Asthma
Conditions
Keywords
Asthma
Brief summary
Phase 3 Study to Evaluate the Efficacy and Safety of Tezepelumab in Reducing Oral Corticosteroid Use in Adults with Oral Corticosteroid Dependent Asthma
Detailed description
A Multicentre, Randomized, Double-Blind, Placebo Controlled, Phase 3 Study to Evaluate the Efficacy and Safety of Tezepelumab in Reducing Oral Corticosteroid Use in Adults with Oral Corticosteroid Dependent Asthma
Interventions
BIOLOGICALTezepelumab
Tezepelumab subcutaneous injection
OTHERPlacebo
Placebo subcutaneous injection
Sponsors
AstraZeneca
Amgen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Investigator)
Masking description
Double-Blind
Intervention model description
Subjects will be randomized in a 1:1 ratio to either tezepelumab or matching placebo both administered subcutaneously
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Subjects must have received a physician-prescribed medium- or high-dose ICS as per GINA guideline for at least 12 months 2. Subjects must have received physician prescribed LABA and high dose ICS (total daily dose \>500μg fluticasone propionate dry powder formulation equivalent) for at least 3 months. The ICS and LABA can be parts of a combination product, or given by separate inhalers. 3. Additional maintenance asthma controller medications are allowed according to standard practice of care i.e., leukotriene receptor antagonists (LTRAs), theophylline, long-acting muscarinic antagonists (LAMAs), secondary ICS and cromones. The use of these medications must be documented for at least 3 months 4. Subjects must have received OCS for the treatment of asthma for at least 6 months prior to screening and on a stable dose of between ≥ 7.5 to ≤ 30mg (prednisone or prednisolone equivalent) daily or daily equivalent for at least 1 month. The OCS dose may be administered every other day (or different doses every other day); Average dose over two days = The daily dose. 5. Morning pre-bronchodilator (BD) FEV1 must be \< 80% predicted normal 6. Subjects must have evidence of asthma as documented by post-BD (albuterol/salbutatomol) reversibility of FEV1 ≥12% and ≥200 mL (15-30 min after administration of 4 puffs of albuterol/salbutamol), documented either in the previous 12 months 7. Subjects must have a history of at least 1 asthma exacerbation event within 12 months 8. Minimum 10 days compliance with the morning and evening eDiary completion and OCS,ICS,LABA as well as other asthma controller medications as captured in the eDiary during the 14 days prior to randomization 9. Documented physician-diagnosed asthma for at least 12 months
Exclusion criteria
1. Any clinically important pulmonary disease other than asthma (e.g. active lung infection, Chronic Obstructive Pulmonary Disease (COPD), bronchiectasis, pulmonary fibrosis, cystic fibrosis, hypoventilation syndrome associated with obesity, lung cancer, alpha 1 anti-trypsin deficiency, and primary ciliary dyskinesia) or ever diagnosed with pulmonary or systemic disease, other than asthma, that are associated with elevated peripheral eosinophil counts (e.g. allergic bronchopulmonary aspergillosis/mycosis, Churg-Strauss syndrome, hypereosinophilic syndrome). 2. Any disorder, including, but not limited to, cardiovascular, gastrointestinal, hepatic, renal, neurological, musculoskeletal, infectious, endocrine, metabolic, hematological, psychiatric, or major physical impairment that is not stable in the opinion of the Investigator and could: Affect the safety of the subject throughout the study Influence the findings of the study or the interpretation Impede the subject's ability to complete the entire duration of study 3. History of cancer: Subjects who have had basal cell carcinoma, localized squamous cell carcinoma of the skin or in situ carcinoma of the cervix are eligible to participate in the study provided that curative therapy was completed at least 12 months prior to visit 1.Subjects who have had other malignancies are eligible provided that curative therapy was completed at least 5 years 4. A helminth parasitic infection diagnosed within 6 months prior to screening that has not been treated with, or has failed to respond to, standard of care therapy. 5. Current smokers or subjects with smoking history ≥ 10 pack-years and subjects using vaping products, including electronic cigarettes. Former smokers with a smoking history of \<10 pack years and users of vaping or e-cigarette products must have stopped for at least 6 months prior to visit 1 to be eligible. 6. History of chronic alcohol or drug abuse within 12 months 7. Tuberculosis requiring treatment within the 12 months 8. History of any known immunodeficiency disorder including a positive human immunodeficiency virus (HIV) test. 9. Major surgery within 8 weeks prior to visit 1 or planned surgical procedures requiring general anaesthesia or in-subject status for \>1 day during the conduct of the study. 10. Clinically significant asthma exacerbation, in the opinion of the Investigator, including those requiring use of systemic corticosteroids or increase in the maintenance dose of OCS within 30 days
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | Baseline to Week 48 | Categorized percent reduction from baseline at Week 48. Percent change from baseline is defined as {final dose-baseline dose)/baseline dose}\*100, and the categories of percent change from baseline in daily OCS dose are defined as: ≥90% to ≤100% reduction, ≥75% to \<90% reduction, ≥50% to \<75% reduction, \>0% to \<50% reduction, and, no change or any increase. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of Subjects With 100% Reduction From Baseline in Daily OCS Dose at Week 48 | Baseline to Week 48 | Proportion (expressed as a percentage) of subjects with 100% reduction from baseline in daily OCS dose at Week 48. Percent change from baseline is defined as {(final dose-baseline dose)/baseline dose}\*100. |
| Proportion of Subjects With Daily OCS Dose ≤5 mg at Week 48 | Week 48 | Proportion (expressed as a percentage) of subjects with daily OCS dose ≤5 mg at Week 48. |
| Proportion of Subjects With ≥50% Reduction From Baseline in Daily OCS Dose at Week 48 | Baseline to Week 48 | Proportion (expressed as a percentage) of subjects with ≥50% reduction from baseline in daily OCS dose at Week 48. Percent change from baseline is defined as {(final dose-baseline dose)/baseline dose}\*100. |
| Change From Baseline in Pre-bronchodilator (Pre-BD) Forced Expiratory Volume in 1 Second (FEV1) | Baseline to Week 48 | Change from baseline in pre-BD FEV1 at Week 48. FEV1 is defined as the volume of air exhaled from the lungs in the first second of a forced expiration. |
| Change From Baseline in Weekly Mean Daily Asthma Symptom Score Via the Daily Asthma Symptom Diary | Baseline to Week 48 | Change from baseline in Asthma Symptom Diary score at Week 48. The Asthma Symptom Diary comprises of 10 items (5 items in the morning; 5 items in the evening). Asthma symptoms during night time and daytime are recorded by the patient each morning and evening in the daily diary. A daily ASD score is the mean of the 10 items. Responses for all 10 items are required to calculate the daily ASD score; otherwise, it is treated as missing. For the 7-day average asthma symptom score, scoring is done with no imputation using the mean of at least 4 of the 7 daily ASD scores as a mean weekly item score. The 7-day average ASD score ranges from 0 to 4, where 0 indicates no asthma symptoms. |
| Change From Baseline in Weekly Mean Rescue Medication Use | Baseline to Week 48 | Change from baseline in weekly mean rescue medication use at Week 48. Daily rescue medication use is defined as: Number of night inhaler puffs + 2 x \[number of night nebulizer times\] + number of daytime inhaler puffs + 2 x \[number of day nebulizer times\]. Each timepoint is calculated as weekly means based on daily diary data. |
| Change From Baseline in Weekly Mean Home Peak Expiratory Flow (PEF) (Morning and Evening) | Baseline to Week 48 | Change from baseline in weekly mean morning and evening peak expiratory flow (PEF) at Week 48. Home PEF testing will be performed by the subject in the morning upon awakening and in the evening at bedtime using an electronic, hand-held spirometer. Each timepoint is calculated as weekly means using at least 4 of the 7 days of PEF data. |
| Change From Baseline in Weekly Mean Number of Night-time Awakening Due to Asthma | Baseline to Week 48 | Change from baseline in weekly mean number (expressed as a percentage) of night time awakenings at Week 48. Night-time awakenings percentage defined as number of nights with awakenings due to asthma and requiring rescue medication divided by number of nights with data and multiplied by 100%. At least 4 out of 7 days of data is required to calculate a weekly mean. |
| Change From Baseline in Asthma Control Questionnaire 6 (ACQ-6) Score | Baseline to Week 48 | Change from baseline in ACQ-6 at Week 48. The ACQ-6 captures asthma symptoms and short-acting β2-agonist use via subject-report. Questions are weighted equally and scored from 0 (totally controlled) to 6 (severely uncontrolled). The ACQ-6 score is the mean of the responses. |
| Annualised Asthma Exacerbation Rate (AAER) | Baseline to Week 48 | The annualized exacerbation rate is based on exacerbations reported by the investigator in the eCRF over 48 weeks. |
| Change From Baseline in European Quality of Life - 5 Dimensions 5 Levels Questionnaire (EQ-5D-5L) Score | Baseline to Week 48 | Change from baseline in EQ-5D-5L at Week 48. The EQ-5D-5L questionnaire assesses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response options (no/slight/moderate/severe/extreme problems) that reflect increasing levels of difficulty. The EQ-5D-5L scores are converted into a single index-based value (Health State Valuation), using the UK population-based weights. The Helth State Valuation is scored between 0 to 1, where higher score indicates a better health state. |
| Number of Participants With Asthma Specific Resource Utilizations | Baseline to Week 48 | Number of participants with asthma specific resource utilizations (e.g. unscheduled physician visits, unscheduled phone calls to physicians, use of other asthma medications) over 48 weeks. |
| Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score | Baseline to Week 48 | Change from baseline in WPAI+CIQ score at Week 48. The WPAI+CIQ consists of 10 questions about how asthma and asthma related issues impact a subject's ability to work, attend classes, and perform regular daily activities. Work (Class) productivity loss is derived by sum of percentage of missed work (class hours) due to asthma and product of percentage of actual working hours (class) times degree of asthma affecting work (class) productivity while working. Percentage of missed work (class hours) due to asthma is calculated by number of hours missed work (class) due to asthma divided by total number of hours missed work (class) plus number of hours actually worked (in class). Activity impairment is the degree health affected regular activities (other than work or class) rated from 0 to 10, with 0 meaning no effect, divided by 10, and then expressed as a percentage. |
| Change From Baseline in FENO | Baseline to Week 48 | Change from baseline in fractional exhaled nitric oxide (FeNO) at week 48. |
| Change From Baseline in Peripheral Blood Eosinophils | Baseline to Week 48 | Change from baseline in blood eosinophil counts at week 48. |
| Change From Baseline From Total Serum IgE | Baseline to Week 48 | Change from baseline in total serum IgE at week 48. |
| PK: Serum Trough Concentrations | Pre-dose samples at Baseline, Week 4, Week 12, Week 24, Week 40, Week 48, Week 60 | Serum trough concentrations at each scheduled visit. |
| Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Baseline to Week 60 | Anti-drug antibodies (ADA) responses at baseline and post baseline. Persistently positive is defined as positive at \>=2 post baseline assessments (with \>=16 weeks between the first and the last positive) or positive at last post baseline assessment. Transiently positive is defined as having at least one post baseline ADA positive assessment and not fulfilling the conditions of persistently positive. Treatment boosted ADA defined as baseline positive ADA that was boosted to a 4 fold or higher level following treatment. Treatment emergent ADA defined as sum of treatment induced ADA and treatment boosted ADA. |
| Change From Baseline in Standardized Asthma Quality of Life Questionnaire for 12 Years and Older (AQLQ(s)+12) Total Score | Baseline to Week 48 | Change from baseline in AQLQ(S)+12 as compared to placebo at Week 48. The AQLQ(S)+12 is a questionnaire that measures the health-related quality of life experienced by asthma subjects. The total score is defined as the average of all 32 questions in the AQLQ(S)+12 questionnaire. AQLQ(S)+12 is a 7-point scale questionnaire, ranging from 7 (no impairment) to 1 (severe impairment). |
Countries
Argentina, Germany, Poland, South Korea, Turkey (Türkiye), Ukraine, United States
Participant flow
Recruitment details
The study was conducted at 60 centres in 7 countries. A total of 243 subjects were screened between 5MAR2018 and 27SEP2019, of which 150 were randomized and treated. 93 subjects were screen failures mainly due to exclusion criteria met and/or inclusion criteria not met. Assignment was done by Interactive Voice/Web Response System(IVRS/IWRS).
Pre-assignment details
The screening period included a Run-in (2 weeks) and an OCS optimization phase (up to 8 weeks). At the end of period, subjects were randomized in 1:1 ratio for tezepelumab or placebo. Randomization was stratified by region (Central/Eastern Europe, Western Europe and North America, Rest of the World).
Participants by arm
| Arm | Count |
|---|---|
| Tezepelumab Tezepelumab 210 mg administered every 4 weeks subcutaneously | 74 |
| Placebo Placebo administered every 4 weeks subcutaneously | 76 |
| Total | 150 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Death | 1 | 0 |
| Overall Study | Lost to Follow-up | 0 | 1 |
| Overall Study | Withdrawal by Subject | 5 | 2 |
Baseline characteristics
| Characteristic | Tezepelumab | Placebo | Total |
|---|---|---|---|
| Age, Continuous | 53.5 years STANDARD_DEVIATION 12.1 | 53.4 years STANDARD_DEVIATION 11.9 | 53.4 years STANDARD_DEVIATION 12 |
| Race/Ethnicity, Customized American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Asian | 11 Participants | 11 Participants | 22 Participants |
| Race/Ethnicity, Customized Black or African American | 1 Participants | 0 Participants | 1 Participants |
| Race/Ethnicity, Customized Hispanic or Latino | 10 Participants | 14 Participants | 24 Participants |
| Race/Ethnicity, Customized Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Not Hispanic or Latino | 64 Participants | 62 Participants | 126 Participants |
| Race/Ethnicity, Customized Other | 0 Participants | 1 Participants | 1 Participants |
| Race/Ethnicity, Customized White | 62 Participants | 64 Participants | 126 Participants |
| Sex: Female, Male Female | 49 Participants | 45 Participants | 94 Participants |
| Sex: Female, Male Male | 25 Participants | 31 Participants | 56 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 74 | 0 / 76 |
| other Total, other adverse events | 35 / 74 | 48 / 76 |
| serious Total, serious adverse events | 12 / 74 | 16 / 76 |
Outcome results
Primary
Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control
Categorized percent reduction from baseline at Week 48. Percent change from baseline is defined as {final dose-baseline dose)/baseline dose}\*100, and the categories of percent change from baseline in daily OCS dose are defined as: ≥90% to ≤100% reduction, ≥75% to \<90% reduction, ≥50% to \<75% reduction, \>0% to \<50% reduction, and, no change or any increase.
Time frame: Baseline to Week 48
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Tezepelumab | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >=75% to <90% reduction | 5 Participants |
| Tezepelumab | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >0% to <50% reduction | 5 Participants |
| Tezepelumab | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >=50% to <75% reduction | 10 Participants |
| Tezepelumab | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | no change or any increase | 14 Participants |
| Tezepelumab | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >=90% to <=100% reduction | 40 Participants |
| Placebo | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | no change or any increase | 14 Participants |
| Placebo | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >=90% to <=100% reduction | 35 Participants |
| Placebo | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >=75% to <90% reduction | 4 Participants |
| Placebo | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >=50% to <75% reduction | 14 Participants |
| Placebo | Categorized Percent Reduction From Baseline in the Daily OCS Dose While Not Losing Asthma Control | >0% to <50% reduction | 9 Participants |
p-value: 0.43495% CI: [0.69, 2.35]Proportional odds model
Secondary
Annualised Asthma Exacerbation Rate (AAER)
The annualized exacerbation rate is based on exacerbations reported by the investigator in the eCRF over 48 weeks.
Time frame: Baseline to Week 48
| Arm | Measure | Value (LEAST_SQUARES_MEAN) |
|---|---|---|
| Tezepelumab | Annualised Asthma Exacerbation Rate (AAER) | 1.38 Events per year |
| Placebo | Annualised Asthma Exacerbation Rate (AAER) | 2.00 Events per year |
Secondary
Change From Baseline From Total Serum IgE
Change from baseline in total serum IgE at week 48.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline From Total Serum IgE | -80.66 IU/mL | Standard Error 36.253 |
| Placebo | Change From Baseline From Total Serum IgE | 37.77 IU/mL | Standard Error 35.621 |
Secondary
Change From Baseline in Asthma Control Questionnaire 6 (ACQ-6) Score
Change from baseline in ACQ-6 at Week 48. The ACQ-6 captures asthma symptoms and short-acting β2-agonist use via subject-report. Questions are weighted equally and scored from 0 (totally controlled) to 6 (severely uncontrolled). The ACQ-6 score is the mean of the responses.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Asthma Control Questionnaire 6 (ACQ-6) Score | -0.87 Score on a scale | Standard Error 0.125 |
| Placebo | Change From Baseline in Asthma Control Questionnaire 6 (ACQ-6) Score | -0.51 Score on a scale | Standard Error 0.123 |
Secondary
Change From Baseline in European Quality of Life - 5 Dimensions 5 Levels Questionnaire (EQ-5D-5L) Score
Change from baseline in EQ-5D-5L at Week 48. The EQ-5D-5L questionnaire assesses 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 response options (no/slight/moderate/severe/extreme problems) that reflect increasing levels of difficulty. The EQ-5D-5L scores are converted into a single index-based value (Health State Valuation), using the UK population-based weights. The Helth State Valuation is scored between 0 to 1, where higher score indicates a better health state.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in European Quality of Life - 5 Dimensions 5 Levels Questionnaire (EQ-5D-5L) Score | 0.07 Score on a scale | Standard Error 0.026 |
| Placebo | Change From Baseline in European Quality of Life - 5 Dimensions 5 Levels Questionnaire (EQ-5D-5L) Score | 0.00 Score on a scale | Standard Error 0.027 |
Secondary
Change From Baseline in FENO
Change from baseline in fractional exhaled nitric oxide (FeNO) at week 48.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in FENO | -11.71 ppb | Standard Error 2.757 |
| Placebo | Change From Baseline in FENO | -1.40 ppb | Standard Error 2.774 |
Secondary
Change From Baseline in Peripheral Blood Eosinophils
Change from baseline in blood eosinophil counts at week 48.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Peripheral Blood Eosinophils | -83.79 cells/μL | Standard Error 17.078 |
| Placebo | Change From Baseline in Peripheral Blood Eosinophils | 33.38 cells/μL | Standard Error 16.605 |
Secondary
Change From Baseline in Pre-bronchodilator (Pre-BD) Forced Expiratory Volume in 1 Second (FEV1)
Change from baseline in pre-BD FEV1 at Week 48. FEV1 is defined as the volume of air exhaled from the lungs in the first second of a forced expiration.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Pre-bronchodilator (Pre-BD) Forced Expiratory Volume in 1 Second (FEV1) | 0.21 Litre | Standard Error 0.046 |
| Placebo | Change From Baseline in Pre-bronchodilator (Pre-BD) Forced Expiratory Volume in 1 Second (FEV1) | -0.04 Litre | Standard Error 0.046 |
Secondary
Change From Baseline in Standardized Asthma Quality of Life Questionnaire for 12 Years and Older (AQLQ(s)+12) Total Score
Change from baseline in AQLQ(S)+12 as compared to placebo at Week 48. The AQLQ(S)+12 is a questionnaire that measures the health-related quality of life experienced by asthma subjects. The total score is defined as the average of all 32 questions in the AQLQ(S)+12 questionnaire. AQLQ(S)+12 is a 7-point scale questionnaire, ranging from 7 (no impairment) to 1 (severe impairment).
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Standardized Asthma Quality of Life Questionnaire for 12 Years and Older (AQLQ(s)+12) Total Score | 0.94 Score on a scale | Standard Error 0.124 |
| Placebo | Change From Baseline in Standardized Asthma Quality of Life Questionnaire for 12 Years and Older (AQLQ(s)+12) Total Score | 0.58 Score on a scale | Standard Error 0.123 |
Secondary
Change From Baseline in Weekly Mean Daily Asthma Symptom Score Via the Daily Asthma Symptom Diary
Change from baseline in Asthma Symptom Diary score at Week 48. The Asthma Symptom Diary comprises of 10 items (5 items in the morning; 5 items in the evening). Asthma symptoms during night time and daytime are recorded by the patient each morning and evening in the daily diary. A daily ASD score is the mean of the 10 items. Responses for all 10 items are required to calculate the daily ASD score; otherwise, it is treated as missing. For the 7-day average asthma symptom score, scoring is done with no imputation using the mean of at least 4 of the 7 daily ASD scores as a mean weekly item score. The 7-day average ASD score ranges from 0 to 4, where 0 indicates no asthma symptoms.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Weekly Mean Daily Asthma Symptom Score Via the Daily Asthma Symptom Diary | -0.36 Score on a scale | Standard Error 0.071 |
| Placebo | Change From Baseline in Weekly Mean Daily Asthma Symptom Score Via the Daily Asthma Symptom Diary | -0.26 Score on a scale | Standard Error 0.068 |
Secondary
Change From Baseline in Weekly Mean Home Peak Expiratory Flow (PEF) (Morning and Evening)
Change from baseline in weekly mean morning and evening peak expiratory flow (PEF) at Week 48. Home PEF testing will be performed by the subject in the morning upon awakening and in the evening at bedtime using an electronic, hand-held spirometer. Each timepoint is calculated as weekly means using at least 4 of the 7 days of PEF data.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Tezepelumab | Change From Baseline in Weekly Mean Home Peak Expiratory Flow (PEF) (Morning and Evening) | evening PEF | 10.05 L/min | Standard Error 5.98 |
| Tezepelumab | Change From Baseline in Weekly Mean Home Peak Expiratory Flow (PEF) (Morning and Evening) | morning PEF | 13.29 L/min | Standard Error 5.653 |
| Placebo | Change From Baseline in Weekly Mean Home Peak Expiratory Flow (PEF) (Morning and Evening) | morning PEF | -9.71 L/min | Standard Error 5.435 |
| Placebo | Change From Baseline in Weekly Mean Home Peak Expiratory Flow (PEF) (Morning and Evening) | evening PEF | -11.37 L/min | Standard Error 5.749 |
Secondary
Change From Baseline in Weekly Mean Number of Night-time Awakening Due to Asthma
Change from baseline in weekly mean number (expressed as a percentage) of night time awakenings at Week 48. Night-time awakenings percentage defined as number of nights with awakenings due to asthma and requiring rescue medication divided by number of nights with data and multiplied by 100%. At least 4 out of 7 days of data is required to calculate a weekly mean.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Weekly Mean Number of Night-time Awakening Due to Asthma | -15.71 Percentage of nights with awakenings | Standard Error 3.482 |
| Placebo | Change From Baseline in Weekly Mean Number of Night-time Awakening Due to Asthma | -12.79 Percentage of nights with awakenings | Standard Error 3.317 |
Secondary
Change From Baseline in Weekly Mean Rescue Medication Use
Change from baseline in weekly mean rescue medication use at Week 48. Daily rescue medication use is defined as: Number of night inhaler puffs + 2 x \[number of night nebulizer times\] + number of daytime inhaler puffs + 2 x \[number of day nebulizer times\]. Each timepoint is calculated as weekly means based on daily diary data.
Time frame: Baseline to Week 48
Population: Number of participants analysed presents the number of subjects with an observation at Week 48. All subjects from the Full Analysis Set with at least one change from baseline value at any post baseline visit contributes to the analyses.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Tezepelumab | Change From Baseline in Weekly Mean Rescue Medication Use | -0.85 Weekly mean rescue medication use | Standard Error 0.28 |
| Placebo | Change From Baseline in Weekly Mean Rescue Medication Use | -0.37 Weekly mean rescue medication use | Standard Error 0.268 |
Secondary
Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score
Change from baseline in WPAI+CIQ score at Week 48. The WPAI+CIQ consists of 10 questions about how asthma and asthma related issues impact a subject's ability to work, attend classes, and perform regular daily activities. Work (Class) productivity loss is derived by sum of percentage of missed work (class hours) due to asthma and product of percentage of actual working hours (class) times degree of asthma affecting work (class) productivity while working. Percentage of missed work (class hours) due to asthma is calculated by number of hours missed work (class) due to asthma divided by total number of hours missed work (class) plus number of hours actually worked (in class). Activity impairment is the degree health affected regular activities (other than work or class) rated from 0 to 10, with 0 meaning no effect, divided by 10, and then expressed as a percentage.
Time frame: Baseline to Week 48
Population: The work productivity loss is only applicable to subjects who were employed, which is a subset of the study population. The class productivity loss is only applicable to subjects attending school, which is a subset of the study population. No subject in Placebo arm has selected the option 'in school' on the WPAI+CIQ questionnaire at Week 48.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Tezepelumab | Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score | Work productivity loss | -6.27 Percentage | Standard Deviation 25.3 |
| Tezepelumab | Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score | Class productivity loss | -10.00 Percentage | Standard Deviation 0 |
| Tezepelumab | Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score | Activity impairment | -13.2 Percentage | Standard Deviation 29.3 |
| Placebo | Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score | Work productivity loss | -9.66 Percentage | Standard Deviation 36.63 |
| Placebo | Change From Baseline in Work Productivity and Activity Impairment Questionnaire and Classroom Impairment Questionnaire (WPAI+CIQ) Score | Activity impairment | -7.8 Percentage | Standard Deviation 26.4 |
Secondary
Immunogenicity: Incidence of Anti-drug Antibodies (ADA)
Anti-drug antibodies (ADA) responses at baseline and post baseline. Persistently positive is defined as positive at \>=2 post baseline assessments (with \>=16 weeks between the first and the last positive) or positive at last post baseline assessment. Transiently positive is defined as having at least one post baseline ADA positive assessment and not fulfilling the conditions of persistently positive. Treatment boosted ADA defined as baseline positive ADA that was boosted to a 4 fold or higher level following treatment. Treatment emergent ADA defined as sum of treatment induced ADA and treatment boosted ADA.
Time frame: Baseline to Week 60
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | ADA positive at baseline and/or post-baseline (ADA prevalence) | 3 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Any baseline ADA positive | 2 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Only baseline ADA positive | 1 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Any post-baseline ADA positive | 2 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Both baseline and at least one post-baseline ADA positive | 1 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Treatment-induced ADA positive | 1 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Treatment-boosted ADA positive | 0 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | TE-ADA positive (ADA incidence) | 1 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | ADA persistently positive | 1 Participants |
| Tezepelumab | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | ADA transiently positive | 1 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | TE-ADA positive (ADA incidence) | 0 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | ADA positive at baseline and/or post-baseline (ADA prevalence) | 2 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Treatment-induced ADA positive | 0 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Any baseline ADA positive | 2 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | ADA transiently positive | 0 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Only baseline ADA positive | 1 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Treatment-boosted ADA positive | 0 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Any post-baseline ADA positive | 1 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | ADA persistently positive | 1 Participants |
| Placebo | Immunogenicity: Incidence of Anti-drug Antibodies (ADA) | Both baseline and at least one post-baseline ADA positive | 1 Participants |
Secondary
Number of Participants With Asthma Specific Resource Utilizations
Number of participants with asthma specific resource utilizations (e.g. unscheduled physician visits, unscheduled phone calls to physicians, use of other asthma medications) over 48 weeks.
Time frame: Baseline to Week 48
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Tezepelumab | Number of Participants With Asthma Specific Resource Utilizations | Home visit | 1 Participants |
| Tezepelumab | Number of Participants With Asthma Specific Resource Utilizations | Unscheduled visit to specialist | 29 Participants |
| Tezepelumab | Number of Participants With Asthma Specific Resource Utilizations | Telephone call | 26 Participants |
| Tezepelumab | Number of Participants With Asthma Specific Resource Utilizations | Emergency room visit | 4 Participants |
| Tezepelumab | Number of Participants With Asthma Specific Resource Utilizations | Ambulance transport | 0 Participants |
| Tezepelumab | Number of Participants With Asthma Specific Resource Utilizations | Hospitalisation | 5 Participants |
| Placebo | Number of Participants With Asthma Specific Resource Utilizations | Ambulance transport | 1 Participants |
| Placebo | Number of Participants With Asthma Specific Resource Utilizations | Hospitalisation | 10 Participants |
| Placebo | Number of Participants With Asthma Specific Resource Utilizations | Unscheduled visit to specialist | 41 Participants |
| Placebo | Number of Participants With Asthma Specific Resource Utilizations | Home visit | 2 Participants |
| Placebo | Number of Participants With Asthma Specific Resource Utilizations | Telephone call | 43 Participants |
| Placebo | Number of Participants With Asthma Specific Resource Utilizations | Emergency room visit | 7 Participants |
Secondary
PK: Serum Trough Concentrations
Serum trough concentrations at each scheduled visit.
Time frame: Pre-dose samples at Baseline, Week 4, Week 12, Week 24, Week 40, Week 48, Week 60
Population: The placebo arm is not applicable since it is not the experimental product.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Tezepelumab | PK: Serum Trough Concentrations | Baseline | 0 μg/mL | Geometric Coefficient of Variation 0 |
| Tezepelumab | PK: Serum Trough Concentrations | Week 4 | 10.3298 μg/mL | Geometric Coefficient of Variation 42.31 |
| Tezepelumab | PK: Serum Trough Concentrations | Week 12 | 17.9626 μg/mL | Geometric Coefficient of Variation 57.85 |
| Tezepelumab | PK: Serum Trough Concentrations | Week 24 | 18.9210 μg/mL | Geometric Coefficient of Variation 55.83 |
| Tezepelumab | PK: Serum Trough Concentrations | Week 40 | 16.7095 μg/mL | Geometric Coefficient of Variation 181.44 |
| Tezepelumab | PK: Serum Trough Concentrations | Week 48 | 13.9224 μg/mL | Geometric Coefficient of Variation 352.35 |
| Tezepelumab | PK: Serum Trough Concentrations | Week 60 | 3.5591 μg/mL | Geometric Coefficient of Variation 177.36 |
Secondary
Proportion of Subjects With 100% Reduction From Baseline in Daily OCS Dose at Week 48
Proportion (expressed as a percentage) of subjects with 100% reduction from baseline in daily OCS dose at Week 48. Percent change from baseline is defined as {(final dose-baseline dose)/baseline dose}\*100.
Time frame: Baseline to Week 48
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Tezepelumab | Proportion of Subjects With 100% Reduction From Baseline in Daily OCS Dose at Week 48 | 54.1 Percentage of participants |
| Placebo | Proportion of Subjects With 100% Reduction From Baseline in Daily OCS Dose at Week 48 | 46.1 Percentage of participants |
Secondary
Proportion of Subjects With ≥50% Reduction From Baseline in Daily OCS Dose at Week 48
Proportion (expressed as a percentage) of subjects with ≥50% reduction from baseline in daily OCS dose at Week 48. Percent change from baseline is defined as {(final dose-baseline dose)/baseline dose}\*100.
Time frame: Baseline to Week 48
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Tezepelumab | Proportion of Subjects With ≥50% Reduction From Baseline in Daily OCS Dose at Week 48 | 74.3 Percentage of participants |
| Placebo | Proportion of Subjects With ≥50% Reduction From Baseline in Daily OCS Dose at Week 48 | 69.7 Percentage of participants |
Secondary
Proportion of Subjects With Daily OCS Dose ≤5 mg at Week 48
Proportion (expressed as a percentage) of subjects with daily OCS dose ≤5 mg at Week 48.
Time frame: Week 48
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Tezepelumab | Proportion of Subjects With Daily OCS Dose ≤5 mg at Week 48 | 71.6 Percentage of participants |
| Placebo | Proportion of Subjects With Daily OCS Dose ≤5 mg at Week 48 | 72.4 Percentage of participants |