Tezepelumab COPD Exacerbation Study (COURSE)
Primary Purpose
Chronic Obstructive Pulmonary Disease (COPD)
Status
Active
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tezepelumab
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease (COPD) focused on measuring COPD, Moderate COPD, Severe COPD, chronic obstructive pulmonary disease
Eligibility Criteria
Inclusion Criteria:
- History of moderate to very severe physician-diagnosed COPD for at least 12 months prior to enrolment with a post-bronchodilator FEV1/FVC<0.70 and a post-bronchodilator FEV1 ≥20% and ≤80% of predicted normal value.
- History of at least 2 documented moderate to severe COPD exacerbations within 2 to 52 weeks prior to enrollment.
- CAT score of ≥15 at enrollment and on day of randomization.
- Documented treatment with triple therapy for COPD (medium or high dose ICS/LABA/LAMA) throughout the year prior to enrollment. The dose of ICS should be stable for 3 months prior to enrollment.
Exclusion Criteria:
- Clinically important pulmonary disease other than COPD, as judged by the Investigator (including current or historic asthma diagnosis).
- Any disorder, including, but not limited to, cardiovascular, gastrointestinal, hepatic, renal, neurological, musculoskeletal, infectious (including risk factors for pneumonia), endocrine, metabolic, hematological, psychiatric, or major physical impairment that is not stable.
- Major surgery within 8 weeks before enrollment.
- History of clinically significant infection requiring antibiotics or antiviral medication within 14 days before enrollment.
- Pregnant or breastfeeding.
- The chest/lungs with pathology that precludes the patient's ability to complete the study
- The patient has active COVID 19 infection during screening period.
Sites / Locations
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
- Research Site
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Tezepelumab
Matching Placebo
Arm Description
Tezepelumab, SC, Q4W
Matching placebo, SC, Q4W
Outcomes
Primary Outcome Measures
Moderate or severe COPD exacerbation rate ratio (tezepelumab vs placebo)
The exacerbation rate is based on exacerbations reported by the investigator over 52 weeks.
Secondary Outcome Measures
Time to first moderate or severe COPD exacerbation
Time to first occurrence of moderate/severe exacerbation post randomization. Outcome measures: Hazard ratio
Proportion with at least one moderate/severe COPD exacerbation
Proportion of subjects with at least one moderate/severe exacerbation reported by the Investigator over 52 weeks Outcome measure: Odds Ratio
Severe COPD exacerbation rate ratio (tezepelumab vs. placebo)
The severe exacerbation rate is based on severe exacerbations reported by the Investigator over 52 weeks.
Change from baseline in pre-bronchodilator (pre-BD) forced expiratory volume in 1 second (FEV1)
Difference in change from baseline in pre-BD forced expiratory volume in 1 second (FEV1) in tezepelumab arm as compared to placebo at Week 52.
FEV1 is defined as the volume of air exhaled from the lungs in the first second of forced expiration.
Change in respiratory health status/health-related quality of life
Proportion of subjects achieving a decrease of 4 units or more in the St. George's Respiratory Questionnaire (SGRQ) total score at Week 52, i.e. minimum clinically important difference (MCID).
Outcome measure: odds ratio
Change from baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score
Difference (tezepelumab vs. placebo) in SGRQ from baseline at Week 52.
SGRQ is a 50-item patient reported outcome questionnaire. The SGRQ total score is expressed as a percentage of overall impairment, in which 100% means the worst possible health status and 0% indicates the best possible health status. Likewise, the domain scores range from 0 to 100, with higher scores indicative of greater impairment. Decrease of 4 units is associated with a minimum clinically important difference (MCID).
Change from baseline in the COPD Assessment Test (CAT) Total Score
Difference (tezepelumab vs. placebo) in COPD assessment tool (CAT) from baseline at Week 52.
CAT is an 8-item patient reported outcome questionnaire developed to measure the impact of COPD on health status. The instrument uses semantic differential six-point response scales. A CAT total score is the sum of item responses. The score ranges from 0 to 40, with higher scores indicating greater COPD impact on health status.
Evaluate pharmacokinetics of tezepelumab
Serum trough concentration of tezepelumab
Evaluate immunogenicity of tezepelumab
Incidence of anti-drug antibodies (ADA)
Full Information
NCT ID
NCT04039113
First Posted
July 29, 2019
Last Updated
July 21, 2023
Sponsor
AstraZeneca
Collaborators
Amgen
1. Study Identification
Unique Protocol Identification Number
NCT04039113
Brief Title
Tezepelumab COPD Exacerbation Study
Acronym
COURSE
Official Title
A Randomized, Double-blind, Placebo-controlled, Parallel Group, Multicenter Phase 2a Study to Explore the Efficacy and Safety of Tezepelumab in Patients With Moderate to Very Severe Chronic Obstructive Pulmonary Disease (COPD) (COURSE)
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
July 30, 2019 (Actual)
Primary Completion Date
November 7, 2023 (Anticipated)
Study Completion Date
January 30, 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca
Collaborators
Amgen
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase 2a Study to Explore the Efficacy and Safety of Tezepelumab in Adults with Moderate to Very Severe Chronic Obstructive Pulmonary Disease (COPD)
Detailed Description
This is a Phase 2a, multicenter, randomized, double-blind, placebo-controlled, parallel group study to evaluate the safety and efficacy of tezepelumab in adults with moderate to very severe chronic obstructive pulmonary disease (COPD) receiving triple inhaled maintenance therapy, and having had 2 or more documented COPD exacerbations in the 12 months prior to Visit 1. Approximately, 338 subjects will be randomized globally. Subjects will be stratified by region and prior number of exacerbations (2 vs. 3 or more). Subjects will receive tezepelumab, or placebo, administered via subcutaneous injection at the study site, over a 52 week treatment period. The study also includes a post-treatment follow-up period of 12 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease (COPD)
Keywords
COPD, Moderate COPD, Severe COPD, chronic obstructive pulmonary disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subjects will be randomized in a 1:1 ratio to either tezepelumab or matching placebo both administered subcutaneously.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Double-blinded
Allocation
Randomized
Enrollment
337 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Tezepelumab
Arm Type
Active Comparator
Arm Description
Tezepelumab, SC, Q4W
Arm Title
Matching Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo, SC, Q4W
Intervention Type
Biological
Intervention Name(s)
Tezepelumab
Intervention Description
Tezepelumab subcutaneous injection
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Placebo subcutaneous injection
Primary Outcome Measure Information:
Title
Moderate or severe COPD exacerbation rate ratio (tezepelumab vs placebo)
Description
The exacerbation rate is based on exacerbations reported by the investigator over 52 weeks.
Time Frame
Over 52 Weeks
Secondary Outcome Measure Information:
Title
Time to first moderate or severe COPD exacerbation
Description
Time to first occurrence of moderate/severe exacerbation post randomization. Outcome measures: Hazard ratio
Time Frame
By Week 52
Title
Proportion with at least one moderate/severe COPD exacerbation
Description
Proportion of subjects with at least one moderate/severe exacerbation reported by the Investigator over 52 weeks Outcome measure: Odds Ratio
Time Frame
Over 52 Weeks
Title
Severe COPD exacerbation rate ratio (tezepelumab vs. placebo)
Description
The severe exacerbation rate is based on severe exacerbations reported by the Investigator over 52 weeks.
Time Frame
Over 52 Weeks
Title
Change from baseline in pre-bronchodilator (pre-BD) forced expiratory volume in 1 second (FEV1)
Description
Difference in change from baseline in pre-BD forced expiratory volume in 1 second (FEV1) in tezepelumab arm as compared to placebo at Week 52.
FEV1 is defined as the volume of air exhaled from the lungs in the first second of forced expiration.
Time Frame
Baseline, Week 52
Title
Change in respiratory health status/health-related quality of life
Description
Proportion of subjects achieving a decrease of 4 units or more in the St. George's Respiratory Questionnaire (SGRQ) total score at Week 52, i.e. minimum clinically important difference (MCID).
Outcome measure: odds ratio
Time Frame
Baseline, Week 52
Title
Change from baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score
Description
Difference (tezepelumab vs. placebo) in SGRQ from baseline at Week 52.
SGRQ is a 50-item patient reported outcome questionnaire. The SGRQ total score is expressed as a percentage of overall impairment, in which 100% means the worst possible health status and 0% indicates the best possible health status. Likewise, the domain scores range from 0 to 100, with higher scores indicative of greater impairment. Decrease of 4 units is associated with a minimum clinically important difference (MCID).
Time Frame
Baseline, Week 52
Title
Change from baseline in the COPD Assessment Test (CAT) Total Score
Description
Difference (tezepelumab vs. placebo) in COPD assessment tool (CAT) from baseline at Week 52.
CAT is an 8-item patient reported outcome questionnaire developed to measure the impact of COPD on health status. The instrument uses semantic differential six-point response scales. A CAT total score is the sum of item responses. The score ranges from 0 to 40, with higher scores indicating greater COPD impact on health status.
Time Frame
Baseline, Week 52
Title
Evaluate pharmacokinetics of tezepelumab
Description
Serum trough concentration of tezepelumab
Time Frame
Weeks 0, 4, 12, 24, 36, 52, 64
Title
Evaluate immunogenicity of tezepelumab
Description
Incidence of anti-drug antibodies (ADA)
Time Frame
Over 52 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
History of moderate to very severe physician-diagnosed COPD for at least 12 months prior to enrolment with a post-bronchodilator FEV1/FVC<0.70 and a post-bronchodilator FEV1 ≥20% and ≤80% of predicted normal value.
History of at least 2 documented moderate to severe COPD exacerbations within 2 to 52 weeks prior to enrollment.
CAT score of ≥15 at enrollment and on day of randomization.
Documented treatment with triple therapy for COPD (medium or high dose ICS/LABA/LAMA) throughout the year prior to enrollment. The dose of ICS should be stable for 3 months prior to enrollment.
Exclusion Criteria:
Clinically important pulmonary disease other than COPD, as judged by the Investigator (including current or historic asthma diagnosis).
Any disorder, including, but not limited to, cardiovascular, gastrointestinal, hepatic, renal, neurological, musculoskeletal, infectious (including risk factors for pneumonia), endocrine, metabolic, hematological, psychiatric, or major physical impairment that is not stable.
Major surgery within 8 weeks before enrollment.
History of clinically significant infection requiring antibiotics or antiviral medication within 14 days before enrollment.
Pregnant or breastfeeding.
The chest/lungs with pathology that precludes the patient's ability to complete the study
The patient has active COVID 19 infection during screening period.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dave Singh, MD
Organizational Affiliation
Division of Infection, Immunity & Resp Medicine, The University of Manchester, United Kingdom
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site
City
Dothan
State/Province
Alabama
ZIP/Postal Code
36305
Country
United States
Facility Name
Research Site
City
Huntington Beach
State/Province
California
ZIP/Postal Code
92647
Country
United States
Facility Name
Research Site
City
Newport Beach
State/Province
California
ZIP/Postal Code
92663
Country
United States
Facility Name
Research Site
City
Upland
State/Province
California
ZIP/Postal Code
91786
Country
United States
Facility Name
Research Site
City
Westminster
State/Province
California
ZIP/Postal Code
92683
Country
United States
Facility Name
Research Site
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06510
Country
United States
Facility Name
Research Site
City
Brandon
State/Province
Florida
ZIP/Postal Code
33511
Country
United States
Facility Name
Research Site
City
Orlando
State/Province
Florida
ZIP/Postal Code
32819
Country
United States
Facility Name
Research Site
City
Panama City
State/Province
Florida
ZIP/Postal Code
32405
Country
United States
Facility Name
Research Site
City
Tampa
State/Province
Florida
ZIP/Postal Code
33607
Country
United States
Facility Name
Research Site
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789-4681
Country
United States
Facility Name
Research Site
City
Buckley
State/Province
Michigan
ZIP/Postal Code
49620
Country
United States
Facility Name
Research Site
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87108
Country
United States
Facility Name
Research Site
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28277
Country
United States
Facility Name
Research Site
City
Mooresville
State/Province
North Carolina
ZIP/Postal Code
28117
Country
United States
Facility Name
Research Site
City
New Bern
State/Province
North Carolina
ZIP/Postal Code
28562
Country
United States
Facility Name
Research Site
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43215
Country
United States
Facility Name
Research Site
City
Edmond
State/Province
Oklahoma
ZIP/Postal Code
73034
Country
United States
Facility Name
Research Site
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Research Site
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
Research Site
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Research Site
City
Mount Pleasant
State/Province
South Carolina
ZIP/Postal Code
29464
Country
United States
Facility Name
Research Site
City
Rock Hill
State/Province
South Carolina
ZIP/Postal Code
29732
Country
United States
Facility Name
Research Site
City
Rapid City
State/Province
South Dakota
ZIP/Postal Code
57702
Country
United States
Facility Name
Research Site
City
McKinney
State/Province
Texas
ZIP/Postal Code
75069
Country
United States
Facility Name
Research Site
City
Abingdon
State/Province
Virginia
ZIP/Postal Code
24210
Country
United States
Facility Name
Research Site
City
Everett
State/Province
Washington
ZIP/Postal Code
98208
Country
United States
Facility Name
Research Site
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 4Z6
Country
Canada
Facility Name
Research Site
City
Sherwood Park
State/Province
Alberta
ZIP/Postal Code
T8L 0N2
Country
Canada
Facility Name
Research Site
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V5Z 1M9
Country
Canada
Facility Name
Research Site
City
Truro
State/Province
Nova Scotia
ZIP/Postal Code
B2N 1L2
Country
Canada
Facility Name
Research Site
City
Burlington
State/Province
Ontario
ZIP/Postal Code
L7N 3V2
Country
Canada
Facility Name
Research Site
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
Facility Name
Research Site
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H1M 1B1
Country
Canada
Facility Name
Research Site
City
St Charles Borromee
State/Province
Quebec
ZIP/Postal Code
J6E 2B4
Country
Canada
Facility Name
Research Site
City
Trois-Rivières
State/Province
Quebec
ZIP/Postal Code
G8T 7A1
Country
Canada
Facility Name
Research Site
City
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Facility Name
Research Site
City
Quebec
ZIP/Postal Code
G3K 2P8
Country
Canada
Facility Name
Research Site
City
Aarhus N
ZIP/Postal Code
8200
Country
Denmark
Facility Name
Research Site
City
Hvidovre
ZIP/Postal Code
2650
Country
Denmark
Facility Name
Research Site
City
København NV
ZIP/Postal Code
2400
Country
Denmark
Facility Name
Research Site
City
Odense C
ZIP/Postal Code
5000
Country
Denmark
Facility Name
Research Site
City
Roskilde
ZIP/Postal Code
4000
Country
Denmark
Facility Name
Research Site
City
Vejle
ZIP/Postal Code
7100
Country
Denmark
Facility Name
Research Site
City
Ålborg
ZIP/Postal Code
9000
Country
Denmark
Facility Name
Research Site
City
Amiens Cedex 1
ZIP/Postal Code
80054
Country
France
Facility Name
Research Site
City
Brest Cedex 2
ZIP/Postal Code
29609
Country
France
Facility Name
Research Site
City
Grenoble Cedex
ZIP/Postal Code
38043
Country
France
Facility Name
Research Site
City
Lyon Cedex 04
ZIP/Postal Code
69317
Country
France
Facility Name
Research Site
City
Marseille
ZIP/Postal Code
13015
Country
France
Facility Name
Research Site
City
Montpellier
ZIP/Postal Code
34090
Country
France
Facility Name
Research Site
City
Nantes Cedex 1
ZIP/Postal Code
44093
Country
France
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
12203
Country
Germany
Facility Name
Research Site
City
Frankfurt
ZIP/Postal Code
60596
Country
Germany
Facility Name
Research Site
City
Grosshansdorf
ZIP/Postal Code
20927
Country
Germany
Facility Name
Research Site
City
Lübeck
ZIP/Postal Code
23552
Country
Germany
Facility Name
Research Site
City
Mainz
ZIP/Postal Code
55131
Country
Germany
Facility Name
Research Site
City
Ashkelon
ZIP/Postal Code
7830604
Country
Israel
Facility Name
Research Site
City
Beer Sheva
ZIP/Postal Code
84101
Country
Israel
Facility Name
Research Site
City
Haifa
ZIP/Postal Code
34362
Country
Israel
Facility Name
Research Site
City
Jerusalem
ZIP/Postal Code
91031
Country
Israel
Facility Name
Research Site
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel
Facility Name
Research Site
City
Kfar Saba
ZIP/Postal Code
49281
Country
Israel
Facility Name
Research Site
City
Rehovot
ZIP/Postal Code
7661041
Country
Israel
Facility Name
Research Site
City
Daegu
ZIP/Postal Code
42415
Country
Korea, Republic of
Facility Name
Research Site
City
Incheon
ZIP/Postal Code
21431
Country
Korea, Republic of
Facility Name
Research Site
City
Jeonju-si
ZIP/Postal Code
54907
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
ZIP/Postal Code
03312
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
ZIP/Postal Code
03722
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
ZIP/Postal Code
05030
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
ZIP/Postal Code
05505
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
ZIP/Postal Code
06591
Country
Korea, Republic of
Facility Name
Research Site
City
Seoul
ZIP/Postal Code
06973
Country
Korea, Republic of
Facility Name
Research Site
City
Uijeongbu-si
ZIP/Postal Code
11765
Country
Korea, Republic of
Facility Name
Research Site
City
Eindhoven
ZIP/Postal Code
5623 EJ
Country
Netherlands
Facility Name
Research Site
City
Heerlen
ZIP/Postal Code
6419 PC
Country
Netherlands
Facility Name
Research Site
City
Rotterdam
ZIP/Postal Code
3045 PM
Country
Netherlands
Facility Name
Research Site
City
Rotterdam
ZIP/Postal Code
3083 AN
Country
Netherlands
Facility Name
Research Site
City
Zutphen
ZIP/Postal Code
7207 AE
Country
Netherlands
Facility Name
Research Site
City
Alzira
ZIP/Postal Code
46410
Country
Spain
Facility Name
Research Site
City
Barcelona
ZIP/Postal Code
08025
Country
Spain
Facility Name
Research Site
City
Granada
ZIP/Postal Code
18014
Country
Spain
Facility Name
Research Site
City
Málaga
ZIP/Postal Code
29010
Country
Spain
Facility Name
Research Site
City
Mérida (Badajoz)
ZIP/Postal Code
06800
Country
Spain
Facility Name
Research Site
City
Bradford
ZIP/Postal Code
BND9 6RJ
Country
United Kingdom
Facility Name
Research Site
City
Chertsey
ZIP/Postal Code
KT16 0PZ
Country
United Kingdom
Facility Name
Research Site
City
Cottingham
ZIP/Postal Code
HU16 5JQ
Country
United Kingdom
Facility Name
Research Site
City
Glasgow
ZIP/Postal Code
G12 0YN
Country
United Kingdom
Facility Name
Research Site
City
London
ZIP/Postal Code
SW10 9NH
Country
United Kingdom
Facility Name
Research Site
City
Newcastle-upon-Tyne
ZIP/Postal Code
NE1 4LP
Country
United Kingdom
Facility Name
Research Site
City
Wakefield
ZIP/Postal Code
WF1 4DG
Country
United Kingdom
12. IPD Sharing Statement
Learn more about this trial
Tezepelumab COPD Exacerbation Study
We'll reach out to this number within 24 hrs