Effects of Blocking TSLP on Airway Inflammation and the Epithelial Immune-response to Exacerbation Triggers in Patients With COPD (UPSTREAM-COPD)
Primary Purpose
COPD, COPD Exacerbation, COPD Bronchitis
Status
Recruiting
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tezepelumab
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for COPD focused on measuring COPD
Eligibility Criteria
Inclusion Criteria:
- Written informed consent
- A diagnosis of COPD (according to GOLD (GOLD 2021 Report))
- ≥ 10 packyears smoked (current or ex-smokers)
- Age 40 years or older
- Postbronchodilator FEV1 ≥ 30% predicted (and ≥ 1.0L) and < 80% predicted
- Maintenance treatment with LAMA+LABA±ICS (stable dose) for at least 3 months prior to V1
- ≥1 prednisolon and/or antibiotic treated exacerbation in the past 12 months
- Subjects must demonstrate acceptable inhaler and spirometry techniques during screening (as evaluated and in the opinion of study site staff)
- Subjects must demonstrate ≥ 70% compliance with daily inhalers during the screening/run-in
- Females of childbearing potential who are sexually active with a nonsterilized male partner must use a highly effective method of contraception from the time informed consent is obtained and must agree to continue using such precautions through Week 20 of the study; cessation of contraception after this point should be discussed with a responsible physician. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of contraception. Females of childbearing potential are defined as those who are not surgically sterile (ie, bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy) or postmenopausal (defined as 12 months with no menses without an alternative medical cause).
Exclusion Criteria:
- Previous medical history or evidence of an uncontrolled intercurrent illness that in the opinion of the investigator may compromise the safety of the subject in the study or interfere with evaluation of the investigational product or reduce the subject's ability to participate in the study. Subjects with well-controlled comorbid disease (eg, hypertension, hyperlipidemia, gastroesophageal reflux disease) on a stable treatment regimen for 15 days prior to Visit 1 are eligible.
- Any concomitant respiratory disease that in the opinion of the investigator will interfere with the evaluation of the investigational product or interpretation of subject safety or study results (e.g., cystic fibrosis, pulmonary fibrosis, aspergillosis, active tuberculosis).
- Current asthma
- Lung volume reduction surgery for COPD
- Exacerbation requiring oral corticosteroids or antibiotics (any dose for more than 3 days) 4 weeks prior to Visit 1 or during the run-in period
- Any use of home oxygen therapy
- Any clinically relevant abnormal findings in hematology or clinical chemistry (laboratory results from Visit 1), physical examination, vital signs during the screening, which in the opinion of the investigator, may put the subject at risk because of his/her participation in the study, or may influence the results of the study, or the subject's ability to participate in the study
- History of cancer: Subjects who have had basal cell carcinoma or in situ carcinoma of the cervix are eligible to participate in the study provided that curative therapy was completed at least 12 months prior to Visit 1. Subjects who have had other malignancies are eligible provided that curative therapy was completed at least 5 years prior to Visit 1.
- Acute upper or lower respiratory infections requiring antibiotics or antiviral medications within 4 weeks prior to Visit 1 or during the screening period
- A positive human immunodeficiency virus (HIV) test at screening or subject taking antiretroviral medications, as determined by medical history
- Positive hepatitis B surface antigen, or hepatitis C virus antibody serology at screening, or a positive medical history for hepatitis B or C. Subjects with a history of hepatitis B vaccination without history of hepatitis B are allowed to enroll.
- History of sensitivity to any component of the investigational product formulation or a history of drug or other allergy that, in the opinion of the investigator or medical monitor contraindicates their participation.
- History of any known primary immunodeficiency disorder excluding asymptomatic selective immunoglobulin A or IgG subclass deficiency.
- Active tuberculosis or history of untreated latent tuberculosis
- History of anaphylaxis to any biologic therapy.
- Use of immunosuppressive medication (eg, methotrexate, troleandomycin, oral gold, cyclosporine, azathioprine, intramuscular long-acting depot corticosteroid, or any experimental anti-inflammatory therapy) within 3 months prior to Visit 1.
- Receipt of any of the following within 30 days prior to Visit 1: immunoglobulin or blood products, or receipt of any investigational nonbiologic agent within 30 days or 5 half-lives prior Visit 1, whichever is longer.
- Receipt of any marketed or investigational biologic agent within 4 months or 5 half- lives prior to Visit 1, whichever is longer.
- Pregnant, breastfeeding or lactating females
- History of chronic alcohol or drug abuse within 12 months prior to Visit 1.
- Planned surgical procedures requiring general anesthesia or in-patient status for > 1 day during the conduct of the study.
- Unwillingness or inability to follow the procedures outlined in the protocol.
- Concurrent enrollment in another clinical study involving an investigational treatment.
- Receipt of any live or attenuated vaccines within 15 days prior to Visit 1.
Sites / Locations
- Research site
- Research siteRecruiting
- Research site
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Tezepelumab
Placebo
Arm Description
Tezepelumab subcutaneous injection
Placebo subcutaneous injection
Outcomes
Primary Outcome Measures
To evaluate the effect of tezepelumab on eosinophilic bronchial mucosal tissue inflammation
The change, expressed as ratio, in eosinophil cell counts per mm2 from baseline to week-20
Secondary Outcome Measures
To evaluate the effect of tezepelumab on neutrophilic bronchial mucosal tissue inflammation
The change, expressed as ratio, in neutrophil cell couts per mm2 from baseline to week-20
To evaluate the effect of tezepelumab on mast cell bronchial mucosal tissue inflammation
The change, expressed as ratio, in mast cell couts per mm2 from baseline to week-20
To evaluate the effect of tezepelumab on CD4+ cell bronchial mucosal tissue inflammation
The change, expressed as ratio, in CD4+ cell couts per mm2 from baseline to week-20
To evaluate the effect of tezepelumab on CD8+ cell bronchial mucosal tissue inflammation
The change, expressed as ratio, in CD8+ cell couts per mm2 from baseline to week-20
To evaluate the effect of tezepelumab on macrophage cell bronchial mucosal tissue inflammation
The change, expressed as ratio, in macrophage cell couts per mm2 from baseline to week-20
Full Information
NCT ID
NCT05507242
First Posted
August 17, 2022
Last Updated
February 7, 2023
Sponsor
Asger Sverrild
Collaborators
AstraZeneca, University Hospital, Antwerp, University Hospitals, Leicester
1. Study Identification
Unique Protocol Identification Number
NCT05507242
Brief Title
Effects of Blocking TSLP on Airway Inflammation and the Epithelial Immune-response to Exacerbation Triggers in Patients With COPD
Acronym
UPSTREAM-COPD
Official Title
Effects of Blocking TSLP on Airway Inflammation and the Epithelial Immune-response to Exacerbation Triggers in Patients With COPD A Randomized Double-blind, Placebo-controlled Trial of Tezepelumab UPSTREAM-COPD
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Recruiting
Study Start Date
October 25, 2022 (Actual)
Primary Completion Date
May 31, 2025 (Anticipated)
Study Completion Date
May 31, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Asger Sverrild
Collaborators
AstraZeneca, University Hospital, Antwerp, University Hospitals, Leicester
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.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
A phase 2, multicentre, randomized, double-blind, placebo-controlled, parallel group study to evaluate the effect of tezepelumab on airway inflammation in patients with COPD.
Detailed Description
This is a multicentre, randomized, double-blind, placebo-controlled, parallel group study to evaluate the effect of tezepelumab on airway inflammation in patients with COPD on LABA+LAMA±ICS with ≥ 1 exacerbation the past 12 months. Approximately 80 subjects will be randomized to receive tezepelumab, or placebo, administered via subcutaneous injection at the study site, over a 20-week treatment period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COPD, COPD Exacerbation, COPD Bronchitis, Airway Disease, Immune System Disorder
Keywords
COPD
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
80 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Tezepelumab
Arm Type
Experimental
Arm Description
Tezepelumab subcutaneous injection
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo subcutaneous injection
Intervention Type
Biological
Intervention Name(s)
Tezepelumab
Intervention Description
Tezepelumab 210 mg for 20 weeks (5 doses in total, 4-week intervals), administered subcutaneously
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo subcutaneous injection for 20 weeks (5 doses in total, 4-week intervals)
Primary Outcome Measure Information:
Title
To evaluate the effect of tezepelumab on eosinophilic bronchial mucosal tissue inflammation
Description
The change, expressed as ratio, in eosinophil cell counts per mm2 from baseline to week-20
Time Frame
20 weeks
Secondary Outcome Measure Information:
Title
To evaluate the effect of tezepelumab on neutrophilic bronchial mucosal tissue inflammation
Description
The change, expressed as ratio, in neutrophil cell couts per mm2 from baseline to week-20
Time Frame
20 weeks
Title
To evaluate the effect of tezepelumab on mast cell bronchial mucosal tissue inflammation
Description
The change, expressed as ratio, in mast cell couts per mm2 from baseline to week-20
Time Frame
20 weeks
Title
To evaluate the effect of tezepelumab on CD4+ cell bronchial mucosal tissue inflammation
Description
The change, expressed as ratio, in CD4+ cell couts per mm2 from baseline to week-20
Time Frame
20 weeks
Title
To evaluate the effect of tezepelumab on CD8+ cell bronchial mucosal tissue inflammation
Description
The change, expressed as ratio, in CD8+ cell couts per mm2 from baseline to week-20
Time Frame
20 weeks
Title
To evaluate the effect of tezepelumab on macrophage cell bronchial mucosal tissue inflammation
Description
The change, expressed as ratio, in macrophage cell couts per mm2 from baseline to week-20
Time Frame
20 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Written informed consent
A diagnosis of COPD (according to GOLD (GOLD 2021 Report))
≥ 10 packyears smoked (current or ex-smokers)
Age 40 years or older
Postbronchodilator FEV1 ≥ 30% predicted (and ≥ 1.0L) and < 80% predicted
Maintenance treatment with LAMA+LABA±ICS (stable dose) for at least 3 months prior to V1
≥1 prednisolon and/or antibiotic treated exacerbation in the past 12 months
Subjects must demonstrate acceptable inhaler and spirometry techniques during screening (as evaluated and in the opinion of study site staff)
Subjects must demonstrate ≥ 70% compliance with daily inhalers during the screening/run-in
Females of childbearing potential who are sexually active with a nonsterilized male partner must use a highly effective method of contraception from the time informed consent is obtained and must agree to continue using such precautions through Week 20 of the study; cessation of contraception after this point should be discussed with a responsible physician. Periodic abstinence, the rhythm method, and the withdrawal method are not acceptable methods of contraception. Females of childbearing potential are defined as those who are not surgically sterile (ie, bilateral tubal ligation, bilateral oophorectomy, or complete hysterectomy) or postmenopausal (defined as 12 months with no menses without an alternative medical cause).
Exclusion Criteria:
Previous medical history or evidence of an uncontrolled intercurrent illness that in the opinion of the investigator may compromise the safety of the subject in the study or interfere with evaluation of the investigational product or reduce the subject's ability to participate in the study. Subjects with well-controlled comorbid disease (eg, hypertension, hyperlipidemia, gastroesophageal reflux disease) on a stable treatment regimen for 15 days prior to Visit 1 are eligible.
Any concomitant respiratory disease that in the opinion of the investigator will interfere with the evaluation of the investigational product or interpretation of subject safety or study results (e.g., cystic fibrosis, pulmonary fibrosis, aspergillosis, active tuberculosis).
Current asthma
Lung volume reduction surgery for COPD
Exacerbation requiring oral corticosteroids or antibiotics (any dose for more than 3 days) 4 weeks prior to Visit 1 or during the run-in period
Any use of home oxygen therapy
Any clinically relevant abnormal findings in hematology or clinical chemistry (laboratory results from Visit 1), physical examination, vital signs during the screening, which in the opinion of the investigator, may put the subject at risk because of his/her participation in the study, or may influence the results of the study, or the subject's ability to participate in the study
History of cancer: Subjects who have had basal cell carcinoma or in situ carcinoma of the cervix are eligible to participate in the study provided that curative therapy was completed at least 12 months prior to Visit 1. Subjects who have had other malignancies are eligible provided that curative therapy was completed at least 5 years prior to Visit 1.
Acute upper or lower respiratory infections requiring antibiotics or antiviral medications within 4 weeks prior to Visit 1 or during the screening period
A positive human immunodeficiency virus (HIV) test at screening or subject taking antiretroviral medications, as determined by medical history
Positive hepatitis B surface antigen, or hepatitis C virus antibody serology at screening, or a positive medical history for hepatitis B or C. Subjects with a history of hepatitis B vaccination without history of hepatitis B are allowed to enroll.
History of sensitivity to any component of the investigational product formulation or a history of drug or other allergy that, in the opinion of the investigator or medical monitor contraindicates their participation.
History of any known primary immunodeficiency disorder excluding asymptomatic selective immunoglobulin A or IgG subclass deficiency.
Active tuberculosis or history of untreated latent tuberculosis
History of anaphylaxis to any biologic therapy.
Use of immunosuppressive medication (eg, methotrexate, troleandomycin, oral gold, cyclosporine, azathioprine, intramuscular long-acting depot corticosteroid, or any experimental anti-inflammatory therapy) within 3 months prior to Visit 1.
Receipt of any of the following within 30 days prior to Visit 1: immunoglobulin or blood products, or receipt of any investigational nonbiologic agent within 30 days or 5 half-lives prior Visit 1, whichever is longer.
Receipt of any marketed or investigational biologic agent within 4 months or 5 half- lives prior to Visit 1, whichever is longer.
Pregnant, breastfeeding or lactating females
History of chronic alcohol or drug abuse within 12 months prior to Visit 1.
Planned surgical procedures requiring general anesthesia or in-patient status for > 1 day during the conduct of the study.
Unwillingness or inability to follow the procedures outlined in the protocol.
Concurrent enrollment in another clinical study involving an investigational treatment.
Receipt of any live or attenuated vaccines within 15 days prior to Visit 1.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Kristoffer Norheim, PhD
Phone
+4542831337
Email
kristoffer.norheim@regionh.dk
First Name & Middle Initial & Last Name or Official Title & Degree
Asger Sverrild, MD, PhD
Email
asger.sverrild@regionh.dk
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Asger Sverrild, MD, PhD
Organizational Affiliation
Bispebjerg Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research site
City
Antwerp
ZIP/Postal Code
2650
Country
Belgium
Individual Site Status
Not yet recruiting
Facility Name
Research site
City
Copenhagen
ZIP/Postal Code
2400
Country
Denmark
Individual Site Status
Recruiting
Facility Name
Research site
City
Leicester
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Individual Site Status
Not yet recruiting
12. IPD Sharing Statement
Learn more about this trial
Effects of Blocking TSLP on Airway Inflammation and the Epithelial Immune-response to Exacerbation Triggers in Patients With COPD
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