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AD17002 Treating Poorly Controlled, Moderate to Severe Eosinophilic Asthma

Primary Purpose

Eosinophilic Asthma

Status
Not yet recruiting
Phase
Phase 2
Locations
Taiwan
Study Type
Interventional
Intervention
AD17002
Placebo
Sponsored by
Advagene Biopharma Co. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Eosinophilic Asthma

Eligibility Criteria

20 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Subject 20-80 years of age on the day of signing informed consent Subject who is not a current smoker with poorly controlled, moderate to severe eosinophilic asthma based on GINA 2022 criteria. Subject who is diagnosed with asthma, over 2 years of follow-up. Subjects who have the post-bronchodilator reversibility of Forced expiratory volume 1 (FEV1) of ≥ 12% and ≥ 200 mL in response to a SABA at the screening visit or documented in the medical chart within 2 years of the screening visit. Subjects who have >15% eosinophil counts in the induced sputum within 7 days of Visit 1. Subjects with ACT scores <19 under regular low to moderate-dose inhaled corticosteroids (ICS) and/or a combination with inhaled long-acting beta 2 agonists for at least 3 months before the Screening Visit. Subjects without a recent respiratory tract infection within 3 weeks prior to the study. Subjects without a recent COVID-19 infection within 3 months prior to study. Have a negative serum pregnancy test at the screening, and randomization visits (female subjects of childbearing potential). A female subject who is of reproductive potential agrees to remain abstinent or use (or have their partner use) an acceptable method of birth control within the projected duration of the trial. Acceptable birth control methods are intrauterine devices, hormonal contraception, diaphragm with spermicide, contraceptive sponge, condoms, and vasectomy, as per local regulations or guidelines. A female subject who is not of reproductive potential is eligible without requiring the use of contraception. A female subject who is not of reproductive potential is defined as one who has either Reached natural menopause (defined as 6 months of spontaneous amenorrhea with serum follicle-stimulating hormone levels in the postmenopausal range as determined by the laboratory, or 12 months of spontaneous amenorrhea), Six weeks postsurgical documented total hysterectomy and/or bilateral salpingo-oophorectomy, or Bilateral tubal ligation. Subject or the subject's legal representative understands the trial procedures, alternative treatments available, and risks involved with the trial, and voluntarily agrees to participate by giving written informed consent. Be able to understand, and complete questionnaires and diaries. Provide written informed consent for the trial and be willing to adhere to dose and visit schedules. Exclusion Criteria: Subjects with serious underlying chronic illness or severe systemic disease, including SLE, malignant diseases, uremia and heart failure, or abnormal liver function. Subjects with clinically important lung disease, including but not limited to COPD (Chronic Obstructive Pulmonary Disease), chronic respiratory infection, lung cancer, etc. Arrhythmia, myocardial infarction, or stroke in the last 3 months. Active COVID-19 disease (SARS-CoV-2 Lateral flow tests (LFA)-positive) at Screening. A clinical history of persistent allergic asthma or rhinitis caused by an allergen to which the subject is regularly exposed and sensitized. A clinical history of active chronic sinusitis (> 3 months). Any clinically relevant chronic disease (>=3 months duration) (e.g. cystic fibrosis, malignancy, renal or hepatic insufficiency). Subject with a documented history of Bell's palsy. Has any nasal condition that could confound the efficacy or safety assessments (e.g., severe nasal polyposis) Immunosuppressive treatment (ATC code L04 or L01) within 3 months prior to the screening visit (except the specified concomitant medications for allergy and asthma symptoms). Has unstable or severe asthma, as judged by the clinical Investigator, or a subject who has experienced a life-threatening asthma attack or an occurrence of any clinical deterioration of asthma that resulted in emergency treatment, hospitalization due to asthma, or treatment with systemic corticosteroids (but allowing SABA) at any time within the last 3 months before Screening Visit. Has asthma requiring high-dose oral corticosteroid (OCS) within the last 6 months before Screening Visit. Has a history of anaphylaxis with cardiorespiratory symptoms with prior immunotherapy, unknown cause, or inhalant allergen. Has a history of chronic urticaria and/or angioedema within the last 2 years before the Screening visit. Is pregnant or expecting to conceive within the projected duration of the trial. Is nursing at randomization and within the projected duration of the trial? Has had previous exposure to the study drug or Flu Vaccine AD07030. Is receiving ongoing treatment with any specific immunotherapy at the time of the Screening Visit. Has a known history of allergy, hypersensitivity, or intolerance to investigational medicinal products, rescue medications, or self-injectable epinephrine

Sites / Locations

  • Taipei Medical University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Experimental

Placebo Comparator

Experimental

Arm Label

Cohort 1 Placebo

Cohort 1 Low dose

Cohort 2 Placebo

Cohort 2 High dose

Arm Description

Formulation buffer

Formulation buffer + 10 μg LTh(αK)

Formulation buffer

Formulation buffer + 20 μg LTh(αK)

Outcomes

Primary Outcome Measures

FEV1 improvement
Lung function tests with spirometry

Secondary Outcome Measures

Change to the use of Short-Acting Beta Agonists (SABA)
The number of use of rescue Short-Acting Beta Agonists
Fractional exhaled nitric oxide (FeNO) change
Change to the FeNO levels
Sputum eosinophil change
Change to the induced sputum eosinophils' count
Asthma Control Test (ACT) scores improvement
Change to the ACT scores. A maximum score of 25 points indicates complete asthma control. A score between 20 and 25 represents well controlled asthma, while a score of 19 or below represents not well controlled asthma, and a score less than 16 indicates very poorly controlled asthma.
Corticosteroid used to control asthma
Numbers of corticosteroid used, inhaled or oral
Immunological biomarkers of sputum
Changes in the concentration of sputum IL-4, -5, -13, IFN-α, eosinophil peroxidase (EPO), eosinophil cationic protein (ECP) from the baseline
Immunological biomarkers of serum
Change of concentration from baseline of induced serum IL-4, -5, -13
Peripheral eosinophil count
Change of cell numbers from baseline of peripheral eosinophil count
Adverse events_clinical visit
Clinical visit and check up by physicians
Adverse events-Diary
Patient self report adverse events via diary

Full Information

First Posted
July 26, 2023
Last Updated
August 29, 2023
Sponsor
Advagene Biopharma Co. Ltd.
Collaborators
Taipei Medical University Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05985694
Brief Title
AD17002 Treating Poorly Controlled, Moderate to Severe Eosinophilic Asthma
Official Title
A Single-blind (Patient-blind), Randomized, Placebo-controlled, Intranasal Administration Study on Mechanisms and Potential Efficacy of AD17002 in Subjects With Poorly Controlled, Moderate to Severe Eosinophilic Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
September 11, 2023 (Anticipated)
Primary Completion Date
March 8, 2024 (Anticipated)
Study Completion Date
May 3, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Advagene Biopharma Co. Ltd.
Collaborators
Taipei Medical University Hospital

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
The goal of this clinical trial is to investigate patients who have poorly controlled, moderate to severe eosinophilic asthma. The main questions it aims to answer are Could the LTh(αK) intranasal treatment improve the clinical condition of these patients? Could patients self-administrate LTh(αK) via the intranasal route? Is the LTh(αK) at multiple doses safe for asthmatic patients? Participants will be asked to self-administrate two doses per week for a total of 6 weeks and a diary on the usage of LTh(αK), adverse event, and reliever medication used will be recorded.
Detailed Description
Eosinophilic asthma is recognized as a sub-phenotype of asthma based on the pattern of inflammatory cellular infiltration in the airway. Eosinophilic asthma can be associated with increased asthma severity, atopy, late-onset disease, and steroid refractoriness. Induced sputum cell count is the gold standard for identifying eosinophilic inflammation in asthma and fractional exhaled nitric oxide and periostin are emerging as potential surrogates. The Type I and III interferons (IFNs) can negatively regulate the allergic reaction, and their production from mucosal epithelium is reported to be lower in patients with asthma. The investigational intranasal pharmaceutical product named AD17002 contains a detoxified Escherichia coli heat-labile enterotoxin, LTh(αK). Studies showed that AD17002 enhanced the production of Type I and III IFNs from mucosal epithelial cells. Studies also supported that AD17002 attenuates allergic reactions. The safety and tolerability of LTh(αK) have been demonstrated in several clinical trials as an intranasal adjuvant for influenza vaccine (NCT03293732 and NCT03784885) or an intranasal immunomodulator for respiratory hypersensitivity (NCT04088721) or viral infection (NCT05069610 and NCT05541510). This study is conducted to determine the potential efficacy and mechanism of LTh(αK) as a controller in attenuating the severity of clinical manifestations in patients with unstable, moderate to severe eosinophilic asthma. Patients with clinical history and ongoing eosinophilic asthma will be randomly assigned to either AD17002 (10 μg or 20 μg) or placebo, per 3-4 days, in a 1:1 ratio, in a single-blinded (patient-blinded) fashion. The nasal administration will be self-administrated by participants. Progression and improvement in asthmatic symptoms will be recorded. All study subjects will sign ethics committee-approved informed consent forms before participating in any trial-related activities. Subjects who participate in this trial of AD17002 will provide information about the dosing, efficacy, and safety of the new indication that will guide its future clinical use.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Eosinophilic Asthma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 Placebo
Arm Type
Placebo Comparator
Arm Description
Formulation buffer
Arm Title
Cohort 1 Low dose
Arm Type
Experimental
Arm Description
Formulation buffer + 10 μg LTh(αK)
Arm Title
Cohort 2 Placebo
Arm Type
Placebo Comparator
Arm Description
Formulation buffer
Arm Title
Cohort 2 High dose
Arm Type
Experimental
Arm Description
Formulation buffer + 20 μg LTh(αK)
Intervention Type
Drug
Intervention Name(s)
AD17002
Other Intervention Name(s)
LTh(αK)
Intervention Description
The investigational intranasal pharmaceutical product named AD17002 contains a detoxified Escherichia coli heat-labile enterotoxin, LTh(αK). Dosing days: 1, 4, 8, 11, 15, 18, 22, 25, 29, 32.
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Formulation buffer
Intervention Description
Formulation buffer. Dosing days: 1, 4, 8, 11, 15, 18, 22, 25, 29, 32.
Primary Outcome Measure Information:
Title
FEV1 improvement
Description
Lung function tests with spirometry
Time Frame
Day 1 to Day 78
Secondary Outcome Measure Information:
Title
Change to the use of Short-Acting Beta Agonists (SABA)
Description
The number of use of rescue Short-Acting Beta Agonists
Time Frame
Day 1 to Day 78
Title
Fractional exhaled nitric oxide (FeNO) change
Description
Change to the FeNO levels
Time Frame
Day 1 to Day 78
Title
Sputum eosinophil change
Description
Change to the induced sputum eosinophils' count
Time Frame
Day 1 to Day 78
Title
Asthma Control Test (ACT) scores improvement
Description
Change to the ACT scores. A maximum score of 25 points indicates complete asthma control. A score between 20 and 25 represents well controlled asthma, while a score of 19 or below represents not well controlled asthma, and a score less than 16 indicates very poorly controlled asthma.
Time Frame
Day 1 to Day 78
Title
Corticosteroid used to control asthma
Description
Numbers of corticosteroid used, inhaled or oral
Time Frame
Day 1 to Day 78
Title
Immunological biomarkers of sputum
Description
Changes in the concentration of sputum IL-4, -5, -13, IFN-α, eosinophil peroxidase (EPO), eosinophil cationic protein (ECP) from the baseline
Time Frame
Day 1 to Day 78
Title
Immunological biomarkers of serum
Description
Change of concentration from baseline of induced serum IL-4, -5, -13
Time Frame
Day 1 to Day 78
Title
Peripheral eosinophil count
Description
Change of cell numbers from baseline of peripheral eosinophil count
Time Frame
Day 1 to Day 78
Title
Adverse events_clinical visit
Description
Clinical visit and check up by physicians
Time Frame
Day 1 to Day 36 and Day 78
Title
Adverse events-Diary
Description
Patient self report adverse events via diary
Time Frame
Day 1 to Day 78

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject 20-80 years of age on the day of signing informed consent Subject who is not a current smoker with poorly controlled, moderate to severe eosinophilic asthma based on GINA 2022 criteria. Subject who is diagnosed with asthma, over 2 years of follow-up. Subjects who have the post-bronchodilator reversibility of Forced expiratory volume 1 (FEV1) of ≥ 12% and ≥ 200 mL in response to a SABA at the screening visit or documented in the medical chart within 2 years of the screening visit. Subjects who have >15% eosinophil counts in the induced sputum within 7 days of Visit 1. Subjects with ACT scores <19 under regular low to moderate-dose inhaled corticosteroids (ICS) and/or a combination with inhaled long-acting beta 2 agonists for at least 3 months before the Screening Visit. Subjects without a recent respiratory tract infection within 3 weeks prior to the study. Subjects without a recent COVID-19 infection within 3 months prior to study. Have a negative serum pregnancy test at the screening, and randomization visits (female subjects of childbearing potential). A female subject who is of reproductive potential agrees to remain abstinent or use (or have their partner use) an acceptable method of birth control within the projected duration of the trial. Acceptable birth control methods are intrauterine devices, hormonal contraception, diaphragm with spermicide, contraceptive sponge, condoms, and vasectomy, as per local regulations or guidelines. A female subject who is not of reproductive potential is eligible without requiring the use of contraception. A female subject who is not of reproductive potential is defined as one who has either Reached natural menopause (defined as 6 months of spontaneous amenorrhea with serum follicle-stimulating hormone levels in the postmenopausal range as determined by the laboratory, or 12 months of spontaneous amenorrhea), Six weeks postsurgical documented total hysterectomy and/or bilateral salpingo-oophorectomy, or Bilateral tubal ligation. Subject or the subject's legal representative understands the trial procedures, alternative treatments available, and risks involved with the trial, and voluntarily agrees to participate by giving written informed consent. Be able to understand, and complete questionnaires and diaries. Provide written informed consent for the trial and be willing to adhere to dose and visit schedules. Exclusion Criteria: Subjects with serious underlying chronic illness or severe systemic disease, including SLE, malignant diseases, uremia and heart failure, or abnormal liver function. Subjects with clinically important lung disease, including but not limited to COPD (Chronic Obstructive Pulmonary Disease), chronic respiratory infection, lung cancer, etc. Arrhythmia, myocardial infarction, or stroke in the last 3 months. Active COVID-19 disease (SARS-CoV-2 Lateral flow tests (LFA)-positive) at Screening. A clinical history of persistent allergic asthma or rhinitis caused by an allergen to which the subject is regularly exposed and sensitized. A clinical history of active chronic sinusitis (> 3 months). Any clinically relevant chronic disease (>=3 months duration) (e.g. cystic fibrosis, malignancy, renal or hepatic insufficiency). Subject with a documented history of Bell's palsy. Has any nasal condition that could confound the efficacy or safety assessments (e.g., severe nasal polyposis) Immunosuppressive treatment (ATC code L04 or L01) within 3 months prior to the screening visit (except the specified concomitant medications for allergy and asthma symptoms). Has unstable or severe asthma, as judged by the clinical Investigator, or a subject who has experienced a life-threatening asthma attack or an occurrence of any clinical deterioration of asthma that resulted in emergency treatment, hospitalization due to asthma, or treatment with systemic corticosteroids (but allowing SABA) at any time within the last 3 months before Screening Visit. Has asthma requiring high-dose oral corticosteroid (OCS) within the last 6 months before Screening Visit. Has a history of anaphylaxis with cardiorespiratory symptoms with prior immunotherapy, unknown cause, or inhalant allergen. Has a history of chronic urticaria and/or angioedema within the last 2 years before the Screening visit. Is pregnant or expecting to conceive within the projected duration of the trial. Is nursing at randomization and within the projected duration of the trial? Has had previous exposure to the study drug or Flu Vaccine AD07030. Is receiving ongoing treatment with any specific immunotherapy at the time of the Screening Visit. Has a known history of allergy, hypersensitivity, or intolerance to investigational medicinal products, rescue medications, or self-injectable epinephrine
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mingi Chang, Ph.D.
Phone
+886-2-7970073
Ext
21
Email
mingi.chang@advagene.com.tw
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yushen Hsu, Ph.D.
Organizational Affiliation
Advagene Biopharma
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Han-Pin Kuo, MD. Ph.D.
Organizational Affiliation
Taipei Medical University Hospital
Official's Role
Study Director
Facility Information:
Facility Name
Taipei Medical University Hospital
City
Taipei
Country
Taiwan
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Emily Lien
Phone
+-886-27970073
Email
emily.lien@advagene.com.tw

12. IPD Sharing Statement

Learn more about this trial

AD17002 Treating Poorly Controlled, Moderate to Severe Eosinophilic Asthma

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