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What is the goal of this study? The goal of this clinical trial is to find out whether the study drug LQ036 (a nebulized solution taken by inhaling through a nebulizer) works to improve lung function and asthma control in people whose asthma is not well controlled. The study will also learn about the safety of LQ036, how the body processes it, and whether the body develops an immune response to it.
What are the main questions?
The most important question is:
• Does LQ036 improve lung function (measured by FEV₁ - the amount of air you can blow out in one second) more than a placebo at Week 12?
Other important questions include:
The study includes four periods: a screening period of up to 2 weeks to check eligibility, followed by a 2 week run in period during which all participants take a placebo once daily by nebulizer and record symptoms and rescue medication use. Participants are then randomly assigned to one of three groups for the 24 week treatment period: LQ036 12 mg, LQ036 24 mg, or placebo once daily. For the first 12 weeks, the LQ036 groups are compared with the placebo group; after 12 weeks, those originally on placebo are reassigned to either LQ036 12 mg or 24 mg for the remaining 12 weeks. Throughout the study period, all participants continue their usual asthma controller medicines. A 4 week safety follow up visit occurs after the 24 week treatment to monitor for side effects.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LQ036 12 mg | Experimental | LQ036 12 mg solution for nebulization, once daily for 24 weeks. |
|
| LQ036 24 mg | Experimental | LQ036 24 mg solution for nebulization, once daily for 24 weeks. |
|
| Placebo then Re-randomized to LQ036 | Placebo Comparator | Placebo solution for nebulization once daily for 12 weeks, followed by re-randomization (1:1) to either LQ036 12 mg or LQ036 24 mg solution for nebulization once daily for an additional 12 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Biological | Placebo is a look-alike solution for nebulization that contains no active drug. Participants will self-administer the placebo once daily by inhaling the nebulized solution. |
| Measure | Description | Time Frame |
|---|---|---|
| Absolute Change From Baseline in Pre-bronchodilator Forced Expiratory Volume in 1 Second (FEV1) at Week 12 | Baseline, Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Percent Change From Baseline in Pre-bronchodilator FEV1 at Week 12 | Baseline, Week 12 | |
| Absolute and Percent Change From Baseline in Pre-bronchodilator FEV1 at Weeks 1, 2, 4, 8, 16, 20, 24 | Baseline, Weeks 1, 2, 4, 8, 16, 20, 24 |
| Measure | Description | Time Frame |
|---|---|---|
| Safety Measures: Number of participants with treatment-related adverse events as assessed by CTCAE v5.0 | An adverse event (AE) is any untoward medical occurrence in a participant who received study drug, regardless of causal relationship. TEAEs are defined as AEs that start or worsen on or after the first dose of study drug. | From 2-week placebo run-in period up to Week 28 |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Meng Huang | Contact | 86+02120985259 | mhuang@novamab.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ruijin Hospital, Shanghai Jiao Tong University School of Medicine | Recruiting | Shanghai | China |
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| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
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Parallel assignment for 12 weeks (1:1:1), followed by re-randomization of placebo participants to LQ036 12 mg or 24 mg for weeks 13-24.
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| LQ036 | Biological | LQ036 is a single-domain antibody formulated as a solution for nebulization. Participants will self-administer the assigned dose once daily by inhaling the nebulized solution. |
|
| Absolute and Percent Change From Baseline in Morning and Evening Peak Expiratory Flow (PEF) at Weeks 1, 2, 4, 8, 12, 16, 20, 24 | Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Absolute and Percent Change From Baseline in Pre-bronchodilator FEV1% Predicted, Forced Vital Capacity (FVC), and Forced Expiratory Flow (FEF25%-75%) at Weeks 1, 2, 4, 8, 12, 16, 20, 24 | Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Absolute and Percent Change From Baseline in Post-bronchodilator FEV1 at Weeks 12 and 24 | Baseline, Weeks 12, 24 |
| Annualized Rate of Composite Exacerbation (CompEx) Events During the Treatment Period | Baseline up to Week 24 |
| Time to First Composite Exacerbation (CompEx) Event | Baseline up to Week 24 |
| Annualized Rate of Loss of Asthma Control (LOAC) Events During the Treatment Period | Baseline up to Week 24 |
| Time to First Loss of Asthma Control (LOAC) Event | Baseline up to Week 24 |
| Annualized Rate of Severe Exacerbation (SevEx) Events During the Treatment Period (in participants with history of severe exacerbation in past 12 months) | Baseline up to Week 24 |
| Annualized Rate of Severe Exacerbation Events Resulting in Hospitalization or Emergency Room Visit During the Treatment Period (in participants with history of severe exacerbation in past 12 months) | Baseline up to Week 24 |
| Time to First Severe Exacerbation (SevEx) Event (in participants with history of severe exacerbation in past 12 months) | Baseline up to Week 28 |
| Time to First Severe Exacerbation Event Resulting in Hospitalization or Emergency Room Visit (in participants with history of severe exacerbation in past 12 months) | Baseline up to Week 28 |
| Absolute Change From Baseline in Asthma Control Questionnaire-5 (ACQ-5) Score at Weeks 1, 2, 4, 8, 12, 16, 20, 24 | The ACQ-5 has 5 questions, reflecting the top-scoring five asthma symptoms: woken at night by symptoms, wake in the mornings with symptoms, limitation of daily activities, shortness of breath and wheeze. Participants were asked to recall how their asthma had been during the previous week and to respond to each of the five symptom questions on a 7-point scale ranging from 0 (no impairment) to 6 (maximum impairment). ACQ-5 total score was mean of the scores of all 5 questions and, therefore, ranged from 0 (totally controlled) to 6 (severely uncontrolled). Higher score indicated lower asthma control. | Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Absolute Change From Baseline in Nighttime Asthma Symptom Scores at Weeks 1, 2, 4, 8, 12, 16, 20, 24 | Nighttime asthma symptom score was determined using an AM (ante meridiem) symptom scoring system, which evaluated the participant's overall asthma symptoms experienced during the night. It ranged from 0 to 4 as follows: 0 = No symptoms;
| Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Absolute Change From Baseline in Daytime Asthma Symptom Scores at Weeks 1, 2, 4, 8, 12, 16, 20, 24 | Daytime asthma symptom score was determined using a PM (post meridiem) symptom scoring system, which evaluated the participant's overall asthma symptoms experienced during the day. It ranged from 0 to 5 as follows: 0 = No symptoms;
| Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Absolute Change From Baseline in Average Daily Reliever Medication Use (puffs/day) at Weeks 1, 2, 4, 8, 12, 16, 20, 24 | Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Number of Reliever Medication-Free Days During the Treatment Period | Baseline up to Week 24 |
| Absolute Change From Baseline in Asthma Quality of Life Questionnaire With Standardized Activities (AQLQ[S]) Global Score at Weeks 12 and 24 | The Asthma Quality of Life Questionnaire with Standardized Activities (AQLQ[S]) is a 32 item disease specific instrument measuring the functional impairments that are most important to adults with asthma. Each item is scored on a 7 point Likert scale where 1 = maximal impairment and 7 = no impairment. The global score is the mean of all 32 responses, ranging from 1 (severely impaired quality of life) to 7 (not impaired at all). Higher scores indicate better quality of life. A positive change from baseline indicates improvement. | Baseline, Weeks 12, 24 |
| Absolute and Percent Change From Baseline in Fractional Exhaled Nitric Oxide (FeNO) at Each Time Point | Baseline, Weeks 1, 2, 4, 8, 12, 16, 20, 24 |
| Safety Measures: Incidence and Severity of Serious Adverse Events (SAEs) | A serious adverse event (SAE) is any AE that results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, or is a congenital anomaly/birth defect. | From Screening up to Week 28 |
| Safety Measures: Number of Participants With Abnormal Vital Signs of Potential Clinical Importance | Vital signs assessments include systolic blood pressure (mmHg), diastolic blood pressure (mmHg), respiratory rate (bmp), heart rate (bpm) and body temperature (℃). Clinically significant abnormalities are determined by the investigator based on pre-defined criteria or medical judgment. | From Screening up to Week 28 |
| Safety Measures: Number of Participants With Clinically Significant Findings on Physical Examination | Physical examination includes assessment of general appearance; skin; head, eyes, ears, nose and throat (HEENT); chest; abdomen; spine; extremities; nervous system; and lymph nodes. Clinically significant findings are determined by the investigator based on pre-defined criteria or medical judgment. | At Screening, Baseline (Week 0), Week 12 and 24. |
| Safety Measures: Number of Participants With Abnormal Hematology Parameters of Potential Clinical Importance | Hematology assessments include white blood cell count (WBC), white blood cell differential (neutrophils, lymphocytes, monocytes, eosinophils, basophils), red blood cell count (RBC), hemoglobin (Hb), platelet count (PLT), and hematocrit (HCT). Clinically significant abnormalities are determined by the investigator based on pre-defined criteria or medical judgment. | At Screening, Baseline (Week 0), Week 4, 8, 12, 16, 20, 24, 28. |
| Safety Measures: Number of Participants With Abnormal Clinical Chemistry Parameters of Potential Clinical Importance | Blood chemistry assessments include alanine aminotransferase (ALT); aspartate aminotransferase (AST); total protein (TP); albumin (ALB); total bilirubin (TBIL); direct bilirubin (DBIL); alkaline phosphatase (ALP); gamma-glutamyltransferase (gamma-GGT); serum creatinine (Cr); blood urea (UREA) or blood urea nitrogen (BUN); uric acid (UA); fasting glucose (GLU); triglycerides (TG); total cholesterol (CHOL); low-density lipoprotein cholesterol (LDL-C); high-density lipoprotein cholesterol (HDL-C); lactate dehydrogenase (LDH); and electrolytes (sodium [Na], potassium [K], chloride [Cl]). Clinically significant abnormalities are determined by the investigator based on pre-defined criteria or medical judgment. | At Screening, Baseline (Week 0), at Week 4, 8, 12, 16, 20, 24, 28. |
| Safety Measures: Number of Participants With Abnormal Urinalysis Parameters of Potential Clinical Importance | Urinalysis assessments include leukocytes, red blood cells, protein, glucose, and urine pH. Clinically significant abnormalities are determined by the investigator based on pre-defined criteria or medical judgment. | At Screening, Baseline (Week 0), Week 4, 12, 24, 28. |
| Safety Measures: Number of Participants With Potentially Clinically Significant Abnormalities in 12-Lead Electrocardiogram (ECG) Parameters | 12-lead ECGs were recorded after participants had rested in a supine position for at least 5 minutes. The following ECG parameters were assessed: heart rate, PR interval, QRS duration, QT interval, and QT interval corrected for heart rate using Fridericia's formula (QTcF, in ms; QTcF = QT/RR^0.33). The clinical significance of any abnormalities was determined by the investigator based on predefined criteria. | At Screening, Baseline (Week 0), Weeks 4, 12, 24 and 28 |
| Pharmacokinetics (PK): Maximum Plasma Concentration (Cmax) of LQ036 | Maximum observed plasma concentration after nebulized inhalation. Measured in ng/mL. | Day 1, Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Time to Maximum Plasma Concentration (Tmax) of LQ036 | Time at which Cmax is observed following drug administration. Measured in hours. | Day 1, Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Area Under the Plasma Concentration Time Curve From Time 0 to t (AUC(0-t)) of LQ036 | Area under the plasma concentration versus time curve from time 0 to the time of the last measurable concentration (t). Measured in h·ng/mL. | Day 1, Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Apparent Clearance (CL/F) of LQ036 | Apparent clearance after nebulized inhalation, calculated as Dose/AUC(0-∞). Measured in L/h. | Day 1, Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Apparent Volume of Distribution (Vd/F) of LQ036 | Apparent volume of distribution during terminal phase after nebulized inhalation, calculated as (CL/F)/λz. Measured in L. | Day 1, Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Terminal Half Life (t1/2) of LQ036 | Terminal phase half life calculated as ln(2)/λz. Measured in hours. | Day 1, Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Trough Plasma Concentration (Ctrough) of LQ036 | Plasma concentration at the end of a dosing interval just before the next dose. Measured in ng/mL. | Week 2, 4, 12 or early termination |
| Pharmacokinetics (PK): Last Measurable Plasma Concentration (Clast) of LQ036 | Last measurable concentration above the limit of quantification. Measured in ng/mL. | After last dose |
| Pharmacokinetics (PK): Time of Last Measurable Concentration (Tlast) of LQ036 | Time at which Clast is observed after the last dose. Measured in hours. | After last dose |
| Immunogenicity: Incidence and Titer of Anti-Drug Antibodies (ADA) and Incidence of Neutralizing Antibodies (Nab) | Baseline, Weeks 2, 4, 12, 20, 24, 28 |
| Exploratory outcome: Absolute and Percent Change From Baseline in Induced Sputum Eosinophils (EOS) at Each Time Point (if applicable) | Baseline, Weeks 12, 24 |
| D012130 |
| Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |