Phase 3
N=935
Pivotal Study to Assess the Efficacy, Safety and Tolerability of Dupilumab in Patients With Moderate to Severe COPD With Type 2 Inflammation
Chronic Obstructive Pulmonary Disease
Bottom Line
View on ClinicalTrials.gov: NCT04456673 ↗Enrolled (actual)
935
Serious AEs
15.4%
Results posted
Mar 2025
Primary outcome: Primary: Annualized Rate of Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations Over the 52-week Treatment Period — 1.295; 0.859 Exacerbation per participant-year — p=0.0002
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Dupilumab SAR231893 (Drug); Inhaled Corticosteroid (Drug); Inhaled Long-Acting Beta Agonist (Drug); Inhaled Long-Acting Muscarinic Antagonist (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 40+ yrs
- Sex
- All
- Sponsor
- Sanofi
- Primary completion
- Feb 2024
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Annualized Rate of Moderate or Severe Chronic Obstructive Pulmonary Disease (COPD) Exacerbations Over the 52-week Treatment Period |
1.295; 0.859 | 0.0002 sig |
| SECONDARY Change From Baseline in Pre-Bronchodilator Forced Expiratory Volume in 1 Second (FEV1) to Week 12 |
0.057; 0.139 | 0.0001 sig |
| SECONDARY Change From Baseline in Saint George's Respiratory Questionnaire (SGRQ) Total Score to Week 52 |
-6.444; -9.816 | 0.0068 sig |
| SECONDARY Percentage of Participants With Saint George's Respiratory Questionnaire Improvement ≥4 Points at Week 52 |
46.5; 51.4 | 0.3329 |
| SECONDARY Change From Baseline in Pre-Bronchodilator Forced Expiratory Volume in 1 Second to Week 52 |
0.054; 0.115 | 0.0182 sig |
| SECONDARY Change From Baseline in Pre-Bronchodilator Forced Expiratory Volume in 1 Second to Weeks 2, 4, 8, 24, 36, and 44 |
0.072; 0.108; 0.077; 0.132; 0.069; 0.133 | — |
| SECONDARY Change From Baseline in Post-Bronchodilator Forced Expiratory Volume in 1 Second to Weeks 2, 4, 8, 12, 24, 36, and 52 |
0.082; 0.101; 0.098; 0.126; 0.083; 0.147 | — |
| SECONDARY Change From Baseline in Forced Expiratory Flow (FEF) 25 to 75 Percent (%) to Weeks 2, 4, 8, 12, 24, 36, 44, and 52 |
0.057; 0.103; 0.056; 0.114; 0.059; 0.134 | — |
| SECONDARY Annualized Rate of Severe Chronic Obstructive Pulmonary Disease Exacerbations Over the 52-week Treatment Period |
0.124; 0.070 | — |
| SECONDARY Time to First Moderate or Severe Chronic Obstructive Pulmonary Disease Exacerbation Event During the 52-week Treatment Period |
0.172; 0.108; 0.265; 0.206; 0.342; 0.292 | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Treatment-Emergent Serious Adverse Events (TESAEs) |
330; 322; 79; 65 | — |
| SECONDARY Percentage of Participants With Potentially Clinically Significant Abnormalities (PCSA) in Hematology |
6.1; 5.0; 3.7; 4.7; 9.8; 11.4 | — |
| SECONDARY Percentage of Participants With Potentially Clinically Significant Abnormalities in Clinical Chemistry |
1.7; 1.9; 0; 0.2; 0.4; 0.4 | — |
| SECONDARY Percentage of Participants With Abnormal Results for Urine Protein in Urinalysis |
5.0; 6.2; 4.1; 4.9; 3.7; 5.3 | — |
| SECONDARY Number of Participants With Anti-Drug Antibodies (ADA) to Dupilumab |
6; 4; 11; 47; 0; 1 | — |
Summary
Primary Objective:
To evaluate the efficacy of dupilumab administered every 2 weeks in patients with moderate or severe Chronic Obstructive Pulmonary Disease (COPD) as measured by
* Annualized rate of acute moderate or severe COPD exacerbation (AECOPD)
Secondary Objectives:
To evaluate the effect of dupilumab administered every 2 weeks on
* Pre-bronchodilator forced expiratory volume in 1 second (FEV1) over 12 weeks compared to placebo
* Health related quality of life, assessed by the change from baseline to Week 52 in the St. George's Respiratory Questionnaire (SGRQ)
* Pre-bronchodilator FEV1 over 52 weeks compared to placebo
* Lung function assessments
* Moderate and severe COPD exacerbations
* To evaluate safety and tolerability
* To evaluate dupilumab systemic exposure and incidence of antidrug antibodies (ADA)
Eligibility Criteria
Inclusion Criteria
- Participants with a physician diagnosis of COPD who met the following criteria at screening:
- Current or former smokers with a smoking history of ≥10 pack-years.
- Moderate-to-severe COPD (post-bronchodilator FEV1/ forced vital capacity [FVC] ratio 30% and ≤70%).
- Medical Research Council (MRC) Dyspnea Scale grade ≥2.
- Patient-reported history of signs and symptoms of chronic bronchitis (chronic productive cough) for 3 months in the year up to screening in the absence of other known causes of chronic cough.
- Documented history of high exacerbation risk defined as exacerbation history of ≥2 moderate or ≥1 severe within the year prior to inclusion. At least one exacerbation should have occurred while the participant was taking inhaled corticosteroid (ICS)/long-acting beta agonist (LABA)/long-acting muscarinic antagonist (LAMA) (or LABA/LAMA if ICS is contraindicated). Moderate exacerbations were recorded by the investigator and defined as AECOPD that required either systemic corticosteroids (intramuscular, intravenous, or oral) and/or antibiotics. One of the two required moderate exacerbations had to require the use of systemic corticosteroids. Severe exacerbations were recorded by the investigator and defined as AECOPD requiring hospitalization or observation > 24 hours in emergency department/urgent care facility.
- Background triple therapy (ICS + LABA + LAMA) for 3 months prior to randomization with a stable dose of medication for ≥1 month prior to Visit 1; Double therapy (LABA + LAMA) allowed if ICS is contraindicated.
- Evidence of Type 2 inflammation: Participants with blood eosinophils ≥300 cells/microliter at Visit 1.
Exclusion Criteria
- COPD diagnosis for less than 12 months prior to randomization.
- Participants with current diagnosis of asthma according to the Global Initiative for Asthma (GINA) guidelines, or documented history of asthma.
- Significant pulmonary disease other than COPD (e.g., lung fibrosis, sarcoidosis, interstitial lung disease, pulmonary hypertension, bronchiectasis, Churg-Strauss Syndrome etc) or another diagnosed pulmonary or systemic disease associated with elevated peripheral eosinophil counts.
- Cor pulmonale, evidence of right cardiac failure.
- Long-term treatment with oxygen >4.0 L/min OR if a participant requires more than 2.0 L/min in order to maintain oxygen saturation >88%
- Hypercapnia requiring Bi-level ventilation.
- AECOPD as defined in inclusion criteria within 4 weeks prior to screening, or during the screening period.
- Respiratory tract infection within 4 weeks prior to screening, or during the screening period.
- History of, or planned pneumonectomy or lung volume reduction surgery. Participants who were participating in the acute phase of a pulmonary rehabilitation program, ie, who started rehabilitation <4 weeks prior to screening (Note: participants in the maintenance phase of a rehabilitation program can be included).
- Diagnosis of α-1 anti-trypsin deficiency.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.
Data sourced from ClinicalTrials.gov (NCT04456673). 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.