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Reslizumab

Phase 3

Asthma | Monoclonal antibody | Respiratory |Teva Pharmaceutical Industries Limited|Last Updated: Nov 9, 2021

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials3
Total Enrollment751

FDA Designations

No designations recorded

Clinical trial landscape

Reslizumab · 12 trials · 9 indications

Phase 3 7Phase 2 4Phase 1 1
NCT00635089Open-Label Extension Study of Reslizumab in Pediatric Subjects With Eosinophilic EsophagitisEosinophilic Esophagitis
COMPLETED190 Analytics
NCT02501629An Efficacy and Safety Study of Reslizumab Subcutaneous in Patients With Oral Corticosteroid Dependent Asthma and Elevated Blood EosinophilsAsthma
COMPLETED177 Analytics
NCT02452190Study of Reslizumab in Participants With Uncontrolled Asthma and Elevated Blood EosinophilsAsthma
COMPLETED468 Analytics
NCT01508936Study to Evaluate the Efficacy and Safety of Reslizumab Treatment in Patients With Moderate to Severe AsthmaEosinophilic Asthma
COMPLETED511 Analytics
NCT01287039A Study to Evaluate the Efficacy and Safety of Reslizumab (3.0 mg/kg) in the Reduction of Clinical Asthma Exacerbations in Patients (12-75 Years of Age) With Eosinophilic AsthmaEosinophilic Asthma
COMPLETED489 Analytics
NCT01285323A Study to Evaluate the Efficacy and Safety of Reslizumab in Patients With Eosinophilic AsthmaEosinophilic Asthma
COMPLETED464 Analytics
NCT01270464A Study to Evaluate the Efficacy and Safety of Reslizumab (0.3 or 3.0 mg/kg) as Treatment for Patients (12-75 Years of Age) With Eosinophilic AsthmaEosinophilic Asthma
COMPLETED315 Analytics
PHASE3COMPLETED
Open-Label Extension Study of Reslizumab in Pediatric Subjects With Eosinophilic Esophagitis
Eosinophilic EsophagitisUnlock trial analytics
PHASE3COMPLETED
An Efficacy and Safety Study of Reslizumab Subcutaneous in Patients With Oral Corticosteroid Dependent Asthma and Elevated Blood Eosinophils
AsthmaUnlock trial analytics
PHASE3COMPLETED
Study of Reslizumab in Participants With Uncontrolled Asthma and Elevated Blood Eosinophils
AsthmaUnlock trial analytics
PHASE3COMPLETED
Study to Evaluate the Efficacy and Safety of Reslizumab Treatment in Patients With Moderate to Severe Asthma
Eosinophilic AsthmaUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate the Efficacy and Safety of Reslizumab (3.0 mg/kg) in the Reduction of Clinical Asthma Exacerbations in Patients (12-75 Years of Age) With Eosinophilic Asthma
Eosinophilic AsthmaUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate the Efficacy and Safety of Reslizumab in Patients With Eosinophilic Asthma
Eosinophilic AsthmaUnlock trial analytics
PHASE3COMPLETED
A Study to Evaluate the Efficacy and Safety of Reslizumab (0.3 or 3.0 mg/kg) as Treatment for Patients (12-75 Years of Age) With Eosinophilic Asthma
Eosinophilic AsthmaUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Treatment-emergent Adverse Events (AEs), Serious AEs, or Discontinuation Due to AEs
From start of study drug until end of treatment (mean [standard deviation {SD}] duration of treatment was 30.0 [5.89] months)

An AE was defined as any adverse experience, including side effect, injury, toxicity, sensitivity reaction, intercurrent illness, or sudden death, whether or not it was considered related to the use of study drug. Treatment emergent adverse events were those that started any time after the administration of the first dose of study drug (at baseline of this study) and before the cessation of study drug. Serious adverse events that occurred any time after the administration of the first dose of study drug until 30 days after administration of the last dose of study drug were reported as treatment emergent serious adverse events.

Number of Participants With at Least 1 Potentially Clinically Significant Abnormal Hematology Value
From start of study drug until end of treatment (mean [SD] duration of treatment was 30.0 [5.89] months)

Hematology laboratory tests performed include: hemoglobin, hematocrit, red blood cell count, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, platelet count, white blood cell count, and differential count and percentage (polymorphonuclear leukocytes \[neutrophils\], lymphocytes, eosinophils, monocytes, basophils, platelets).

Number of Participants With at Least 1 Potentially Clinically Significant Abnormal Serum Chemistry Laboratory Test Results or Urinalysis Abnormality
From start of study drug until end of treatment (mean [SD] duration of treatment was 30.0 [5.89] months)

Serum chemistry laboratory tests performed include: calcium, phosphorus, magnesium, sodium, potassium, chloride, creatinine, glucose \[nonfasting\], blood urea nitrogen, total cholesterol, uric acid, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, gamma glutamyl transpeptidase, alkaline phosphatase, bicarbonate, creatine kinase, total protein, albumin, total bilirubin, direct bilirubin, indirect bilirubin. Urinalysis tests performed include: protein, glucose, ketones, bilirubin, urobilinogen, nitrite content, pH, specific gravity, white blood cells, microscopic (red blood cells, white blood cells, casts, crystals).

Number of Participants With at Least 1 Potentially Clinically Significant Abnormal Vital Signs Value
From start of study drug until end of treatment (mean [SD] duration of treatment was 30.0 [5.89] months)

Low systolic blood pressure: \< 90 and decrease (↓) of 30 mm Hg from baseline (BL) (ages 5-18); high systolic blood pressure: \> 160 and increase (↑) of 30 mm Hg from BL (age 5-12), \> 130 and ↑ of 30 mm Hg from BL (age 13-18). Low diastolic blood pressure: \< 45 and ↓ of 12 mm Hg from BL (age 5-12), \< 55 and ↓ of 12 mm Hg from BL (age 13-18), \< 50 and ↓ of 15 mm Hg from BL; high diastolic blood pressure: \> 85 and ↑ of 12 mm Hg from BL (ages 5-18). Low heart rate: \< 80 and and ↓ of 30 beats per minute (bpm) from BL (age 5-12), \< 60 and and ↓ of 30 bpm from BL (age 13-18), \< 50 and and ↓ of 15 bpm from BL (age \> 18); high heart rate: \> 120 and ↑ of 30 bpm from BL (age 5-12), \> 100 and ↑ of 30 bpm from BL (age 13-18), \> 100 and ↑ of 15 bpm from BL (age \> 18). Low oral body temperature: \< 35.8° Celsius (age 5 to \>18); high oral body temperature: \> 38.1° C and ↑ 2° Celsius from BL (age 5-18).

Number of Participants With Newly Diagnosed Physical Examination Abnormalities at Endpoint
From start of study drug until end of treatment (mean [SD] duration of treatment was 30.0 [5.89] months)

HEENT=head, eyes, ears, nose and throat.

Infusion Site Evaluations
Day 0, Weeks 4, 8, 12, 16, endpoint (last visit), any time during study (mean [SD] duration of treatment was 30.0 [5.89] months)

The infusion site was assessed before treatment and within 30 minutes after the end of the infusion at each monthly treatment visit (or at early withdrawal if before Week 16). The infusion site was graded according to a 5-point scale as follows: 0=no tenderness at IV site, no erythema, no swelling, no induration, no purulence, no palpable venous cord; 1=tender IV site, no erythema, no swelling, no induration, no purulence, no palpable venous cord; 2=tender IV site with erythema, some degree of swelling, no induration, no purulence, no palpable venous cord; 3=tender IV site with erythema and swelling, with induration or palpable venous cord, no purulence; 4=frank vein thrombosis, along with all signs of grade 3 with purulence; IV may stop running because of thrombosis. After the 16-week visit, formal infusion site evaluations were not continued. However, any infusion site reactions were recorded as adverse events and graded as other adverse events.

Therapeutic Classification of Concomitant Medications in at Least 10% of Participants
From start of study drug until end of treatment (mean [SD] duration of treatment was 30.0 [5.89] months)

Number of participants receiving therapeutic classes of concomitant medications.

Number of Participants With Reduction In Daily Oral Corticosteroid (OCS) Dose During Weeks 20-24 As Compared to the Optimized Dose At Baseline
Baseline (Day 1), Weeks 20-24

The primary endpoint was the 5-level categorized percent reduction in OCS dose during weeks 20 to 24 compared with the optimized dose at baseline. The primary analysis incorporated data from all randomized patients. Analysis of the primary and secondary variables related to categorical OCS dose reduction incorporated missing data as non-responders. No decrease indicates there was no decrease in OCS, loss of baseline asthma control during weeks 20 to 24, or discontinuation from study drug.

Number of Clinical Asthma Exacerbations (CAEs) During 52 Weeks of Treatment
Day 1 to Week 52

A CAE was defined as a clinically-judged deterioration in asthma control, as determined by the investigator and as evidenced by new or worsening asthma signs or symptoms based on the participant's history, asthma control diary, physical examination, and/or ambulatory or clinic visit assessment of lung function and that resulted in a medical intervention, including at least 1 of the following: 1) use of systemic corticosteroids (oral or injection) or at least a doubling from a stable maintenance oral corticosteroid dose for at least 3 days; 2) asthma-specific hospital admission; 3) asthma-specific emergency department visit. Adjusted CAE rate and confidence intervals were based on Negative Binomial regression model adjusted for stratification factors. Results are presented as adjusted means. For this analysis, the offset variable is calculated as the logarithm of treatment duration minus the summed duration of exacerbations during the treatment period.

Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) at Week 16 in Full Analysis Set
Baseline (Day 1), Week 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma. It is the volume of air expired in the first second of a forced expiration. Improvement in FEV1 is a measure in the reduction of bronchospasm, the reduction of airway inflammation, or both. FEV1 was measured using forced expiratory air spirometry. Data represent the slope estimate of change from baseline in FEV1 (measured in liters) at Week 16 versus baseline eosinophil count (measured in 10\^9/liter) by treatment group.

Frequency of Clinical Asthma Exacerbations (CAEs) During 12 Months of Treatment
Day 1 to Week 52

An exacerbation event was considered a CAE if the patient met either or both of the criteria listed below and this was corroborated with at least 1 other measurement to indicate the worsening of clinical signs and symptoms of asthma: * use of systemic, or an increase in the use of inhaled, corticosteroid treatment for 3 or more days; or an increased 2 or more fold for at least 3 or more days for patient's already on corticosteroids. * asthma-related emergency treatment, such as an unscheduled visit to the physician's office or emergency room for nebulizer treatment or other urgent treatment to prevent worsening of asthma symptoms, or an asthma-related hospitalization CAEs were adjudicated by committee to assure consistency. Adjusted CAE rate and confidence intervals were based on Negative Binomial regression model adjusted for stratification factors. Results are offered as adjusted means.

Frequency of Each of the Two Criteria for Clinical Asthma Exacerbations (CAEs)
Day 1 to Week 52

An exacerbation event was considered a CAE if the patient met either or both of the criteria listed below and this was corroborated with at least 1 other measurement to indicate the worsening of clinical signs and symptoms of asthma: * use of systemic, or an increase in the use of inhaled, corticosteroid treatment for 3 or more days; or an increased 2 or more fold for at least 3 or more days for patient's already on corticosteroids. * asthma-related emergency treatment, such as an unscheduled visit to the physician's office or emergency room for nebulizer treatment or other urgent treatment to prevent worsening of asthma symptoms, or an asthma-related hospitalization. CAEs were adjudicated by committee to assure consistency. Adjusted CAE rate and confidence intervals for the two criteria were based on Negative Binomial regression model adjusted for stratification factors. Results are offered as adjusted means.

Change From Baseline In Forced Expiratory Volume In 1 Second (FEV1) Over 16 Weeks Using Mixed Model for Repeated Measures
Day 0 (baseline, pre-dose), Weeks 4, 8, 12 and 16

FEV1 is a standard measurement of air movement in the lungs of patients with asthma obtained from pulmonary function tests. It is the volume of air expired in the first second of a forced expiration using a spirometer. The during treatment (weeks 4, 8, 12 and 16) average FEV1 was estimated using a mixed-effect model for repeated measures (MMRM) with fixed effects (treatment, stratification factors, sex, visit, interaction of treatment and visit), covariates (height, baseline value), and patient as the random effect for the repeated measurements. Positive change from baseline scores indicate improvement in asthma control.

Change from baseline in Asthma Control Test score (ACT)
Baseline and 24 weeks

Change in Asthma Control Test score (ACT) between baseline and week 24.

Sputum eosinophil percentage
Measured before the placebo phase (week 2), after 2 infusions of placebo (week 10), and after 4 infusions (week 26) of reslizumab 3mg/kg

Change in sputum eosinophil %

Blood eosinophil absolute number
Measured before the placebo phase (week 2), after 2 infusions of placebo (week 10), and after 4 infusions/4 months (week 26) of reslizumab 3mg/kg

Change in blood eosinophil absolute number

Mean Change From Baseline to End of Therapy in Asthma Control Questionnaire (ACQ) Score
Baseline through End of Therapy (up to 15 weeks)

The ACQ is a 7 question instrument. Each question has 7 possible answers of 0, 1, 2, 3, 4, 5, and 6. Each increasing value is an indication of poorer asthma control. At protocol specified visits, the participant answered questions 1 to 6, circling the response that best described how that participant was during the past week, on the basis of a daily diary for the week before the visit. At the actual visit, study center personnel reviewed the questions and responses with the participant and determined the response and score for question 7. The overall ACQ score was presented as the mean of these 7 individual scores and was a number between 0 and 6, but not necessarily an integer.

Mean Percent Change From Baseline to End of Treatment in Peak Esophageal Eosinophil (EE) Levels
Baseline, End of Treatment (up to 15 weeks [+/- 4 days])

Participants underwent esophagogastroduodenoscopy (EGD) with biopsy (2 biopsies each at proximal and distal esophageal locations, plus any inflamed or abnormal areas) per standard clinical practice for the determination of esophageal eosinophils.

Mean Change From Baseline in Physician's Esophageal Eosinophil (EE) Global Assessment At The End-of-Treatment Visit (or at Early Withdrawal)
Baseline (Day 1, pre-treatment), End of Treatment (Week 15, 3 weeks [± 4 days] after the last dose of study drug, or at early withdrawal)

The investigator completed the Physician's EE Global Assessment based upon the participant's reporting of symptoms, weight, dietary status, and overall well-being. The assessment rated severity on a five-point scale (0=none to 4=very severe), taking into account physical findings, vital signs, the Subject's Predominant EE Symptom Assessment, the subject's diary data, and dietary questions. The Subject's Predominant EE Symptom was the EE symptom (vomiting/regurgitation, abdominal/chest pain, or dysphagia) that had the greatest negative impact on the subject based on patient diary data as of the baseline visit. The full range for change from baseline values is -4 (very severe at baseline, none at end of study) to 4 (none at baseline, severe at end of study). Negative change from baseline scores in the Physician's EE Global Assessment indicate improvement in EE status.

Absolute bioavailability
From baseline to Day 140

Absolute bioavailability calculated as (AUC0-∞)sc/(AUC0-∞)

Secondary Endpoints

Mean Change From Baseline to Endpoint in Peak Esophageal Eosinophil Counts
Baseline, Week 16 or early withdrawal (if before Week 16)
Participant's EoE Predominant Symptoms Over Time
Every 3 weeks from Day 0 up to Week 42 (mean [SD] duration of treatment was 30.0 [5.89] months)
Physician's EoE Global Assessment Over Time
Every 3 weeks from Day 0 up to Week 42 (mean [SD] duration of treatment was 30.0 [5.89] months)
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Open-Label ReslizumabOTHEROpen-label reslizumab intravenous (IV) infusion at an initial dose of 1 mg/kg monthly
Reslizumab 110 mgEXPERIMENTALReslizumab was administered by subcutaneous injection (sc) in a dosage of 110 mg (1.0 mL) every 4 weeks for a total of six doses.
PlaceboPLACEBO_COMPARATORMatching placebo was administered by subcutaneous injection (sc) 1.0 mL every 4 weeks for a total of six doses.
ReslizumabEXPERIMENTALReslizumab
Reslizumab 3.0 mg/kgEXPERIMENTALReslizumab intravenous injection at a dosage of 3.0 mg/kg every 4 weeks for a total of 4 doses.
Reslizumab - 0.3 mg/kgEXPERIMENTAL0.3 mg/kg, administered intravenously (iv) once every 4 weeks, for a total of 4 doses
Reslizumab - 3.0 mg/kgEXPERIMENTAL3.0 mg/kg, administered intravenously (iv) once every 4 weeks, for a total of 4 doses.
Study participantsEXPERIMENTALAll study participants will receive 2 monthly doses of placebo followed by 4 monthly doses of IV reslizumab 3mg/kg
Reslizumab 3 mg/kgEXPERIMENTALReslizumab 3 mg/kg intravenous (IV) on Day 0 of each 28-day (+/- 7 days) cycle, for 4 cycles
Reslizumab 1 mg/kgEXPERIMENTALreslizumab 1 mg/kg intravenous (IV) on Day 0 of each 28-day (+/-7 days) cycle, for up to 4 cycles
Reslizumab 2 mg/kgEXPERIMENTALreslizumab 2 mg/kg IV on Day 0 of each 28-day (+/-7 days) cycle, for up to 4 cycles
Reslizumab IVEXPERIMENTALReslizumab 220-mg administered Intravenously (IV)
Reslizumab SCEXPERIMENTALReslizumab 220-mg administered Subcutaneously (SC)

Interventions

NameTypeDescription
reslizumabDRUG -
PlaceboDRUGPlacebo was administered by qualified study personnel as subcutaneous injections in the upper arm(s) once every 4 weeks for a total of 6 doses. Drug was supplied in pre-filled syringes.
Non-Oral Corticosteroid (non-OCS) Asthma MedicationDRUGParticipants continue using their non-OCS background asthma medications without change during the study's treatment period.
Oral Corticosteroid (OCS)DRUGAfter screening and prior to study start, the participant's OCS dose was adjusted to determine the minimal effective OCS requirement.
SalineOTHER -
Reslizumab IVDRUGReslizumab 220-mg intravenous (IV)
Reslizumab SCDRUGReslizumab 220 mg administered subcutaneous (SC)
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Eligibility Criteria

Age Range5 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites36

Inclusion Criteria: * Informed consent * Received at least two doses of study drug in Study Res-05-0002 (NCT00538434) * Did not withdraw from Study Res-05-0002 due to drug related adverse event * Completed End of Treatment Visit for Study Res-05-0002 Exclusion Criteria: * Pregnant or nursing fema...

Countries:United StatesCanadaArgentinaAustraliaBelgiumCzechiaFranceGermanyHungaryIsraelItalyMexicoNetherlandsPolandRussiaSouth KoreaSpainUkraineJapanNew ZealandRomaniaSouth AfricaTurkey (Türkiye)ChileColombiaDenmarkMalaysiaPhilippinesSwedenThailandBrazilGreecePeruSlovakiaTaiwan
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Frequently asked questions about Reslizumab

What is Reslizumab used for?

Reslizumab is an investigational drug being studied for use in eosinophilic asthma and related conditions. Clinical trials have evaluated it in patients with eosinophilic asthma, severe persistent asthma, severe asthma, and eosinophilic bronchitis. It has also been studied in healthy subjects for absolute bioavailability. Reslizumab is not FDA approved and remains in clinical development.

What does Reslizumab target?

Reslizumab is an anti-interleukin-5 (IL-5) monoclonal antibody. It targets IL-5, a cytokine involved in the growth and activation of eosinophils, which are white blood cells implicated in eosinophilic asthma. By binding to IL-5, Reslizumab aims to reduce eosinophilic inflammation.

Who makes Reslizumab?

Reslizumab is developed by Teva Pharmaceutical Industries Limited, which trades on the New York Stock Exchange under the ticker TEVA. Teva is conducting clinical trials to evaluate the safety and efficacy of Reslizumab in patients with eosinophilic asthma and other eosinophilic conditions.

What phase is Reslizumab in?

Reslizumab is in Phase 1 clinical development. While some completed trials were Phase 2 and Phase 3, the current development stage is Phase 1. Reslizumab is investigational and has not been approved by the FDA. All four clinical trials listed for Reslizumab are completed.

What clinical trials is Reslizumab in?

Reslizumab has been studied in four completed clinical trials. NCT01285323 was a Phase 3 study in 464 patients with eosinophilic asthma. NCT01990443 was a Phase 1 bioavailability study in 75 healthy subjects. NCT02559791 was a Phase 2 study in 10 patients with prednisone-dependent eosinophilic asthma. NCT03074942 was a Phase 2 study in 30 patients with severe asthma who failed omalizumab.

Is Reslizumab the same as Cinqair?

Reslizumab is also known by the brand name Cinqair in some markets. Cinqair is the trade name for reslizumab, an anti-IL-5 monoclonal antibody. The drug is being developed by Teva Pharmaceutical Industries for eosinophilic asthma and related conditions.