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Pemirolast in Allergen Challenge (PEMAG) (PEMAG)

Primary Purpose

Allergic Asthma

Status
Terminated
Phase
Phase 2
Locations
Sweden
Study Type
Interventional
Intervention
Pemirolast
Placebo Oral Tablet
Sponsored by
Karolinska University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Allergic Asthma focused on measuring bronchoprovocation, early-late asthmatic reaction, mast cell stabilizer, mast cell mediators, sputum eosinophils

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age 18-65 years inclusive
  • Diagnosed asthma as defined by at least one of the following:

    • response to standard asthma treatment
    • episodic wheezing
    • change in lung function over short periods of time
  • Non-smoker for the past two years and a total of smoking less than 5 pack-years
  • Stable intermittent asthma, only using bronchodilator therapy as needed for the last 4 weeks
  • FEV1 ≥ 75 % of predicted
  • A positive skin prick test to pollen (grass, birch, mugwort) or animal dander (dog, cat) and a history of associated symptoms on exposure.

Exclusion Criteria:

  • Any significant respiratory disease, other than asthma.
  • Subjects with seasonal asthma may not be included if they are in their season and subjects allergic to animal dander must not have a pet on their own or similar close exposure.
  • Use of:

    • Oral, injectable or inhaled glucocorticosteroid treatment for the last 4 weeks prior to inclusion or during the study
    • Inhaled long-acting β2-agonists, anticholinergic bronchodilators, antihistamines, theofyllines, nasal or inhaled cromones and antileukotrienes within 2 weeks of screening
    • Beta-blocking agents.
    • Immunomodulator drugs
    • NSAIDs.
  • Upper or lower respiratory tract infection within 4 weeks of screening
  • Females who are pregnant, intend to be or who are lactating. Female subjects of childbearing potential who are not willing to use adequate contraceptive methods (measures as required by local requirements or practice) during participation in the trial until at least three days after last intake of study treatments. Male subjects not surgically sterilized, who or whose partner is not using adequate contraceptive methods (measures as required by local requirements or practice) during participation in the trial until at least three days after last intake of study drug.
  • Subjects with BMI >30.
  • Evidence (from clinical laboratory tests, physical examination or medical history) of hepatic disease (other than Gilbert´s Syndrome)
  • Evidence (from physical examination or medical history) of any diseases that affects gastrointestinal absorption.
  • A diagnosis of brittle asthma (rapid fluctuations in disease severity).
  • Participation in other study in the four weeks prior to screening.
  • Evidence of drug or alcohol abuse.
  • History of having taken barbiturates or other drugs affecting the liver drug-metabolising enzymes within one month of the start of the trial.
  • Blood donor during the last four months prior to study start and throughout the study.

Sites / Locations

  • Lung and Allergy Research Unit C2-88 Karolinska University Hospital Huddinge

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Pemirolast

Placebo Oral Tablet

Arm Description

Pemirolast 200mg bid 14-16 days

Matching placebo bid 14-16 days

Outcomes

Primary Outcome Measures

Bronchoconstriction measured as fall in FEV1 during the early (EAR) and late (LAR) asthmatic reaction induced by allergen

Secondary Outcome Measures

Mast cell activation measured as urinary excretion of metabolites of lipid mediators (prostaglandins,isoprostanes,leukotrienes,tromboxanes)
Urine samples will be analysed with mass spectrometry (UPLC-MS/MS) and data presented as ng.mmol creatinine-1 for all metabolites
Airway inflammation measured as the percentage of sputum eosinophils
Induced sputum will be collected 7 hours after the last inhaled allergen dose and percentage of eosinophils will be measured

Full Information

First Posted
November 11, 2016
Last Updated
May 6, 2019
Sponsor
Karolinska University Hospital
Collaborators
Experimental Asthma and Allergy Research Unit, Karolinska Institutet, Unit for Chemistry II, Department of Medical Biochemistry, Karolinska Institutet, Occupational and Environmental Medicine, Sahlgrenska UH, Gothenburg, Div Clinical Pharmacology, Karolinska University Hospital, Dept. Respiratory Medicine, University of Amsterdam, Amsterdam, The Centre for Infection Medicine, Karolinska Institutet
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1. Study Identification

Unique Protocol Identification Number
NCT03119714
Brief Title
Pemirolast in Allergen Challenge (PEMAG)
Acronym
PEMAG
Official Title
A Placebo-controlled, Cross-over, Study to Assess the Efficacy of the Oral Mast Cell Inhibitor Pemirolast in Allergen-induced Airway Obstruction and Inflammation in Subjects With Allergic Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
May 2019
Overall Recruitment Status
Terminated
Why Stopped
Due to results from other studies regarding efficacy of pemirolast
Study Start Date
November 2016 (undefined)
Primary Completion Date
February 2018 (Actual)
Study Completion Date
February 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Karolinska University Hospital
Collaborators
Experimental Asthma and Allergy Research Unit, Karolinska Institutet, Unit for Chemistry II, Department of Medical Biochemistry, Karolinska Institutet, Occupational and Environmental Medicine, Sahlgrenska UH, Gothenburg, Div Clinical Pharmacology, Karolinska University Hospital, Dept. Respiratory Medicine, University of Amsterdam, Amsterdam, The Centre for Infection Medicine, Karolinska Institutet

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to establish the influence of the non-steroidal candidate-drug pemirolast on allergen-induced airway obstruction and inflammation in allergic subjects with asthma. Pemirolast is an orally available inhibitor of the release of mast cell mediators. The study will therefore test the hypothesis that global inhibition of the mast cell, resulting in decreased production of most of its mediator molecules, will provide a highly significant anti-asthmatic effect.
Detailed Description
This is a crossover randomized double blind, placebo-controlled study where the early and late response to allergen inhalation challenge will be compared during two treatment periods, with pemirolast 200 mg bid for 14 (to 16) days and matching placebo, respectively. Non-smoking female and male subjects (n = 12-15) with intermittent atopic asthma, requiring only β2-agonists to treat their asthma, will be recruited. A total of twelve subjects who demonstrate an early and a late asthmatic response to inhaled allergen challenge are required to complete the study for the primary end-point. The sample size is sufficient according to experience from a large number of studies and published power calculations of the model. The effects of pemirolast have never been studied before in an allergen provocation model. Primary variable is the effect of treatment on the mean maximum fall in forced expiratory volume in one second (FEV1) during the early and the late asthmatic reactions induced by allergen. Secondary variables are the effect on mast cell activation and airway inflammation measured as the urinary excretion of metabolites of prostaglandins and other lipid mediators and the percentage of sputum eosinophils, respectively. Tertiary variables are the effect of treatment on airway responsiveness expressed as the provocative dose of methacholine causing 20 per cent decrease in FEV1 (PD20FEV1), as well as biomarkers of airway inflammation in saliva, sputum, exhaled air and blood.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Allergic Asthma
Keywords
bronchoprovocation, early-late asthmatic reaction, mast cell stabilizer, mast cell mediators, sputum eosinophils

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Pemirolast
Arm Type
Active Comparator
Arm Description
Pemirolast 200mg bid 14-16 days
Arm Title
Placebo Oral Tablet
Arm Type
Placebo Comparator
Arm Description
Matching placebo bid 14-16 days
Intervention Type
Drug
Intervention Name(s)
Pemirolast
Other Intervention Name(s)
CRD 007
Intervention Description
Treatment with pemirolast 200 mg bid for 14-16 days
Intervention Type
Drug
Intervention Name(s)
Placebo Oral Tablet
Intervention Description
Treatment with placebo bid for 14-16 days
Primary Outcome Measure Information:
Title
Bronchoconstriction measured as fall in FEV1 during the early (EAR) and late (LAR) asthmatic reaction induced by allergen
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Secondary Outcome Measure Information:
Title
Mast cell activation measured as urinary excretion of metabolites of lipid mediators (prostaglandins,isoprostanes,leukotrienes,tromboxanes)
Description
Urine samples will be analysed with mass spectrometry (UPLC-MS/MS) and data presented as ng.mmol creatinine-1 for all metabolites
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Title
Airway inflammation measured as the percentage of sputum eosinophils
Description
Induced sputum will be collected 7 hours after the last inhaled allergen dose and percentage of eosinophils will be measured
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Other Pre-specified Outcome Measures:
Title
Airway responsiveness expressed as methacholine PD20FEV1
Description
Change in methacholine responsiveness after the allergen challenge will be compared during the two treatment periods
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Title
Measurement of inflammatory biomarkers in saliva
Description
Saliva is collected before and after challenges to monitor activation of mast cells and other inflammatory pathways
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Title
Measurement of biomarkers in blood
Description
Venous blood samples are collected at clinic visits for asthma biomarkers. Biomarkers are taken before and after challenges according to sub-protocols specific for each analyte.
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Title
Measurement of biomarkers in sputum
Description
Sputum induction is performed on particular study days to assess inflammatory cell content and to collect sputum supernatant for analysis of biomarkers.
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days
Title
Measurement of biomarkers in exhaled breath samples
Description
Collection of exhaled air using the eNose will be used for exploratory studies of specific volatile and particular components of the exhaled breath
Time Frame
After treatment with pemirolast or matching placebo for 14-16 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-65 years inclusive Diagnosed asthma as defined by at least one of the following: response to standard asthma treatment episodic wheezing change in lung function over short periods of time Non-smoker for the past two years and a total of smoking less than 5 pack-years Stable intermittent asthma, only using bronchodilator therapy as needed for the last 4 weeks FEV1 ≥ 75 % of predicted A positive skin prick test to pollen (grass, birch, mugwort) or animal dander (dog, cat) and a history of associated symptoms on exposure. Exclusion Criteria: Any significant respiratory disease, other than asthma. Subjects with seasonal asthma may not be included if they are in their season and subjects allergic to animal dander must not have a pet on their own or similar close exposure. Use of: Oral, injectable or inhaled glucocorticosteroid treatment for the last 4 weeks prior to inclusion or during the study Inhaled long-acting β2-agonists, anticholinergic bronchodilators, antihistamines, theofyllines, nasal or inhaled cromones and antileukotrienes within 2 weeks of screening Beta-blocking agents. Immunomodulator drugs NSAIDs. Upper or lower respiratory tract infection within 4 weeks of screening Females who are pregnant, intend to be or who are lactating. Female subjects of childbearing potential who are not willing to use adequate contraceptive methods (measures as required by local requirements or practice) during participation in the trial until at least three days after last intake of study treatments. Male subjects not surgically sterilized, who or whose partner is not using adequate contraceptive methods (measures as required by local requirements or practice) during participation in the trial until at least three days after last intake of study drug. Subjects with BMI >30. Evidence (from clinical laboratory tests, physical examination or medical history) of hepatic disease (other than Gilbert´s Syndrome) Evidence (from physical examination or medical history) of any diseases that affects gastrointestinal absorption. A diagnosis of brittle asthma (rapid fluctuations in disease severity). Participation in other study in the four weeks prior to screening. Evidence of drug or alcohol abuse. History of having taken barbiturates or other drugs affecting the liver drug-metabolising enzymes within one month of the start of the trial. Blood donor during the last four months prior to study start and throughout the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Barbro Dahlén, MD,PhD
Organizational Affiliation
Lung and Allergy Clinic, Karolinska UH
Official's Role
Principal Investigator
Facility Information:
Facility Name
Lung and Allergy Research Unit C2-88 Karolinska University Hospital Huddinge
City
Stockholm
ZIP/Postal Code
14186
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Not planing to share data

Learn more about this trial

Pemirolast in Allergen Challenge (PEMAG)

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