A Phase 4, Randomized, Double-blind, Placebo-controlled,Multicenter, Parallel-group Study of the Effect of Dupilumab on Sleep Disturbance in Patients With Uncontrolled Persistent Asthma (MORPHEO)

• ClinicalTrials.gov Identifier: NCT04502862
• Recruitment Status: Completed
• First Posted: August 6, 2020
• Last Update Posted: January 26, 2024
• Sponsor: Sanofi
• Collaborator: Regeneron Pharmaceuticals
• Information provided by (Responsible Party): Sanofi

Tracking Information

• First Submitted Date: August 4, 2020
• First Posted Date: August 6, 2020
• Last Update Posted Date: January 26, 2024
• Actual Study Start Date: August 10, 2020
• Actual Primary Completion Date: October 3, 2023 (Final data collection date for primary outcome measure)

Current Primary Outcome Measures (submitted: August 4, 2020)

Change in sleep disturbance score in Asthma Sleep Disturbance Questionnaire [ Time Frame: Baseline to Week 12 ]

Change from baseline to Week 12 in sleep disturbance score using the Asthma Sleep Disturbance Questionnaire

• Original Primary Outcome Measures: Same as current

Current Secondary Outcome Measures (submitted: August 4, 2020)

• Change in the number of nocturnal awakenings in Sleep Diary [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in the number of nocturnal awakenings as recorded in Sleep Diary
• Change in PROMIS sleep-related impairment assessment [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in Patient-Reported Outcomes Measurement Information System (PROMIS) sleep-related impairment 8a scale
• Change in sleep quality in Sleep Diary [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in sleep quality (Sleep Diary)
• Change in restorative sleep in Sleep Diary [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in restorative sleep (Sleep Diary)
• Change in WASO in Sleep Diary [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in wake after sleep onset (WASO) (Sleep Diary)
• Change in WASO (actigraphy data) [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in WASO based on actigraphy data
• Change in daytime and nighttime asthma symptoms in Asthma Daytime Symptom Diary (ADSD) and Asthma Nighttime Symptom Diary (ANSD) [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in Asthma Daytime Symptom Diary (ADSD) and Asthma Nighttime Symptom Diary (ANSD)
• Change in pre-bronchodilator (BD) FEV1 [ Time Frame: Baseline to Week 12 ]
  Change from baseline to Week 12 in prebronchodilator forced expiratory volume in 1 second (pre-BD FEV1)
• Incidence of adverse events [ Time Frame: Baseline up to Week 24 ]
  Incidence of treatment-emergent adverse events (TEAEs), serious adverse events (SAEs) and adverse events of special interest (AESI), including clinically significant changes in vital signs considered to be adverse events

• Original Secondary Outcome Measures: Same as current
• Current Other Pre-specified Outcome Measures: Not Provided
• Original Other Pre-specified Outcome Measures: Not Provided

Descriptive Information

• Brief Title: A Phase 4, Randomized, Double-blind, Placebo-controlled,Multicenter, Parallel-group Study of the Effect of Dupilumab on Sleep Disturbance in Patients With Uncontrolled Persistent Asthma
• Official Title: A Phase 4, Randomized, Double-blind, Placebo-controlled, Multicenter, Parallel-group Study of the Effect of Dupilumab on Sleep Disturbance in Patients With Uncontrolled Persistent Asthma

Brief Summary

Primary Objective:

To assess the effect of dupilumab on sleep

Secondary Objectives:

• To evaluate the effect of dupilumab on additional patient reported sleep outcomes
• To evaluate the effect of dupilumab on objective sleep assessment
• To evaluate the effect of dupilumab on asthma symptoms
• To evaluate the effect of dupilumab on lung function
• To evaluate the safety of dupilumab

• Detailed Description: Study duration per participant will be approximately 16 weeks and up to 29 weeks including up to 5 weeks screening period, a 12-week treatment period and up to 12 weeks post-treatment follow-up period or until the participant switches to commercialized dupilumab (or other biologic product), whichever comes first.
• Study Type: Interventional
• Study Phase: Phase 4

Study Design

Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:

Interim analysis for sample size re-estimation

Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment

• Condition: Asthma

Intervention

• Drug: SAR231893
  Pharmaceutical form: Solution for injection; Route of administration: Subcutaneous
  Other Name: Dupixent
• Drug: Placebo
  Pharmaceutical form: Solution for injection; Route of administration: Subcutaneous

Study Arms

• Experimental: Dupilumab
  2 x dupilumab injections as loading dose on Day 1, followed by 1 dupilumab maintenance dose injection every 2 weeks (Q2W) during 12 weeks
  Intervention: Drug: SAR231893
• Placebo Comparator: Placebo
  2 x placebo injections on Day 1, then 1 placebo injection Q2W during 12 weeks
  Intervention: Drug: Placebo

• Publications *: Not Provided

Recruitment Information

• Recruitment Status: Completed
• Actual Enrollment (submitted: August 23, 2023): 202
• Original Estimated Enrollment (submitted: August 4, 2020): 260
• Actual Study Completion Date: November 10, 2023
• Actual Primary Completion Date: October 3, 2023 (Final data collection date for primary outcome measure)

Eligibility Criteria

Inclusion Criteria:

• Physician diagnosis of asthma based on the Global Initiative for Asthma (GINA) 2020 Guidelines for ≥12 months treated with medium to high dose inhaled corticosteroid (ICS) and a second controller (ie, long-acting beta agonist, leukotriene receptor antagonist). A third controller is allowed but not mandatory. The dose regimen should be stable for at least 1 month before the study and during the screening period
• History of at least one severe asthma exacerbation within 1 year prior to screening. Severe exacerbation is defined as deterioration of asthma that results in emergency treatment, hospitalization due to asthma, or treatment with systemic steroids (oral or injectable)

• Eosinophils ≥150 cells/μL and fractional exhaled nitric oxide (FeNO) ≥25 ppb during screening, prior to randomization

  • NOTES:
  • Historical values of blood eosinophil count meeting the eligibility criterion measured within 6 months prior to screening Visit 1 in the absence of oral corticosteroid (OCS) treatment are allowed
  • FeNO value to be checked for eligibility at Visit 2 as well
• Asthma control questionnaire (ACQ)-5 ≥2.5 at screening Visit 1 and Visit 2, prior to randomization
• Pre-bronchodilator Forced Expiratory Volume in 1 Second (FEV1) ≤ 80% of predicted normal during screening, prior to randomization
• Exhibit bronchodilator reversibility (≥12% and 200 mL improvement in FEV1 post short-acting beta agonist administration) during screening period, prior to randomization, unless reversibility test meeting the inclusion criteria was done within 6 months prior to screening Visit 1
• Weekly average nocturnal awakenings due to asthma symptoms in the week prior to screening Visit 1 is ≥1

Exclusion Criteria:

• Current smoker
• Former smoker for 10 years with a smoking history of >10 pack-years
• Severe asthma exacerbation during screening, prior to randomization
• History or clinical evidence of chronic obstructive pulmonary disease (COPD) including Asthma-COPD Overlap Syndrome (ACOS) or any other significant lung disease (eg, lung fibrosis, sarcoidosis, interstitial lung disease, pulmonary hypertension, bronchiectasis, Churg-Strauss Syndrome)
• History of or current evidence of clinically significant non-respiratory diseases that in the opinion of the investigator may interfere with the aims of the study or put the participant at undue risk
• Active tuberculosis (TB) or non-tuberculous mycobacterial infection, or a history of incompletely treated TB will be excluded unless it is well documented by a specialist that the participant has been adequately treated and can now start treatment with a biologic agent, in the medical judgment of the Investigator and/or infectious disease specialist. Tuberculosis testing would be performed on a country by country basis, according to local guidelines if required by Regulatory Authorities or ethics boards
• Diagnosed active endoparasitic infection; suspected or high risk of endoparasitic infection, unless clinical and (if necessary) laboratory assessment have ruled out active infection before randomization
• History of human immunodeficiency (HIV) infection or positive HIV test at screening Visit 1
• Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, antiprotozoals, or antifungals within 2 weeks before screening
• Known or suspected immunodeficiency including history of invasive opportunistic infections, despite infection resolution
• Current evidence of clinically significant oncological disease
• History of systemic hypersensitivity or anaphylaxis to any biologic therapy
• Severe uncontrolled depression
• Sleep disturbances not related to asthma, including sleep apnea, hypersomnia, or insomnia secondary to chronic pain, atopic dermatitis (AD), COPD or other conditions
• Participant who works night shift (ie, any work between 8 pm and 6 am)
• Erratic sleep habits, as determined by the Investigator
• Restless leg syndrome or periodic limb movement disorder
• Chronic treatment with oral corticosteroid (OCS) for more than 2 weeks before screening Visit 1
• Participant taking sedative, anxiolytic, or hypnotic treatments, including melatonin, within 3 months before randomization
• Participant taking systemic sedative antihistamines (excluding newer generations of antihistamines) or theophylline
• Current treatment with antidepressants, lipophilic beta blockers, clonidine, opioids, or other medications known to interfere with sleep and may confound the study assessments, as determined by the Investigator
• Participant who has taken biologic therapy (including dupilumab)/systemic immunosuppressant to treat inflammatory disease or autoimmune disease (eg, rheumatoid arthritis, inflammatory bowel disease, primary biliary cirrhosis, systemic lupus erythematosus, multiple sclerosis, etc) within 2 months or 5 half-lives before screening Visit 1, whichever is longer

• Treatment with live (attenuated) vaccine within 4 weeks before screening Visit 1

  • NOTE: For participants who have vaccination with live, attenuated vaccines planned during the course of the study (based on national vaccination schedule/local guidelines), it will be determined, after consultation with a physician, whether the administration of vaccine can be postponed until after the end of the study, (i.e. after the 12 week follow-up period off-treatment or until the participant switches to commercialized dupilumab or other biologic product, whichever comes first), or preponed to before the start of the study without compromising the health of the participant:
  • Participant for whom administration of live (attenuated) vaccine can be safely postponed would be eligible to enroll into the study
  • Participant who have their vaccination preponed can enroll in the study only after a gap of 4 weeks following administration of the vaccine

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Sex/Gender

• Sexes Eligible for Study: All

• Ages: 18 Years to 65 Years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Contacts: Contact information is only displayed when the study is recruiting subjects
• Listed Location Countries: Argentina, Canada, Germany, Italy, Netherlands, Portugal, Russian Federation, Spain, Ukraine, United Kingdom, United States

Administrative Information

• NCT Number: NCT04502862
• Other Study ID Numbers: LPS16677; U1111-1249-6054 ( Registry Identifier: ICTRP ); 2020-001217-20 ( EudraCT Number )
• Has Data Monitoring Committee: No

U.S. FDA-regulated Product

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

IPD Sharing Statement

• Plan to Share IPD: Yes
• Plan Description: Qualified researchers may request access to patient level data and related study documents including the clinical study report, study protocol with any amendments, blank case report form, statistical analysis plan, and dataset specifications. Patient level data will be anonymized and study documents will be redacted to protect the privacy of trial participants. Further details on Sanofi's data sharing criteria, eligible studies, and process for requesting access can be found at: https://vivli.org

• Current Responsible Party: Sanofi
• Original Responsible Party: Same as current
• Current Study Sponsor: Sanofi
• Original Study Sponsor: Same as current
• Collaborators: Regeneron Pharmaceuticals

Investigators

• Study Director: Clinical Sciences & Operations; Sanofi

• PRS Account: Sanofi
• Verification Date: January 2024