Phase 2
N=165
Efficacy and Safety Study of GSK3772847 in Subjects With Moderately Severe Asthma
Asthma
Bottom Line
View on ClinicalTrials.gov: NCT03207243 ↗Enrolled (actual)
165
Serious AEs
1.8%
Results posted
Mar 2020
Primary outcome: Primary: Percentage of Participants With Loss of Asthma Control Over Weeks 0-16 — 81; 67 Percentage of participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- GSK3772847 (Drug); Placebo (Drug); Fluticasone propionate/salmeterol (Drug); Fluticasone propionate (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- Feb 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Loss of Asthma Control Over Weeks 0-16 |
81; 67 | — |
| SECONDARY Percentage of Participants With >=0.5 Point Asthma Control Questionnaire (ACQ-5) Score Increase From Baseline |
39; 30 | — |
| SECONDARY Percentage of Participants Who Have Pre-bronchodilator FEV1 Decrease From Baseline >7.5 % |
63; 68 | — |
| SECONDARY Percentage of Participants With Inability to Titrate Inhaled Corticosteroids (ICS) |
23; 30 | — |
| SECONDARY Percentage of Participants With Clinically Significant Asthma Exacerbation |
7; 13 | — |
| SECONDARY Percentage of Participants With Loss of Asthma Control Over Weeks 0-6 |
50; 36 | — |
| SECONDARY Time to Loss of Asthma Control |
50; 96 | 0.044 sig |
| SECONDARY Percentage of Participants With Clinically Significant Asthma Exacerbation or Inability to Titrate |
25; 40 | — |
| SECONDARY Number of Participants Experiencing Asthma Related Hospitalization During the Study Period |
1; 0 | — |
| SECONDARY Rate Per 1000 Person-years of Participants With Hospitalization |
70.5; 0 | — |
| SECONDARY Number of Hospitalizations or Emergency Room Visits Per Participants |
77; 78; 1; 0; 0; 0 | — |
| SECONDARY Change From Baseline in Asthma Control Questionnaire (ACQ-5) Total Score |
-0.36; -0.48; -0.53; -0.74; -0.59; -0.78 | — |
| SECONDARY Percentage of Participants With <=-0.5 Point ACQ-5 Score Decrease From Baseline (Responder) |
38; 41; 46; 56; 49; 56 | — |
| SECONDARY Change From Baseline in St George's Respiratory Questionnaire (SGRQ) Total Score |
-10.0; -7.0; -10.7; -7.2; -15.8; -12.9 | — |
| SECONDARY Percentage of Participants With at Least a 4 Units Improvement From Baseline of St. George's Respiratory Questionnaire (SGRQ) |
60; 58; 61; 67; 70; 74 | — |
| SECONDARY Change From Baseline in Pre-bronchodilator Forced Expiratory Volume in One Second (FEV1) |
0.094; 0.089; 0.074; 0.086; 0.078; 0.135 | — |
| SECONDARY Change From Baseline in Mean Morning Peak Expiratory Flow (PEF) and Mean Evening PEF |
4.13; 4.32; -1.84; -3.82; -4.15; -1.69 | — |
| SECONDARY Change From Baseline in Mean Daytime Asthma Symptom Score Over Each Four Weeks of the 16 Week Treatment Period |
-0.09; -0.02; -0.18; -0.09; -0.29; -0.08 | — |
| SECONDARY Change From Baseline in Mean Daily Rescue Medication Use (Albuterol/Salbutamol) |
-0.52; -1.09; -0.52; -1.24; -0.17; -1.59 | — |
| SECONDARY Change From Baseline in Percent Night-time Awakenings Due to Asthma Symptoms Requiring Rescue Medication Use |
-3.80; -7.42; -7.85; -10.49; -5.67; -13.43 | — |
| SECONDARY Percent Change From Baseline in Fractional Exhaled Nitric Oxide (FeNO) |
-3.6; -4.9; 15.4; 0.0; 15.2; 3.3 | — |
| SECONDARY Number of Participants Reporting Serious Adverse Events (SAEs) and Non-Serious Adverse Events (Non-SAEs) |
20; 19; 1; 2 | — |
| SECONDARY Change From Baseline in Diastolic Blood Pressure (DBP) and Systolic Blood Pressure (SBP) |
-2.0; 1.3; -0.9; 0.4; -1.3; -1.3 | — |
| SECONDARY Change From Baseline in Pulse Rate (PR) |
-2.2; -0.1; 0.8; 3.1; 2.9; 1.7 | — |
| SECONDARY Change From Baseline Between Post-dose and Pre-dose in DBP and SBP |
-2.0; 1.3; -0.4; 2.4; -0.8; 1.9 | — |
| SECONDARY Change From Baseline Between Post-dose and Pre-dose in Pulse Rate |
-2.2; -0.1; -1.6; -1.1; -0.5; -1.6 | — |
| SECONDARY Change From Baseline in PR Interval, QRS Duration, Uncorrected QT Interval, QT Corrected Interval-Fredericia [QTcF] Interval and RR Interval |
1.8; 3.1; -0.4; 1.3; 1.2; 1.9 | — |
| SECONDARY Change From Baseline in ECG Heart Rate |
-1.6; 0.2; 0.4; 0.7; -2.4; -1.0 | — |
| SECONDARY Change From Baseline in QRS Axis |
-0.8; 1.9; 0.7; 2.3; -0.1; 1.4 | — |
| SECONDARY Change Between Pre-dose and Post-dose of PR Interval, QRS Duration, Uncorrected QT Interval, QTcF Interval and RR Interval |
1.8; 3.1; 1.7; 0.5; 0.3; -0.1 | — |
| SECONDARY Change Between Pre-dose and Post-dose of Heart Rate |
-1.6; 0.2; -2.9; -1.7; -1.8; -2.3 | — |
| SECONDARY Change Between Pre-dose and Post-dose of QRS Axis |
-0.8; 1.9; -0.3; -0.9; 1.2; -0.2 | — |
| SECONDARY Change From Baseline in Maximum, Minimum and Average Changes in Heart Rate |
-1.1; -2.0; 76.8; 80.0; 78.8; 79.9 | — |
| SECONDARY Change From Baseline in Supraventricular Couplets, Supraventricular Ectopics, Supraventricular Runs, Supraventricular Singles, Ventricular Couplets, Ventricular Ectopics, Ventricular Runs, Ventricular Singles |
-2.0; 16.5; -1.9; -2.2; -3.9; -0.5 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameter: Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP), Gamma- Glutamyl Transferase (GGT) and Creatine Kinase (CK) |
-0.9; -0.2; -0.5; -2.6; -0.1; -2.4 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Glucose, Potassium, Sodium, Calcium, Phosphate, Chloride, Urea and Carbon Dioxide (CO2) |
0.13; 0.05; 0.18; 0.19; 0.26; 0.00 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Creatinine, Total Bilirubin and Direct Bilirubin |
2.35; 1.71; 2.35; 0.72; 1.18; 1.76 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Total Protein and Albumin |
-0.5; 0.4; -0.4; -0.4; 0.1; 0.8 | — |
| SECONDARY Change From Baseline in Hematology Parameters: Basophil, Eosinophils, Leukocytes, Lymphocytes, Neutrophils, Monocytes, and Platelets |
0.001; -0.001; 0.003; 0.005; 0.005; 0.004 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Erythrocyte Mean Corpuscular Volume |
0.3; -0.1; 0.2; -0.2; -0.4; -0.6 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Erythrocytes |
-0.01; -0.03; 0.01; 0.01; 0.05; -0.01 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hemoglobin |
0.5; -0.7; 0.5; 0.0; 1.6; -0.4 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hematocrit Level |
0.0007; -0.0025; 0.0024; -0.0046; 0.0038; -0.0033 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Mean Corpuscular Hemoglobin |
0.17; 0.01; 0.01; -0.07; 0.01; -0.04 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Mean Corpuscular Hemoglobin Concentration |
0.8; 0.5; -0.6; 0.2; 1.2; 1.5 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Erythrocytes Distribution Width (%) |
-0.06; -0.08; -0.02; -0.20; -0.22; -0.33 | — |
| SECONDARY Change From Baseline in Cardiac Marker: N-Terminal ProB-type Natriuretic Peptide |
-14.8442; 8.4023; -10.8134; -2.5196; -17.9849; -4.5560 | — |
| SECONDARY Change From Baseline in Cardiac Marker: Cardiac Troponin I |
0.000; 0.000; 0.000; 0.000; 0.001; 0.000 | — |
| SECONDARY Number of Participants With Incidence and Titres of Anti- GSK3772847 Antibodies |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Serum Concentrations of GSK3772847 |
78.40; 44.42; 61.44; 63.42; 224.21; 63.03 | — |
| SECONDARY Percent Change From Baseline in Free Soluble Suppressor of Tumorigenicity 2 (ST2) Concentration |
-5.6; -93.8; -8.5; -93.5; 10.5; -92.5 | <0.001 sig |
| SECONDARY Percent Change From Baseline in Total Soluble ST2 Concentration |
16.3; 2691.1; -6.9; 2326.9; -13.4; 1858.0 | <0.001 sig |
Summary
GSK3772847, an anti-interleukin (IL)33 receptor monoclonal antibody, is a novel treatment for asthma. This is a phase 2a study which aims to evaluate efficacy, safety, tolerability, pharmacokinetic (PK) and pharmacodynamic (PD) profiles of GSK3772847 in subjects with moderately severe asthma. The study will be conducted in 4 phases including screening, run-in phase, treatment phase and follow-up. In treatment phase, eligible subjects will be randomized to receive either GSK3772847 or placebo administered via intravenous (IV) route every 4 weeks in addition to open-label background therapy of fluticasone propionate/ salmeterol (FP/Sal) 500/50 micrograms (mcg) twice daily. During the treatment phase, the background therapy will be switched to FP 500 mcg for 2 weeks and the dose of FP will be reduced by approximately 50 percent at every 2 weeks until complete FP discontinuation. The total duration of study will be approximately 33 weeks and approximately 165 subjects with moderately severe asthma who are maintained on high-dose of inhaled corticosteroids/ Long-Acting Beta-2-Agonists (ICS/LABA) will be randomized.
Eligibility Criteria
Inclusion Criteria
- Age: At least 18 years of age at the time of signing the informed consent.
- Males and females: A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP) OR A WOCBP who agrees to follow highly effective contraceptive methods from 4 weeks prior to the first dose of study medication and until at least 16 weeks after the last dose of study medication and completion of the follow-up visit.
- Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the consent form and in this protocol.
- A subject with a documented diagnosis of moderate severe asthma based on Global Initiative for Asthma (GINA) 2016 Guidelines, whose asthma has been managed with regular treatment of high dose ICS defined as FP 500 mcg twice daily (i.e. 1000 mcg total daily dose) or equivalent, and LABA for at least 4 months. Additional therapy with a leukotriene receptor antagonist (LTRA) is permissible.
- Airway reversibility of at least 12 percent and 200 milliliter (mL) in FEV1 at Screening (Visit 1), or documented reversibility prior to Screening (Visit 1), or documented history of bronchial hyper reactivity (e.g. fall in FEV1 from baseline of more than or equal to 20percent with standard doses of methacholine or histamine, or more than or equal to 15 percent with standardized hyperventilation, hypertonic saline or mannitol challenge) from a bronchoprovocation study [e.g. methacholine challenge prior to Screening (Visit 1)].
- ACQ-5 score more than or equal to 1.0 and less than 4.0 at Screening (Visit 1).
- Had at least one asthma exacerbation within 12 months prior to screening that required treatment with systemic corticosteroid and/or hospitalization.
- All subjects must be able to replace their current Short-Acting Beta2-Agonists (SABA) treatment with albuterol/salbutamol aerosol inhaler at Visit 1 for use as needed, per product label, for the duration of the study.
Randomization inclusion criteria:
- ACQ-5 score more than or equal to 1.0 and less than 4.0 at Visit 2.
- Compliance with completion of the Daily eDiary reporting defined as completion of all questions/assessments on more than or equal to 4 of the last 7 days during the run-in period.
Exclusion Criteria
- Current smokers or former smokers with a smoking history more than or equal to 10 pack years.
- Presence of a known pre-existing, clinically important respiratory conditions (e.g. pneumonia, pneumothorax, atelectasis segmental or larger, pulmonary fibrotic disease, bronchopulmonary dysplasia, chronic bronchitis, emphysema, chronic obstructive pulmonary disease, or other respiratory abnormalities) other than asthma.
- A pre-bronchodilator FEV1 less than 50 percent predicted of normal value at Screening (Visit 1).
- Subjects with a diagnosis of malignancy or in the process of investigation for a malignancy. Subjects with carcinoma that have not been in complete remission for at least 5 years. Subjects who have had carcinoma in situ of the cervix, squamous cell carcinoma and basal cell carcinoma of the skin would not be excluded based on the 5 year waiting period if the subject has been considered cured by treatment.
- Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at Screening (Visit 1) or within 3 months prior to first dose of study treatment.
- Site investigators will be provided with ECG over-read conducted by a centralized independent cardiologist, to assist in evaluation of subject eligibility.
- Weight: less than 50 kilograms (kg) and more than 150 kg.
- Regular use of systemic corticosteroids for conditions including asthma within 3 months prior to Screening (Visit 1).
- Subjects with high parasympathetic tone (e.g. trained athletes with baseline bradycardia) or chronic conditions associated with parasympathetic surges (e.g. migrain
Data sourced from ClinicalTrials.gov (NCT03207243). 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.