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Phase 2 Completed N=36 Other

Pharmacokinetics and Pharmacodynamics of Mepolizumab Administered Subcutaneously in Children

Source: ClinicalTrials.gov NCT02377427 ↗
Enrolled (actual)
36
Serious AEs
19.7%
Results posted
Nov 2017
Primary outcomePrimary: Maximum Plasma Concentration (Cmax) of Mepolizumab for Part A — 12.8188; 16.3412; 10.1960 Microgram (ug) per mL

Summary

Mepolizumab is a humanized immunoglobulin G (IgG1) monoclonal antibody (mAb) that exhibits dose proportional and time-independent pharmacokinetics. The study will be conducted in 2 parts. Part A: it will be pharmacokinetic (PK) and pharmacodynamic (PD) study conducted to support the use of mepolizumab in children aged 6 to 11 years with severe eosinophilic asthma and characterize the PK/PD of mepolizumab 40 milligrams (mg) or 100 mg administered subcutaneously depending on participant body weight. Part B: It is a long-term safety / pharmacodynamic phase in which extended treatment for a further 52 weeks will be offered on an optional basis to those subjects eligible for continued treatment. Participants with bodyweight =40 kg will be dosed with mepolizumab 100 mg subcutaneously in upper arm or thigh at Visit 2 (Week 0). Approximately 40 male or female participants aged 6 to 11 years will be screened to achieve approximately 28 eligible participants entering the treatment phase to allow availability of 20 evaluable participants, with a minimum of six participants enrolled in the <40 kg bodyweight group. The total duration of the study will be 22 weeks and will include a run-in period of 1-2 weeks, a treatment period of 12 weeks and a follow-up phase of 8 weeks. A participant will be considered having completed the study if the participant completes all phases of the study including the follow-up phase (Week 20 [visit 8]).

Outcome Measures

OutcomeResultp-value
PRIMARY
Maximum Plasma Concentration (Cmax) of Mepolizumab for Part A
12.8188; 16.3412; 10.1960
PRIMARY
Area Under Concentration Time Curve to Infinity (AUC [0-inf]) of Mepolizumab for Part A
508.23; 675.20; 454.39
PRIMARY
Terminal Phase Elimination Half-life (T1/2) of Mepolizumab During Treatment Period for Part A
20.9583; 21.8420; 23.5582
PRIMARY
Plasma Apparent Clearance (CL/F) of Mepolizumab in Part A
0.1968; 0.1481; 0.08803
PRIMARY
Ratio to Baseline in Absolute Blood Eosinophil Count at Week 12 for Part A
0.115; 0.166
PRIMARY
Number of Participants With on Treatment Serious Adverse Events (SAEs) and Non-SAEs for Part B
4; 2; 1; 15; 8; 4
PRIMARY
Number of Participants With Positive Anti-mepolizumab Binding Antibodies and Neutralizing Antibodies Response for Part B
0; 0; 0; 0; 0; 0
PRIMARY
Change From Baseline in Sitting Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) for Part B
1.4; -0.9; -0.8; 5.7; 1.6; -4.0
PRIMARY
Change From Baseline in Sitting Pulse Rate for Part B
-3.8; 4.3; 7.0; -7.0; 2.7; 1.7
PRIMARY
Number of Participants With Any Time Change From Baseline Relative to Normal Range in Clinical Chemistry Parameters for Part B
0; 0; 0; 16; 10; 4
PRIMARY
Number of Participants With Any Time Change From Baseline Relative to Normal Range in Hematology Parameters for Part B
0; 0; 0; 16; 10; 4
PRIMARY
Number of Participants With Abnormal Findings for Urinalysis Parameters in Part B
7; 6; 0
SECONDARY
Body Weight-adjusted Apparent Clearance of Mepolizumab for Part A
0.1968; 0.1481; 0.0880
SECONDARY
Change From Baseline in Asthma Control Questionnaire-7 (ACQ-7) at Week 12 in Part A
-0.414; 0.082
SECONDARY
Change From Baseline in Asthma Control Questionnaire-7 (ACQ-7) at Weeks 4,8,16 and 20 in Part A
-0.548; -0.473; -0.652; -0.302; -0.154; -0.087
SECONDARY
Change From Baseline in Childhood Asthma Control Test (C-ACT) at Week 12 for Part A
2.1; -0.3
SECONDARY
Change From Baseline in C-ACT at Weeks 4,8,16 and 20 in Part A
1.8; 2.4; 3.0; 1.5; 1.5; -0.7
SECONDARY
Number of Participants With on Treatment SAEs and Non-SAEs in Part A
18; 6; 5; 1
SECONDARY
Number of Participants With Any Time Change From Baseline Relative to Normal Range in Hematology Parameters in Part A
0; 0; 25; 10; 1; 0
SECONDARY
Number of Participants With Any Time Change From Baseline Relative to Normal Range in Clinical Chemistry Parameters in Part A
0; 0; 26; 10; 0; 0
SECONDARY
Number of Participants With Abnormal Findings for Urinalysis in Part A
5; 4
SECONDARY
Number of Participants With Positive Anti-mepolizumab Binding Antibodies and Neutralizing Antibodies Response in Part A
1; 1; 0; 0
SECONDARY
Change From Baseline in Sitting SBP and DBP in Part A
0.4; 2.1; -0.4; 3.4; 1.8; 4.9
SECONDARY
Change From Baseline in Sitting Pulse Rate in Part A
-4.0; -1.1; -3.2; 1.8; -2.9; 2.3
SECONDARY
Ratio to Baseline in Absolute Blood Eosinophil Count at Weeks 32, 44, 56, 68, 72 and 80 for Part B
0.161; 0.176; 0.072; 0.157; 0.189; 0.147

Eligibility Criteria

Inclusion Criteria

  • Between 6 and 11 years of age inclusive, at the time of screening.
  • Diagnosis of severe asthma, defined by the regional asthma guidelines (i.e., National Institute of Health (NIH), Global Initiative for Asthma (GINA), etc.), for at least 12 months prior to Visit 1. If the participant is naïve to the study site, the participant/guardian must self-report a physician diagnosis of asthma and the investigator must confirm by review of medical history with the participant/guardian.
  • Eosinophilic airway inflammation that is related to asthma characterized as eosinophilic in nature as indicated by: elevated peripheral blood eosinophil count of >=300 cells per microliter (cells/μL) demonstrated in the past 12 months OR elevated peripheral blood eosinophil count of >=150/μL at visit 1.
  • A well-documented requirement for regular treatment with inhaled corticosteroid (>200 μg/day fluticasone propionate drug powder inhaler [DPI] or equivalent daily) in the 12 months prior to Visit 1 with or without maintenance oral corticosteroids (OCS). The ICS dose should represent medium or high dose in children aged 6-11 years of age [GINA, 2015].
  • Current treatment with an additional controller medication for at least 3 months or a documented failure in the past 12 months of an additional controller medication for at least 3 successive months. [e.g., long-acting beta-2-agonist (LABA), leukotriene receptor antagonist (LTRA), or theophylline.]
  • Forced expiratory volume in one second (FEV1): Persistent airflow obstruction at either Visit 1 or Visit 2 (FEV1 performed prior to first dose of study medication) as indicated by: A pre-bronchodilator FEV1 2x upper limit of normal (ULN) (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%) at Visit 1.
  • Positive Hepatitis B Surface Antigen or positive Hepatitis C antibody at Visit 1.
  • Parent/guardian has a history of psychiatric disease, intellectual deficiency, substance abuse, or other condition (e.g. inability to read, comprehend and write) which will limit the validity of consent to participate in this study.
  • Unwillingness or inability of the participant or parent/guardian to follow the procedures outlined in the protocol.
  • Participant who is mentally or legally incapacitated.
  • Children who are wards of the state or government.
  • A participant will not be eligible for this study if he/she is an immediate family member of the participating investigator, sub-investigator, study coordinator, or employee of the participating investigator.
  • Omalizumab: Participants who have received omalizumab within 130 days of Visit 1.
  • Other Biologics: Participants who have received any biological (other than omalizumab) to treat inflammatory disease within 5 half-lives of visit 1.
  • History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or Medical Monitor, contraindicates their participation.
  • Hypersensitivity: Participants with allergy/intolerance to a monoclonal antibody or biologic.
  • The participant has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02377427). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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