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Tralokinumab

Phase 3

Asthma | Monoclonal antibody | Respiratory |AstraZeneca PLC|Last Updated: Mar 15, 2019

Success Probability

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials5
Total Enrollment998

FDA Designations

No designations recorded

Clinical trial landscape

Tralokinumab · 7 trials · 4 indications

Phase 3 2Phase 2 3Phase 1 2
NCT02281357Phase 3 Study to Evaluate the Efficacy & Safety of Tralokinumab in Adults & Adolescents With OCS Dependent AsthmaAsthma
COMPLETED140 Analytics
NCT02161757A Phase 3 Study to Evaluate the Efficacy and Safety of Tralokinumab in Adults and Adolescents With Uncontrolled AsthmaUncontrolled Asthma
COMPLETED1,207 Analytics
PHASE3COMPLETED
Phase 3 Study to Evaluate the Efficacy & Safety of Tralokinumab in Adults & Adolescents With OCS Dependent Asthma
AsthmaUnlock trial analytics
PHASE3COMPLETED
A Phase 3 Study to Evaluate the Efficacy and Safety of Tralokinumab in Adults and Adolescents With Uncontrolled Asthma
Uncontrolled AsthmaUnlock trial analytics

Study Endpoints

Primary Endpoints

Percent Change From Baseline in the Final Daily, Average, OCS Dose at Week 40 While Not Losing Asthma Control.
Baseline (Week 0) and Week 40

The 40-week treatment period consisted of 3 phases: an induction phase (Week 0 to Week 12) where patients remained on their optimised OCS dose; an OCS reduction phase (Week 12 to Week 32) where OCS dose reduction could have started at Week 12 with the possibility of dose titration every 4 weeks to reach the lowest possible OCS dose; and a maintenance phase (Week 32 to Week 40) where patients remained on the OCS dose reached at Week 32 to demonstrate asthma control was maintained after achieving the lowest OCS dose. Criteria used to assess asthma control included lung function assessments (forced expiratory volume in 1 second and morning peak expiratory flow), night awakenings, and the use of rescue medication and systemic corticosteroids. The least squares (LS) mean percent change from baseline in average daily OCS dose is presented. The final daily percent change from baseline was defined as {(Final daily average dose - baseline daily average dose)/baseline daily average dose}\*100%.

Annualised Asthma Exacerbation Rate (AAER) up to Week 52
Baseline (Week 0) up to Week 52

Asthma exacerbation was defined as a worsening of asthma that led to any of the following: * Use of systemic corticosteroids for at least 3 days; a single depo-injectable dose of corticosteroids was considered equivalent to a 3-day course of systemic corticosteroids. * An emergency room (ER) or urgent care (UC) visit (defined as evaluation and treatment for \<24 hours in an ER or UC centre) due to asthma that required systemic corticosteroids (see above). * An inpatient hospitalisation (defined as admission to an inpatient facility and/or evaluation and treatment in a healthcare facility for ≥24 hours) due to asthma. AAER = number of exacerbations\*365.25 / (follow-up date - date of randomisation + 1) (where maximum follow-up time for a patient was approximately 52 weeks). AAER in the tralokinumab group was compared to that seen in the placebo group up to Week 52 using a negative binomial model; rate ratios and rate reductions are both presented for comparative statistical analyses.

Change From Baseline to Week 12, Expressed as a Ratio, in Number of Airway Submucosal Eosinophils
Baseline (Week 0) and Week 12

The number of airway submucosal eosinophils per millimetre squared (mm\^2) was determined by microscopic evaluation of bronchoscopic biopsies. The ratio of post-randomisation value at Week 12 to baseline value was computed as (Week 12 value / baseline value). The change from baseline to Week 12 (ratio) in the number of airway submucosal eosinophils is presented as geometric mean ± standard deviation (SD) of log values.

Clinical Response at Week 8 Based on Mayo Score
Eight week treatment period

Clinical response was measured as a decrease in Mayo score of ≥3 points from baseline, decrease in the total Mayo score from baseline ≥30 percentage and a decrease in the sub score for rectal bleeding ≥1 or absolute sub score for rectal bleeding of 0 or 1 point. Mayo score is sum of four sub-scores: stool frequency, rectal bleeding, endoscopy findings and the physician's global assessment. The total Mayo score ranges from 0-12, with higher scores indicating a more severe disease.

Annual Asthma Exacerbation Rate (AER)
Week 1 up to Week 53

Annualized AER was assessed based on AER data up to Week 53. An asthma exacerbation defined as a progressive increase of asthma symptoms that does not resolve after the initiation of rescue medications and remains troublesome for the participant resulting in either 1) use of systemic corticosteroids or increase of a stable systemic maintenance dose for a duration of at least 3 consecutive days as prescribed or administered by the investigator or healthcare provider; or 2) participant initiation of systemic corticosteroids for a duration of at least 3 consecutive days. An asthma exacerbation event was considered resolved 7 days after the last dose of oral corticosteroids (OCS) is administered (10 days after administration of an injectable corticosteroid). Courses of corticosteroids initiated after this time period were considered a separate new asthma exacerbation. Data were summarized together for 'Placebo, Q2W' and 'Placebo, Q2/4W' arms.

Area Under the Concentration-Time Curve From Zero to Infinity (AUC [0-infinity])
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

AUC (0 - infinity) = Area under the serum concentration versus time curve (AUC) from time zero to infinite time, obtained from AUC (0 - t) plus AUC (t - infinity). Units are day\*micrograms per millilitres = day\*mcg/mL.

Maximum Observed Serum Concentration (Cmax)
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

The Cmax is the maximum observed serum concentration of tralokinumab.

Time to Maximum Concentration (Tmax)
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

Tmax is defined as actual sampling time to reach maximum observed tralokinumab concentration.

Area Under the Concentration-Time Curve From Zero to Last Measurable Concentration (AUC [0-t])
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

AUC \[0-t\] is defined as area under the serum concentration-time curve from zero to last observed tralokinumab concentration.

Terminal Elimination Half-life (t1/2)
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

Terminal elimination half-life is the time measured for the serum concentration to decrease by one half. It is associated with the terminal slope of the semi logarithmic drug concentration-time curve, and is calculated as 0.693/lambda(z).

Apparent Systemic Clearance (CL/F) After Subcutaneous Dose
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after subcutaneous dose (apparent systemic clearance) is influenced by the fraction of the dose absorbed (bioavailability).

Apparent Terminal-Phase Volume of Distribution (Vz/F)
Day 1 (pre-dose sample collected within 30 minutes prior to study drug administration), Days 2, 4, 6, 8, 10, 15, 22, 36, and 57 post-dose

Volume of distribution was defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired serum concentration of a drug.

Time to Reach Maximum Observed Serum Concentration (Tmax)
0 (predose), 3, 8 and 24 hours postdose on Day 1; Day 4, 6, 8, 10, 15, 22, 36 and 57
Terminal Phase Elimination Half Life (t1/2)
0 (predose), 3, 8 and 24 hours postdose on Day 1; Day 4, 6, 8, 10, 15, 22, 36 and 57

Terminal phase elimination half-life is the time measured for the serum concentration to decrease by one half.

Secondary Endpoints

The Number of Patients With Final Daily Average OCS Dose ≤5 mg at Week 40.
At Week 40
The Number of Patients With ≥50% Reduction in Final Average Daily OCS Dose at Week 40.
At Week 40
Annual Asthma Exacerbation Rate (AAER) up to Week 40.
Baseline (Week 0) up to Week 40
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
TralokinumabEXPERIMENTALTralokinumab subcutaneous injection
PlaceboPLACEBO_COMPARATORPlacebo subcutaneous injection
Tralokinumab Dose Regimen 1EXPERIMENTALTralokinumab subcutaneous injection
Placebo Dose Regimen 1PLACEBO_COMPARATORPlacebo subcutaneous injection
Tralokinumab Dose Regimen 2EXPERIMENTALTralokinumab subcutaneous injection
Placebo Dose Regimen 2PLACEBO_COMPARATORPlacebo subcutaneous injection
Tralokinumab Dose RegimenEXPERIMENTALTralokinumab Subcutaneous Injection
Placebo Dose RegimenPLACEBO_COMPARATORPlacebo Subcutaneous Injection
1EXPERIMENTALtralokinumab (CAT-354) sc injection
2PLACEBO_COMPARATORplacebo sc injection
Placebo, Q2W - Cohort 1PLACEBO_COMPARATORParticipants received matching placebo subcutaneous injection every 2 weeks (Q2W) for a total of 26 doses up to 50 weeks.
Tralokinumab 300 mg, Q2W - Cohort 1EXPERIMENTALParticipants received tralokinumab 300 milligram (mg) subcutaneous injection every 2 weeks (Q2W) for a total of 26 doses up to 50 weeks.
Placebo, Q2/4W - Cohort 2PLACEBO_COMPARATORParticipants received matching placebo subcutaneous injection every 2 weeks (Q2W) for 12 weeks followed by every 4 weeks (Q4W) for 38 weeks (Q2/4W) for a total of 16 doses.
Tralokinumab 300 mg, Q2/4W - Cohort 2EXPERIMENTALParticipants received tralokinumab 300 mg subcutaneous injection every 2 weeks (Q2W) for 12 weeks followed by every 4 weeks (Q4W) for 38 weeks (Q2/4W) for a total of 16 doses.
Cohort 1ACTIVE_COMPARATORParticipants received 300 milligram (mg) tralokinumab when delivered as a 2 milliliter (mL) subcutaneous injection at a flow rate of 'W' mL/min.
Cohort 2EXPERIMENTALParticipants received 300 milligram (mg) tralokinumab when delivered as a 2 milliliter (mL) subcutaneous injection at a flow rate of 'X' mL/min.
Cohort 3EXPERIMENTALParticipants received 300 milligram (mg) tralokinumab when delivered as a 2 milliliter (mL) subcutaneous injection at a flow rate of 'Y' mL/min.
Cohort 4EXPERIMENTALParticipants received 300 milligram (mg) tralokinumab when delivered as a 2 milliliter (mL) subcutaneous injection at a flow rate of 'Z' mL/min.
Tralokinumab 300 mgEXPERIMENTALParticipants aged 12 to 14 years and 15 to 17 years will receive a single dose of tralokinumab (CAT-354) 300 milligram (mg), subcutaneously on Day 1.

Interventions

NameTypeDescription
TralokinumabBIOLOGICALTralokinumab dose
PlaceboOTHERPlacebo dose
Placebo Q2WOTHERParticipants who received matching placebo subcutaneous injection every 2 weeks (Q2W) for a total of 26 doses up to 50 weeks.
Tralokinumab 300 mg, Q2WBIOLOGICALParticipants received tralokinumab 300 mg subcutaneous injection Q2W for a total of 26 doses up to 50 weeks.
Placebo, Q2/4WOTHERParticipants received matching placebo subcutaneous injection Q2W for 12 weeks followed by Q4W for 38 weeks (Q2/4W) for a total of 16 doses.
Tralokinumab 300 mg, Q2/4WBIOLOGICALParticipants received tralokinumab 300 mg subcutaneous injection Q2W for 12 weeks followed by Q4W for 38 weeks (Q2/4W) for a total of 16 doses.
Tralokinumab 300 mgBIOLOGICALParticipants will receive 300 milligram (mg) tralokinumab when delivered as a 2 milliliter (mL) subcutaneous injection at different flow rates.
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Eligibility Criteria

Age Range12 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites51

Inclusion Criteria: 1\) Age 12-75 2) Documented physician-diagnosed asthma. 3) Documented treatment with ICS at a total daily dose corresponding to ≥500µg fluticasone propionate dry powder formulation and a LABA. 4) Subjects must have received OCS for the treatment of asthma for 6 months prior to V...

Countries:United StatesBelgiumFranceGermanyNetherlandsPolandUkraineArgentinaBulgariaColombiaHungaryPeruSlovakiaSouth KoreaSpainTaiwanVietnamCanadaDenmarkUnited KingdomCzechiaItalyChileJapanMexicoPhilippinesRussia
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Frequently asked questions about Tralokinumab

What is Tralokinumab used for?

Tralokinumab is an investigational monoclonal antibody being studied for uncontrolled asthma, ulcerative colitis, asthma, and atopic dermatitis. It is developed by AstraZeneca PLC (AZN) and is currently in Phase 3 clinical development for these indications.

What does Tralokinumab target?

Tralokinumab is a monoclonal antibody that targets interleukin-13 (IL-13), a cytokine involved in inflammatory responses. By binding to IL-13, it aims to modulate the inflammatory pathways implicated in conditions like asthma and ulcerative colitis.

Who makes Tralokinumab?

Tralokinumab is developed by AstraZeneca PLC, a biopharmaceutical company listed on the stock exchange under the ticker symbol AZN. AstraZeneca is conducting clinical trials to evaluate the drug's efficacy and safety in respiratory and inflammatory conditions.

What phase is Tralokinumab in?

Tralokinumab is in Phase 3 clinical development. It has completed Phase 3 trials for uncontrolled asthma, and earlier phase trials have been completed for ulcerative colitis and asthma. The drug is investigational and not yet approved by regulatory authorities.

What clinical trials is Tralokinumab in?

Tralokinumab has been studied in several clinical trials, including NCT02161757, a Phase 3 study in adults and adolescents with uncontrolled asthma, and NCT01482884, a Phase 2 study in patients with active, moderate-to-severe ulcerative colitis. Other trials include NCT01592396 and NCT02085473.

Is Tralokinumab the same as CAT-354?

Yes, Tralokinumab is also known as CAT-354. In a Phase 1 study (NCT01592396), the drug was referred to as Tralokinumab (CAT-354), confirming that these names refer to the same investigational monoclonal antibody.