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A Multicentre, Randomised, Double-blind, Parallel Group, Placebo-controlled, Time-to-first Asthma Exacerbation Phase III Efficacy and Safety Study of Benralizumab in Paediatric Patients With Severe Eosinophilic Asthma (DOMINICA)

200 patients around the world
Available in Spain, United States, Argentina
A randomised, double-blind, parallel-group, placebo-controlled, time-to-first-asthma-exacerbation event study designed. There will be a screening period of 2 months to allow adequate time for the eligibility criteria to be evaluated. The screening period may be reduced to not lesser than 4 weeks from Visit 2a. Furthermore, the Screening Period may be extended up to 12 weeks (or longer, if deemed necessary by the investigator), to accommodate treatment. Visit 2 will be split into Part A (Visit 2a) and Part B (Visit 2b) to reassess eligibility prior to randomisation and first dose of study treatment administration. Patients will be randomised 1:1 to receive benralizumab or placebo. The treatment period will consist of 2 parts: double-blind (DB) treatment period and open-label extension (OLE) period. The initial placebo-controlled, DB treatment period will be of variable duration. The minimum duration of treatment in the DB treatment period for each patient will be 16 weeks. Patient will continue in the DB treatment period until the patient experiences an exacerbation or the required number of events have been observed in the study, whichever occurs sooner. All patients who experience an asthma exacerbation in the DB treatment period may enter the OLE period. The OLE period will be 48 weeks in the ≥ 12 to < 18-year-old age group and 2 years (104 weeks) in the ≥6 to < 12-year-old age group, where all patients will receive benralizumab. An end-of-the-treatment visit will occur 8 weeks after the last dose in the OLE.
AstraZeneca
200Patients around the world

This study is for people with

Asthma
Childhood asthma
Eosinophilic asthma

Requirements for the patient

To 18 Years
All Gender

Medical requirements

Capable of giving assent (signing the assent form) to participate in the study. The caregiver of the patient must be capable of giving written informed consent for the patient's participation in the study. Consent and assent forms must be completed prior to any study specific procedures.
Patient and the caregiver (where applicable) must be willing to and be able to answer questionnaires that are part of the study procedures.
Male or female patients aged ≥ 6 to < 18 years old.
Patients with a diagnosis of eosinophilic asthma, defined by regional for at least 12 months prior to Visit 1.
Patients with a diagnosis of severe asthma confirmed, evaluated, and managed by the clinical site for ≥ 6 months prior to Visit 1.
Patients with an exacerbation history of asthma exacerbations (defined as a requirement for systemic corticosteroids and/or hospitalization) within 12 months prior to Visit 1, OR,
Patients on well-documented, stable treatment for asthma with high dose ICS and at least 1 additional controller medication, such as long-acting β2 agonists (LABA), leukotriene receptor antagonists (LTRA), long-acting muscarinic antagonists (LAMA), or theophylline, since at least 6 months prior to Visit 1.
Eosinophilic airway inflammation that is related to asthma characterised as eosinophilic in nature as indicated by peripheral blood eosinophil count of ≥ 300 cells/μL during screening OR a blood eosinophil count of 150 to 299 cells/μL and documentation of elevated eosinophils in bronchoalveolar lavage (BAL), sputum, or bronchial biopsy within the 2 years prior to Visit 1.
≥ 70% compliance with maintenance asthma medication during the screening period based on the Paediatric Asthma Symptom - Observer reported (PASO) or Asthma Daily Diary.
At least 70% daily PASO or Asthma Daily Diary completion during the entire screening period, with at least 50% PASO or Asthma Daily Diary completion in the 14-day period prior to randomisation.
Pre-BD FEV1 ≤ 95% PN or pre-BD FEV1/FVC ratio < 0.85 required. Patients with ≥ 25 % increase in mean pre-BD FEV1 value during the screening period will be screen failed.
ACQ-IA ≥ 1.5 with no meaningful improvement (ACQ-IA change ≤ -0.5) between screening and Visit 2a.
Body weight ≥ 15 kg.
Females of childbearing potential (FOCBP) who are sexually active, as judged by the investigator, must commit to consistent and correct use of a highly effective and acceptable method of contraception
Clinically important pulmonary disease other than asthma or patients who have ever been diagnosed with pulmonary or systemic disease, other than asthma, that are associated with elevated peripheral eosinophil counts
Life-threatening asthma,
Asthma exacerbation requiring use of systemic corticosteroids or increase in maintenance dose of OCS within 2 weeks prior to Visit 2a or acute upper/lower respiratory infection that requires antibiotics or antiviral medication within 2 weeks prior to the first dose of the IP (Visit 2b).
Any disorder that is not stable in the opinion of the investigator and could affect the safety of the patient during the study, influence the findings of the studies or their interpretations or impede the patient's ability to complete the entire duration of the study.
History of anaphylaxis to any biologic therapy.
Current malignancy, or history of malignancy.
A helminth parasitic infection
Use of immunosuppressive medication
Receipt of immunoglobulin or blood products within 30 days prior to Visit 1.
Receipt of any marketed or investigational biologic within 4 months or 5 half-lives prior to Visit 1
Previously received benralizumab (MEDI-563).
Participation in another interventional clinical study
Patients with known hypersensitivity to benralizumab or any of the excipients of the product.
Currently pregnant, breastfeeding, or lactating females.
Previous randomisation in the present study.
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