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Crossover Trial to Assess Efficacy and Safety of Inhaled AQ001S Compared to a Budesonide Suspension in Mild Asthmatics (BOREAS)

Primary Purpose

Asthma

Status
Completed
Phase
Phase 1
Locations
Belgium
Study Type
Interventional
Intervention
AQ001S 0.125 mg/ml
Budesonide 0.125 mg/ml inhalation suspension
Sponsored by
Aquilon Pharmaceuticals S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asthma

Eligibility Criteria

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

Inclusion Criteria:

  • Body mass index between 18.5 and 29 kg/m2.
  • Documented clinical diagnosis of stable, persistent, asthma for at least 3 months
  • Subjects who are ICS-naïve for minimum 60 days at Screening Visit.
  • Positive methacholine (MCh) challenge test (concentration of MCh provoking an FEV1 fall of 20% [PC20] < 8 mg/ml or dose of MCh provoking an FEV1 fall of 20% [PD20] < 0.2 mg) in the last year.
  • Post-bronchodilator FEV1 at least 80% of the predicted, documented in the last year.
  • Clinical laboratory test results, 12-lead electrocardiogram (ECG), blood pressure and heart rate (supine) within normal reference range or judged to be not clinically significant by the Investigator.
  • Female subjects of childbearing potential should have a negative pregnancy test at Screening Visit and use a highly effective method of contraception.
  • Reliable subjects who are willing to be available for the duration of the clinical trial and willing to comply with clinical trial procedures.
  • Subjects who have the ability to understand the requirements of the clinical trial.
  • Subjects who have given written informed consent.

Exclusion Criteria:

  • Current smokers or recent (< 8 weeks) ex-smokers or ex-smokers if > 10 pack-years.
  • Pregnant or breastfeeding female subjects.
  • Inability to carry out pulmonary function testing.
  • FEV1 < 70%.
  • History of near-fatal asthma and/or intensive care unit admission for asthma symptoms.
  • Exacerbations of asthma requiring oral steroids, hospitalization or change in asthma treatment in the previous three months.
  • Evidence of symptomatic chronic or acute respiratory infection in the previous 8 weeks.
  • Diagnosis of chronic obstructive pulmonary disease (COPD) or bronchiectasis.
  • Pulmonary malformations, tuberculosis, cystic fibrosis.
  • History of hypersensitivity or existing contraindication to budesonide or any other Investigational Medicinal Product (IMP) ingredients.
  • Untreated oral candidiasis.
  • Immunosuppressive treatment, including systemic corticosteroids (e.g., oral, parenteral, ocular, nasal), within 28 days before Screening Visit.
  • Use of ICS within 60 days before Screening Visit.
  • Use of anti-leukotrienes, immunoglobulins, beta-blockers, digitalis, amiodarone, antifungals, macrolides, antidepressants, monoamine oxidase inhibitors, antiretroviral drugs, cholinesterase inhibitors, histamine, theophylline, non-steroidal anti-inflammatory drugs, anticholinergic drugs, neuroleptics, curariform drugs, antihistaminic (anti-H1) drugs, calcium channel blockers, long acting beta2-antagonists, mast cell stabilizers (e.g. natrium cromoglycate).
  • History of alcohol or drug abuse.
  • Unstable or life-threatening cardiac disease
  • History or presence of prolonged QT interval (> 470 ms), or any other clinically significant ECG abnormalities as judged by the Investigator based on 12-lead ECG recordings at Screening Visit.
  • Diabetes mellitus.
  • Neuropsychiatric diseases.
  • Clinically relevant laboratory abnormalities at Screening Visit.
  • Blood or plasma donation within 30 days prior to Screening Visit.
  • History or presence of malignancy of any system organ class (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years prior to Screening Visit, regardless of whether there is evidence of local recurrence or metastases.
  • Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of drugs, or which may jeopardize the subject in case of participation in the clinical trial.
  • History or presence of any other clinically relevant disease of any major system organ class (e.g. cardiovascular, pulmonary, renal, hepatic, gastrointestinal, reproductive, endocrinological, neurological, psychiatric or orthopedic disease) as judged by the Investigator.
  • Human immunodeficiency virus (HIV) and severe acute respiratory syndrome (SARS)-CoV-2 infections.
  • Subjects who participated in an investigational trial within the 12 weeks prior to the start of the trial.

Sites / Locations

  • Pneumocare SPRL

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

AQ001S 0.125 mg/ml

budesonide inhalation suspension 0.125 mg/ml

Arm Description

AQ001S 0.125 mg/ml is a budesonide inhalation solution administered by nebulization once daily.

Budesonide 0.125 mg/ml is a budesonide inhalation suspension administered by nebulization once daily.

Outcomes

Primary Outcome Measures

Change in PC20 assessed by methacholine (MCh) challenge test
At Visit 1 (baseline), Visit 2 (28-day treatment period 1) and Visit 4 (28-day treatment period 2), a MCh challenge test will be performed, i.e. up to the administration of a concentration of MCh provoking an FEV1 fall of 20% (PC20). FEV1 is measured by spirometry. The change in PC20 from baseline to the end of each period (two periods) will be assessed.
Incidence of Treatment-Emergent Adverse Events
Incidence of Treatment-Emergent Adverse Events as assessed by collection of (Serious) Adverse Events, general and local tolerability and hypothalamic-pituitary-adrenal (HPA) axis function

Secondary Outcome Measures

Change in FeNO measurements
Fractional exhaled nitric oxide (FeNO) measurements at Visit 1 (baseline), Visit 2 (treatment period 1) and Visit 4 (treatment period 2)
Change in blood eosinophil counts
Blood eosinophil counts at Visit 1 (baseline), Visit 2 (treatment period 1) and Visit 4 (treatment period 2)
Asthma symptoms
Day- and night-time of asthma symptoms over the treatment periods
Single dose budesonide levels in plasma
Budesonide PK level in plasma measured at Visit 1 (baseline) and following the first single dose treatment
Budesonide levels in plasma
Budesonide PK level in plasma measured at Visit 2 (end of treatment period 1) and Visit 4 (end of treatment period 2). Blood samples will be performed at pre-dose and at 10, 20, 45, 120, 240 and 360 minutes after IMP administration (abridged PK).

Full Information

First Posted
May 31, 2021
Last Updated
June 8, 2023
Sponsor
Aquilon Pharmaceuticals S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT04933383
Brief Title
Crossover Trial to Assess Efficacy and Safety of Inhaled AQ001S Compared to a Budesonide Suspension in Mild Asthmatics
Acronym
BOREAS
Official Title
A Prospective, Active-controlled, Randomized, Open Label, Single-center, Multiple Dose, Crossover Clinical Trial to Assess the Efficacy, Safety and PK of AQ001S Compared to a Budesonide Inhalation Suspension in Adults With Mild Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Completed
Study Start Date
July 23, 2021 (Actual)
Primary Completion Date
December 31, 2022 (Actual)
Study Completion Date
January 31, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aquilon Pharmaceuticals S.A.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a prospective, active-controlled, randomized, open label, single-center, multiple dose, two-period crossover clinical trial to assess the efficacy, safety and pharmacokinetics of AQ001S compared to a budesonide inhalation suspension (comparator) in adults with mild asthma. Both treatments will be administered by nebulization.
Detailed Description
Adults patients with mild asthma (18 to 65 years old), who are 'inhaled corticosteroid (ICS)'-naïve for minimum 60 days at Screening Visit will be enrolled in the study. The patients will be treated for 28 days. The primary endpoint will be assessed by a provocative concentration of methacholine that results in a 20% drop (PC20) in the first second forced expiratory volume (FEV1) as determined by methacholine challenge test. The pharmacokinetics (PK) endpoint, i.e. PK profile of budesonide in plasma, and pharmacodynamics (PD) endpoints, i.e. recording of symptom scores, use of reliever drugs as needed, biomarkers of airway inflammation and pulmonary function tests will be assessed during the study.

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 1, Phase 2
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
23 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AQ001S 0.125 mg/ml
Arm Type
Experimental
Arm Description
AQ001S 0.125 mg/ml is a budesonide inhalation solution administered by nebulization once daily.
Arm Title
budesonide inhalation suspension 0.125 mg/ml
Arm Type
Active Comparator
Arm Description
Budesonide 0.125 mg/ml is a budesonide inhalation suspension administered by nebulization once daily.
Intervention Type
Drug
Intervention Name(s)
AQ001S 0.125 mg/ml
Other Intervention Name(s)
budesonide inhalation solution 0.125 mg/ml
Intervention Description
administered by nebulization once daily
Intervention Type
Drug
Intervention Name(s)
Budesonide 0.125 mg/ml inhalation suspension
Other Intervention Name(s)
Budesonide inhalation suspension 0.125 mg/ml
Intervention Description
administered by nebulization once daily
Primary Outcome Measure Information:
Title
Change in PC20 assessed by methacholine (MCh) challenge test
Description
At Visit 1 (baseline), Visit 2 (28-day treatment period 1) and Visit 4 (28-day treatment period 2), a MCh challenge test will be performed, i.e. up to the administration of a concentration of MCh provoking an FEV1 fall of 20% (PC20). FEV1 is measured by spirometry. The change in PC20 from baseline to the end of each period (two periods) will be assessed.
Time Frame
At the end of Period 1 and end of Period 2 (each period is 29 days)
Title
Incidence of Treatment-Emergent Adverse Events
Description
Incidence of Treatment-Emergent Adverse Events as assessed by collection of (Serious) Adverse Events, general and local tolerability and hypothalamic-pituitary-adrenal (HPA) axis function
Time Frame
Over the treatment period, up to 29-day treatment period
Secondary Outcome Measure Information:
Title
Change in FeNO measurements
Description
Fractional exhaled nitric oxide (FeNO) measurements at Visit 1 (baseline), Visit 2 (treatment period 1) and Visit 4 (treatment period 2)
Time Frame
At the end of Period 1 and Period 2 (each period is 29 days)
Title
Change in blood eosinophil counts
Description
Blood eosinophil counts at Visit 1 (baseline), Visit 2 (treatment period 1) and Visit 4 (treatment period 2)
Time Frame
At the end of Period 1 and Period 2 (each period is 29 days)
Title
Asthma symptoms
Description
Day- and night-time of asthma symptoms over the treatment periods
Time Frame
29-day treatment period
Title
Single dose budesonide levels in plasma
Description
Budesonide PK level in plasma measured at Visit 1 (baseline) and following the first single dose treatment
Time Frame
1-day treatment
Title
Budesonide levels in plasma
Description
Budesonide PK level in plasma measured at Visit 2 (end of treatment period 1) and Visit 4 (end of treatment period 2). Blood samples will be performed at pre-dose and at 10, 20, 45, 120, 240 and 360 minutes after IMP administration (abridged PK).
Time Frame
At Day 28 of Period 1 and at Day 28 of Period 2

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: Body mass index between 18.5 and 29 kg/m2. Documented clinical diagnosis of stable, persistent, asthma for at least 3 months Subjects who are ICS-naïve for minimum 60 days at Screening Visit. Positive methacholine (MCh) challenge test (concentration of MCh provoking an FEV1 fall of 20% [PC20] < 8 mg/ml or dose of MCh provoking an FEV1 fall of 20% [PD20] < 0.2 mg) in the last year. Post-bronchodilator FEV1 at least 80% of the predicted, documented in the last year. Clinical laboratory test results, 12-lead electrocardiogram (ECG), blood pressure and heart rate (supine) within normal reference range or judged to be not clinically significant by the Investigator. Female subjects of childbearing potential should have a negative pregnancy test at Screening Visit and use a highly effective method of contraception. Reliable subjects who are willing to be available for the duration of the clinical trial and willing to comply with clinical trial procedures. Subjects who have the ability to understand the requirements of the clinical trial. Subjects who have given written informed consent. Exclusion Criteria: Current smokers or recent (< 8 weeks) ex-smokers or ex-smokers if > 10 pack-years. Pregnant or breastfeeding female subjects. Inability to carry out pulmonary function testing. FEV1 < 70%. History of near-fatal asthma and/or intensive care unit admission for asthma symptoms. Exacerbations of asthma requiring oral steroids, hospitalization or change in asthma treatment in the previous three months. Evidence of symptomatic chronic or acute respiratory infection in the previous 8 weeks. Diagnosis of chronic obstructive pulmonary disease (COPD) or bronchiectasis. Pulmonary malformations, tuberculosis, cystic fibrosis. History of hypersensitivity or existing contraindication to budesonide or any other Investigational Medicinal Product (IMP) ingredients. Untreated oral candidiasis. Immunosuppressive treatment, including systemic corticosteroids (e.g., oral, parenteral, ocular, nasal), within 28 days before Screening Visit. Use of ICS within 60 days before Screening Visit. Use of anti-leukotrienes, immunoglobulins, beta-blockers, digitalis, amiodarone, antifungals, macrolides, antidepressants, monoamine oxidase inhibitors, antiretroviral drugs, cholinesterase inhibitors, histamine, theophylline, non-steroidal anti-inflammatory drugs, anticholinergic drugs, neuroleptics, curariform drugs, antihistaminic (anti-H1) drugs, calcium channel blockers, long acting beta2-antagonists, mast cell stabilizers (e.g. natrium cromoglycate). History of alcohol or drug abuse. Unstable or life-threatening cardiac disease History or presence of prolonged QT interval (> 470 ms), or any other clinically significant ECG abnormalities as judged by the Investigator based on 12-lead ECG recordings at Screening Visit. Diabetes mellitus. Neuropsychiatric diseases. Clinically relevant laboratory abnormalities at Screening Visit. Blood or plasma donation within 30 days prior to Screening Visit. History or presence of malignancy of any system organ class (other than localized basal cell carcinoma of the skin), treated or untreated, within the past 5 years prior to Screening Visit, regardless of whether there is evidence of local recurrence or metastases. Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of drugs, or which may jeopardize the subject in case of participation in the clinical trial. History or presence of any other clinically relevant disease of any major system organ class (e.g. cardiovascular, pulmonary, renal, hepatic, gastrointestinal, reproductive, endocrinological, neurological, psychiatric or orthopedic disease) as judged by the Investigator. Human immunodeficiency virus (HIV) and severe acute respiratory syndrome (SARS)-CoV-2 infections. Subjects who participated in an investigational trial within the 12 weeks prior to the start of the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jean-Benoît Martinot
Organizational Affiliation
Pneumocare SPRL
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pneumocare SPRL
City
Erpent
State/Province
Namur
ZIP/Postal Code
5101
Country
Belgium

12. IPD Sharing Statement

Plan to Share IPD
No

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Crossover Trial to Assess Efficacy and Safety of Inhaled AQ001S Compared to a Budesonide Suspension in Mild Asthmatics

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