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Phase 3 N=397 Randomized Quadruple-blind Treatment

Dupilumab for the Treatment of Chronic Spontaneous Urticaria in Patients Who Remain Symptomatic Despite the Use of H1 Antihistamine and Who Are naïve to, Intolerant of, or Incomplete Responders to Omalizumab (LIBERTY-CSU CUPID)

Chronic Spontaneous Urticaria

Enrolled (actual)
397
Serious AEs
4.5%
Results posted
Aug 2025
Primary outcome: Primary: Change From Baseline in Weekly Itch Severity Score at Week 24 — -6.01; -10.24; -4.81; -7.68 score on a scale — p=0.0005

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Dupilumab SAR231893 (Drug); Placebo (Drug); non sedating H1-antihistamine (Drug)
Age
Pediatric, Adult, Older Adult · 6+ yrs
Sex
All
Sponsor
Sanofi
Primary completion
Aug 2024

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline in Weekly Itch Severity Score at Week 24
-6.01; -10.24; -4.81; -7.68; -6.10; -8.64 0.0005 sig
SECONDARY
Change From Baseline in Weekly Urticaria Activity Score at Week 24
-12.00; -20.53; -8.54; -14.37; -11.21; -15.86 0.0003 sig
SECONDARY
Change From Baseline in Weekly Hives Severity Score at Week 24
-5.90; -10.28; -3.63; -6.64; -5.11; -7.27 0.0003 sig
SECONDARY
Percentage of Responders for Weekly Itch Severity Score Minimally Important Difference (MID) at Week 24
42.6; 72.9; 38.9; 59.3; 51.9; 70.3 0.0014 sig
SECONDARY
Percentage of Participants With Weekly Urticaria Activity Score <=6 at Week 24
23.5; 45.7; 18.5; 24.1; 23.4; 40.5 0.0075 sig
SECONDARY
Percentage of Participants With Weekly Urticaria Activity Score =0 at Week 24
13.2; 31.4; 9.3; 13.0; 18.2; 29.7 0.0199 sig
SECONDARY
Change From Baseline in Urticaria Control Test (UCT) at Week 24
4.88; 7.71; 3.38; 5.33; 4.16; 5.09 0.1940
SECONDARY
Change From Baseline in Weekly Itch Severity Score at Week 12
-6.01; -8.37; -4.52; -7.37; -5.31; -7.15 0.0377 sig
SECONDARY
Change From Baseline in Weekly Urticaria Activity Score at Week 12
-11.79; -16.81; -8.22; -13.33; -9.51; -12.87 0.0223 sig
SECONDARY
Percentage of Participants With Weekly Urticaria Activity Score <=6 and =0 at Week 12
17.6; 34.3; 9.3; 24.1; 16.9; 31.1 0.0215 sig
SECONDARY
Percentage of Responders for Weekly Itch Severity Score Minimally Important Difference at Week 12
52.9; 70.0; 46.3; 64.8; 51.9; 58.1 0.0971
SECONDARY
Change From Baseline in Weekly Hives Severity Score at Week 12
-5.69; -8.39; -3.71; -5.97; -4.22; -5.75
SECONDARY
Change From Baseline in Urticaria Control Test at Week 12
4.62; 6.48; 3.11; 5.48; 3.26; 4.61
SECONDARY
Change From Baseline in Weekly Itch Severity Score at Weeks 4, 8, 16 and 20
-3.30; -4.96; -4.12; -5.51; -3.78; -5.26
SECONDARY
Time to First Weekly Itch Severity Score Minimally Important Difference Response During the 24-Week Treatment Period
4.0; 3.0; 4.0; 3.0; 5.0; 3.5
SECONDARY
Change From Baseline in Angioedema Activity Score Over 7 Days (AAS7) at Weeks 12 and 24
-23.46; -19.14; -16.74; -19.41; -32.14; -34.33
SECONDARY
Percentage of Well-controlled Participants (Urticaria Control Test >=12) at Weeks 12 and 24
27.9; 44.3; 18.5; 51.9; 22.1; 37.8
SECONDARY
Change From Baseline in Health-related Quality-of-life (HRQoL) as Measured by Dermatology Life Quality Index (DLQI) in Participants >=16 Years Old at Weeks 12 and 24
-7.55; -8.55; -4.53; -6.77; -5.01; -6.61
SECONDARY
Change From Baseline in Health-related Quality-of-life as Measured by Children's Dermatology Life Quality Index (CDLQI) in Participants >=6 to <16 Years Old at Weeks 12 and 24
-5.00; -8.00; -7; -4.60; -9.00; -12.50
SECONDARY
Patient Global Impression of Change (PGIC) of Chronic Spontaneous Urticaria at Weeks 12 and 24
1.68; 1.10; 2.06; 1.62; 1.59; 1.27
SECONDARY
Change From Baseline in Patient Global Impression of Severity (PGIS) of Chronic Spontaneous Urticaria at Weeks 12 and 24
-0.89; -1.23; -0.46; -1.15; -0.82; -0.95
SECONDARY
Time to First Oral Corticosteroid (OCS) Use for Chronic Spontaneous Urticaria During the 24-week Treatment Period
0.110; 0.087; 0.158; 0.116; 0.067; 0.014
SECONDARY
Percentage of Participants Receiving Oral Corticosteroid for Chronic Spontaneous Urticaria During the 24-week Treatment Period
10.3; 8.6; 14.8; 11.1; 6.5; 1.4
SECONDARY
Number of Participants With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
40; 38; 29; 33; 41; 40
SECONDARY
Number of Participants With Treatment-emergent Anti-drug Antibodies (ADA) Against Dupilumab
1; 9; 2; 10; 0; 1

Summary

Primary Objective: This study aimed to demonstrate the efficacy of dupilumab in study participants with CSU who remained symptomatic despite the use of H1 antihistamine (Study A and C: omalizumab naïve; Study B: omalizumab intolerant or incomplete responders) Secondary Objectives: This study aimed to demonstrate the efficacy of dupilumab on urticaria activity composite endpoint and itch or hives, separately, at various timepoints This study aimed to demonstrate the efficacy of dupilumab on angioedema This study aimed to demonstrate the efficacy of dupilumab on urticaria control This study aimed to demonstrate improvement in health-related quality of life and overall disease status and severity This study aimed to evaluate the ability of dupilumab in reducing the proportion of participants who require treatment with oral corticosteroids (OCS) This study aimed to evaluate safety outcome measures This study aimed to evaluate immunogenicity of dupilumab

Eligibility Criteria

Inclusion Criteria

  • Study A and C: Participant were ≥6 years to 80 years of age at the time of signing the informed consent.
  • Study B: Participant were ≥12 years (or the minimum legal age for adolescents in the country of the investigational site) to 80 years of age at the time of signing the informed consent
  • Participants who had a diagnosis of CSU refractory to H1 antihistamines (H1-AH) at the time of randomization defined by
  • Diagnosis of CSU>6 months prior to screening visit
  • Presence of itch and hives for >6 consecutive weeks at any time prior to screening visit despite the use of H1-AH during that time period
  • Used a study defined H1-antihistamine for CSU treatment
  • During the 7 days before randomization:

UAS7≥16 ISS7≥ 8

  • Study A and C: omalizumab naïve, Study B; intolerant or incomplete responder to omalizumab
  • Participants were willing and able to complete a daily symptom e-Diary for the duration of the study

Exclusion Criteria

Participants were excluded from any of the studies if any of the following criteria apply:

  • Weight was less than 30 kg in adults and adolescents and 15 kg in children aged 6 to<12years
  • Clearly defined underlying etiology for chronic urticarias other than CSU
  • Presented of skin morbidities other than CSU that may interfere with the assessment of the study outcomes
  • Active atopic dermatitis
  • Severe concomitant illness(es) that, in the investigator's judgment, would have adversely affected the participant's participation in the study
  • Active tuberculosis or non-tuberculous mycobacterial infection, or a history of incompletely treated tuberculosis unless documented adequately treated.
  • Diagnosed active endoparasitic infections; suspected or high risk of endoparasitic infection
  • Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiprotozoals, or antifungals within 2 weeks before the screening visit and during the screening period
  • Known or suspected immunodeficiency
  • Active malignancy or history of malignancy within 5 years before the baseline visit, except completely treated in situ carcinoma of the cervix, completely treated and resolved non-metastatic squamous or basal cell carcinoma of the skin
  • History of systemic hypersensitivity or anaphylaxis to omalizumab or any biologic therapy, including any excipients
  • Participation in prior dupilumab clinical study, or have been treated with commercially available dupilumab.

The above information is not intended to contain all considerations relevant to a participant's potential participation in a clinical trial.

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04180488). 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.

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