Dupilumab in Chronic Spontaneous Urticaria (DUPICSU)
Primary Purpose
Chronic Spontaneous Urticaria, Recurrent Angioedema
Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Dupilumab
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Spontaneous Urticaria focused on measuring hives, itch
Eligibility Criteria
Inclusion Criteria:
Diagnosis: chronic spontaneous urticaria (defined as ongoing disease)
- Patient is informed about study procedures and medications and has given written informed consent before any assessment.
- Patient is able to communicate with the investigator, understands and complies with the requirements of the study.
- Male or Female
- Patient is 18-75 years of age
Patient is diagnosed with moderate to severe CSU and refractory to standard of care treatment at the time of randomization, as defined by the following:
- The presence of itch and hives for more than 6 consecutive weeks at any time prior to enrollment despite current use of H1 antihistamine
- Urticaria activity score UAS7 score (range 0-42) equal or more than 16, 7 days prior to randomization (Day 1)
- CSU diagnosis for 6 months
- Willing and able to complete a daily symptom diary for the duration of the study and adhere to the study visit schedules.
- Patients must not have more than one missing diary entry in the 7 days prior to randomization. Re-screening may be considered.
- Women of childbearing potential have to agree to use an acceptable form of contraception (as determined by the site investigator) and have to continue its use for the duration of the study.
Exclusion Criteria:
- Patients whose urticaria is solely due to inducible urticaria.
- Other diseases with symptoms of urticaria or angioedema, including urticarial vasculitis, erythema multiforme, cutaneous mastocytosis (urticaria pigmentosa), and hereditary or acquired angioedema (e.g., due to C1 inhibitor deficiency)
- Any other active skin disease associated with chronic itching that might confound the study evaluations and results (e.g., atopic dermatitis, bullous pemphigoid, dermatitis herpetiformis, etc.)
Patients who have received concomitant prohibited medication within the last 3 months prior to screening
- Anti-IgE therapy (e.g. omalizumab)
- Routine (daily or every other day during 5 or more consecutive days) doses of systemic corticosteroids or other immunosuppressants
- Intravenous immunoglobulins
- Biological therapy
- Systemic immunosuppressants
- Live/attenuated vaccines
- Other investigational drug
- History of anaphylactic shock
- Active helminthic parasite infection or treatment of helminthic parasites within 6 months of screening
Sites / Locations
- Universitätsklinikum Giessen und Marburg
- Hautklinik Universitätsklinikum Münster
- Hautklinik der Universitätsmedizin Mainz Clinical Research Center
- Universitätsklinikum Carl Gustav Carus
- Universitätsmedizin Leipzig, Klinik für Dermatologie, Venerologie und Allergologie
- Charite University, Berlin, Germany
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Dupilumab
Placebo Comparator
Arm Description
Dupilumab (anti-IL4Ra), s.c. administration
matching Placebo, s.c. administration
Outcomes
Primary Outcome Measures
Urticaria activity score over 7 days (UAS7)
0-42 Points total range over 7 days, higher values equal more disease activity
Secondary Outcome Measures
Itch severity score (ISS7; 0 - no pruritus; 21 - most severe pruritus), hive severity score (HSS7; 0 - no hives; 21 - max. hive severity)
Disease activity scores
Global assessment for disease activity
Global assessment for disease activity(physician and patient) by visual analogue scale (VAS; 0 - no pain; 10 - max. amount of pain)
urticaria control test (UCT; 16 - complete disease control; 0 - strong symptoms), dermatological quality of life (DLQI; 0 - no impairment; 30 - max. impairment), chronic urticaria quality of life (Cu2-QoL; 23 - no impairment; 115 - max. impairment)
Disease specific quality of life
Responder rates (regarding disease activity and quality of live (QoL))
Responder rates (regarding disease activity and quality of live (QoL))
rate of angioedema burdened days angioedema activity score (AAS; 0 - lowest disease activity; 15 - highest disease activity) angioedema quality of life (AE-Qol; 0 - no impairment; 100 - worst impairment)
For patients with concomitant angioedema
Rescue medication use
Frequency of of how often rescue medication is used
Full Information
NCT ID
NCT03749135
First Posted
July 12, 2018
Last Updated
February 1, 2022
Sponsor
Charite University, Berlin, Germany
Collaborators
Sanofi, Proinnovera GmbH
1. Study Identification
Unique Protocol Identification Number
NCT03749135
Brief Title
Dupilumab in Chronic Spontaneous Urticaria
Acronym
DUPICSU
Official Title
A Multicenter, Randomized, Double-blind, Placebo-controlled, Proof-of-concept Phase 2, 16-week Treatment Study With a 16 Week Follow-up Period to Assess the Efficacy and Safety of Dupilumab (Anti-IL4Ra) in Adult Patients With Chronic Spontaneous Urticaria Despite H1-antihistamine Treatment.
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
November 12, 2018 (Actual)
Primary Completion Date
July 7, 2021 (Actual)
Study Completion Date
July 7, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Charite University, Berlin, Germany
Collaborators
Sanofi, Proinnovera GmbH
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to assess the efficacy in reducing disease activity and safety of Dupilumab in adult patients with chronic spontaneous urticaria (CSU) who are symptomatic despite H1-antihistamine treatment.
Detailed Description
Treatment with Dupilumab has been shown to reduce clinically significant exacerbations and to improve skin symptom control as well as quality of life in moderate to severe atopic dermatitis patients and in moderate to severe asthma patients. It has been approval by European Medicines Agency (EMA) for the treatment of atopic dermatitis patients in September 2017.
Dupilumab is a novel monoclonal antibody that inhibits interleukin-4 (IL-4) and interleukin-13 (IL-13) signaling and was previously found to be effective in atopic dermatitis and asthma. Considering that CSU and atopic diseases share many common features (e.g. key pathogenic role of mast cells and immunoglobulin E (IgE), itch is a dominant symptom, Th2 dominance), it is reasonable to expect that Dupilumab is beneficial in CSU.
These results suggest that Dupilumab may provide an effective treatment option for patients with insufficient treatment responses to H1-antihistamines exhibiting wheal and flare type skin reactions.
The gold standard treatment of CSU consists of administration of antihistamines. In more than 50% of the patients, symptoms persist with standard dosing of antihistamines. In antihistamine-refractory patients with chronic spontaneous urticaria, the currently only licensed treatment is omalizumab, a monoclonal anti-IgE antibody. In 2014, omalizumab has been licensed for add-on therapy in CSU patients who still have symptoms despite standard-dosed antihistamine treatment. There is, however, still a great medical need for additional treatment options, as 20-40% of patients are still without effective therapy. These patients have no other licensed treatment option and can only be treated off-label with therapeutics with several known safety risks such as Cyclosporine A.
Dupilumab has excellent potential to provide symptom control in CSU. This study will provide additional valuable insights into the therapeutic potential of Dupilumab in improving quality of life in these patients, in addition to managing CSU symptoms.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Spontaneous Urticaria, Recurrent Angioedema
Keywords
hives, itch
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This is a Phase 2a multicenter, randomized, double blind, placebo controlled, parallel group, two-arm, proof-of-concept investigator-initiated trial
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
randomized, double blind, placebo controlled
Allocation
Randomized
Enrollment
72 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Dupilumab
Arm Type
Active Comparator
Arm Description
Dupilumab (anti-IL4Ra), s.c. administration
Arm Title
Placebo Comparator
Arm Type
Placebo Comparator
Arm Description
matching Placebo, s.c. administration
Intervention Type
Drug
Intervention Name(s)
Dupilumab
Intervention Description
anti-IL4-Receptor alpha
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Urticaria activity score over 7 days (UAS7)
Description
0-42 Points total range over 7 days, higher values equal more disease activity
Time Frame
Change from 7 days prior to baseline (Visit (V) 1) to 7 days prior to week 16 (V9)
Secondary Outcome Measure Information:
Title
Itch severity score (ISS7; 0 - no pruritus; 21 - most severe pruritus), hive severity score (HSS7; 0 - no hives; 21 - max. hive severity)
Description
Disease activity scores
Time Frame
Change from 7 days prior to baseline (Visit (V) 1) to 7 days prior to week 16 (V9)
Title
Global assessment for disease activity
Description
Global assessment for disease activity(physician and patient) by visual analogue scale (VAS; 0 - no pain; 10 - max. amount of pain)
Time Frame
Change from 7 days prior to baseline (V1) to 7 days prior to week 16 (V9)
Title
urticaria control test (UCT; 16 - complete disease control; 0 - strong symptoms), dermatological quality of life (DLQI; 0 - no impairment; 30 - max. impairment), chronic urticaria quality of life (Cu2-QoL; 23 - no impairment; 115 - max. impairment)
Description
Disease specific quality of life
Time Frame
Change from 7 days prior to baseline (V1) to 7 days prior to week 16 (V9)
Title
Responder rates (regarding disease activity and quality of live (QoL))
Description
Responder rates (regarding disease activity and quality of live (QoL))
Time Frame
Change from 7 days prior to baseline (V1) to 7 days prior to week 16 (V9)
Title
rate of angioedema burdened days angioedema activity score (AAS; 0 - lowest disease activity; 15 - highest disease activity) angioedema quality of life (AE-Qol; 0 - no impairment; 100 - worst impairment)
Description
For patients with concomitant angioedema
Time Frame
Change from 7 days prior to baseline (V1) to 7 days prior to week 16 (V9)]
Title
Rescue medication use
Description
Frequency of of how often rescue medication is used
Time Frame
Change from 7 days prior to baseline (V1) to 7 days prior to week 16 (V9)]
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis: chronic spontaneous urticaria (defined as ongoing disease)
Patient is informed about study procedures and medications and has given written informed consent before any assessment.
Patient is able to communicate with the investigator, understands and complies with the requirements of the study.
Male or Female
Patient is 18-75 years of age
Patient is diagnosed with moderate to severe CSU and refractory to standard of care treatment at the time of randomization, as defined by the following:
The presence of itch and hives for more than 6 consecutive weeks at any time prior to enrollment despite current use of H1 antihistamine
Urticaria activity score UAS7 score (range 0-42) equal or more than 16, 7 days prior to randomization (Day 1)
CSU diagnosis for 6 months
Willing and able to complete a daily symptom diary for the duration of the study and adhere to the study visit schedules.
Patients must not have more than one missing diary entry in the 7 days prior to randomization. Re-screening may be considered.
Women of childbearing potential have to agree to use an acceptable form of contraception (as determined by the site investigator) and have to continue its use for the duration of the study.
Exclusion Criteria:
Patients whose urticaria is solely due to inducible urticaria.
Other diseases with symptoms of urticaria or angioedema, including urticarial vasculitis, erythema multiforme, cutaneous mastocytosis (urticaria pigmentosa), and hereditary or acquired angioedema (e.g., due to C1 inhibitor deficiency)
Any other active skin disease associated with chronic itching that might confound the study evaluations and results (e.g., atopic dermatitis, bullous pemphigoid, dermatitis herpetiformis, etc.)
Patients who have received concomitant prohibited medication within the last 3 months prior to screening
Anti-IgE therapy (e.g. omalizumab)
Routine (daily or every other day during 5 or more consecutive days) doses of systemic corticosteroids or other immunosuppressants
Intravenous immunoglobulins
Biological therapy
Systemic immunosuppressants
Live/attenuated vaccines
Other investigational drug
History of anaphylactic shock
Active helminthic parasite infection or treatment of helminthic parasites within 6 months of screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marcus Maurer, Prof.
Organizational Affiliation
Charite University, Berlin, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitätsklinikum Giessen und Marburg
City
Marburg
State/Province
Hessen
ZIP/Postal Code
35043
Country
Germany
Facility Name
Hautklinik Universitätsklinikum Münster
City
Münster
State/Province
NRW, Germany
ZIP/Postal Code
48149
Country
Germany
Facility Name
Hautklinik der Universitätsmedizin Mainz Clinical Research Center
City
Mainz
State/Province
Rheinland-Pfalz, Germany
ZIP/Postal Code
55101
Country
Germany
Facility Name
Universitätsklinikum Carl Gustav Carus
City
Dresden
State/Province
Sachsen
ZIP/Postal Code
01307
Country
Germany
Facility Name
Universitätsmedizin Leipzig, Klinik für Dermatologie, Venerologie und Allergologie
City
Leipzig
State/Province
Sachsen
ZIP/Postal Code
04103
Country
Germany
Facility Name
Charite University, Berlin, Germany
City
Berlin
ZIP/Postal Code
10117
Country
Germany
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Dupilumab in Chronic Spontaneous Urticaria
We'll reach out to this number within 24 hrs