Effects of Dupilumab on Allergic Reactions to House Dust Mites

Mechanistic Trial of Dupilumab in Adults With House Dust Mite-associated Asthma Using an Aeroallergen Challenge Chamber

This study is testing if the medication dupilumab can help people with asthma who are allergic to house dust mites feel better when exposed to allergens.

Quick facts

• Phase: Phase 2
• Study type: Interventional
• Enrollment: 88 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: The University of Texas Health Science Center at San Antonio (Academic / other)
• Drugs / interventions: dupilumab, immunotherapy
• Locations: 2 sites (San Antonio, Texas and 1 other locations)
• Trial ID: NCT05720325 on ClinicalTrials.gov

What this trial studies

This trial investigates the effects of dupilumab on individuals with asthma and house dust mite allergies by exposing participants to allergens in a controlled chamber. Participants will be phenotyped based on their response to the allergens and then randomized to receive either dupilumab or a placebo for 18 weeks. Throughout the trial, symptom severity will be monitored to assess the impact of the treatment. The study aims to better understand the relationship between dupilumab and allergic responses in asthma patients.

Who should consider this trial

Good fit: Ideal candidates for this study are adults aged 18 to 65 with a history of perennial nasal allergy and asthma, specifically those who test positive for house dust mite allergens.

Not a fit: Patients without a documented history of asthma or those who do not have a positive skin prick test for house dust mites may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could lead to improved treatment options for patients suffering from asthma and allergies, potentially reducing their symptoms and enhancing their quality of life.

How similar studies have performed: Other studies have shown promising results with dupilumab in treating asthma and allergic conditions, indicating that this approach has potential based on previous findings.

Eligibility criteria

Inclusion Criteria:

1. Will demonstrate understanding of the study and will provide a signed and dated informed consent.
2. Will be male or female, 18 to 65 years of age at the time of the screening visit.
3. Will have symptoms consistent with perennial nasal allergy for a minimum of 2 years prior to the screening visit.
4. Will have a positive standard skin prick test (SPT) to D. pteronyssinus within 24 months of screening. A positive SPT is defined as a wheal diameter of at least 5 mm larger than the negative control (normal saline).
5. Will have asthma with a documented FEV1 reversibility of ≥10% within 18 months of screening.
6. If a participant manifests symptoms suggestive of COVID-19, the participant must have a negative SARS-CoV-2 rapid antigen nasopharyngeal swab test before each HDM exposure visit.
7. A woman of childbearing potential, must have a negative urine pregnancy test at Visit 1 and prior to each exposure in the ACC. All women of childbearing potential must agree to a medically acceptable form of birth control throughout the study duration and for at least 2 months prior to Visit 1. Acceptable methods of birth control for this study include:

   1. oral, patch, or intra-vaginal contraceptives
   2. Norplant System® or other implant system
   3. Depo-Provera®
   4. IUD
   5. double barrier method
   6. abstinence
   7. surgical sterility (hysterectomy, tubal ligation, or uterine ablation)

   Post-menopausal women defined as women without a menstrual cycle for at least 12 consecutive months qualify as non-childbearing for this study.
8. Will have never smoked or will be an ex-smoker (\<20 pack year history and no cigarette or smokeless tobacco use in the past year).

Exclusion Criteria:

1. Have a chronic lung disease other than asthma.
2. Have atopic dermatitis.
3. Have any ocular disease that is not associated with allergic rhinoconjunctivitis.
4. Are on home oxygen requirement.
5. Have a history of rebound nasal congestion (brought on by extended use of topical decongestants), chronic rhinosinusitis with or without nasal polyps, nasal septal perforation, or severe nasal tract malformations noted on physical exam.
6. Have FEV1 \<70% predicted as determined by pre-bronchodilator spirometry at visit 1.
7. Are unwilling/unable to withhold intranasal steroids or asthma medications before specified visits.
8. Are unwilling/unable to abstain from protocol-defined prohibited medications for the protocol-specified times before and during screening/selection and ACC HDM exposure visits.
9. Have received any oral or other form of systemic glucocorticosteroids within 1 month prior to the screening visit.
10. Have received JAK-1 inhibitors within 3 months prior to the screening visit.
11. Have known hypersensitivity to dupilumab or any of its excipients.
12. Have an ongoing helminth infection.
13. Have received a live vaccine within 30 days of screening or are planned to receive one during study participation.Note: Participant can receive a live vaccine \> 30 days after final study investigational product injection (visit 14)
14. Are pregnant or nursing.
15. Have a history of keratoconjunctivitis sicca.
16. Have indoor pet exposure causing upper or lower symptoms.
17. Have received allergen immunotherapy of any form within 12 months of screening visit.
18. Received biologics, other than anti-obesity or diabetes medications (such as tirzepatides, semaglutides), for any indication within 12 months of screening visit.
19. Have participated in a trial with an investigational drug in the past 30 days.
20. Have past or current medical problems or findings from physical examination or laboratory testing that are not listed above, that, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements, or may impact the quality or interpretation of the data obtained from the study.

Where this trial is running

San Antonio, Texas and 1 other locations

• Biogenics Research Chamber — San Antonio, Texas, United States (Recruiting)
• University of Texas Health Science Center at San Antonio — San Antonio, Texas, United States (Recruiting)

Study contacts

• Principal investigator: Sunil K Ahuja, MD — The University of Texas Health Science Center at San Antonio
• Study coordinator: Sunil K Ahuja, MD

Conditions Asthma, Allergic; House Dust Mite Allergy; Asthma; Aeroallergen chamber; Dupilumab