mRNA Expression as a Biomarker of Omalizumab Response

Sponsor

Instituto de Investigação em Imunologia (Other)

Overall Status

Unknown status

CT.gov ID

NCT01584687

Collaborator

(none)

Enrollment

Arm

Duration (Months)

Study Details

Study Description

Brief Summary

Objectives: 1. Determine if mRNA expression could be use as a biomarker to predict and monitor the response to omalizumab in patients with difficult control asthma 2. Identify which genes are switched on and which are switched off by using Omalizumab.

Methods: This study is an open label clinical trial, with six patients. The patients will receive Omalizumab according to their age and weight (maximum dose: 375 mg every 15 days) for 4 months. There will be a run-in period of one month, when allergic asthma diagnosis will be confirmed and treatment will be optimized. Patients will be evaluated and will have blood sample collected on 3 occasions: in the beginning, 2 months after baseline and at the end of the study. Blood samples will always be collected one week after the last omalizumab dose. Primary outcome will be RNA expression of 20 genes measured by real time-PCR (high-affinity IgE receptor, IL-4, IL-5, IL-13, gama-IFN, quimokines, Fc epsilon, between others). Secondary outcomes will be ACT, ACQ and spirometry.

Condition or Disease	Intervention/Treatment	Phase
Asthma	Biological: Omalizumab	Phase 4

Detailed Description

Study rational: There is not a biomarker that can predict which patients will respond to Omalizumab and those who will not respond. Nowadays, the monitoring of therapeutic response to Omalizumab is based on clinical and spirometric data.

On the other hand, when a medication is administered, it has its main expected effect, but also acts on other targets with various direct and indirect effects. We do not know all the genes that are switched on and those that are switched off by the use of Omalizumab. For example, anti-IgE has been developed to block serum total IgE and thereby improve control of allergic asthma. However, the studies noted that Omalizumab also reduces the receptors FcepsilonRI, which may have implications for the treatment of autoimmune urticaria.

Study Design

Study Type:

Interventional

Anticipated Enrollment :

6 participants

Allocation:

N/A

Intervention Model:

Single Group Assignment

Masking:

None (Open Label)

Primary Purpose:

Treatment

Official Title:

mRNA Expression as a Biomarker of Xolair (Omalizumab) Response

Study Start Date :

Jun 1, 2012

Anticipated Primary Completion Date :

Dec 1, 2012

Anticipated Study Completion Date :

Dec 1, 2012

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Omalizumab All patients will receive omalizumab.	Biological: Omalizumab The patients will receive Omalizumab according to their age and weight for 4 months. Other Names: Anti-IgE Xolair

Arm

Intervention/Treatment

Experimental: Omalizumab

All patients will receive omalizumab.

Biological: Omalizumab

The patients will receive Omalizumab according to their age and weight for 4 months.

Other Names:

Anti-IgE

Xolair

Outcome Measures

Primary Outcome Measures

Change of mRNA expression in leukocytes (real time-PCR) [At the end of the study (4months after baseline)]
Patients will be evaluated and will have blood sample collected on 3 occasions: in the beginning, 2 months after baseline and at the end of the study. Blood samples will always be collected one week after the last omalizumab dose. Primary outcome will be RNA expression of 30 genes measured by real time-PCR.

Secondary Outcome Measures

Change in the scores of questionnaires of asthma control [At the end of the study (4 months after baseline)]
Patients will be evaluated on 3 occasions: in the beginning, 2 months after baseline and at the end of the study. Secondary outcomes will be the scores of Asthma Control Test and Asthma Control Questionnaire.

Eligibility Criteria

Criteria

Ages Eligible for Study:

12 Years to 60 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

over 12 years
severe asthma not controlled despite medication
IgE between 70 and 1300 IU/ml and evidence of allergy clinical history and/or skin test or blood.