Have a previous diagnosis of asthma.
  • Participants taking inhaled fluticasone at a dosage of at least 440 micrograms (mcg) daily, or equivalent.
  • The participant's baseline asthma therapy must be stable for 30 days prior to screening and judged by their treating physician to be able to continue without dosage changes throughout the study.
  • Participants with a blood eosinophil level of at least 400 cells/microliter (cells/μL) at screening. Participants with a blood eosinophil level below 400 cells/μL will be given 2 additional screening opportunities to determine blood eosinophil levels.

    • Additional criteria apply; please contact the investigator for more information.

Exclusion Criteria:

  • Participants requiring treatment with oral, intramuscular, or IV corticosteroids within 6 weeks of the Part 1 baseline visit for an asthma exacerbation.
  • Participants with any other confounding underlying lung disorder including but not limited to: bronchiectasis, chronic obstructive pulmonary disorder, smoking greater than or equal to (≥)10 pack year history, pulmonary fibrosis, emphysema, cystic fibrosis, and lung cancer.
  • Participants diagnosed with diabetes mellitus.
  • Participants with pulmonary conditions and blood eosinophilia other than eosinophilic asthma.
  • Participants with clinically meaningful comorbidity that can interfere with the study schedule or procedures, or compromise the participant's safety.
  • Participants that are current smokers (that is, have smoked within the last 12 months prior to screening).
  • Participants using systemic immunosuppressive, immunomodulating, or other biologic agents (including, but not limited to, anti-IgE mAb, methotrexate, cyclosporin, interferon-α, or anti-tumor necrosis factor mAb) within 6 months prior to screening. Participants whose treatment with anti-IgE mAb therapy (omalizumab) is considered ineffective by their physician may be included as potential participants when:

    1. The omalizumab (Xolair) therapy has been discontinued.
    2. The participant's blood eosinophil level meets inclusion criteria.
  • Participants who have previously received an anti-hIL-5 mAb (for example, reslizumab, mepolizumab [Nucala]) or anti-IL-5 receptor mAb (eg, benralizumab). Participants whose treatment with mepolizumab or benralizumab is considered ineffective by their physician may be included as potential participants when:

    1. The mepolizumab or benralizumab therapy has been discontinued.
    2. The participant's blood eosinophil level meets inclusion criteria.
  • Participants who had concurrent infection or disease that may preclude assessment of active asthma.
  • Participants with a history of concurrent immunodeficiency (human immunodeficiency virus or acquired immunodeficiency syndrome or congenital immunodeficiency).
  • Participants that had an active parasitic infection within 6 months prior to screening.
  • Participants with any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery).
  • Known hypersensitivity to study drug or to FDG/contrast agents
  • Treatment with metformin.
  • Compromised renal function.

    • Additional criteria apply; please contact the investigator for more information.

Sites / Locations

  • Teva Investigational Site 13808

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Part 1: PET/CT Scan

Part 2: Reslizumab

Part 2: Placebo

Arm Description

Healthy participants will have 2 PET/CT scan in Part 1: within 7 days of eligibility being confirmed, and 7 days after the first PET/CT scan. Participants will receive Fluorodeoxyglucose F-18 (FDG) as part of the PET/CT procedures and will provide sputum/blood samples.

Reslizumab 3.0 milligrams/kilogram (mg/kg) will be administered by intravenous (IV) infusion, over 20 to 50 minutes, at Baseline (Day 1) of Part 2. PET/CT scan will be done on Weeks 2, 4 and 6. Participants will receive FDG as part of the PET/CT procedures and will provide sputum/blood samples.

Matching placebo will be administered by IV infusion at Baseline (Day 1) of Part 2. PET/CT scan will be done on Weeks 2, 4 and 6. Participants will receive FDG as part of the PET/CT procedures and will provide sputum/blood samples.

Outcomes

Primary Outcome Measures

Part 1: Average Global Lung Glycolysis (GLG) at Baseline (Day 1)
GLG is the total FDG uptake in the whole lung. A region of interest (ROI) was drawn around lung boundary in each axial slice. Standardized uptake value (SUV) mean and area of each ROI was recorded. Using the formula: area*slice thickness the volume of each slice was calculated. Then the SUVmean of each slice was multiplied by the volume of the corresponding slice, which represented the total FDG uptake in one slice. This number for each slice was summed together to provide GLG of that lung. Average between GLG of right lung and GLG of left lung was reported.
Part 1: Average Global Lung Glycolysis (GLG) at Day 8
GLG is the total FDG uptake in the whole lung. ROI was drawn around lung boundary in each axial slice. SUV mean and area of each ROI was recorded. Using the formula: area*slice thickness the volume of each slice was calculated. Then the SUVmean of each slice was multiplied by the volume of the corresponding slice, which represented the total FDG uptake in one slice. This number for each slice was summed together to provide GLG of that lung. Average between GLG of right lung and GLG of left lung was reported.
Part 2: Change From Baseline to Week 4 in GLG
Part 2: Change From Baseline to Week 4 in Lung Parenchyma (LP) SUV Mean

Secondary Outcome Measures

Part 2: Change From Baseline to Week 4 in Blood Eosinophil Counts
Change From Baseline to Week 4 in Forced Expiratory Volume in 1 Second (FEV1)
Change From Baseline to Week 4 in Fractional Exhaled Nitric Oxide (FeNO)
Change From Baseline to Week 4 in Asthma Quality of Life Questionnaire (AQLQ) Score
Number of Participants With Adverse Events (AEs)
An AE was defined 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. SAEs included death, a life-threatening AE, 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 participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of serious and non-serious AEs regardless of causality is located in 'Reported Adverse Events module'.

Full Information

First Posted
October 14, 2016
Last Updated
November 5, 2021
Sponsor
Teva Branded Pharmaceutical Products R&D, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02937168
Brief Title
An Imaging Study Using PET/CT to Characterize the Effect of Intravenous Reslizumab on Airway Inflammation
Acronym
DEAR
Official Title
Distribution of Eosinophils in Asthma After Reslizumab (DEAR). A 7-Week, Placebo-Controlled, Double-Blinded, Parallel-Group, Imaging Study Using Positron Emission Tomography/Computer Tomography (PET/CT) to Characterize the Effect of Intravenous Reslizumab on Airway Inflammation in Patients With Eosinophilic Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Terminated
Why Stopped
The study was terminated early due to challenges in recruitment. The decision to terminate the study was not related to any safety issues or concerns.
Study Start Date
May 8, 2017 (Actual)
Primary Completion Date
May 24, 2017 (Actual)
Study Completion Date
May 24, 2017 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an exploratory study with the following primary objectives: 1) to establish that PET/CT of the lung can reliably distinguish healthy, non-asthmatic participants from participants with severe asthma and an eosinophilic phenotype and 2) to examine the utility of PET/CT for demonstrating that reslizumab produces a reduction in lung inflammation in participants with severe asthma and an eosinophilic phenotype .

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 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part 1: PET/CT Scan
Arm Type
Experimental
Arm Description
Healthy participants will have 2 PET/CT scan in Part 1: within 7 days of eligibility being confirmed, and 7 days after the first PET/CT scan. Participants will receive Fluorodeoxyglucose F-18 (FDG) as part of the PET/CT procedures and will provide sputum/blood samples.
Arm Title
Part 2: Reslizumab
Arm Type
Experimental
Arm Description
Reslizumab 3.0 milligrams/kilogram (mg/kg) will be administered by intravenous (IV) infusion, over 20 to 50 minutes, at Baseline (Day 1) of Part 2. PET/CT scan will be done on Weeks 2, 4 and 6. Participants will receive FDG as part of the PET/CT procedures and will provide sputum/blood samples.
Arm Title
Part 2: Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo will be administered by IV infusion at Baseline (Day 1) of Part 2. PET/CT scan will be done on Weeks 2, 4 and 6. Participants will receive FDG as part of the PET/CT procedures and will provide sputum/blood samples.
Intervention Type
Drug
Intervention Name(s)
Reslizumab
Intervention Description
Reslizumab will be administered as per the dose and schedule specified in the arm.
Intervention Type
Drug
Intervention Name(s)
Fludeoxyglucose F 18 (FDG)
Intervention Description
FDG will be administered by IV infusion prior to each PET/CT scan.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo matching to reslizumab will be administered as per the schedule specified in the arm.
Primary Outcome Measure Information:
Title
Part 1: Average Global Lung Glycolysis (GLG) at Baseline (Day 1)
Description
GLG is the total FDG uptake in the whole lung. A region of interest (ROI) was drawn around lung boundary in each axial slice. Standardized uptake value (SUV) mean and area of each ROI was recorded. Using the formula: area*slice thickness the volume of each slice was calculated. Then the SUVmean of each slice was multiplied by the volume of the corresponding slice, which represented the total FDG uptake in one slice. This number for each slice was summed together to provide GLG of that lung. Average between GLG of right lung and GLG of left lung was reported.
Time Frame
Baseline (Day 1) of Part 1
Title
Part 1: Average Global Lung Glycolysis (GLG) at Day 8
Description
GLG is the total FDG uptake in the whole lung. ROI was drawn around lung boundary in each axial slice. SUV mean and area of each ROI was recorded. Using the formula: area*slice thickness the volume of each slice was calculated. Then the SUVmean of each slice was multiplied by the volume of the corresponding slice, which represented the total FDG uptake in one slice. This number for each slice was summed together to provide GLG of that lung. Average between GLG of right lung and GLG of left lung was reported.
Time Frame
Day 8
Title
Part 2: Change From Baseline to Week 4 in GLG
Time Frame
Baseline, Week 4
Title
Part 2: Change From Baseline to Week 4 in Lung Parenchyma (LP) SUV Mean
Time Frame
Baseline, Week 4
Secondary Outcome Measure Information:
Title
Part 2: Change From Baseline to Week 4 in Blood Eosinophil Counts
Time Frame
Baseline, Week 4
Title
Change From Baseline to Week 4 in Forced Expiratory Volume in 1 Second (FEV1)
Time Frame
Baseline, Week 4
Title
Change From Baseline to Week 4 in Fractional Exhaled Nitric Oxide (FeNO)
Time Frame
Baseline, Week 4
Title
Change From Baseline to Week 4 in Asthma Quality of Life Questionnaire (AQLQ) Score
Time Frame
Baseline, Week 4
Title
Number of Participants With Adverse Events (AEs)
Description
An AE was defined 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. SAEs included death, a life-threatening AE, 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 participant and required medical intervention to prevent 1 of the outcomes listed in this definition. A summary of serious and non-serious AEs regardless of causality is located in 'Reported Adverse Events module'.
Time Frame
21 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female, 18 through 50 years of age. Females that are either surgically sterile, are 2 years postmenopausal, or have a negative pregnancy test at screening. Females of childbearing potential (not surgically sterile or 2 years postmenopausal), have to use a medically accepted method of contraception and have to agree to continue to use of this method for the duration of the study and for 5 months after study drug administration. Participants with less that 10-pack year history of smoking. Have a previous diagnosis of asthma. Participants taking inhaled fluticasone at a dosage of at least 440 micrograms (mcg) daily, or equivalent. The participant's baseline asthma therapy must be stable for 30 days prior to screening and judged by their treating physician to be able to continue without dosage changes throughout the study. Participants with a blood eosinophil level of at least 400 cells/microliter (cells/μL) at screening. Participants with a blood eosinophil level below 400 cells/μL will be given 2 additional screening opportunities to determine blood eosinophil levels. Additional criteria apply; please contact the investigator for more information. Exclusion Criteria: Participants requiring treatment with oral, intramuscular, or IV corticosteroids within 6 weeks of the Part 1 baseline visit for an asthma exacerbation. Participants with any other confounding underlying lung disorder including but not limited to: bronchiectasis, chronic obstructive pulmonary disorder, smoking greater than or equal to (≥)10 pack year history, pulmonary fibrosis, emphysema, cystic fibrosis, and lung cancer. Participants diagnosed with diabetes mellitus. Participants with pulmonary conditions and blood eosinophilia other than eosinophilic asthma. Participants with clinically meaningful comorbidity that can interfere with the study schedule or procedures, or compromise the participant's safety. Participants that are current smokers (that is, have smoked within the last 12 months prior to screening). Participants using systemic immunosuppressive, immunomodulating, or other biologic agents (including, but not limited to, anti-IgE mAb, methotrexate, cyclosporin, interferon-α, or anti-tumor necrosis factor mAb) within 6 months prior to screening. Participants whose treatment with anti-IgE mAb therapy (omalizumab) is considered ineffective by their physician may be included as potential participants when: The omalizumab (Xolair) therapy has been discontinued. The participant's blood eosinophil level meets inclusion criteria. Participants who have previously received an anti-hIL-5 mAb (for example, reslizumab, mepolizumab [Nucala]) or anti-IL-5 receptor mAb (eg, benralizumab). Participants whose treatment with mepolizumab or benralizumab is considered ineffective by their physician may be included as potential participants when: The mepolizumab or benralizumab therapy has been discontinued. The participant's blood eosinophil level meets inclusion criteria. Participants who had concurrent infection or disease that may preclude assessment of active asthma. Participants with a history of concurrent immunodeficiency (human immunodeficiency virus or acquired immunodeficiency syndrome or congenital immunodeficiency). Participants that had an active parasitic infection within 6 months prior to screening. Participants with any disorder that may interfere with drug absorption, distribution, metabolism, or excretion (including gastrointestinal surgery). Known hypersensitivity to study drug or to FDG/contrast agents Treatment with metformin. Compromised renal function. Additional criteria apply; please contact the investigator for more information.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Teva Medical Expert, MD
Organizational Affiliation
Teva Branded Pharmaceutical Products R&D, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Teva Investigational Site 13808
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States

12. IPD Sharing Statement

Learn more about this trial

An Imaging Study Using PET/CT to Characterize the Effect of Intravenous Reslizumab on Airway Inflammation

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