Dupilumab As An Adjunct For Subcutaneous Grass Immunotherapy

NCT ID: NCT03558997

Last Updated: 2020-05-28

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

103 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-07

Study Completion Date

2019-06-13

Brief Summary

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The primary objective is to assess whether 16 weeks of treatment with dupilumab as an adjunct to Timothy Grass Subcutaneous Immunotherapy (SCIT) improves upon the efficacy of Timothy Grass SCIT to reduce provoked allergic rhinitis symptoms, as measured by Total Nasal Symptom Score (TNSS) after nasal allergen challenge (NAC) with Timothy Grass extract at week 17.

The secondary objectives of the study are:

* To assess whether 16 weeks of treatment with dupilumab as compared to placebo reduces provoked allergic rhinitis symptoms, as measured by TNSS after nasal allergen challenge (NAC) with Timothy Grass extract
* To assess whether 16 weeks of treatment with dupilumab as compared to dupilumab + SCIT reduces provoked allergic rhinitis symptoms, as measured by TNSS after nasal allergen challenge (NAC) with Timothy Grass extract
* To assess changes in serum Timothy-grass-specific immunoglobulin G4 (IgG4), serum Timothy grass-specific immunoglobulin E (IgE), and ratio of serum Timothy Grass-specific IgG4 to IgE over 16 weeks of treatment with dupilumab + SCIT as compared to SCIT monotherapy
* To evaluate the safety and tolerability of 16 weeks of treatment with dupilumab as an adjunct to Timothy Grass SCIT

Detailed Description

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Conditions

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Allergic Rhinitis

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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SCIT

Participants received SCIT titrated up to a 4000 bioequivalent allergy unit (BAU) for 8 weeks followed by maintenance dose of 4000 BAU for following 8 weeks and SC injections of placebo matched to Dupilumab Q2W for 16 weeks. Both SCIT and placebo matched to Dupilumab doses were administered with a gap of 1 or 7 days.

Group Type EXPERIMENTAL

Timothy Grass SCIT

Intervention Type DRUG

Timothy grass extract was administered SC.

Placebo matching dupilumab

Intervention Type DRUG

Placebo matching dupilumab was prepared in the same formulation without the addition of protein

Dupilumab + SCIT

Participants received SC injections of Dupilumab at a loading dose of 600 mg on Day 1, followed by 300 mg Q2W for 16 weeks and SCIT titrated up to 4000 BAU for 8 weeks followed by maintenance dose of 4000 BAU for following 8 weeks. Both SCIT and Dupilumab doses were administered with a gap of 1 or 7 days.

Group Type EXPERIMENTAL

Dupilumab

Intervention Type DRUG

Dupilumab was administered SC in a single-use, pre-filled glass syringe

Timothy Grass SCIT

Intervention Type DRUG

Timothy grass extract was administered SC.

Placebo

Participants received placebo matched to Dupilumab and placebo matched to Timothy grass subcutaneous immunotherapy (SCIT) every 2 weeks (Q2W) for 16 weeks. Both placebo doses were administered with a gap of 1 or 7 days.

Group Type EXPERIMENTAL

Placebo matching dupilumab

Intervention Type DRUG

Placebo matching dupilumab was prepared in the same formulation without the addition of protein

Placebo matching SCIT

Intervention Type DRUG

Placebo matching SCIT was prepared in the same formulation (SCIT diluent) without the addition of Timothy grass extract

Dupilumab

Participants received placebo matched to SCIT and subcutaneous (SC) injections of Dupilumab at a loading dose of 600 milligrams (mg) on Day 1, followed by a 300 mg for Q2W for 16 weeks. Both placebo matched to SCIT and Dupilumab doses were administered with a gap of 1 or 7 days.

Group Type EXPERIMENTAL

Dupilumab

Intervention Type DRUG

Dupilumab was administered SC in a single-use, pre-filled glass syringe

Placebo matching SCIT

Intervention Type DRUG

Placebo matching SCIT was prepared in the same formulation (SCIT diluent) without the addition of Timothy grass extract

Interventions

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Dupilumab

Dupilumab was administered SC in a single-use, pre-filled glass syringe

Intervention Type DRUG

Timothy Grass SCIT

Timothy grass extract was administered SC.

Intervention Type DRUG

Placebo matching dupilumab

Placebo matching dupilumab was prepared in the same formulation without the addition of protein

Intervention Type DRUG

Placebo matching SCIT

Placebo matching SCIT was prepared in the same formulation (SCIT diluent) without the addition of Timothy grass extract

Intervention Type DRUG

Other Intervention Names

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DUPIXENT® REGN668 SAR231893

Eligibility Criteria

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Inclusion Criteria

1. Male and female participants aged 18 to 55
2. History of grass pollen-induced seasonal allergic rhinitis
3. Grass pollen allergy confirmed by both:

1. Positive skin prick test (SPT) with Timothy Grass extract (mean wheal diameter at least ≥5 mm greater than a negative control)
2. Positive serum Timothy Grass-specific IgE (≥0.35KU/L)

Exclusion Criteria

1. Significant rhinitis, sinusitis, outside of the grass pollen season
2. Any contraindications to SCIT (i.e, severe cardiovascular disease, malignancies, autoimmune disease, use of beta blocker, asthma severe enough to require chronic medication, acute infection)
3. Use of systemic corticosteroids within 4 weeks of screening visits or any NAC visits
4. Abnormal lung function as judged by the investigator
5. A clinical history of asthma requiring chronic medication such as regular inhaled corticosteroids for \>4 weeks per year
6. History of significant recurrent sinusitis, defined as 3 episodes per year for the last 2 years, all of which required antibiotic treatment
7. History of chronic sinusitis (with or without nasal polyps)
8. Tobacco smoking (ANY) within the last year
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role collaborator

Regeneron Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clinical Trial Management

Role: STUDY_DIRECTOR

Regeneron Pharmaceuticals

Locations

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Regeneron Investigational Site

Los Angeles, California, United States

Site Status

Regeneron Investigational Site

Mountain View, California, United States

Site Status

Regeneron Investigational Site

Walnut Creek, California, United States

Site Status

Regeneron Investigational Site

Baltimore, Maryland, United States

Site Status

Regeneron Investigational Site

Andover, Massachusetts, United States

Site Status

Regeneron Investigational Site

North Dartmouth, Massachusetts, United States

Site Status

Regeneron Investigational Site

St Louis, Missouri, United States

Site Status

Regeneron Investigational Site

Bellevue, Nebraska, United States

Site Status

Regeneron Investigational Site

Portland, Oregon, United States

Site Status

Regeneron Investigational Site

East Providence, Rhode Island, United States

Site Status

Regeneron Investigational Site

Seattle, Washington, United States

Site Status

Regeneron Investigational Site

Madison, Wisconsin, United States

Site Status

Regeneron Investigational Site

Kingston, Ontario, Canada

Site Status

Regeneron Investigational Site

Mississauga, Ontario, Canada

Site Status

Regeneron Investigational Site

Ottawa, Ontario, Canada

Site Status

Regeneron Investigational Site

Toronto, Ontario, Canada

Site Status

Regeneron Investigational Site

Québec, Quebec, Canada

Site Status

Countries

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United States Canada

References

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Wipperman MF, Gayvert KM, Atanasio A, Wang CQ, Corren J, Covarrubias A, Setliff I, Chio E, Laws E, Wolfe K, Harel S, Maloney J, Herman G, Orengo JM, Lim WK, Hamon SC, Hamilton JD, O'Brien MP. Differential modulation of allergic rhinitis nasal transcriptome by dupilumab and allergy immunotherapy. Allergy. 2024 Apr;79(4):894-907. doi: 10.1111/all.16001. Epub 2024 Jan 27.

Reference Type DERIVED
PMID: 38279910 (View on PubMed)

Kamal MA, Franchetti Y, Lai CH, Xu C, Wang CQ, Radin AR, O'Brien MP, Ruddy M, Davis JD. Pharmacokinetics and Concentration-Response of Dupilumab in Patients With Seasonal Allergic Rhinitis. J Clin Pharmacol. 2022 May;62(5):689-695. doi: 10.1002/jcph.2004. Epub 2022 Jan 6.

Reference Type DERIVED
PMID: 34791679 (View on PubMed)

Corren J, Saini SS, Gagnon R, Moss MH, Sussman G, Jacobs J, Laws E, Chung ES, Constant T, Sun Y, Maloney J, Hamilton JD, Ruddy M, Wang CQ, O'Brien MP. Short-Term Subcutaneous Allergy Immunotherapy and Dupilumab are Well Tolerated in Allergic Rhinitis: A Randomized Trial. J Asthma Allergy. 2021 Aug 16;14:1045-1063. doi: 10.2147/JAA.S318892. eCollection 2021.

Reference Type DERIVED
PMID: 34429614 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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R668-ALG-16115

Identifier Type: -

Identifier Source: org_study_id

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