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Anti-Inflammatory Agent in Sinusitis

A Phase 2A, Single-Center, Randomized, Placebo-Controlled, Double-Blind Study to Assess the Efficacy of an Anti-Inflammatory Agent in Patients With Sinusitis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02874144
Acronym
E1416
Enrollment
43
Registered
2016-08-22
Start date
2016-06-20
Completion date
2020-08-10
Last updated
2022-05-25

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Nasal Polyps

Brief summary

To evaluate the efficacy of an anti-inflammatory agent compared with placebo in relieving signs and symptoms of disease in patients with sinusitis.

Detailed description

This is a Phase 2a, single-center, randomized, placebo-controlled, double-blind study that includes 12 weeks of treatment with experimental drug anti-inflammatory agent or placebo TID administered orally. All subjects will be ≥18 years, have sinusitis with persistent symptoms despite standard of care treatment, and have failed a course of steroids in the past.

Interventions

40 mg three times daily po for 12 weeks

collection of biomarkers for analysis of nasal disease

DRUGIntranasal corticosteroid

QD Nasal Spray

DRUGPlacebo

looks like AZ compound, made by same company, double blind. 40 mg three times daily po for 12 weeks

Sponsors

Northwestern University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
No

Inclusion criteria

1\. Females must have a negative urine pregnancy test at screening unless documented to have a hysterectomy or be postmenopausal.

Exclusion criteria

1. Inability or unwillingness of a participant to give written informed consent or comply with study protocol 2. Use of any investigational drugs within 30 days of screening. 3. Acute infection needing antibiotic treatment at screening.

Design outcomes

Primary

MeasureTime frameDescription
TOTAL POLYP SCORE (TPS)Baseline and Week 12Measure Description: Measurement of Primary outcome- 0-4 scale in each nostril, total is 8. The total polyp score is the sum of the right and left nasal polyp score. Maximum is 8, minimum is 0. Higher score indicates worse disease. 0 =No polyps 1=Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate 2=Polyps reaching the lower border of the middle turbinate or polyp medial to the middle turbinate 3 = Large polyps reaching the lower border of the inferior turbinate 4 =Large polyps causing complete obstruction. The primary outcome measured change in polyp size and secondary outcomes included change in radiographic severity of sinus disease, quality of life, and nasal symptoms as measured by Sino Nasal Outcome Test-22 (SNOT-22) and sense of smell by Brief Smell Identification Test (B-SIT) at 12 weeks in the AZD1981 group vs. the placebo. These were done at the baseline visit and the Week 12 visit.
Sinus CT Scan Scores by Lund-Mackay ScoresBaseline and Week 12Measurement of secondary outcome: sinus CT scan scores by Lund-Mckay scores. We measured sinus radiographic severity with Lund-Mackay scores of 0 to 24. 0 was the least severe and 24 was the most severe. This secondary outcomes included change in radiographic severity of sinus disease, as measured by sinus CT scan scores at baseline and 12 weeks in the AZD1981 group vs. the placebo group.
BSIT (Brief Smell Identification Test)Baseline and Week 12Measurement of secondary outcome- BSIT (brief smell identification test) is a 12-item test measuring sense of smell. This is a multiple choice test with one correct answer out of four possible answer choices. This test features distinct types of smells. Minimum score: 0/12, which indicates that none of the correct answers were chosen on the 12-item test. Maximum score: 12/12, which indicates that all of the correct answers were chosen on the 12-item test. The higher the score, the better the outcome. Only one out of the four possible answer choices for each multiple choice question is correct. There are no subscales. This secondary outcome measures sense of smell by Brief Smell Identification Test (B-SIT) at baseline (visit 1) and 12 weeks (visit 5) in the AZD1981 group vs. the placebo group.

Secondary

MeasureTime frameDescription
SNOT-22 (Sino-Nasal Outcome Test-22) ScoreBaseline and Week 12Measurement of secondary outcome- the SNOT-22 test contains 22 items regarding patient-reported outcomes of sino-nasal symptom severity on a 0-5 scale for each item. 0 is no problem and 5 is problem as bad as it can be, so higher values represent a worse outcome than lower values. The subscale is 0 - 5 of each of the 22 items and the total score is the sum of the subscales of all 22 items. The minimum total score is 0/110. The maximum total score is 110/110. This secondary outcome measured change in patient-reported outcomes of nasal symptoms as measured by Sino Nasal Outcome Test-22 (SNOT-22) over 12 weeks in the AZD1981 group vs. the placebo group.
Visual Analog Scale (VAS)Baseline and Week 12Measurement of secondary outcome- 0 to 10 scale bilaterally that measures how subjective sinus symptom severity, with 0 being the least troublesome to 10 being the most troublesome over 12 weeks in the AZD1981 group vs. the placebo group.

Participant flow

Participants by arm

ArmCount
AZD + INCS
AZD1981 40 mg 3 times a day orally, added to 2 sprays daily of intranasal corticosteroid (INCS) spray for 12 weeks.
22
PLACEBO + INCS
Placebo 3 times a day orally added to 2 sprays daily of intranasal corticosteroid (INCS) spray for 12 weeks.
21
Total43

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyLost to Follow-up35

Baseline characteristics

CharacteristicPLACEBO + INCSTotalAZD + INCS
Age, Continuous47 years
STANDARD_DEVIATION 12
46 years
STANDARD_DEVIATION 13
45 years
STANDARD_DEVIATION 13
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
3 Participants9 Participants6 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants4 Participants0 Participants
Race (NIH/OMB)
White
14 Participants30 Participants16 Participants
Sex: Female, Male
Female
13 Participants21 Participants8 Participants
Sex: Female, Male
Male
8 Participants22 Participants14 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 220 / 21
other
Total, other adverse events
1 / 220 / 21
serious
Total, serious adverse events
1 / 221 / 21

Outcome results

Primary

BSIT (Brief Smell Identification Test)

Measurement of secondary outcome- BSIT (brief smell identification test) is a 12-item test measuring sense of smell. This is a multiple choice test with one correct answer out of four possible answer choices. This test features distinct types of smells. Minimum score: 0/12, which indicates that none of the correct answers were chosen on the 12-item test. Maximum score: 12/12, which indicates that all of the correct answers were chosen on the 12-item test. The higher the score, the better the outcome. Only one out of the four possible answer choices for each multiple choice question is correct. There are no subscales. This secondary outcome measures sense of smell by Brief Smell Identification Test (B-SIT) at baseline (visit 1) and 12 weeks (visit 5) in the AZD1981 group vs. the placebo group.

Time frame: Baseline and Week 12

Population: The secondary outcome was the mean change from baseline to 12 weeks of BSIT scores in the AZD1981 treated group compared to the placebo-treated group.

ArmMeasureGroupValue (MEAN)Dispersion
AZD + INCSBSIT (Brief Smell Identification Test)Visit 1 (Baseline)5.75 units on a scaleStandard Error 0.81
AZD + INCSBSIT (Brief Smell Identification Test)Visit 5 (12 weeks)6.92 units on a scaleStandard Error 1.12
PLACEBO + INCSBSIT (Brief Smell Identification Test)Visit 1 (Baseline)5.20 units on a scaleStandard Error 0.88
PLACEBO + INCSBSIT (Brief Smell Identification Test)Visit 5 (12 weeks)5.80 units on a scaleStandard Error 1.22
Primary

Sinus CT Scan Scores by Lund-Mackay Scores

Measurement of secondary outcome: sinus CT scan scores by Lund-Mckay scores. We measured sinus radiographic severity with Lund-Mackay scores of 0 to 24. 0 was the least severe and 24 was the most severe. This secondary outcomes included change in radiographic severity of sinus disease, as measured by sinus CT scan scores at baseline and 12 weeks in the AZD1981 group vs. the placebo group.

Time frame: Baseline and Week 12

Population: The secondary outcome was the mean change in Lund-Mackay scores of sinus CT scans from baseline to 12 weeks in the AZD1981 treated group compared to the placebo-treated group.

ArmMeasureGroupValue (MEAN)Dispersion
AZD + INCSSinus CT Scan Scores by Lund-Mackay ScoresVisit 1 (Baseline)17.44 units on a scaleStandard Error 1.38
AZD + INCSSinus CT Scan Scores by Lund-Mackay ScoresVisit 5 (12 weeks)18.25 units on a scaleStandard Error 1.1
PLACEBO + INCSSinus CT Scan Scores by Lund-Mackay ScoresVisit 1 (Baseline)15.53 units on a scaleStandard Error 1.43
PLACEBO + INCSSinus CT Scan Scores by Lund-Mackay ScoresVisit 5 (12 weeks)16.33 units on a scaleStandard Error 1.14
Primary

TOTAL POLYP SCORE (TPS)

Measure Description: Measurement of Primary outcome- 0-4 scale in each nostril, total is 8. The total polyp score is the sum of the right and left nasal polyp score. Maximum is 8, minimum is 0. Higher score indicates worse disease. 0 =No polyps 1=Small polyps in the middle meatus not reaching below the inferior border of the middle turbinate 2=Polyps reaching the lower border of the middle turbinate or polyp medial to the middle turbinate 3 = Large polyps reaching the lower border of the inferior turbinate 4 =Large polyps causing complete obstruction. The primary outcome measured change in polyp size and secondary outcomes included change in radiographic severity of sinus disease, quality of life, and nasal symptoms as measured by Sino Nasal Outcome Test-22 (SNOT-22) and sense of smell by Brief Smell Identification Test (B-SIT) at 12 weeks in the AZD1981 group vs. the placebo. These were done at the baseline visit and the Week 12 visit.

Time frame: Baseline and Week 12

Population: The primary outcome was the mean change from baseline to 12 weeks in the size of nasal polyps as measured by the total polyp score in the AZD1981 treated group compared to the placebo-treated group.

ArmMeasureValue (MEAN)Dispersion
AZD + INCSTOTAL POLYP SCORE (TPS)4.67 units on a scaleStandard Error 0.38
PLACEBO + INCSTOTAL POLYP SCORE (TPS)5.24 units on a scaleStandard Error 0.36
Comparison: We used baseline scores to track change to follow-up scores and used a difference-in-differences (D-I-D) statistical approach to compare the change over time compare relative rate of change over time between scores within the treatment group (AZD1981 plus INCS) and within the to scores within the placebo group (INCS treatment only)..p-value: <0.05Regression, Linear
Comparison: The trial design is a continuous outcome superiority trial with primary efficacy outcome measures of change in Total Polyp Score (TPS) comparing AZD to placebo arm from V1 to V5. Total polyp score is a standardized method for assessing nasal polyp size by endoscopy, based on a scale of 1-4 per side. Inclusion criterion for this study is a TPS of ≥4 with a maximum of 8 and a standard deviation ± 2. A clinically meaningful effect is considered to be a decrease in total polyp score of 1.5.p-value: <0.05repeated-measures linear regression
Secondary

SNOT-22 (Sino-Nasal Outcome Test-22) Score

Measurement of secondary outcome- the SNOT-22 test contains 22 items regarding patient-reported outcomes of sino-nasal symptom severity on a 0-5 scale for each item. 0 is no problem and 5 is problem as bad as it can be, so higher values represent a worse outcome than lower values. The subscale is 0 - 5 of each of the 22 items and the total score is the sum of the subscales of all 22 items. The minimum total score is 0/110. The maximum total score is 110/110. This secondary outcome measured change in patient-reported outcomes of nasal symptoms as measured by Sino Nasal Outcome Test-22 (SNOT-22) over 12 weeks in the AZD1981 group vs. the placebo group.

Time frame: Baseline and Week 12

Population: This secondary outcome was the mean change from baseline to 12 weeks in sinonasal symptoms detailed in the SNOT-22 as measured by the total polyp score in the AZD1981 treated group compared to the placebo-treated group.

ArmMeasureGroupValue (MEAN)Dispersion
AZD + INCSSNOT-22 (Sino-Nasal Outcome Test-22) ScoreVisit 1 (baseline)33.73 units on a scaleStandard Error 5.17
AZD + INCSSNOT-22 (Sino-Nasal Outcome Test-22) ScoreVisit 5 (12 weeks)26.07 units on a scaleStandard Error 4.94
PLACEBO + INCSSNOT-22 (Sino-Nasal Outcome Test-22) ScoreVisit 1 (baseline)40.41 units on a scaleStandard Error 5.01
PLACEBO + INCSSNOT-22 (Sino-Nasal Outcome Test-22) ScoreVisit 5 (12 weeks)36.13 units on a scaleStandard Error 4.78
Secondary

Visual Analog Scale (VAS)

Measurement of secondary outcome- 0 to 10 scale bilaterally that measures how subjective sinus symptom severity, with 0 being the least troublesome to 10 being the most troublesome over 12 weeks in the AZD1981 group vs. the placebo group.

Time frame: Baseline and Week 12

Population: The secondary outcome was the mean change from baseline (visit 1) to 12 weeks (visit 5) of the VAS scores in the AZD1981 treated group compared to the placebo-treated group.

ArmMeasureGroupValue (MEAN)Dispersion
AZD + INCSVisual Analog Scale (VAS)Visit 15.57 units on a scaleStandard Error 2.59
AZD + INCSVisual Analog Scale (VAS)Visit 54.75 units on a scaleStandard Error 2.66
PLACEBO + INCSVisual Analog Scale (VAS)Visit 15.70 units on a scaleStandard Error 2.6
PLACEBO + INCSVisual Analog Scale (VAS)Visit 54.74 units on a scaleStandard Error 2.66

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026