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Anti-IgE Monoclonal Antibody Treatment in Patients With Allergic Asthma.

Primary Purpose

Asthma, Allergic

Status
Completed
Phase
Phase 3
Locations
China
Study Type
Interventional
Intervention
CMAB007
Symbicort
Seretide
Ventolin
placebo
Sponsored by
Shanghai Biomabs Pharmaceutical Co., Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asthma, Allergic

Eligibility Criteria

15 Years - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Signed and dated informed consent prior to any study assessment;
  2. Age 15-75 years inclusive, female or male;
  3. Diagnosed as asthma according to the guideline for the prevention and treatment of bronchial asthma in China (version 2016), with duration for more than 1 years;
  4. Have had at least one severe asthma exacerbations(requiring systemic steroid use) in the previous one year;
  5. At screening, serum total IgE level 60-1500IU/ml and body weight 20-150kg.
  6. Receiving seretide(fluticasone>250ug/day) or symbicort(budesonide>400ug/day) for at least 3 months and stable dose for at least 4 weeks prior to screening. Asthma symptom control level is still partly controlled or uncontrolled. Detailed drugs and usage are one of the following: Seretide 50/250ug 1 inhalation bid;Seretide 50/500ug 1 inhalation bid;Symbicort 160/4.5ug 2 inhalations bid or Symbicort 320/9ug 1 inhalation bid.
  7. None of other asthma controller medications other than seretide or symbicort including systemic steroid, leukotriene modifiers, theophylline, histamine1 receptor blockers, anticholinergic drugs, traditional Chinese medicine and so on have been used 2 weeks prior to screening.
  8. At screening, FEV1 < 80% of the predicted normal value.
  9. At screening, laboratory tests results should meet all of the following: hemoglobin≥80g/l;3*10^9/l≤white blood cell≤10*10^9/l;platelet≥75*10^9/l;liver function(glutamic-pyruvic transaminase, glutamic-oxalacetic transaminase and total bilirubin)≤2*upper limit of normal value;renal function≤1.5*upper limit of normal value.
  10. At screening, pregnant test is negative,or not lactating, for women of child-bearing potential. Effective methods of contraception will be maintained throughout the study and 6 months after the study.
  11. Can understand and complete questionnaires correctly, complete PEF and patient diary correctly, and be followed up according to scheduled table.

Exclusion Criteria:

  1. History of critical asthma exacerbations,such as tracheal intubation or intensive care unit admission.
  2. Currently smoker, or a former smoker with a smoking history > 10 pack-years(defined as the number of packs of 20 cigarettes smoked per day multiplied by number of years the patient smoked).
  3. Have elevated serum IgE levels for other causes other than allergens, such as parasite infections, allergic bronchopulmonary aspergillosis, Churg-Strauss syndrome and so on.
  4. Desensitization therapy or immunosuppressant agents such as cyclosporine, methotrexate and gold preparation during 3 months prior to screening.
  5. Biological agents such as monoclonal antibody including investigational biological drugs during 6 months prior to screening.
  6. Vaccinated live/attenuated virus or bacterial vaccines, or intravenous used immunoglobulin G, during 4 weeks prior to screening.
  7. History of bronchial thermoplasty for asthma during 12 months prior to screening.
  8. Use of any anti-IgE monoclonal antibody including Xolair for asthma during 12 months prior to screening.
  9. Respiratory infections(such as pneumonia,upper respiratory tract infection,etc)or large surgeries during 4 weeks prior to screening.
  10. Combined with other pulmonary diseases, such as chronic obstructive pulmonary disease, bronchiectasis, pulmonary interstitial fibrosis, etc.
  11. History of malignancies other than squamous cell carcinoma or basal cell carcinoma of the skin and carcinoma in situs of cervix with complete excision and no evidence of recurrences.
  12. Acquired immune deficiency syndrome or human immunodeficiency virus infection patients.
  13. History of malignant or proliferative diseases of the lymphatic system such as lymphoma, or there are symptoms and signs indicating lymphatic proliferative diseases, or splenomegaly (≥2cm under the ribs).
  14. With uncontrolled hypertension(systolic pressure ≥160 or diastolic pressure ≥100 in millimeters of mercury) at screening.
  15. With severe, progressive or uncontrolled hepatic, renal, gastrointestinal, cardio-cerebral vascular, hematopoietic,genitourinary, endocrine, nervous and immunological medical conditions, or other conditions that investigators think the patient not suitable for this study.
  16. Have a history of drug or alcohol abuse or poor compliance of drugs.
  17. With known hypersensitivity to human immunoglobulin, anti-IgE monoclonal antibody for injection or components.
  18. Have attended other clinical trials of investigational drugs, or within 30 days or 5 half-lives of enrollment, whichever is longer.

Sites / Locations

  • The First Affiliated Hospital of Guangzhou Medical University
  • The First Affiliated Hospital of Wenzhou Medical University

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

CMAB007 + Seretide/Symbicort + Ventolin

Placebo + Seretide/Symbicort + Ventolin

Arm Description

CMAB007(recombinant humanized anti-IgE monoclonal antibody for injection ) will be at a fixed dose determined by the subjects' total IgE and weight at V0. All the subjects will be treated subcutaneously for 24 weeks. The 4-week total dose is 0.016mg/kg/IgE(IU/ml), administered every 2 or 4 weeks, for the subjects with total IgE level 60-700IU/ml. If the total IgE level is 700-1500IU/ml, they will be administered 375mg every 2 weeks. Symbicort(Budesonide and formoterol fumarate powder for inhalation) or Seretide (salmeterol xinafoate and fluticasone propionate powder for inhalation) will be used 1/2 inhalations bid as asthma-controlled drug during the whole study. Ventolin (Salbutamol sulphate aerosol) will be used as asthma rescue drug.

Placebo is without active components of the study drug and used as same as the study drug.

Outcomes

Primary Outcome Measures

the mean number of asthma exacerbations per patient during the 24-week treatment period
Asthma exacerbation is defined by a worsening of asthma symptoms resulting in: 1.out-planned outpatient visit; 2.use of systemic and/or nebulized inhaled corticosteroids; 3.emergency room visit; 4. hospitalization.

Secondary Outcome Measures

the proportion of patients with asthma exacerbations during the 24-week treatment period
the number of patients with at least one exacerbations divided by the total number of patients.
time to the first asthma exacerbation during treatment period
the time from baseline to the first asthma exacerbation
change from baseline in asthma symptom scores(daytime, nocturnal and total) over the 24-week treatment period
mean asthma symptom scores(daytime, nocturnal and total): (pre-treatment - post-treatment)/pre-treatment *100%
change from baseline in Asthma Control Test(ACT) over the 24-week treatment period
ACT total score: (pre-treatment - post-treatment)/pre-treatment *100%
change from baseline in Asthma Quality of Life Questionnaire(AQLQ) over the 24-week treatment period
AQLQ total score and threshold score: (pre-treatment - post-treatment)/pre-treatment *100%
investigator's and patient's Global Evaluation of Treatment Effectiveness(GETE) over 16 and 24-week treatment period
GETE score at week 16 and 24
change from baseline in rescue medication use over the 24-week treatment period
mean rescue medication use(puff/day): (pre-treatment - post-treatment)/pre-treatment *100%
change from baseline in lung function parameters(FEV1,FVC and FEV1/FVC) over the 24-week treatment period
FEV1,FVC and FEV1/FVC values: (post-treatment - pre-treatment)/pre-treatment *100%
change from baseline in mean peak expiratory flow(PEF) over the 24-week treatment period
mean PEF value: (post-treatment - pre-treatment)/pre-treatment *100%

Full Information

First Posted
March 7, 2018
Last Updated
October 8, 2021
Sponsor
Shanghai Biomabs Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03468790
Brief Title
Anti-IgE Monoclonal Antibody Treatment in Patients With Allergic Asthma.
Official Title
A Multi-centre, Randomized, Double-blind, Placebo-controlled Phase III Study to Evaluate the Efficacy and Safety of Anti-IgE Monoclonal Antibody to Treat Allergic Asthma Patients Not Adequately Controlled Despite Med/High ICS/LABA.
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
May 9, 2018 (Actual)
Primary Completion Date
January 12, 2021 (Actual)
Study Completion Date
March 9, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Shanghai Biomabs Pharmaceutical Co., Ltd.

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 multi-centre, randomized, double-blind,placebo parallel-controlled phase III study to evaluate the efficacy and safety of CMAB007 (recombinant humanized anti-immunoglobulin E(IgE) monoclonal antibody for injection) to treat asthma patients who remain not adequately controlled despite Med/high ICS plus LABA in China. Following a screening period of up to 2 weeks and run-in period of 4 weeks, randomized patients will enter a 24-week treatment period with CMAB007 or placebo. Efficacy and safety will be assessed at 4-week intervals during the treatment period.
Detailed Description
Approximately 400 asthma patients with an increased serum total IgE level(60-1500 international unit(IU)/ml) and uncontrolled receiving medium to high dose inhaled corticosteroid (ICS) plus long-acting β2-agonist(LABA) will be randomised in about 43 sites in China. They will be administered CMAB007 or placebo at a ratio of 2:1 for 24 weeks. During the whole study, all subjects will be on regularly fixed combination of med/high ICS and LABA (budesonide and formoterol fumarate powder for inhalation or salmeterol xinafoate and fluticasone propionate powder for inhalation). They should complete PEF measurement and patient diary daily and be assessed every 4 weeks. Spirometry, questionnaires, laboratory tests and so on will be performed. At selected sites, about 45 patients will be enrolled in a sub-study to assess the pharmacokinetic and pharmacodynamic characterises of CMAB007. Anti-drug antibody (ADA) will be sampled at V1, V2 and V7 too.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
placebo parallel-controlled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
double-blind
Allocation
Randomized
Enrollment
393 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CMAB007 + Seretide/Symbicort + Ventolin
Arm Type
Experimental
Arm Description
CMAB007(recombinant humanized anti-IgE monoclonal antibody for injection ) will be at a fixed dose determined by the subjects' total IgE and weight at V0. All the subjects will be treated subcutaneously for 24 weeks. The 4-week total dose is 0.016mg/kg/IgE(IU/ml), administered every 2 or 4 weeks, for the subjects with total IgE level 60-700IU/ml. If the total IgE level is 700-1500IU/ml, they will be administered 375mg every 2 weeks. Symbicort(Budesonide and formoterol fumarate powder for inhalation) or Seretide (salmeterol xinafoate and fluticasone propionate powder for inhalation) will be used 1/2 inhalations bid as asthma-controlled drug during the whole study. Ventolin (Salbutamol sulphate aerosol) will be used as asthma rescue drug.
Arm Title
Placebo + Seretide/Symbicort + Ventolin
Arm Type
Placebo Comparator
Arm Description
Placebo is without active components of the study drug and used as same as the study drug.
Intervention Type
Drug
Intervention Name(s)
CMAB007
Other Intervention Name(s)
recombinant humanized anti-IgE monoclonal antibody
Intervention Description
the study drug
Intervention Type
Drug
Intervention Name(s)
Symbicort
Other Intervention Name(s)
budesonide and formoterol fumarate powder for inhalation
Intervention Description
asthma-controlled drug
Intervention Type
Drug
Intervention Name(s)
Seretide
Other Intervention Name(s)
salmeterol xinafoate and fluticasone propionate
Intervention Description
asthma-controlled drug
Intervention Type
Drug
Intervention Name(s)
Ventolin
Other Intervention Name(s)
Salbutamol sulphate aerosol
Intervention Description
asthma rescue drug
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
No active components
Primary Outcome Measure Information:
Title
the mean number of asthma exacerbations per patient during the 24-week treatment period
Description
Asthma exacerbation is defined by a worsening of asthma symptoms resulting in: 1.out-planned outpatient visit; 2.use of systemic and/or nebulized inhaled corticosteroids; 3.emergency room visit; 4. hospitalization.
Time Frame
from baseline(0 week) to 24 weeks
Secondary Outcome Measure Information:
Title
the proportion of patients with asthma exacerbations during the 24-week treatment period
Description
the number of patients with at least one exacerbations divided by the total number of patients.
Time Frame
from baseline(0 week) to 24 weeks
Title
time to the first asthma exacerbation during treatment period
Description
the time from baseline to the first asthma exacerbation
Time Frame
from baseline(0 week) to 24 weeks
Title
change from baseline in asthma symptom scores(daytime, nocturnal and total) over the 24-week treatment period
Description
mean asthma symptom scores(daytime, nocturnal and total): (pre-treatment - post-treatment)/pre-treatment *100%
Time Frame
from baseline(0 week) to 24 weeks
Title
change from baseline in Asthma Control Test(ACT) over the 24-week treatment period
Description
ACT total score: (pre-treatment - post-treatment)/pre-treatment *100%
Time Frame
from baseline(0 week) to 24 weeks
Title
change from baseline in Asthma Quality of Life Questionnaire(AQLQ) over the 24-week treatment period
Description
AQLQ total score and threshold score: (pre-treatment - post-treatment)/pre-treatment *100%
Time Frame
from baseline(0 week) to 24 weeks
Title
investigator's and patient's Global Evaluation of Treatment Effectiveness(GETE) over 16 and 24-week treatment period
Description
GETE score at week 16 and 24
Time Frame
from baseline(0 week) to 16 and 24 weeks
Title
change from baseline in rescue medication use over the 24-week treatment period
Description
mean rescue medication use(puff/day): (pre-treatment - post-treatment)/pre-treatment *100%
Time Frame
from baseline(0 week) to 24 weeks
Title
change from baseline in lung function parameters(FEV1,FVC and FEV1/FVC) over the 24-week treatment period
Description
FEV1,FVC and FEV1/FVC values: (post-treatment - pre-treatment)/pre-treatment *100%
Time Frame
from baseline(0 week) to 24 weeks
Title
change from baseline in mean peak expiratory flow(PEF) over the 24-week treatment period
Description
mean PEF value: (post-treatment - pre-treatment)/pre-treatment *100%
Time Frame
from baseline(0 week) to 24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
15 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed and dated informed consent prior to any study assessment; Age 15-75 years inclusive, female or male; Diagnosed as asthma according to the guideline for the prevention and treatment of bronchial asthma in China (version 2016), with duration for more than 1 years; Have had at least one severe asthma exacerbations(requiring systemic steroid use) in the previous one year; At screening, serum total IgE level 60-1500IU/ml and body weight 20-150kg. Receiving seretide(fluticasone>250ug/day) or symbicort(budesonide>400ug/day) for at least 3 months and stable dose for at least 4 weeks prior to screening. Asthma symptom control level is still partly controlled or uncontrolled. Detailed drugs and usage are one of the following: Seretide 50/250ug 1 inhalation bid;Seretide 50/500ug 1 inhalation bid;Symbicort 160/4.5ug 2 inhalations bid or Symbicort 320/9ug 1 inhalation bid. None of other asthma controller medications other than seretide or symbicort including systemic steroid, leukotriene modifiers, theophylline, histamine1 receptor blockers, anticholinergic drugs, traditional Chinese medicine and so on have been used 2 weeks prior to screening. At screening, FEV1 < 80% of the predicted normal value. At screening, laboratory tests results should meet all of the following: hemoglobin≥80g/l;3*10^9/l≤white blood cell≤10*10^9/l;platelet≥75*10^9/l;liver function(glutamic-pyruvic transaminase, glutamic-oxalacetic transaminase and total bilirubin)≤2*upper limit of normal value;renal function≤1.5*upper limit of normal value. At screening, pregnant test is negative,or not lactating, for women of child-bearing potential. Effective methods of contraception will be maintained throughout the study and 6 months after the study. Can understand and complete questionnaires correctly, complete PEF and patient diary correctly, and be followed up according to scheduled table. Exclusion Criteria: History of critical asthma exacerbations,such as tracheal intubation or intensive care unit admission. Currently smoker, or a former smoker with a smoking history > 10 pack-years(defined as the number of packs of 20 cigarettes smoked per day multiplied by number of years the patient smoked). Have elevated serum IgE levels for other causes other than allergens, such as parasite infections, allergic bronchopulmonary aspergillosis, Churg-Strauss syndrome and so on. Desensitization therapy or immunosuppressant agents such as cyclosporine, methotrexate and gold preparation during 3 months prior to screening. Biological agents such as monoclonal antibody including investigational biological drugs during 6 months prior to screening. Vaccinated live/attenuated virus or bacterial vaccines, or intravenous used immunoglobulin G, during 4 weeks prior to screening. History of bronchial thermoplasty for asthma during 12 months prior to screening. Use of any anti-IgE monoclonal antibody including Xolair for asthma during 12 months prior to screening. Respiratory infections(such as pneumonia,upper respiratory tract infection,etc)or large surgeries during 4 weeks prior to screening. Combined with other pulmonary diseases, such as chronic obstructive pulmonary disease, bronchiectasis, pulmonary interstitial fibrosis, etc. History of malignancies other than squamous cell carcinoma or basal cell carcinoma of the skin and carcinoma in situs of cervix with complete excision and no evidence of recurrences. Acquired immune deficiency syndrome or human immunodeficiency virus infection patients. History of malignant or proliferative diseases of the lymphatic system such as lymphoma, or there are symptoms and signs indicating lymphatic proliferative diseases, or splenomegaly (≥2cm under the ribs). With uncontrolled hypertension(systolic pressure ≥160 or diastolic pressure ≥100 in millimeters of mercury) at screening. With severe, progressive or uncontrolled hepatic, renal, gastrointestinal, cardio-cerebral vascular, hematopoietic,genitourinary, endocrine, nervous and immunological medical conditions, or other conditions that investigators think the patient not suitable for this study. Have a history of drug or alcohol abuse or poor compliance of drugs. With known hypersensitivity to human immunoglobulin, anti-IgE monoclonal antibody for injection or components. Have attended other clinical trials of investigational drugs, or within 30 days or 5 half-lives of enrollment, whichever is longer.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nanshan Zhong, M.D.
Organizational Affiliation
The First Affiliated Hospital of Guangzhou Medical University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital of Guangzhou Medical University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510030
Country
China
Facility Name
The First Affiliated Hospital of Wenzhou Medical University
City
Wenzhou
State/Province
Zhejiang
ZIP/Postal Code
325000
Country
China

12. IPD Sharing Statement

Plan to Share IPD
No

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Anti-IgE Monoclonal Antibody Treatment in Patients With Allergic Asthma.

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