A Study to Evaluate Efficacy of Remibrutinib Compared to Dupilumab at Early Timepoints in Adults With Chronic Spontaneous Urticaria Inadequately Controlled by Second Generation H1-antihistamines

NCT ID: NCT06868212

Last Updated: 2025-12-22

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

PHASE3

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-07-11

Study Completion Date

2027-05-17

Brief Summary

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This is a US, multi-center, randomized, double-blind, double-dummy, Phase 3b study to evaluate efficacy of remibrutinib (25 mg twice daily \[b.i.d.\] by mouth \[p.o.\]) compared to dupilumab (600 mg loading dose administered subcutaneously (s.c.) followed by 300 mg every 2 weeks s.c.) at early timepoints (4 weeks and earlier), when administered as an add-on treatment to second generation H1-antihistamines (sgH1-AH) (standard label dose as background therapy) in adult US participants with moderate to severe chronic spontaneous urticaria (CSU) inadequately controlled by sgH1-AHs.

Detailed Description

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This study consists of a screening period (up to 4 weeks), a core treatment period (12 weeks double-blind, double-dummy), an optional open-label extension \[OLE\] period, and safety follow-up period.

Screening period: participants will have a screening period of a minimum of 7 days up to a maximum of 28 days to establish eligibility for the study. Participants meeting all the inclusion criteria and none of the exclusion criteria will be eligible to participate in the study.

Core treatment period (double-blind, double-dummy): approximately, 400 participants diagnosed with CSU inadequately controlled by sgH1-AH will be randomized in this study. Participants will be stratified based on prior exposure to anti-IgE biologics.

Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib and placebo solution for injection or dupilumab and remibrutinib matching placebo, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit.

Additionally, all participants will be on a stable, standard label dose of a sgH1-AH ("background therapy") throughout the entire core treatment period (starting a minimum of 7 days prior to randomization until the end of Week 12). To treat unbearable symptoms of CSU, participants will be allowed to add more of the same sgH1-AH on an as-needed basis ("rescue therapy"). The total maximum daily dose of sgH1-AH (background plus rescue) should not exceed 4 tablets/day (4-fold the standard label dose).

Optional open-label extension \[OLE\] period: At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional OLE safety period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).

Safety follow-up period:

* For participants who do not enter the OLE period: there will be a safety follow-up for 12 weeks with safety follow-up phone calls at Week 16 and Week 24 (Week 24 will be end of study).
* For participants who enter the OLE period: there will be 2 options at the end of Week 24:
* If remibrutinib is commercially available: participants will discontinue study treatment, perform their EOT visit and receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
* If remibrutinib is not commercially available, participants may continue on remibrutinib 25 mg b.i.d. until its commercial availability and return for site visits for safety follow up and treatment dispensation every 3 months. When remibrutinib becomes commercially available, the participant will be contacted for a site visit to complete the EOT visit and will receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).

Conditions

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Chronic Spontaneous Urticaria (CSU)

Keywords

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BTK inhibitor chronic spontaneous urticaria Urticaria activity score Hives severity score Itch severity score

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be stratified based on prior exposure to anti-IgE biologics. Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib or dupilumab and remibrutinib matching placebo or placebo solution for injection, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit.

At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional open label extension (OLE) period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Treatment group 1: Remibrutinib + Placebo

Remibrutinib tablet (25 mg b.i.d. p.o.) + placebo solution for injection in pre-filled syringe (2 s.c. injections at baseline and then 1 s.c. injection every other week \[Weeks 2-10\])

Group Type EXPERIMENTAL

Remibrutinib

Intervention Type DRUG

Film-coated tablet, oral administration, 25 mg b.i.d.

Placebo solution for injection

Intervention Type DRUG

Solution for injection in pre-filled syringe every 2 weeks

Treatment group 2: Dupilumab + remibrutinib matching placebo

Dupilumab pre-filled syringe (600 mg loading dose \[2 x 300 mg dupilumab s.c. injection\] at baseline visit followed by dupilumab 300 mg s.c. injection every other week \[Weeks 2-10\]) + remibrutinib matching placebo tablet (1 tablet b.i.d. p.o.)

Group Type ACTIVE_COMPARATOR

Remibrutinib matching placebo

Intervention Type DRUG

Film-coated tablet, oral administration, b.i.d.

Dupilumab

Intervention Type DRUG

Solution for injection in pre-filled syringe 600 mg loading dose followed by 300 mg dose every 2 weeks

Interventions

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Remibrutinib

Film-coated tablet, oral administration, 25 mg b.i.d.

Intervention Type DRUG

Remibrutinib matching placebo

Film-coated tablet, oral administration, b.i.d.

Intervention Type DRUG

Dupilumab

Solution for injection in pre-filled syringe 600 mg loading dose followed by 300 mg dose every 2 weeks

Intervention Type DRUG

Placebo solution for injection

Solution for injection in pre-filled syringe every 2 weeks

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adults ≥ 18 years of age at the time of signing the informed consent
* CSU duration for ≥ 6 months prior to screening (defined as the onset of CSU determined by the Investigator based on all available supporting documentation)
* Diagnosis of CSU inadequately controlled by sgH1-AH at the time of randomization, defined as:
* The presence of itch and hives for ≥ 6 consecutive weeks prior to screening despite the use of sgH1-AH during the 7 days prior to randomization (Day 1):
* UAS7 score (range, 0-42) ≥ 16, and
* ISS7 score (range, 0-21) ≥ 6, and
* HSS7 score (range, 0-21) ≥ 6
* Documentation of hives within 3 months before randomization (either at screening and/or at randomization); or documented in the participants medical history
* Willing and able to complete an Urticaria Patient Daily Diary (UPDD) for the duration of the study and adhere to the study protocol
* Participants must not have had more than one missing UPDD entry (either morning or evening) in the 7 days prior to randomization (Day 1)

Exclusion Criteria

* Previous use of remibrutinib or other bruton's tyrosine kinase (BTK) inhibitors
* Previous use of dupilumab
* Evidence of clinically significant cardiovascular (such as but not limited to myocardial infarction, unstable ischemic heart disease, NYHA Class III/IV left ventricular failure, arrhythmia and uncontrolled hypertension within 12 months prior to Visit 1), neurological, psychiatric, pulmonary, renal, hepatic (past history or current), endocrine or metabolic disorder, or immunodeficiency that, in the investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant.
* Evidence of hematological disorders (including coagulation disorders or significant bleeding risk)
* History or evidence of gastrointestinal disease (including gastrointestinal bleeding, e.g., in association with use of nonsteroidal anti-inflammatory drugs (NSAID), that was clinically relevant (e.g., where intervention was indicated or requiring hospitalization or blood transfusion)
* Requirement for anti-platelet medication, except for acetylsalicylic acid up to 100 mg/d or clopidogrel up to 75 mg/d. The use of dual anti-platelet therapy (e.g., acetylsalicylic acid + clopidogrel) is prohibited.
* Requirement for anticoagulant medication (for example, warfarin or Novel Oral Anti-Coagulants \[NOAC\])
* History or current hepatic disease including but not limited to acute or chronic hepatitis, cirrhosis or hepatic failure or hepatic parameters at screening: Aspartate Aminotransferase (AST)/ Alanine Aminotransferase (ALT) levels more than 1.5x ULN or International Normalized Ratio (INR) \> 1.5 at screening
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Novartis Pharmaceuticals

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Allervie Clinical Research

Birmingham, Alabama, United States

Site Status RECRUITING

Cahaba Derm and skin hlth ctr 27

Birmingham, Alabama, United States

Site Status RECRUITING

Research Solutions of Arizona

Litchfield Park, Arizona, United States

Site Status RECRUITING

Peak Dermatology

Payson, Arizona, United States

Site Status RECRUITING

Premier Allergy Asthma And Immunology

Phoenix, Arizona, United States

Site Status RECRUITING

Avacare Center for Dermatology

Phoenix, Arizona, United States

Site Status RECRUITING

Orso Health

Scottsdale, Arizona, United States

Site Status RECRUITING

Acuro Research Inc

Little Rock, Arkansas, United States

Site Status RECRUITING

First OC Dermatology

Fountain Valley, California, United States

Site Status RECRUITING

Ctr for Dermatology Clinical Res

Fremont, California, United States

Site Status RECRUITING

Allergy and Asthma Specialists Group

Huntington Beach, California, United States

Site Status RECRUITING

Orso Health

Long Beach, California, United States

Site Status RECRUITING

Ark Clinical Research

Long Beach, California, United States

Site Status RECRUITING

California Allergy and Asthma Medical Group

Los Angeles, California, United States

Site Status RECRUITING

Dermatology Research Associates

Los Angeles, California, United States

Site Status RECRUITING

One Of A Kind Clinical Research

Napa, California, United States

Site Status RECRUITING

Empire Clinical Research

Pomona, California, United States

Site Status RECRUITING

Allergy and Asthma Consultants

Redwood City, California, United States

Site Status RECRUITING

Integrative Skin Science and Res

Sacramento, California, United States

Site Status RECRUITING

UC Davis Neuromuscular Research Center

Sacramento, California, United States

Site Status RECRUITING

Therapeutics Clinical Research

San Diego, California, United States

Site Status RECRUITING

Integrated Research of Inland Inc

Upland, California, United States

Site Status RECRUITING

Allergy and Asthma Clin Res Inc

Walnut Creek, California, United States

Site Status RECRUITING

Asthma and Allergy Associates P C

Colorado Springs, Colorado, United States

Site Status RECRUITING

UCONN Health Dermatology

Farmington, Connecticut, United States

Site Status RECRUITING

Howard University Hospital Division of Geriatrics

Washington D.C., District of Columbia, United States

Site Status RECRUITING

Florida Ctr Allergy Asthma Research

Aventura, Florida, United States

Site Status RECRUITING

Florida Ctr Allergy Asthma Research

Aventura, Florida, United States

Site Status RECRUITING

Skin Care Research Inc

Boca Raton, Florida, United States

Site Status RECRUITING

Skin Care Research LLC

Hollywood, Florida, United States

Site Status RECRUITING

Jacksonville Center for Clinical Research

Jacksonville, Florida, United States

Site Status RECRUITING

University of MiamiHealth System

Miami, Florida, United States

Site Status RECRUITING

FXM Clinical Res Miami LLC

Miami, Florida, United States

Site Status RECRUITING

Miami Dade Medical Research

Miami, Florida, United States

Site Status RECRUITING

Eminat Research Group

Miramar, Florida, United States

Site Status RECRUITING

Ziaderm Research LLC

North Miami Beach, Florida, United States

Site Status RECRUITING

AllerVie Health

Panama, Florida, United States

Site Status RECRUITING

Sarasota Clinical Research

Sarasota, Florida, United States

Site Status RECRUITING

Lenus Research and Med Group LLC

Sweetwater, Florida, United States

Site Status RECRUITING

Olympian Clinical Research

Tampa, Florida, United States

Site Status RECRUITING

Asthma Allergy Immunology Clin Res

Tampa, Florida, United States

Site Status RECRUITING

Conquest Research

Winter Park, Florida, United States

Site Status RECRUITING

AllerVie Clin Res Columbus GA

Columbus, Georgia, United States

Site Status RECRUITING

Cleaver Medical Group

Cumming, Georgia, United States

Site Status RECRUITING

Southeast Dermatology Specialists

Douglasville, Georgia, United States

Site Status RECRUITING

Aeroallergy Research Laboratories

Savannah, Georgia, United States

Site Status RECRUITING

The Allergy Group-Meridian Clinic

Meridian, Idaho, United States

Site Status RECRUITING

Northshore University Health System

Glenview, Illinois, United States

Site Status RECRUITING

Midwest Allergy Sinus Asthma SC

Normal, Illinois, United States

Site Status RECRUITING

Clinical Res Ctr of S Illinois

O'Fallon, Illinois, United States

Site Status RECRUITING

Asthma and Allergy Center of Chicago S C

River Forest, Illinois, United States

Site Status RECRUITING

Deaconess Clin Allerg Res Inst

Evansville, Indiana, United States

Site Status RECRUITING

Southern IN Clinical Trials

New Albany, Indiana, United States

Site Status RECRUITING

Family Allergy And Asthma Rsch Inst

Louisville, Kentucky, United States

Site Status RECRUITING

Allergy and Asthma Specialist P S C

Owensboro, Kentucky, United States

Site Status RECRUITING

Ochsner Health Center

Baton Rouge, Louisiana, United States

Site Status RECRUITING

Chesapeake Clinical Research Inc

Baltimore, Maryland, United States

Site Status RECRUITING

AllerVie Clin Res Glenn Dale

Glenn Dale, Maryland, United States

Site Status RECRUITING

Boston Specialists LLC

Boston, Massachusetts, United States

Site Status RECRUITING

Derm Institute West Michigan PLLC

Caledonia, Michigan, United States

Site Status RECRUITING

Revival Research Institute

Troy, Michigan, United States

Site Status RECRUITING

Somerset Skin Centre

Troy, Michigan, United States

Site Status RECRUITING

Clinical Research Institute

Minneapolis, Minnesota, United States

Site Status RECRUITING

University of Minnesota

Minneapolis, Minnesota, United States

Site Status RECRUITING

Mayo Clinic - Rochester

Rochester, Minnesota, United States

Site Status RECRUITING

The Clinical Research Center

St Louis, Missouri, United States

Site Status RECRUITING

Washington University

St Louis, Missouri, United States

Site Status RECRUITING

Las Vegas Dermatology

Las Vegas, Nevada, United States

Site Status RECRUITING

Hudson Essex Allergy-Circuit Clinical

Belleville, New Jersey, United States

Site Status RECRUITING

Circuit Clinical Mercer Algy Pulm

Hamilton, New Jersey, United States

Site Status RECRUITING

Allergy Asthma Assoc Monmouth

Little Silver, New Jersey, United States

Site Status RECRUITING

Circuit Clinical

Riverdale, New Jersey, United States

Site Status RECRUITING

Equity Medical

The Bronx, New York, United States

Site Status RECRUITING

UNC DermatologyandSkinCancer Ctr

Chapel Hill, North Carolina, United States

Site Status RECRUITING

Bernstein Clinical Research Center

Cincinnati, Ohio, United States

Site Status RECRUITING

CR Services Acquisition US

Columbus, Ohio, United States

Site Status RECRUITING

Optimed Research LLC

Columbus, Ohio, United States

Site Status RECRUITING

Wright State University

Fairborn, Ohio, United States

Site Status RECRUITING

Toledo Institute of Clinical Research

Toledo, Ohio, United States

Site Status RECRUITING

Unity Clinical Research

Oklahoma City, Oklahoma, United States

Site Status RECRUITING

Vital Prospects Clinical Research Institute

Tulsa, Oklahoma, United States

Site Status RECRUITING

Oregon Medical Research Center

Portland, Oregon, United States

Site Status RECRUITING

Oregon Health Sciences University

Portland, Oregon, United States

Site Status RECRUITING

Allergy and Clinical Immunology Associates

Pittsburgh, Pennsylvania, United States

Site Status RECRUITING

Tribe Clinical Research LLC

Greenville, South Carolina, United States

Site Status RECRUITING

Allergic Disease and Asthma Center

Greenville, South Carolina, United States

Site Status RECRUITING

Charleston ENT and Allergy

North Charleston, South Carolina, United States

Site Status RECRUITING

National Allergy and Asthma Research LLS

North Charleston, South Carolina, United States

Site Status RECRUITING

International Clinical Research Tennessee, LCC

Murfreesboro, Tennessee, United States

Site Status RECRUITING

Arlington Center for Dermatology

Arlington, Texas, United States

Site Status RECRUITING

Orion Clinical Research

Austin, Texas, United States

Site Status RECRUITING

Bellaire Dermatology Associates

Bellaire, Texas, United States

Site Status RECRUITING

Reveal Research Institute

Dallas, Texas, United States

Site Status RECRUITING

Pharma Research and Amp Consult

Dallas, Texas, United States

Site Status RECRUITING

Western Sky Medical Research

El Paso, Texas, United States

Site Status RECRUITING

Center for Clinical Studies

Houston, Texas, United States

Site Status RECRUITING

Sante Clinical Research

Kerrville, Texas, United States

Site Status RECRUITING

RFSA Dermatology

San Antonio, Texas, United States

Site Status RECRUITING

Andante Research

San Antonio, Texas, United States

Site Status RECRUITING

University Of Utah

Murray, Utah, United States

Site Status RECRUITING

Allergy Associates of Utah

Sandy City, Utah, United States

Site Status RECRUITING

Bellingham Asthma Allergy and Immunology

Bellingham, Washington, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Novartis Pharmaceuticals

Role: CONTACT

Phone: 1-888-669-6682

Email: [email protected]

Novartis Pharmaceuticals

Role: CONTACT

Facility Contacts

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Abbey Patrick

Role: primary

Wes Booth

Role: primary

Role: primary

Olusola Oladipo

Role: primary

Jeruselem Rendon

Role: primary

Lindsey Arcuri

Role: primary

Hanna Varytska

Role: primary

Mindy Demarco

Role: primary

Nathan Tauta

Role: primary

Evguenia Vals

Role: primary

Kourtney Hutchinson

Role: primary

Karina Linares

Role: primary

Jesus Gutierrez

Role: primary

Clare Kanchana

Role: primary

Justin An

Role: primary

Michelle Humbard

Role: primary

Halley Torres

Role: primary

Sherry Lipson

Role: primary

Hailey Rietz Rietz

Role: primary

Jordan Nava

Role: primary

Avigail Cueto

Role: primary

Alma Gonzalez

Role: primary

Siddharth Sandhu

Role: primary

Lauren Utter

Role: primary

Ektor Rafti

Role: primary

Edward Bauer

Role: primary

Aixa Valdes

Role: primary

Alexandra Villa

Role: primary

Esther Perez

Role: primary

Lucy Vargas

Role: primary

Alexander Hill

Role: primary

Felierix Castro Palmero

Role: primary

Maritza D Diego

Role: primary

Stacy Machado

Role: primary

Maritza D Diego

Role: primary

Daine Velazco

Role: primary

Lauren Green

Role: primary

Sally A Kastes

Role: primary

Claudia Monteagudo

Role: primary

Ingrid Rodriguez

Role: primary

Megan Stonehocker

Role: primary

Sandy Pate

Role: primary

Victoria Sherer

Role: primary

Sofia Shamim

Role: primary

Taylor Harrell

Role: primary

Susie Gault

Role: primary

Stephanie Gil

Role: primary

Kelsey Hulen

Role: primary

Stephanie Oliver

Role: primary

Nichole Stonich

Role: primary

Emily Rodriguez

Role: primary

Brandi Burgdorf

Role: primary

Misty Humphress

Role: primary

Rebecca Whitehead

Role: primary

Angela Haynes

Role: primary

Magen Parker

Role: primary

Geri Novak

Role: primary

Chasity Nichols

Role: primary

Lina Fikri

Role: primary

Alexa Lum

Role: primary

Manali Ambegaonkar

Role: primary

Tiffany Rothenhauser

Role: primary

Amy Saykao

Role: primary

Thomas Pritchard

Role: primary

Jodi Mahon

Role: primary

Margaret Ellington

Role: primary

Megan Baldenweck

Role: primary

Faith Limon

Role: primary

Melba Ventura

Role: primary

Cynthia Pinargotte

Role: primary

Danielle Imperiale

Role: primary

Amanda Tellefsen

Role: primary

Courtnie Yokono

Role: primary

Michael Povelaitis

Role: primary

Karen J Berendts

Role: primary

Jyohaarika Nagilla

Role: primary

Tosha Heineman

Role: primary

Jessica Hong

Role: primary

Abbas Zaidi

Role: primary

Charlotte Tinsley

Role: primary

Ashley Brown

Role: primary

Megan Lamey

Role: primary

Lorenzo Redmond

Role: primary

Susan Shidel

Role: primary

Karleigh Williams

Role: primary

Elissa Peery

Role: primary

Amanda Jones

Role: primary

Faye Singleton

Role: primary

Andrew Garcia

Role: primary

Yariana Canini

Role: primary

Amber Ogden

Role: primary

Hannah Green

Role: primary

Redina Bardhi

Role: primary

Roxanne Garcia

Role: primary

Elisa Hernandez

Role: primary

Mario Guerrero

Role: primary

Danielle Monclova

Role: primary

Jonathan Joseph

Role: primary

Kevin Ramirez

Role: primary

Angela Contreras

Role: primary

Sandy Warr

Role: primary

Nancy Moore

Role: primary

Other Identifiers

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CLOU064AUS02

Identifier Type: -

Identifier Source: org_study_id