BOREAS: Pivotal Study to Assess the Efficacy, Safety and Tolerability of Dupilumab in Patients With Moderate-to-severe COPD With Type 2 Inflammation

Sponsor
Sanofi (Industry)
Overall Status
Active, not recruiting
CT.gov ID
NCT03930732
Collaborator
Regeneron Pharmaceuticals (Industry)
939
287
2
48.6
3.3
0.1

Study Details

Study Description

Brief 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 and 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 anti-drug antibodies (ADA)

Condition or Disease Intervention/Treatment Phase
  • Drug: Dupilumab SAR231893
  • Drug: Inhaled Corticosteroid
  • Drug: Inhaled Long-Acting Beta Agonist
  • Drug: Inhaled Long-Acting Muscarinic Antagonist
  • Drug: Placebo
Phase 3

Detailed Description

Approximately 68 weeks including a 4-week screening period, a 52-week treatment period, and 12 weeks of follow-up.

Study Design

Study Type:
Interventional
Actual Enrollment :
939 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:
Treatment
Official Title:
A Randomized, Double-blind, Placebo-controlled, Parallel-group, 52-week Pivotal Study to Assess the Efficacy, Safety and Tolerability of Dupilumab in Patients With Moderate-to-severe Chronic Obstructive Pulmonary Disease (COPD) With Type 2 Inflammation
Actual Study Start Date :
Apr 15, 2019
Anticipated Primary Completion Date :
Feb 1, 2023
Anticipated Study Completion Date :
May 2, 2023

Arms and Interventions

Arm Intervention/Treatment
Experimental: Dupilumab

Dupilumab administered every 2 weeks

Drug: Dupilumab SAR231893
Pharmaceutical form: Solution for injection Route of administration: Subcutaneous
Other Names:
  • Dupixent
  • Drug: Inhaled Corticosteroid
    Pharmaceutical form: Inhaled Powder Route of administration: Oral inhalation

    Drug: Inhaled Long-Acting Beta Agonist
    Pharmaceutical form: Inhaled Powder Route of administration: Oral inhalation

    Drug: Inhaled Long-Acting Muscarinic Antagonist
    Pharmaceutical form: Inhaled Powder Route of administration: Oral inhalation

    Placebo Comparator: Placebo

    Placebo dose administered every 2 weeks

    Drug: Inhaled Corticosteroid
    Pharmaceutical form: Inhaled Powder Route of administration: Oral inhalation

    Drug: Inhaled Long-Acting Beta Agonist
    Pharmaceutical form: Inhaled Powder Route of administration: Oral inhalation

    Drug: Inhaled Long-Acting Muscarinic Antagonist
    Pharmaceutical form: Inhaled Powder Route of administration: Oral inhalation

    Drug: Placebo
    Pharmaceutical form: Solution for injection Route of administration: Subcutaneous

    Outcome Measures

    Primary Outcome Measures

    1. Annual rate of acute COPD exacerbation (AECOPD) [Baseline to Week 52]

      Annualized rate of moderate or severe COPD exacerbations over the 52-week treatment period compared to placebo

    Secondary Outcome Measures

    1. Change in pre-bronchodilator FEV1 [Baseline to Week 12]

      Change in pre-bronchodilator FEV1 from baseline to Week 12 compared to placebo

    2. Change in SGRQ [Baseline to Week 52]

      Change from baseline to Week 52 in SGRQ total score compared to placebo

    3. Improvement in SGRQ [Baseline to Week 52]

      Proportion of patients with SGRQ improvement ≥4 points at Week 52

    4. Change in pre-bronchodilator FEV1 from baseline to Week 52 [Baseline to Week 52]

      Change in pre-bronchodilator FEV1 from baseline to Week 52 compared to placebo

    5. Change in pre-bronchodilator FEV1 from baseline to time points up to Week 44 [Baseline to Weeks 2, 4, 8, 24, 36, 44]

      Change in pre-bronchodilator FEV1 from baseline to weeks other than 12 and 52 (i.e. Weeks 2, 4, 8, 24, 36, and 44) compared to placebo

    6. Change in post-bronchodilator FEV1 lung function [Baseline to Weeks 2, 4, 8, 12, 24, 36, 52]

      Change in post-bronchodilator FEV1 from baseline at Weeks 2, 4, 8, 12, 24, 36 and 52 compared to placebo

    7. Change in forced expiratory flow (FEF) 25-75% [Baseline to Weeks 2, 4, 8, 12, 24, 36, 44, 52]

      Change in FEF 25-75% from baseline to Weeks 2, 4, 8, 12, 24, 36, 44 and 52

    8. Annualized rate of severe AECOPD [Baseline through Week 52]

      Annualized rate of severe COPD exacerbations compared to placebo over the 52-week treatment period

    9. Time to first AECOPD [Baseline through Week 52]

      Time to first moderate or severe COPD exacerbation compared with placebo during the 52-week treatment period

    10. Adverse events [Baseline through Week 64]

      Number of adverse events (AEs)/treatment-emergent adverse events (TEAEs)

    11. Potentially clinically significant abnormality (PCSA) in laboratory tests [Baseline through Week 64]

      Percentage of patients with at least one incidence of PCSA

    12. Anti-drug antibodies [Baseline to Week 64]

      Incidence of anti-drug antibodies against dupilumab

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    40 Years to 80 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion criteria:
    • Participants with a physician diagnosis of COPD who meet 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 <0.70 and post-bronchodilator FEV1 % predicted >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 patient was taking inhaled corticosteroid (ICS)/long acting beta agonist (LABA)/long acting muscarinic antagonist (LAMA) (or LABA/LAMA if ICS is contraindicated). Moderate exacerbations are recorded by the investigator and defined as acute exacerbation of COPD (AECOPD) that require either systemic corticosteroids (intramuscular, intravenous, or oral) and/or antibiotics. One of the two required moderate exacerbations has to require the use of systemic corticosteroids. Severe exacerbations are 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: Patients with blood eosinophils ≥300 cells/microliter at Visit 1.

    Exclusion criteria:
    • COPD diagnosis for less than 12 months prior to randomization.

    • A current diagnosis of asthma or history of asthma according to the 2018 Global Initiative for Asthma (GINA) guidelines or other accepted guidelines.

    • 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.

    • Treatment with oxygen of more than 12 hours per day.

    • 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. Patients who are participating in the acute phase of a pulmonary rehabilitation program, ie, who started rehabilitation <4 weeks prior to screening (Note: patients 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.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Investigational Site Number :8400030 Andalusia Alabama United States 36420
    2 Investigational Site Number :8400041 Birmingham Alabama United States 35209
    3 Investigational Site Number :8400013 Birmingham Alabama United States 35294
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    144 Investigational Site Number :2030002 Jindrichuv Hradec III Czechia 37701
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    146 Investigational Site Number :2030009 Miroslav Czechia 67172
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    148 Investigational Site Number :2030003 Praha 4 Czechia 14059
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    187 Investigational Site Number :3760002 Rehovot Israel 76100
    188 Investigational Site Number :3800004 Cona Ferrara Italy 44124
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    191 Investigational Site Number :3800002 Catania Italy 95123
    192 Investigational Site Number :3800007 Pisa Italy 56124
    193 Investigational Site Number :3800001 Reggio Emilia Italy 42123
    194 Investigational Site Number :3800005 Roma Italy 00133
    195 Investigational Site Number :3920013 Kasuga-shi Fukuoka Japan 816-0813
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    205 Investigational Site Number :3920018 Kawachinagano-shi Osaka Japan 586-8521
    206 Investigational Site Number :3920001 Kishiwada-shi Osaka Japan 596-8501
    207 Investigational Site Number :3920028 Osaka-shi Osaka Japan 531-0073
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    209 Investigational Site Number :3920021 Hamamatsu-shi Shizuoka Japan 434-8511
    210 Investigational Site Number :3920008 Chuo-ku Tokyo Japan 103-0022
    211 Investigational Site Number :3920030 Chuo-ku Tokyo Japan 103-0028
    212 Investigational Site Number :3920005 Chuo-ku Tokyo Japan 104-0031
    213 Investigational Site Number :3920015 Kokubunji-shi Tokyo Japan 185-0014
    214 Investigational Site Number :3920016 Shinagawa-ku Tokyo Japan 140-8522
    215 Investigational Site Number :3920004 Toshima-ku Tokyo Japan 170-0003
    216 Investigational Site Number :3920026 Toshima-ku Tokyo Japan 1710014
    217 Investigational Site Number :4100003 Wonju Gangwon-do Korea, Republic of 26426
    218 Investigational Site Number :4100004 Seongnam-si Gyeonggi-do Korea, Republic of 13620
    219 Investigational Site Number :4100008 Incheon Incheon-gwangyeoksi Korea, Republic of 21431
    220 Investigational Site Number :4100001 Seoul Seoul-teukbyeolsi Korea, Republic of 03080
    221 Investigational Site Number :4100009 Seoul Seoul-teukbyeolsi Korea, Republic of 03312
    222 Investigational Site Number :4100007 Seoul Seoul-teukbyeolsi Korea, Republic of 05505
    223 Investigational Site Number :4840002 Guadalajara Jalisco Mexico 44100
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    225 Investigational Site Number :4840003 Durango Mexico 34080
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    227 Investigational Site Number :4840001 Monterrey Mexico 64460
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    230 Investigational Site Number :6160009 Grudziadz Kujawsko-pomorskie Poland 86-300
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    232 Investigational Site Number :6160015 Grodzisk Mazowiecki Mazowieckie Poland 05-825
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    238 Investigational Site Number :6160006 Poznan Wielkopolskie Poland 61-578
    239 Investigational Site Number :6420001 Bucharest Romania 011461
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    241 Investigational Site Number :6420008 Bucuresti Romania 050159
    242 Investigational Site Number :6420003 Cluj-Napoca Romania 400371
    243 Investigational Site Number :6420004 Cluj-Napoca Romania 400371
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    245 Investigational Site Number :6420006 Timisoara Romania 300310
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    247 Investigational Site Number :6430003 Chelyabinsk Russian Federation 454091
    248 Investigational Site Number :6430004 Kazan Russian Federation 420008
    249 Investigational Site Number :6430006 Moscow Russian Federation 105077
    250 Investigational Site Number :6430001 Moscow Russian Federation 115093
    251 Investigational Site Number :6430005 Moscow Russian Federation 115280
    252 Investigational Site Number :6430008 Moscow Russian Federation 115682
    253 Investigational Site Number :6430002 Moscow Russian Federation 117546
    254 Investigational Site Number :6430009 Moscow Russian Federation 125284
    255 Investigational Site Number :6430007 St-Petersburg Russian Federation 193231
    256 Investigational Site Number :7030007 Banska Bystrica Slovakia 97517
    257 Investigational Site Number :7030006 Humenne Slovakia 066 01
    258 Investigational Site Number :7030003 Levice Slovakia 93401
    259 Investigational Site Number :7030001 Poprad Slovakia 058 01
    260 Investigational Site Number :7030002 Spisska Nova Ves Slovakia 05201
    261 Investigational Site Number :7240096 Santiago de Compostela A Coruña [La Coruña] Spain 15706
    262 Investigational Site Number :7240002 Barcelona Barcelona [Barcelona] Spain 08035
    263 Investigational Site Number :7240007 Sant Boi de Llobregat Barcelona [Barcelona] Spain 08830
    264 Investigational Site Number :7240005 Mérida / Badajoz Extremadura Spain 06800
    265 Investigational Site Number :7240006 Pozuelo de Alarcón Madrid Spain 28223
    266 Investigational Site Number :7240003 Madrid Spain 28007
    267 Investigational Site Number :7240001 Málaga Spain 29010
    268 Investigational Site Number :7240010 Palma de Mallorca Spain 07120
    269 Investigational Site Number :7240004 Valencia Spain 46015
    270 Investigational Site Number :7520001 Lund Sweden 221 85
    271 Investigational Site Number :7520002 Stockholm Sweden 114 46
    272 Investigational Site Number :7520003 Örebro Sweden 701 85
    273 Investigational Site Number :7920004 Ankara Turkey 06100
    274 Investigational Site Number :7920001 Istanbul Turkey 34098
    275 Investigational Site Number :7920006 Izmir Turkey 35040
    276 Investigational Site Number :7920007 Izmir Turkey 35110
    277 Investigational Site Number :7920008 Kirikkale Turkey 71450
    278 Investigational Site Number :7920005 Manisa Turkey 45000
    279 Investigational Site Number :7920002 Mersin Turkey 33070
    280 Investigational Site Number :8040003 Chernivtsi Ukraine 58001
    281 Investigational Site Number :8040001 Ivano-Frankivsk Ukraine 76018
    282 Investigational Site Number :8040006 Kharkiv Ukraine 61166
    283 Investigational Site Number :8040004 Kyiv Ukraine 02125
    284 Investigational Site Number :8040009 Odesa Ukraine 65025
    285 Investigational Site Number :8040002 Ternopil Ukraine 46000
    286 Investigational Site Number :8040005 Vinnytsya Ukraine 21001
    287 Investigational Site Number :8040007 Zhytomyr Ukraine 10002

    Sponsors and Collaborators

    • Sanofi
    • Regeneron Pharmaceuticals

    Investigators

    • Study Director: Clinical Sciences & Operations, Sanofi

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Sanofi
    ClinicalTrials.gov Identifier:
    NCT03930732
    Other Study ID Numbers:
    • EFC15804
    • 2018-001953-28
    • U1111-1211-8804
    First Posted:
    Apr 29, 2019
    Last Update Posted:
    May 12, 2022
    Last Verified:
    May 1, 2022
    Individual Participant Data (IPD) Sharing Statement:
    Yes
    Plan to Share IPD:
    Yes
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of May 12, 2022