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Phase 3 N=935 Randomized Quadruple-blind Treatment

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

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

OutcomeResultp-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.

View full record on ClinicalTrials.gov →

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.

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