Complete Remission After Treatment With Biologics for Nasal Polyps

NCT ID: NCT07268313

Last Updated: 2025-12-05

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

66 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-03

Study Completion Date

2027-06-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

In this RCT the investigators randomize patients who are treated with biologic treatment (Nucala or Dupixent) due to nasal polyps and have controlled disease within the last year to either stop treatment og continue as a control group.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

11 Protocol Synopsis 11.1. EU trial number and full trial title: 2024- 5196285-25-00 English title: Complete remission study Subtitle: Discontinuation of Mepolizumab or Dupilumab after at least 12 months without symptoms in patients with severe Chronic rhinosinusitis with polyps - a National Danish RCT study.

11.2. Rationale Specify background and hypothesis of the trial. The Danish Medicines Council has decided that well-controlled patients with nasal polyps should try to cease the medication after two years of treatment with biologics (Mepolizumab or Dupilumab). The investigators find this better to do in a RCT. Based on the experience from asthma patients this could be done in some patients without the symptoms reoccur.

11.3. Objective Specify the main and secondary objectives of the trial. The main objective is to find the percentage of patients in complete remission (no or few symptoms) who can cease the biologic treatment and keep being in remission. The secondary objective is to observe if one or the other drug is more likely to give this result.

11.4. \& 11.5 Main and secondary trial endpoints: The main endpoint is to monitor the percentage of patients who do not have recurrence of their sino-nasal symptoms when they cease medicine. This is evaluated at baseline and after 12,26,38,52 weeks, however, the patients can contact the investigators at any time if symptoms reoccur. A control group is included and it is assumed that patients kept on treatment will keep being in complete remission. No adverse effects are expected, thus no new medication is started.

11.6. Trial design: Non-blinded, prospective RCT. Half the included patients will keep their treatment unchanged (control-group) the other half will stop the biological treatment (everything else unchanged). Every individual participant will have a 52-week follow-up period. If a participant in the trial group gets symptoms and feel partly uncontrolled they will start treatment again with same drug, dose and interval as before the cease.

11.7. Trial population: Patients over 18 years of age, who have been on hospital administrated biologic treatment for at least 1½ year and have been in remission for at least a year.

11.8. Interventions: The participants are randomized into two groups: one group (33 patients) will be the control group with no change in their treatment, the other group (33 patients) will cease treatment.

11.9. Ethical considerations. The investigators have very few ethical concerns by conducting this study. It is highly unlikely that any side effects will occur, thus there is no suspicion that reducing dose of biologics gives risks of side effects.

Further, none of the examinations or questionnaires are add-on to the examinations that the patients must go through when being in biologic treatment.

The investigators only concern is that some patients will experience recurrence of sino-nasal and/or asthma symptoms when stopping the biologic medicine. However, there is a plan for handling this safely. Lastly, it should also be kept in mind that the Danish medicines council recommends trying to stop the treatment, thus the investigators find it better to do this under RCT conditions.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Nasal Polyps

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

One intervention group stops treatment (but starts again if any symptom returns), one control group
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Arm 1: Continue Drug D

Participants continue their usual treatment with Drug Dupi throughout the study.

Group Type ACTIVE_COMPARATOR

DUPIXENT®

Intervention Type DRUG

Continue Dupixent

Arm 2: Stop Drug D

Participants discontinue Drug Dupi at baseline and receive no active treatment during the study.

Group Type EXPERIMENTAL

Dupi discontinuation

Intervention Type OTHER

Stop taking Dupixent at baseline; no substitute is given

Arm 3: Continue Drug M

Participants continue their usual treatment with Drug Mepo throughout the study.

Group Type ACTIVE_COMPARATOR

NUCALA®

Intervention Type DRUG

"Continue Nucala

Arm 4: Stop Drug M

Participants discontinue Drug Mepo at baseline and receive no active treatment during the study.

Group Type EXPERIMENTAL

Mepo discontinuation

Intervention Type OTHER

Stop taking Nucala at baseline; no substitute is given

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

DUPIXENT®

Continue Dupixent

Intervention Type DRUG

NUCALA®

"Continue Nucala

Intervention Type DRUG

Dupi discontinuation

Stop taking Dupixent at baseline; no substitute is given

Intervention Type OTHER

Mepo discontinuation

Stop taking Nucala at baseline; no substitute is given

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

At the time when the patient started biological treatment, they must have fulfilled the EPOS criteria for initiation of biologic treatment (REF EPOS):

* Fulfil the criteria for CRSwNP
* Presence of bilateral polyps in a patient
* Had ESS (sinus surgery) (exceptional circumstances excluded)
* Fulfil at least three of the following five criteria Evidence of type 2 inflammation Need for (and treated with) systemic corticosteroids or contraindication to these SNOT-22 score of 40 or above Significant loss of smell Asthma needing regular inhaled corticosteroids

To enter this study, the patient must be:

* Above 18 years of age
* Currently be in treatment with either Dupilumab (300 mg) or Mepolizumab (100 mg) with treatment every fourth week. This treatment should have been stable/unchanged for at least three months.
* Within the latest year, the patient must at all times have scored all the below symptoms of CRS five or below on a VAS scale from 0 - 10 - Doing this, it is according to the EPOS defined as controlled disease. The items are: nasal blockage, rhinorrhea/postnasal drip, facial pain/pressure, smell, sleep disturbance or fatigue) Please view appendix 2.
* Within the latest year the nasal endoscopy cannot have showed polyp score of more than 1+1 out of 4+4, further, no thick secretions or general oedema must have been present.
* Within the latest year the patient is not allowed to have had ESS or rescue treatment for their CRSwNP (antibiotics or systemic steroids)
* The patient must be able to understand Danish and able to sign an informed content.

Exclusion Criteria

* In the twelve months of remission the patient is not allowed to have had AECRS (acute exacerbation of chronic rhinosinusitis). A common cold is allowed.
* Polyp removal in the out-patient clinic may not have been performed within the last 3 months.
* In the twelve months of remission the patient cannot at any time have scored higher than 1.2 on the ACQ questionnaire, meaning that the patient does not have uncontrolled asthma (Appendix 3).
* Patients who, because of language barriers, are not able to understand written information and, thus, are not able to answer questionnaires.
* Patients who currently receive biologics for any other disease (asthma not included)
* Patients who are not able to give informed consent (i.e., patients who are permanently incapable)
* Patients who are not eligible because of the investigator's judgement
* Patients who experience pregnancy during the study will be excluded after an unscheduled visit (LOCF) - active IVF treatment. (Please look belove)
* Patients who have or recently have had illness, such as cancer that or its treatment is expected to significantly affect morbidity and/or quality of life in the next two years
* Unwillingness to follow the study procedure
* Hypersensitivity to any of either Dupilumab or Mepolizumab.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Rigshospitalet, Denmark

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Kasper Aanaes

Medical doctor, phd., Principal investigator, associated professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Rigshospitalet

Copenhagen, Region H, Denmark

Site Status RECRUITING

Nordsjællands hospital

Hillerød, Region H, Denmark

Site Status RECRUITING

Køge øre næse hals afd

Køge, Region Sj, Denmark

Site Status RECRUITING

Dept. of otorhinolaryngology, Odense

Odense, Region Syd, Denmark

Site Status RECRUITING

Vejle sygehus

Vejle, Region S, Denmark

Site Status RECRUITING

Gødstrup Hospital

Gødstrup, , Denmark

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Denmark

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Kasper Aanæs, md, phd

Role: CONTACT

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Kasper aanæs, md, phd

Role: primary

60708594

Grethe Samuelsen

Role: primary

Bent Ivan Larsen

Role: primary

Anette Drøhse Kjeldsen

Role: primary

Lars Christian Meyer

Role: primary

Adnan Madzak

Role: primary

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

Rigshospitalet-ENT-1

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Mepolizumab in Nasal Polyposis
NCT01362244 COMPLETED PHASE2