Effects of p38 Inhibitor AZD7624 in Corticosteroid Resistant Asthma
Corticosteroid Resistant (CR) Asthmatics
About this trial
This is an interventional treatment trial for Corticosteroid Resistant (CR) Asthmatics
Eligibility Criteria
Inclusion Criteria:
Asthmatic Subjects
- Males and women of non-childbearing potential aged 18-65 of any racial or ethnic background, who are physically and mentally able to cooperate with the proposed tests and procedures and who are able to give informed consent.
- Asthma defined by symptoms and/or a doctor's diagnosis compatible with asthma as per 2014 GINA Guidelines.
- Symptomatic patients (ACQ>1.25) with FEV1 % predicted 80%, currently taking ICS or ICS/LABA. Patients should demonstrate normal bronchodilator response, i.e. there must be equal or greater than 12% or 200ml improvement in FEV1 post-bronchodilator (albuterol).
Females must have a negative pregnancy test at Visit 1, must not be lactating and must be of non-childbearing potential, by fulfilling one of the following criteria:
- Postmenopausal defined as amenorrhoea for at least 12 months or more following cessation of all possible exogenous hormonal treatments and luteinising hormone (LH) and follicle-stimulating hormone (FSH) levels in the postmenopausal range (at Visit 1)
- Documentation of irreversible surgical sterilisation by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation
- Males must be surgically sterile or agree to use an acceptable method of contraception (defined as barrier methods in conjunction with spermicides) for the duration of the study (from the time they sign consent) and for 3 months after the last dose of investigational product to prevent pregnancy in a partner.
- A weight of ≥50 kg (measured at Visit 1)
Healthy Controls
- Subjects must be 18 to 65 years old, who are physically and mentally able to cooperate with the proposed tests and procedures and who are able to give informed consent.
- They must have no respiratory or cardiac symptoms (cough, phlegm, wheeze, dyspnea) and no physician diagnosed cardiac or respiratory disease.
- No allergic history.
- FEV1≥ 80%
Females must have a negative pregnancy test at Visit 1, must not be lactating and must be of non-childbearing potential, by fulfilling one of the following criteria:
- Postmenopausal defined as amenorrhoea for at least 12 months or more following cessation of all possible exogenous hormonal treatments and luteinising hormone (LH) and follicle-stimulating hormone (FSH) levels in the postmenopausal range (at Visit 1)
- Documentation of irreversible surgical sterilisation by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation
- A weight of ≥50 kg (measured at Visit 1)
Exclusion Criteria:
- An FEVl <60% predicted post albuterol bronchodilator.
- Oral steroid use within the past 6 weeks.
- Acute respiratory illness within 6 weeks of the study.
- Another pulmonary disease expected to affect participation in the study or the measurements to be examined.
- Pregnancy.
- Smoking in last year or prior smoking history of more than 10 pack years.
- Previous randomization to treatment in the present study (at Visit 1)
- Participation in another clinical study with any novel investigational medicine product within 3 months before the first dose of investigational product in this study (at Visit 4)
- Previously intake of any p38 inhibitor (same class as AZD7624)
- Significant disease or disorder other than asthma (e.g. cardiovascular; pulmonary as e.g. tuberculosis and cystic fibrosis; gastrointestinal, liver; neurological; musculoskeletal; endocrine; metabolic; malignant; psychiatric; major physical impairment) which, in the opinion of the investigator, may either put the patient at risk because of participation in the study, or influence the results of the study, or the patient's ability to participate in the study (at Visit 1)
- Any clinically relevant abnormal findings in clinical chemistry, haematology and urinalysis, which, in the opinion of the investigator, may put the patient at risk because of participation in the study (for CR patients only at Visit 3a)
- Any clinically relevant abnormal findings in physical examination, pulse or blood pressure which, in the opinion of the investigator, may put the patient at risk because of participation in the study (at Visit 1)
- History or family history of muscle diseases (at Visit 1)
Abnormal vital signs, after 10 minutes supine rest, defined as any of the following (CR patients, at Visit 3a):
- Systolic blood pressure (SBP) above 140 mmHg if <60 years of age and above 150 mmHg if ≥60 years of age
- Diastolic blood pressure (DBP) above 90 mmHg
- Pulse <50 or >100 bpm
- Unstable angina pectoris or stable angina pectoris classified higher than Canadian Cardiovascular Society (CSS) class 2. History of hospitalization within 12 months caused by heart failure or a diagnosis of heart failure higher than New York Heart Association (NYHA) class II. Acute myocardial infarction within 6 months of screening (CR patients, Visit 3a).
- Treatment with strong CYP3A inhibitors (like erythromycin and itraconazole), within 4 weeks prior to randomization (CVR patients, Visit 4). Patients on anticoagulation treatment.
Healthy Controls
- Evidence on history, physical examination, or screening spirometry of Lung disease or other disease that will affect participation in the study or the measurements to be examined.
- Smoking in the last year or prior smoking history of more than 10 pack years.
Sites / Locations
- National Jewish Health
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
No Intervention
Other
Active Comparator
Placebo Comparator
Normal control
Corticosteroid sensitive (CS) asthmatics
Corticosteroid resistant (CR) asthmatics active
Corticosteroid resistant (CR) asthmatics placebo
Health volunteers will be recruited as an additional control group.
After the initial visit, asthmatics will be given oral prednisone for 1 week and patients will return for the spirometer assessment. Patients will be defined as CR if <10% improvement in FEV1 % predicted is observed and as CS in >12% improvement in FEV1% predicted is observed.
The study will have a 1 week oral corticosteroid (OSC) run-in period. Subjects unresponsive to OCS will be defined as corticosteroid resistant (CR) and randomized to two crossover treatment sequences consisting of 4 weeks of inhaled AZD7624 or placebo, followed by 4 weeks of a washout period, and another 4 weeks of placebo or ASD7624
The study will have a 1 week oral corticosteroid (OSC) run-in period. Subjects unresponsive to OCS will be defined as corticosteroid resistant (CR) and randomized to two crossover treatment sequences consisting of 4 weeks of inhaled AZD7624 or placebo, followed by 4 weeks of a washout period, and another 4 weeks of placebo or ASD7624