A Safety Study of Xolair (Omalizumab) in Patients With Chronic Idiopathic Urticaria (CIU) Who Remain Symptomatic Despite Treatment With H1 Antihistamines, H2 Blockers, and/or Leukotriene Receptor Antagonists

NCT ID: NCT01264939

Last Updated: 2013-11-26

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

336 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-02-28

Study Completion Date

2012-11-30

Brief Summary

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The study is a global Phase III, multicenter, randomized, double-blind, placebo controlled, parallel-group study to evaluate the safety and efficacy of omalizumab administered subcutaneously as an add-on therapy for the treatment of adolescent and adult patients aged 12-75 who have been diagnosed with chronic idiopathic urticaria (CIU) who remain symptomatic despite standard-dosed H1 antihistamine treatment (including doses up to 4 times above the approved dose level), H2 blockers, and/or leukotriene receptor antagonists (LTRA).

Detailed Description

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Conditions

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Chronic Idiopathic Urticaria

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Placebo

Participants received placebo subcutaneously every 4 weeks during the 24 week treatment period.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo was supplied as a lyophilized, sterile powder in a single-use vial without study drug.

H1 antihistamine, H2 antihistamine, leukotriene receptor antagonist

Intervention Type DRUG

Participants were required to maintain stable doses of their pre-randomization combination therapy with an H1 antihistamine and either an H2 blocker or leukotriene receptor antagonist, or all 3 drugs in combination, throughout the 24-week treatment period and 16-week follow-up period of the 40-week study.

Diphenhydramine

Intervention Type DRUG

Participants were provided with diphenhydramine 25 mg for itch relief on an as-needed basis, up to a maximum of 3 doses within 24 hours for the duration of the 40-week study.

Omalizumab 300 mg

Participants received omalizumab 300 mg subcutaneously every 4 weeks during the 24 week treatment period.

Group Type EXPERIMENTAL

Omalizumab

Intervention Type DRUG

Omalizumab was supplied as a lyophilized, sterile powder in a single-use vial.

H1 antihistamine, H2 antihistamine, leukotriene receptor antagonist

Intervention Type DRUG

Participants were required to maintain stable doses of their pre-randomization combination therapy with an H1 antihistamine and either an H2 blocker or leukotriene receptor antagonist, or all 3 drugs in combination, throughout the 24-week treatment period and 16-week follow-up period of the 40-week study.

Diphenhydramine

Intervention Type DRUG

Participants were provided with diphenhydramine 25 mg for itch relief on an as-needed basis, up to a maximum of 3 doses within 24 hours for the duration of the 40-week study.

Interventions

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Omalizumab

Omalizumab was supplied as a lyophilized, sterile powder in a single-use vial.

Intervention Type DRUG

Placebo

Placebo was supplied as a lyophilized, sterile powder in a single-use vial without study drug.

Intervention Type DRUG

H1 antihistamine, H2 antihistamine, leukotriene receptor antagonist

Participants were required to maintain stable doses of their pre-randomization combination therapy with an H1 antihistamine and either an H2 blocker or leukotriene receptor antagonist, or all 3 drugs in combination, throughout the 24-week treatment period and 16-week follow-up period of the 40-week study.

Intervention Type DRUG

Diphenhydramine

Participants were provided with diphenhydramine 25 mg for itch relief on an as-needed basis, up to a maximum of 3 doses within 24 hours for the duration of the 40-week study.

Intervention Type DRUG

Other Intervention Names

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Xolair

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of chronic idiopathic urticaria (CIU) refractory to H1 antihistamines, H2 blockers, and/or leukotriene receptor antagonists (LTRA) at the time of randomization.

* The presence of itch and hives for \> 6 consecutive weeks at any time prior to enrollment despite current use of H1 antihistamine (up to 4 times the approved dosage), H2 blocker, and/or LTRA treatment during this time.
* Urticaria activity score over 7 days (UAS7) score (range 0-42) ≥ 16 and itch component of UAS7 (range 0-21) ≥ 8 during 7 days prior to randomization (Week 0).
* In-clinic UAS ≥ 4 on at least one of the screening visit days (Day -14, Day -7, or Day 1).
* For women of childbearing potential, agreement to use an acceptable form of contraception and to continue its use for the duration of the study.

Exclusion Criteria

* Treatment with an investigational agent within 30 days prior to screening.
* Weight less than 20 kg (44 lbs).
* Clearly defined underlying etiology for chronic urticarias other than CIU.
* Evidence of parasitic infection.
* Atopic dermatitis, bullous pemphigoid, dermatitis herpetiformis, senile pruritus, or other skin disease associated with itch.
* Previous treatment with omalizumab within a year prior to screening.
* Routine doses of the following medications within 30 days prior to screening: Systemic or cutaneous (topical) corticosteroids (prescription or over the counter), hydroxychloroquine, methotrexate, cyclosporine, or cyclophosphamide.
* Intravenous (IV) immunoglobulin G (IVIG), or plasmapheresis within 30 days prior to screening.
* Regular (daily/every other day) doxepin (oral) use within 6 weeks prior to screening.
* Patients with current malignancy, history of malignancy, or currently under work-up for suspected malignancy except non-melanoma skin cancer that has been treated or excised and is considered resolved.
* Hypersensitivity to omalizumab or any component of the formulation.
* History of anaphylactic shock.
* Presence of clinically significant cardiovascular, neurological, psychiatric, metabolic, or other pathological conditions that could interfere with the interpretation of the study results and or compromise the safety of the patients.
* Evidence of current drug or alcohol abuse.
Minimum Eligible Age

12 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Genentech, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Edward R. Conner, M.D.

Role: STUDY_DIRECTOR

Genentech, Inc.

Locations

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Brookline, Massachusetts, United States

Site Status

Brookline, Massachusetts, United States

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Ann Arbor, Michigan, United States

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Minneapolis, Minnesota, United States

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Bozeman, Montana, United States

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Missoula, Montana, United States

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Brick, New Jersey, United States

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Mineola, New York, United States

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Rochester, New York, United States

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High Point, North Carolina, United States

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Sylvania, Ohio, United States

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Lake Oswego, Oregon, United States

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Rochester, Minnesota, United States

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Scottsdale, Arizona, United States

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Mission Viejo, California, United States

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Napa, California, United States

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Orange, California, United States

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Sacramento, California, United States

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San Diego, California, United States

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Miami, Florida, United States

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North Palm Beach, Florida, United States

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Tampa, Florida, United States

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Savannah, Georgia, United States

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Evansville, Indiana, United States

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Iowa City, Iowa, United States

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Crescent Springs, Kentucky, United States

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Owensboro, Kentucky, United States

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Wheaton, Maryland, United States

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Altoona, Pennsylvania, United States

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Blue Bell, Pennsylvania, United States

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Hershey, Pennsylvania, United States

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Charleston, South Carolina, United States

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Knoxville, Tennessee, United States

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Dallas, Texas, United States

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Katy, Texas, United States

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San Antonio, Texas, United States

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San Antonio, Texas, United States

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Draper, Utah, United States

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South Burlington, Vermont, United States

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Richmond, Virginia, United States

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Canberra, Australian Capital Territory, Australia

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Brisbane, Queensland, Australia

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Carlton, Victoria, Australia

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Melbourne, Victoria, Australia

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Berlin, , Germany

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Cologne, , Germany

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Erlangen, , Germany

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Freiburg im Breisgau, , Germany

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Hamburg, , Germany

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Lübeck, , Germany

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Mainz, , Germany

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Marburg, , Germany

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Tübingen, , Germany

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Auckland, , New Zealand

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Beckenham, , New Zealand

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Tauranga, , New Zealand

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Wellington, , New Zealand

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Krakow, , Poland

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Lodz, , Poland

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Lodz, , Poland

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Warsaw, , Poland

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Singapore, , Singapore

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Singapore, , Singapore

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Aarau, , Switzerland

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Bern, , Switzerland

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Sankt Gallen, , Switzerland

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Cambridge, , United Kingdom

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Leicester, , United Kingdom

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London, , United Kingdom

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London, , United Kingdom

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Norwich, , United Kingdom

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Oxford, , United Kingdom

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Sheffield, , United Kingdom

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Countries

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United States Australia Germany New Zealand Poland Singapore Switzerland United Kingdom

References

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Ferrer M, Gimenez-Arnau A, Saldana D, Janssens N, Balp MM, Khalil S, Risson V. Predicting Chronic Spontaneous Urticaria Symptom Return After Omalizumab Treatment Discontinuation: Exploratory Analysis. J Allergy Clin Immunol Pract. 2018 Jul-Aug;6(4):1191-1197.e5. doi: 10.1016/j.jaip.2018.04.003. Epub 2018 Apr 12.

Reference Type DERIVED
PMID: 29655772 (View on PubMed)

Goldstein S, Gabriel S, Kianifard F, Ortiz B, Skoner DP. Clinical features of adolescents with chronic idiopathic or spontaneous urticaria: Review of omalizumab clinical trials. Ann Allergy Asthma Immunol. 2017 Apr;118(4):500-504. doi: 10.1016/j.anai.2017.02.003.

Reference Type DERIVED
PMID: 28390587 (View on PubMed)

Saini SS, Omachi TA, Trzaskoma B, Hulter HN, Rosen K, Sterba PM, Courneya JP, Lackey A, Chen H. Effect of Omalizumab on Blood Basophil Counts in Patients with Chronic Idiopathic/Spontaneous Urticaria. J Invest Dermatol. 2017 Apr;137(4):958-961. doi: 10.1016/j.jid.2016.11.025. Epub 2016 Dec 6. No abstract available.

Reference Type DERIVED
PMID: 27939380 (View on PubMed)

Gimenez-Arnau AM, Spector S, Antonova E, Trzaskoma B, Rosen K, Omachi TA, Stull D, Balp MM, Murphy T. Improvement of sleep in patients with chronic idiopathic/spontaneous urticaria treated with omalizumab: results of three randomized, double-blind, placebo-controlled studies. Clin Transl Allergy. 2016 Aug 18;6:32. doi: 10.1186/s13601-016-0120-0. eCollection 2016.

Reference Type DERIVED
PMID: 27540466 (View on PubMed)

Zazzali JL, Kaplan A, Maurer M, Raimundo K, Trzaskoma B, Solari PG, Antonova E, Mendelson M, Rosen KE. Angioedema in the omalizumab chronic idiopathic/spontaneous urticaria pivotal studies. Ann Allergy Asthma Immunol. 2016 Oct;117(4):370-377.e1. doi: 10.1016/j.anai.2016.06.024. Epub 2016 Jul 14.

Reference Type DERIVED
PMID: 27424128 (View on PubMed)

Casale TB, Bernstein JA, Maurer M, Saini SS, Trzaskoma B, Chen H, Grattan CE, Gimenez-Arnau A, Kaplan AP, Rosen K. Similar Efficacy with Omalizumab in Chronic Idiopathic/Spontaneous Urticaria Despite Different Background Therapy. J Allergy Clin Immunol Pract. 2015 Sep-Oct;3(5):743-50.e1. doi: 10.1016/j.jaip.2015.04.015. Epub 2015 Jun 6.

Reference Type DERIVED
PMID: 26054553 (View on PubMed)

Other Identifiers

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GA00889

Identifier Type: OTHER

Identifier Source: secondary_id

Q4883g

Identifier Type: -

Identifier Source: org_study_id