Dupilumab Effects Against Aeroallergen Challenge

NCT ID: NCT05720325

Last Updated: 2025-02-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

88 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-29

Study Completion Date

2027-11-30

Brief Summary

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The trial involves two interventions: (i) exposure to HDM in the ACC and (ii) administration of dupilumab/placebo for dupilumab.

Detailed Description

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(i)Intervention #1: HDM exposures in the ACC This trial utilizes exposures to House dust mites (HDM) in the Aeroallergen Challenge Chamber (ACC) as a two-pronged tool for (i) precision phenotyping of HDM+PARC+AA+ persons to identify those with the adaptive and maladaptive phenotypes and (ii) assessment of symptoms intermittently throughout the clinical trial to monitor effects of dupilumab/placebo on symptom severity .

(ii) Participants classifying to the adaptive and maladaptive phenotypes are then randomized to 18-weeks dupilumab vs. placebo, with ACC HDM visits during this phase.

Conditions

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Asthma, Allergic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a prospective, double-blind, randomized placebo-controlled mechanistic clinical trial to test the effects of an 18-week course of dupilumab on HDM allergen challenge-induced nasal mucosa and peripheral blood traits and symptoms in persons with HDM-associated perennial allergic rhinoconjunctivitis (PARC) with allergic asthma (HDM+PARC+AA+) participants. For each yearly cohort, participants of each phenotype will be randomly selected, resulting in two groups classified as the (i) adaptive, and (ii) maladaptive phenotypes.

Using the R package SeqAlloc, a covariate-adjusted randomization will be employed to randomize each of these two groups into two subgroups; the subgroups within each group (phenotype) will be balanced by age and gender. Thus, this will result in the generation of four groups:

(i) adaptive-A (ii) adaptive-B (iii) maladaptive-A (iv) maladaptive-B
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

DOUBLE

Participants Investigators
The designated unblinded biostatisticians will allocate dupilumab or placebo for dupilumab to each participant. The designated unblinded biostatisticians will develop the final unblinded randomization key for coding of study drug that will be filed in a secure location in the event that unblinding is necessary at any point during the study.

Study Groups

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Adaptive Phenotypes randomized to study drug

This group will be comprised of the Adaptive-A and Adaptive-B subgroup and will consist of the adaptive phenotype participants identified during the initial HDM ACC challenge, administered the study drug.

Group Type ACTIVE_COMPARATOR

Dupilumab

Intervention Type DRUG

Dupixent is an interleukin-4 receptor alpha antagonist

House Dust Mites (HDM)

Intervention Type OTHER

House Dust Mites used to challenge subjects using an aeroallergen challenge chamber

Maladaptive Phenotypes randomized to study drug

This group will be comprised of the Maladaptive-A and Maladaptive-B subgroup and will consist of the maladaptive phenotype participants identified during the initial HDM ACC challenge administered the study drug.

Group Type EXPERIMENTAL

Dupilumab

Intervention Type DRUG

Dupixent is an interleukin-4 receptor alpha antagonist

House Dust Mites (HDM)

Intervention Type OTHER

House Dust Mites used to challenge subjects using an aeroallergen challenge chamber

Adaptive Phenotype randomized to placebo

This group will be comprised of the Adaptive-A and Adaptive-B subgroup and will consist of the adaptive phenotype participants identified during the initial HDM ACC challenge, administered the placebo.

Group Type PLACEBO_COMPARATOR

House Dust Mites (HDM)

Intervention Type OTHER

House Dust Mites used to challenge subjects using an aeroallergen challenge chamber

Placebo

Intervention Type OTHER

Inert placebo administered to placebo arms of study.

Maladaptive Phenotype randomized to placebo

This group will be comprised of the Maladaptive-A and Maladaptive-B subgroup and will consist of the maladaptive phenotype participants identified during the initial HDM ACC challenge administered the placebo.

Group Type PLACEBO_COMPARATOR

House Dust Mites (HDM)

Intervention Type OTHER

House Dust Mites used to challenge subjects using an aeroallergen challenge chamber

Placebo

Intervention Type OTHER

Inert placebo administered to placebo arms of study.

Interventions

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Dupilumab

Dupixent is an interleukin-4 receptor alpha antagonist

Intervention Type DRUG

House Dust Mites (HDM)

House Dust Mites used to challenge subjects using an aeroallergen challenge chamber

Intervention Type OTHER

Placebo

Inert placebo administered to placebo arms of study.

Intervention Type OTHER

Other Intervention Names

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Dupixent Placebo for Dupixent

Eligibility Criteria

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Inclusion Criteria

1. Will demonstrate understanding of the study and will provide a signed and dated informed consent.
2. Will be male or female, 18 to 65 years of age at the time of the screening visit.
3. Will have symptoms consistent with perennial nasal allergy for a minimum of 2 years prior to the screening visit.
4. Will have a positive standard skin prick test (SPT) to D. pteronyssinus within 24 months of screening. A positive SPT is defined as a wheal diameter of at least 5 mm larger than the negative control (normal saline).
5. Will have asthma with a documented FEV1 reversibility of ≥10% within 18 months of screening.
6. If a participant manifests symptoms suggestive of COVID-19, the participant must have a negative SARS-CoV-2 rapid antigen nasopharyngeal swab test before each HDM exposure visit.
7. A woman of childbearing potential, must have a negative urine pregnancy test at Visit 1 and prior to each exposure in the ACC. All women of childbearing potential must agree to a medically acceptable form of birth control throughout the study duration and for at least 2 months prior to Visit 1. Acceptable methods of birth control for this study include:

1. oral, patch, or intra-vaginal contraceptives
2. Norplant System® or other implant system
3. Depo-Provera®
4. IUD
5. double barrier method
6. abstinence
7. surgical sterility (hysterectomy, tubal ligation, or uterine ablation)

Post-menopausal women defined as women without a menstrual cycle for at least 12 consecutive months qualify as non-childbearing for this study.
8. Will have never smoked or will be an ex-smoker (\<20 pack year history and no cigarette or smokeless tobacco use in the past year).

Exclusion Criteria

1. Have a chronic lung disease other than asthma.
2. Have atopic dermatitis.
3. Have any ocular disease that is not associated with allergic rhinoconjunctivitis.
4. Are on home oxygen requirement.
5. Have a history of rebound nasal congestion (brought on by extended use of topical decongestants), chronic rhinosinusitis with or without nasal polyps, nasal septal perforation, or severe nasal tract malformations noted on physical exam.
6. Have FEV1 \<70% predicted as determined by pre-bronchodilator spirometry at visit 1.
7. Are unwilling/unable to withhold intranasal steroids or asthma medications before specified visits.
8. Are unwilling/unable to abstain from protocol-defined prohibited medications for the protocol-specified times before and during screening/selection and ACC HDM exposure visits.
9. Have received any oral or other form of systemic glucocorticosteroids within 1 month prior to the screening visit.
10. Have received JAK-1 inhibitors within 3 months prior to the screening visit.
11. Have known hypersensitivity to dupilumab or any of its excipients.
12. Have an ongoing helminth infection.
13. Have received a live vaccine within 30 days of screening or are planned to receive one during study participation.Note: Participant can receive a live vaccine \> 30 days after final study investigational product injection (visit 14)
14. Are pregnant or nursing.
15. Have a history of keratoconjunctivitis sicca.
16. Have indoor pet exposure causing upper or lower symptoms.
17. Have received allergen immunotherapy of any form within 12 months of screening visit.
18. Have received biologics, for any indication within 12 months of screening visit.
19. Have participated in a trial with an investigational drug in the past 30 days.
20. Have past or current medical problems or findings from physical examination or laboratory testing that are not listed above, that, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or may impact the quality or interpretation of the data obtained from the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role collaborator

Regeneron Pharmaceuticals

INDUSTRY

Sponsor Role collaborator

The University of Texas Health Science Center at San Antonio

OTHER

Sponsor Role lead

Responsible Party

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Sunil Ahuja

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Sunil K Ahuja, MD

Role: PRINCIPAL_INVESTIGATOR

University of Texas Health Science Center San Antonio

Locations

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Biogenics Research Chamber

San Antonio, Texas, United States

Site Status RECRUITING

University of Texas Health Science Center at San Antonio

San Antonio, Texas, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Sunil K Ahuja, MD

Role: CONTACT

210-567-4823

Alisha Smith, PhD

Role: CONTACT

210-567-3709

Facility Contacts

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Robert L Jacobs, MD

Role: primary

Sunil K Ahuja, MD

Role: backup

210-567-4823

Other Identifiers

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1U01AI158460-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HSC20220665H

Identifier Type: -

Identifier Source: org_study_id

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