CST1-Guided Oral Glucocorticoids Management for CRSwNP (COMPASS)
Primary Purpose
Chronic Rhinosinusitis With Nasal Polyps, Glucocorticoids
Status
Not yet recruiting
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Oral Glucocorticoids
Oral placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Rhinosinusitis With Nasal Polyps
Eligibility Criteria
Inclusion Criteria:
- Age 18-70 years old;
- All meet the diagnostic criteria of CRSwNP in EPOS2020;
- Investigator-assessed endoscopic bilateral Nasal Polyp Size Score (NPSS) was greater than or equal to 4 (minimum score of 2 per nasal cavity);
- Patients with asthma were in a stable state, with FEV1 > 50% of the predicted value or 50% of the optimal value of personal FEV1; (5) Good compliance, able to complete clinical observation.
Exclusion Criteria:
- Medication history of oral glucocorticoids within 3 months before enrollment, antibiotics within 2 weeks;
- Oral glucocorticoid contraindications, such as diabetes, femoral head necrosis, gastric ulcer, etc.;
- Any nasal and/or sinus surgery within 3 months before enrollment;
- Patients have conditions or comorbidities that may preclude evaluation of the primary efficacy endpoint, such as: unilateral posterior nasal polyp of maxillary sinus, acute rhinitis, nasal infection or upper respiratory tract at the screening period or within 2 weeks before the screening period infection, acute asthma attack within 4 weeks, current drug-induced rhinitis, allergic fungal sinusitis (AFRS), benign or malignant tumor of nasal cavity;
- Important clinical comorbidities that may interfere with clinical effectiveness, including but not limited to: active upper or lower respiratory tract infection, cystic fibrosis, eosinophilic granuloma with polyvasculitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener's granulomatosis), Young's syndrome, etc.;
- Accompanying serious diseases or recurrent chronic diseases with poor systemic control, such as (but not limited to), active infection, cardiovascular disease, tuberculosis or other pathogen infection, diabetes, autoimmune disease, HIV, hepatitis B, Hepatitis C or parasitic diseases, malignant tumors, etc.;
- Subjects with severe liver and kidney function injury; such as, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >2 times the upper limit of normal, serum creatinine > the upper limit of normal value;
- Known or suspected immunosuppression, including a history of invasive opportunistic infections (such as tuberculosis, histoplasmosis, listeriosis, coccidioidomycosis, pulmonary cysts, aspergillosis), even if the infection has subsided;
- Women who were pregnant or planned to become pregnant during the study, or who were breastfeeding;
- Subjects who were fertile but were reluctant to use medically approved and effective contraception;
- Those with a history of alcohol or drug abuse;
- Those who believed the patient had other medical or non-medical conditions that were not suitable for the study.
Sites / Locations
- Beijing Tongren Hospital, Capital Medical University
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Oral Glucocorticoids group
Placebo group
Arm Description
Intervention Period:oral glucocorticoids(methylprednisolone 24mg qd, 2-week duration)+nasal spray (Budesonide Nasal Spray 64ug per Nostril, bid, 2-week duration) follow-up period:nasal spray(Budesonide Nasal Spray 64ug per Nostril, bid, 24-week duration)
Intervention Period:oral placebo+nasal spray(oral placebo 24mg qd, 2-week duration)+nasal spray (Budesonide Nasal Spray 64ug per Nostril, bid, 2-week duration) follow-up period:nasal spray(Budesonide Nasal Spray 64ug per Nostril, bid, 24-week duration)
Outcomes
Primary Outcome Measures
The change in endoscopic polyp score
Bilateral polyp volume size described using the Nasal Polyp Size Score (NPSS) score. (0 - 4 points per side: 0 = no polyp; 1 = small polyp in the middle meatus, not reaching the inferior border of the middle turbinate; 2 = small polyp in the middle meatus, reaching the inferior border of the middle turbinate; 3 = large polyp protruding from the middle meatus, not reaching the inferior border of the inferior turbinate; 4 = large polyp that almost causes most or complete obstruction of the nasal cavity.)
Secondary Outcome Measures
The change in Total Nasal Symptom Score(TNSS)
Total Nasal Symptom Score was are graded on a 3-point scale. (0= no symptoms; 1= mild symptoms; 2= moderate symptoms; 3= severe symptoms).
The change in SNOT-22 score
The 22-item Sino-nasal outcome test (SNOT-22) was used to evaluate the changes in symptoms of patients. According to the severity of symptoms caused by RCRS, each item was divided into 6 levels: no distress (0 points), mild distress (1 point), mild distress (2 points) ), moderate distress (3 points), severe distress (4 points), very severe distress (5 points). The higher the score, the more severe the symptoms, and the final total score of the item is counted.
The change in asthma ACQ Score
For patients with asthma, we assessed the change of asthma symptoms through the Asthma Control Questionnaire(ACQ). Each question was scored on a scale of 0 to 6 according to the severity. The result score of each item was averaged. A score of <0.75 indicated that the asthma had been completely controlled; a score of 0.75-1.5 indicates well-controlled asthma; a score of >1.5 indicates that asthma is not controlled.
The change of CST1
The change of Cystatin 1
The change of biomarker
Changes in expression levels of biomarker in nasal brush exfoliated cells, nasal secretions and nasal microbes.
The change in AE / SAE recording
Any adverse event
The needs of upgrading treatment
The needs of upgrading treatment includes surgery, oral glucocorticoids or monoclonal antibodies treatment.
The change of inflammatory cell
The change of inflammatory cell in nasal polyps
Full Information
NCT ID
NCT05598411
First Posted
October 25, 2022
Last Updated
October 25, 2022
Sponsor
Beijing Tongren Hospital
1. Study Identification
Unique Protocol Identification Number
NCT05598411
Brief Title
CST1-Guided Oral Glucocorticoids Management for CRSwNP
Acronym
COMPASS
Official Title
Efficacy of CST1-Guided Oral Glucocorticoid Therapy for Chronic Rhinosinusitis With Polyps
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 17, 2022 (Anticipated)
Primary Completion Date
December 30, 2024 (Anticipated)
Study Completion Date
November 1, 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Beijing Tongren Hospital
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Topical and systemic steroids constitute the first choice in medical treatment for nasal polyps. Glucocorticoids sensitivity is significantly correlated with CST1 in nasal secretions. The goal of this randomized, double-blind, placebo-controlled clinical trial is to clarify the efficacy of a short course of CST1-guided oral glucocorticoids therapy for chronic rhinosinusitis with nasal polyps. Subjects were randomized to receive either oral glucocorticoids or oral placebo for 2 weeks. Endoscopic polyp score, Total Nasal Symptom Score(TNSS), SNOT-22 score, Cystatin 1 and other biomarkers were evaluated before and after the treatment. Researchers will compare oral glucocorticoids group and oral placebo group to test CST1 predictive model of glucocorticoid therapy for Chronic Rhinosinusitis with Polyps.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Rhinosinusitis With Nasal Polyps, Glucocorticoids
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
90 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Oral Glucocorticoids group
Arm Type
Experimental
Arm Description
Intervention Period:oral glucocorticoids(methylprednisolone 24mg qd, 2-week duration)+nasal spray (Budesonide Nasal Spray 64ug per Nostril, bid, 2-week duration) follow-up period:nasal spray(Budesonide Nasal Spray 64ug per Nostril, bid, 24-week duration)
Arm Title
Placebo group
Arm Type
Placebo Comparator
Arm Description
Intervention Period:oral placebo+nasal spray(oral placebo 24mg qd, 2-week duration)+nasal spray (Budesonide Nasal Spray 64ug per Nostril, bid, 2-week duration) follow-up period:nasal spray(Budesonide Nasal Spray 64ug per Nostril, bid, 24-week duration)
Intervention Type
Drug
Intervention Name(s)
Oral Glucocorticoids
Other Intervention Name(s)
methylprednisolone
Intervention Description
methylprednisolone 24mg qd, 2-week duration
Intervention Type
Drug
Intervention Name(s)
Oral placebo
Intervention Description
oral placebo 24mg qd, 2-week duration
Primary Outcome Measure Information:
Title
The change in endoscopic polyp score
Description
Bilateral polyp volume size described using the Nasal Polyp Size Score (NPSS) score. (0 - 4 points per side: 0 = no polyp; 1 = small polyp in the middle meatus, not reaching the inferior border of the middle turbinate; 2 = small polyp in the middle meatus, reaching the inferior border of the middle turbinate; 3 = large polyp protruding from the middle meatus, not reaching the inferior border of the inferior turbinate; 4 = large polyp that almost causes most or complete obstruction of the nasal cavity.)
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Secondary Outcome Measure Information:
Title
The change in Total Nasal Symptom Score(TNSS)
Description
Total Nasal Symptom Score was are graded on a 3-point scale. (0= no symptoms; 1= mild symptoms; 2= moderate symptoms; 3= severe symptoms).
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The change in SNOT-22 score
Description
The 22-item Sino-nasal outcome test (SNOT-22) was used to evaluate the changes in symptoms of patients. According to the severity of symptoms caused by RCRS, each item was divided into 6 levels: no distress (0 points), mild distress (1 point), mild distress (2 points) ), moderate distress (3 points), severe distress (4 points), very severe distress (5 points). The higher the score, the more severe the symptoms, and the final total score of the item is counted.
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The change in asthma ACQ Score
Description
For patients with asthma, we assessed the change of asthma symptoms through the Asthma Control Questionnaire(ACQ). Each question was scored on a scale of 0 to 6 according to the severity. The result score of each item was averaged. A score of <0.75 indicated that the asthma had been completely controlled; a score of 0.75-1.5 indicates well-controlled asthma; a score of >1.5 indicates that asthma is not controlled.
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The change of CST1
Description
The change of Cystatin 1
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The change of biomarker
Description
Changes in expression levels of biomarker in nasal brush exfoliated cells, nasal secretions and nasal microbes.
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The change in AE / SAE recording
Description
Any adverse event
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The needs of upgrading treatment
Description
The needs of upgrading treatment includes surgery, oral glucocorticoids or monoclonal antibodies treatment.
Time Frame
Baseline, week 2, week 6, week 10, week 14, week 18, week 22, week 26
Title
The change of inflammatory cell
Description
The change of inflammatory cell in nasal polyps
Time Frame
Baseline, week 2, week 26
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 18-70 years old;
All meet the diagnostic criteria of CRSwNP in EPOS2020;
Investigator-assessed endoscopic bilateral Nasal Polyp Size Score (NPSS) was greater than or equal to 4 (minimum score of 2 per nasal cavity);
Patients with asthma were in a stable state, with FEV1 > 50% of the predicted value or 50% of the optimal value of personal FEV1; (5) Good compliance, able to complete clinical observation.
Exclusion Criteria:
Medication history of oral glucocorticoids within 3 months before enrollment, antibiotics within 2 weeks;
Oral glucocorticoid contraindications, such as diabetes, femoral head necrosis, gastric ulcer, etc.;
Any nasal and/or sinus surgery within 3 months before enrollment;
Patients have conditions or comorbidities that may preclude evaluation of the primary efficacy endpoint, such as: unilateral posterior nasal polyp of maxillary sinus, acute rhinitis, nasal infection or upper respiratory tract at the screening period or within 2 weeks before the screening period infection, acute asthma attack within 4 weeks, current drug-induced rhinitis, allergic fungal sinusitis (AFRS), benign or malignant tumor of nasal cavity;
Important clinical comorbidities that may interfere with clinical effectiveness, including but not limited to: active upper or lower respiratory tract infection, cystic fibrosis, eosinophilic granuloma with polyvasculitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener's granulomatosis), Young's syndrome, etc.;
Accompanying serious diseases or recurrent chronic diseases with poor systemic control, such as (but not limited to), active infection, cardiovascular disease, tuberculosis or other pathogen infection, diabetes, autoimmune disease, HIV, hepatitis B, Hepatitis C or parasitic diseases, malignant tumors, etc.;
Subjects with severe liver and kidney function injury; such as, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) >2 times the upper limit of normal, serum creatinine > the upper limit of normal value;
Known or suspected immunosuppression, including a history of invasive opportunistic infections (such as tuberculosis, histoplasmosis, listeriosis, coccidioidomycosis, pulmonary cysts, aspergillosis), even if the infection has subsided;
Women who were pregnant or planned to become pregnant during the study, or who were breastfeeding;
Subjects who were fertile but were reluctant to use medically approved and effective contraception;
Those with a history of alcohol or drug abuse;
Those who believed the patient had other medical or non-medical conditions that were not suitable for the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Lou Zhang
Phone
+86-13910830399
Email
dr.luozhang@139.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Luo Zhang
Organizational Affiliation
Beijing Tongren Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Beijing Tongren Hospital, Capital Medical University
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100000
Country
China
12. IPD Sharing Statement
Plan to Share IPD
No
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CST1-Guided Oral Glucocorticoids Management for CRSwNP
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