E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic Obstructive Pulmonary Disease |
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E.1.1.1 | Medical condition in easily understood language |
Chronic Obstructive Pulmonary Disease with frequent exacerbations which can no be fully controlled using standard care of treatment |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10009033 |
E.1.2 | Term | Chronic obstructive pulmonary disease |
E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To evaluate the effect of benralizumab on COPD exacerbations in subjects with moderate to very severe COPD |
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E.2.2 | Secondary objectives of the trial |
To evaluate the effect of benralizumab:
- on health status/health-related quality of life
- on pulmonary function
- on respiratory symptoms
- on rescue medication use
- on nocturnal awakenings
- on the severity, frequency and duration of EXACT-PRO defined events
- on healthcare resource utilization due to COPD
- on general health status
- on blood eosinophil levels
To evaluate the pharmacokinetics parameters of benralizumab.
Assessment of the safety and tolerability of benralizumab.
To evaluate the immunogenicity of benralizumab
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Additional pulmonary function tests:
To evaluate the effect of two doses of
benralizumab in a subset of patients for lung
volumes.
To evaluate the effect of two doses of
benralizumab in a subset of patients for DLCO.
To evaluate the effect of two doses of
benralizumab in a subset of patients on exercise
endurance.
Sputum analysis:
To evaluate the effect of two doses of
benralizumab on sputum biomarkers/cell counts
in a subset of patients.
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E.3 | Principal inclusion criteria |
1.Informed consent.
2.Subjects 40-85 y.o.
3.Moderate to very severe COPD with post-BD FEV1>20% and ≤65% .
4.≥2 moderate or ≥1 severe COPD exacerbation(s) required treatment or hospitalization within 2-52 weeks prior to Visit1.
5.mMRC score ≥1 at Visit 1.
6.Treatment with double or triple therapy throughout the year prior to Visit 1, constant 2 weeks prior to Visit 1. 7.Tobacco history of ≥10 pack-years.
8.Women of childbearing potential must use a highly effective form of birth control from Visit 1 until 16 weeks after their last dose, and negative serum pregnancy test result at Visit 1.
9.Male subjects who are sexually active must be surgically sterile one year prior to Visit 1 or use an adequate method of contraception from the first IP dose until 16 weeks after their last dose. 10.Compliance with maintenance therapy during run-in ≥70%.
11. Blood eosinophils due to subject's stratification and cap for blood eosinophil levels. When any eosinophil cohort is full, subjects in the completed cohort will not be randomised and will be withdrawn from the study. |
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E.4 | Principal exclusion criteria |
1. Clinically important pulmonary disease other than COPD or another diagnosed pulmonary or systemic disease associated with elevated peripheral eosinophil counts.
2. Any disorder or major physical impairment that is not stable by Investigator opinion and/or could affect: - subject safety−study findings or their interpretation or subject’s ability to complete the entire study duration.
3. Unstable ischemic heart disease, arrhythmia, cardiomyopathy, or other relevant cardiovascular disorder that in Investigator’s judgment may put the patient at risk or negatively affect the study outcome.
4. Treatment with systemic corticosteroids and/or antibiotics, and/or hospitalization for a COPD exacerbation within 2 weeks prior to Visit1 or during the enrolment and run-in period.
5. Acute upper or lower respiratory infection requiring antibiotics or antiviral medication within 2 weeks prior to Visit1 or during the enrolment and run-in period.
6. Pneumonia within 8 weeks prior to Visit1 or during the enrolment and run-in period.
7. Pregnant, breastfeeding, or lactating women.
8. Risk factors for pneumonia
9. History of anaphylaxis to any other biologic therapy.
10. Long term oxygen therapy with signs and/or symptoms of cor pulmonale, right ventricular failure.
11. Use of immunosuppressive medication within 2 weeks prior to Visit1 and /or during the enrolment and run-in period.
12. Receipt of any investigational non-biologic product within 30 days or 5 half-lives prior to Visit 1.
13. Evidence of active tuberculosis (TB) without an appropriate course of treatment
14. Lung volume reduction surgery within the 6 months prior to Visit 1. History of partial or total lung resection (single lobe or segmentectomy is acceptable).
15. Asthma as a primary or main diagnosis according to the GINA guidelines or other accepted guidelines.
16. Previous treatment with benralizumab.
17. Helminth parasitic infection diagnosed within 24 weeks prior to Visit 1.
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E.5 End points |
E.5.1 | Primary end point(s) |
Annual COPD exacerbation rate |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
- SGRQ (St. George’s Respiratory Questionnaire)
-CAT (Chronic Obstructive Pulmonary Disease assessment tool)
- Pre-dose/pre-bronchodilator FEV1 at the study center
- BDI/TDI (Baseline/Transitional Dyspnea Index)
- Total rescue medication use (average puffs/day), recorded by patient using electronic diary
- Number of nights with awakening due to COPD, recorded by patient using electronic diary.
- EXACT-PRO (Exacerbations of Chronic Pulmonary Disease Tool – Patient-reported Outcome) questionnaire
- COPD (Chronic Obstructive Pulmonary Disease) specific resource utilization (e.g. unscheduled physician visits, unscheduled phone calls to physicians, use of other Chronic Obstructive Pulmonary Disease medications)
- PK (pharmacokinetics) - steady-state serum pre-dose concentration
- Adverse Events/ Serious Adverse Events (AE/SAE) - Laboratory variables - 12 lead ECG (Electrocardiogram) - Physical Examination - Vital Signs
- Determination of Anti-drug antibodies (ADA)
- EQ-5D-5L (European Quality of Life-5 Dimensions) questionnaire
- Blood eosinophils levels
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 12 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 134 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Austria |
Canada |
Czech Republic |
Germany |
Hungary |
Italy |
Japan |
Korea, Republic of |
Netherlands |
Poland |
Romania |
Russian Federation |
South Africa |
Spain |
Switzerland |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 6 |