Phase 2
Completed N=805
A Study to Assess the Efficacy and Safety of Multiple Dose Levels of AZD7594 Administered Once Daily by Inhalation in Asthmatic Subjects
Source: ClinicalTrials.gov NCT03622112 ↗Enrolled (actual)
805
Serious AEs
1.4%
Results posted
Nov 2020
Primary outcomePrimary: Change From Baseline in Trough FEV1 at Week 12 — -0.013; -0.031; 0.062; 0.099 Liters — p=0.437
Summary
This study will assess the efficacy and safety of multiple dose levels of AZD7594 administered once daily (QD) by inhalation in a 12-week treatment period on asthma subjects. The activity will be assessed by comparing AZD7594 to placebo. The comparison between active comparator (FF) and placebo will be used for bench marking. The efficacy is assessed by the evaluation of change in trough forced expiratory volume in 1 second (FEV1). The aim is to develop AZD7594 as a once daily inhaled non-steroidal selective GR modulator (SGRM), which may ultimately lead to better disease control of both chronic obstructive pulmonary disease (COPD) and asthma through improved efficacy and compliance. The overall rationale for developing a once daily AZD7594 in a dry powder inhaler (DPI) is to provide a safe and effective future treatment option for both asthma and COPD subjects.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline in Trough FEV1 at Week 12 |
-0.013; -0.031; 0.062; 0.099; 0.104; 0.022 | 0.437 |
| SECONDARY Change From Baseline in Trough FEV1 at Weeks 2, 4, 8 and Average Over the Treatment Period |
0.018; 0.011; 0.067; 0.091; 0.093; -0.011 | 0.463 |
| SECONDARY Change From Baseline in Fractional Exhaled Nitic Oxide (FENO) at Weeks 2, 4, 8, 12 and Average Over the Treatment Period |
1.307; 1.223; 1.175; 1.152; 0.959; 1.396 | 0.322 |
| SECONDARY Change From Baseline in Trough Forced Vital Capacity (FVC) at Week 12 and Average Over the Treatment Period |
0.027; -0.017; 0.076; 0.119; 0.088; 0.061 | 0.519 |
| SECONDARY Change From Baseline in Asthma Control Questionnaire -5 (ACQ-5) at Week 12 and Average Over the Treatment Period |
-0.289; -0.394; -0.357; -0.330; -0.406; -0.137 | 0.088 |
| SECONDARY Change From Baseline in Average Morning Peak Expiratory Flow (PEF) Over the Treatment Period |
-4.036; -5.718; -2.576; 3.745; 4.900; -11.699 | 0.097 |
| SECONDARY Change From Baseline in Average Evening PEF Over the Treatment Period |
-5.418; -5.654; -3.983; 2.441; 4.178; -7.816 | 0.597 |
| SECONDARY Change From Baseline in Average Daily Use of Rescue Medication Over the Treatment Period |
-0.370; -0.282; -0.226; -0.435; -0.435; -0.127 | 0.012 sig |
| SECONDARY Change From Baseline in Percent Night-time Awakening Days Over the Treatment Period |
-14.281; -12.260; -8.649; -12.085; -13.017; -4.288 | <0.001 sig |
| SECONDARY Change From Baseline in Average Daily Asthma Symptom Score Over the Treatment Period |
-0.303; -0.201; -0.229; -0.321; -0.275; -0.091 | <0.001 sig |
| SECONDARY Change From Baseline in Percent Asthma Control Days Over the Treatment Period |
15.470; 11.362; 12.646; 15.925; 14.479; 5.859 | 0.026 sig |
| SECONDARY Change From Baseline in Percent Rescue-free Days Over the Treatment Period |
31.138; 24.178; 21.960; 34.991; 30.775; 23.202 | 0.123 |
| SECONDARY Change From Baseline in Percent Symptom-free Days Over the Treatment Period |
13.780; 10.521; 11.935; 14.673; 13.451; 3.329 | 0.015 sig |
| SECONDARY Observed Maximum Concentration at Steady State (Css,Max) of AZD7594 at Day 84 |
48.45; 114.90; 69.71; 154.50; 200.00 | — |
| SECONDARY Observed Minimum Concentration at the End of the Dosing Interval (Css,Min) of AZD7594 at Day 84 |
14.41; 21.45; 30.22; 70.58; 85.13 | — |
| SECONDARY Time to Maximum Concentration at Steady State, Taken Directly From the Individual Concentration-time Curve (Tss, Max) of AZD7594 at Day 84 |
0.25; 0.25; 0.25; 0.25; 0.25 | — |
| SECONDARY Time of Last Quantifiable Analyte Concentration (Tlast) of AZD7594 at Day 84 |
8.01; 24.00; 24.00; 24.00; 24.00 | — |
| SECONDARY Area Under the Plasma Concentration-curve From Time Zero to the Time of Last Quantifiable Analyte Concentration (AUClast) of AZD7594 at Day 84 |
167.50; 573.00; 719.10; 1435.00; 2622.00 | — |
| SECONDARY Area Under the Plasma Concentration-curve Within a Dosing Interval (AUCτ) of AZD7594 at Day 84 |
530.50; 928.60; 1137.00; 2205.00; 2622.00 | — |
| SECONDARY Average Plasma Concentration During a Dosing Interval at Steady State (Css,Avg) of AZD7594 at Day 84 |
22.10; 38.69; 47.37; 91.86; 109.30 | — |
| SECONDARY Dose Normalised Css,Max (Css,Max/D) of AZD7594 at Day 84 |
587.80; 774.40; 234.90; 260.40; 168.50 | — |
| SECONDARY Dose Normalised AUCτ (AUCτ/D) of AZD7594 at Day 84 |
6436.00; 6259.00; 3831.00; 3715.00; 2209.00 | — |
| SECONDARY Percentage Fluctuation of AZD7594 at Day 84 |
387.80; 326.60; 148.90; 172.10; 98.22 | — |
| SECONDARY Change From Baseline in Area Under Plasma Cortisol Concentration-time Curve (AUEC0-24hrs Post Dose), of AZD7594 vs Placebo at Day 84 |
1.029; 1.140; 1.151; 1.003; 0.934; 1.019 | 0.909 |
| SECONDARY Number of Participants With Adverse Events |
35; 45; 39; 54; 46; 47 | — |
Eligibility Criteria
Inclusion criteria
- Provision of informed consent prior to any study-specific procedures 2. Men and women 18 to 85 years of age, inclusive, with body mass index (BMI)≤35 3. Subjects need to be non-smokers or ex-smokers (have quit e cigarettes or other inhaled tobacco products ≥6 months before Visit 1) with a total smoking history of less than 10 pack-years (not applicable for e cigarettes) 4. Documented clinical diagnosis of asthma for ≥6 months before Visit 1 5. Subjects on stable medium to high dose ICS (equivalent of budesonide >400 μg/day) or low to medium dose ICS/LABA for at least 4 weeks prior to screening (Visit 1) (Appendix A, GINA, 2018) 6. Subjects must demonstrate reversibility to inhaled bronchodilators at Visit 2 (a ≥12% and ≥200 mL improvement in FEV1 after administration of a 4 puffs of salbutamol/albuterol) 7. Pre-bronchodilator FEV1 at Visit 3 between 40% and 90% predicted at either -45 or -15 minutes pre-dose 8. At Visit 3, subjects need to be symptomatic on low dose ICS as evidenced by combined daily asthma mean symptom score of >1 over the previous 7 days or SABA use on ≥3 of the last 7 days during the Run-in Period 9. Demonstrate the ability to use the study inhalation device properly 10. Subject able to perform acceptable pulmonary function testing for FEV1 according to American Thoracic Society/European Respiratory Society (ATS/ERS) acceptability criteria 11. Subject is willing and able to follow study procedures and restrictions. Women of child bearing potential (WOCBP) should be stable on their chosen method of highly effective birth control for a minimum of 3 months prior to Visit 1, and willing to use that for the entire duration of the study (from the time they sign the informed consent), and for 1 month after the last dose of IP 12. For optional inclusion in the Gx component of the study, subjects must provide separate informed consent for the genomic sampling and analysis Exclusion criteria
- Known or suspected hypersensitivity to any of the IPs, including budesonide, or excipients, including lactose
- Systemic steroid use within the 6 weeks before Visit 1
- Concomitant chronic respiratory disease (including current sleep apnea)
- History or clinical suspicion of any clinically relevant or active disease or disorder which, in the opinion of the Investigator, may either put the subject at risk because of participation in the study, or influence the results or the subject's ability to participate in the study, or any other safety concerns in the opinion of the Investigator
- Use of prohibited medications that cannot be stopped during the entire period of the study (starting Visit 1).
- Subjects with 240 msec), intermittent second or third degree atrial-ventricular (AV) block or AV dissociation at Visit 1 or Visit 3
- Subjects with implantable cardiac defibrillator and subjects with sustained symptomatic ventricular and/or atrial tachyarrhythmia
- Subjects with unstable angina pectoris or stable angina pectoris classified higher than Canadian Cardiovascular Society Class II, or a myocardial infarction or stroke within 6 months before Visit 1
- History of hospitalisation within 12 months before Visit 1 caused by heart failure or a diagnosis of heart failure higher than New York Heart Association Class II
- Subjects who are positive for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody or human immunodeficiency virus (HIV) at Visit 1
- Donation of blood (≥ 450 mL) within 3 months or donation of plasma within 14 days before Visit 1
- Suspected poor capability to follow instructions of the study, as judged by the Investigator
- Previous participation or prior screen failure in the current study, or participation in any other research study within 1 month prior to Visit 1
- Subject under treatment with biologicals such as monoclonal antibodies or chimeric biomolecules including omalizumab, mepolizumab, and reslizumab within 6 months or 5 half-lives before Vis
Data sourced from ClinicalTrials.gov (NCT03622112). 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.