E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic rhinosinusitis with nasal polyps |
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E.1.1.1 | Medical condition in easily understood language |
Chronic rhinosinusitis with nasal polyps is a condition in which painless growths called polyps are formed in the nasal passages and the sinuses along with inflammation and swelling |
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E.1.1.2 | Therapeutic area | Body processes [G] - Circulatory and Respiratory Physiological Phenomena [G09] |
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 | 10028756 |
E.1.2 | Term | Nasal polyps |
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 efficacy of omalizumab compared with placebo |
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E.2.2 | Secondary objectives of the trial |
•To further evaluate the efficacy of omalizumab compared with placebo •To evaluate the safety of omalizumab compared with placebo •To evaluate the pharmacokinetics and pharmacodynamics of omalizumab
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Age 18 75 years, inclusive, at time of signing Informed Consent Form -Ability to comply with the study protocol, in the investigator's judgment -Nasal polyp score (NPS) >= 5, with a unilateral score of >= 2 for each nostril, at screening (Day -35), and on Day -7 -Sino-Nasal Outcome Test-22 (SNOT-22) score >=20 at screening (Day -35) and at randomization (Day 1) -Treatment with at least nasal mometasone 200 micro gram per day, or equivalent daily dosing of nasal corticosteroid (CS), for at least 4 weeks before screening (Day -35) -Treatment with nasal mometasone 200 micro gram twice a day (BID) (or QD if intolerant to twice daily) during the run-in period with an adherence rate of at least 70% - Presence of nasal blockage/congestion with NCS >=2 (1 week recall) at Day -35 and an average of the daily NCS score over the 7 days prior to randomization of NCS >1 with at least one of the following symptoms prior to screening: nasal discharge (anterior/posterior nasal drip) and/or reduction or loss of smell - Eligibility per the study drugdosing table (serum IgE level >= 30 to =<1500 IU/mL and body weight >= 30 to =< 150 kg) and ability to be dosed per the dosing table - Willingness to maintain all background medications stable for the duration of the treatment and follow-up periods - Willingness and ability to use electronic device to enter study-related information in electronic devices (electronic diary [eDiary]/electronic tablet [eTablet]) - Demonstration of at least 70% adherence to eDiary daily symptom assessment during run in period, with fully completed entries on at least 4 days in the week prior to randomization - For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use acceptable contraceptive methods during the treatment period and for 60 days after the last dose of study drug
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E.4 | Principal exclusion criteria |
-Known history of anaphylaxis/hypersensitivity to omalizumab -Treatment with investigational drugs within 12 weeks or 5 half lives (whichever is longer) prior to screening (Day -35) -Treatment with monoclonal antibodies (e.g., omalizumab, mepolizumab) for 6 months prior to screening (Day -35) -Current treatment with leukotriene antagonists/modifiers, unless patient has been on stable dosing of such medication for at least 1 month prior to screening (Day -35) -Treatment with non-steroid immunosuppressants within 2 months or 5 half-lives, whichever is longer, prior to screening (Day -35) -Treatment with systemic corticosteroids, except when used as treatment for nasal polyposis, within 2 months prior to screening (Day -35) -Usage of systemic CS during the run-in period. Patients requiring systemic CS during run-in may be rescreened after completing systemic CS. -Treatment with intranasal CS drops or CSadministering devices (e.g., OptiNose device or stents) within 1 month prior to screening (Day -35) or during the run-in period -History of nasal surgery (including polypectomy) within 6 months prior to screening -History of sinus or nasal surgery modifying the structure of the nose such that assessment of NPS is not possible -Uncontrolled epistaxis requiring surgical or procedural intervention, including nasal packing, within 2 months prior to screening -Known or suspected diagnosis of cystic fibrosis, primary ciliary dyskinesia (e.g., Kartagener syndrome) or other dyskinetic ciliary syndromes, hypogammaglobulinemia or other immune deficiency syndrome, chronic granulomatous disease and granulomatous vasculitis, granulomatosis with polyangiitis (e.g., Wegener’s Granulomatosis), or eosinophilic granulomatous with polyangiitis (EGPA) (e.g., Churg-Strauss syndrome) -Presence of antrochoanal polyps -Concomitant conditions that interfere with evaluation of primary endpoint: •Nasal septal deviation occluding one or both nostrils •Ongoing rhinitis medicamentosa •Acute sinusitis, nasal infection, or upper respiratory infection during the run-in period •Known or suspected invasive or expansive fungal rhinosinusitis -Known HIV infection at screening -Known acute and chronic infections with hepatitis C virus (HCV) and hepatitis B virus (HBV) at screening -History of myocardial infarction, unstable angina, cerebrovascular accident, or transient ischemic attack or a known history of a hypercoagulable disorder -Active tuberculosis requiring treatment within 12 months prior to screening (Day -35) -Initiation of or change in allergen immunotherapy within 3 months prior to screening (Day -35) or during the run-in period -Initiation of or change in aspirin desensitization within 4 months prior to screening (Day -35) or during the run-in period -Pregnant or breastfeeding, or intending to become pregnant during the study or within 60 days after the last dose of omalizumab -Current malignancy or history of malignancy within 5 years prior to screening, except for appropriately treated carcinoma in situ of the cervix or non-melanoma skin carcinoma that has been treated or excised and is considered resolved -Any serious medical condition (including but not limited to significant arrhythmia, uncontrolled hypertension, significant pulmonary disease other than asthma) or abnormality in clinical laboratory tests that precludes the patient’s safe participation in and completion of the study -History of alcohol, drug, or chemical abuse within 6 months of screening
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E.5 End points |
E.5.1 | Primary end point(s) |
1.Change from baseline at Week 24 in average daily NCS 2.Change from baseline at Week 24 in nasal polyps score NPS
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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) |
1.Change from baseline at Week 24 in the average daily total nasal symptom score (TNSS) 2.Change from baseline at Week 24 in the average daily sense of smell score 3.Change from baseline at Week 24 in the average daily posterior rhinorrhea score 4.Change from baseline at Week 24 in the average daily anterior rhinorrhea score 5.Change from baseline at Week 24 in patient reported health-related quality of life (HRQoL) as assessed by the total SNOT-22 6.Change from baseline at Week 24 in sense of smell, as assessed by the University of Pennsylvania Smell Identification Test (UPSIT) 7.Change from baseline at Week 24 in Asthma Quality of Life Questionnaire (AQLQ) of >= 0.5 (in patients with comorbid asthma only) 8.Change from baseline at Week 16 in the average daily NCS 9.Change from baseline at Week 16 in NPS 10.Reduction in the need for surgery by Week 24, as defined by an NPS of <= 4 (unilateral score of <= 2 on each side) and improvement in SNOT-22 score of >= 8.9 11.Requirement of rescue treatment (systemic CS for >= 3 consecutive days) or having had surgery for nasal polyps through Week 24 12.Requirement of rescue treatment (systemic CS for >=3 consecutive days) through Week 24 13.Having had surgery for nasal polyps through Week 24 14.Incidence of adverse events 15.Incidence of serious adverse events 16.Incidence of adverse events leading to omalizumab/placebo discontinuation 17.Clinically significant change in laboratory values 18.Serum concentration of omalizumab at specified timepoints 19.Serum concentration of total and free IgE at specified timepoints
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1-7.Baseline and Week 24 8-9.Baseline and Week 16 10-13.Up to Week 24 14-17.Up to Week 28 18. Day 1,Week 16, Week 24, Week 28 19.Screening (Day -35), Day 1, Week 16, Week 24, Week 28
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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 | No |
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 | No |
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 | 2 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 30 |
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 |
Canada |
Czech Republic |
Germany |
Mexico |
Poland |
Portugal |
Russian Federation |
Ukraine |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | No |
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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The end of the study is defined as the date of the last patient's last visit (LPLV). The LPLV is expected to occur at a maximum of 28 weeks after the last patient is randomized. |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 15 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 15 |