Sanofi: Chronic Rhinosinusitis without Nasal Polyps

To evaluate the efficacy of dupilumab as assessed by the reduction at Week 24 in sinus opacification on CT scan and sinus total symptom score (sTSS) compared to placebo

Inclusion Criteria:

  • Part A only: Participant must be at least 18 years of age at the time of signing the informed consent form (ICF).
  • Part B only: Participant must be at least 12 years of age (or the minimum legal age for adolescents in the country of the investigational site) at the time of signing the ICF.
  • Participants must have bilateral inflammation of paranasal sinuses in CT scan with LMK ≥8 and bilateral ethmoid opacification before randomization.
  • Participants must have ongoing symptoms of loss of smell and rhinorrhea (anterior/posterior) of any severity, with or without facial pain/pressure for at least 12 consecutive weeks by Visit 1.
  • Participants must have ongoing symptoms of nasal congestion (NC)/obstruction at least 12 consecutive weeks before Visit 1 and a NC score of ≥ 2 at Visit 1 (day score) and Visit 2 (weekly average score).
  • Participants must have sTSS (NC, rhinorrhea, facial pain/pressure) ≥5 at Visit 1 (day score) and Visit 2 (weekly average score).
  • Participants must have at least 2 of the following features:
    • Prior sinonasal surgery for CRS,
    • Comorbid asthma,
    • Treatment with SCS therapy within the prior 2 years before screening (Visit 1) or intolerance/contraindication to SCS.
  • For Part B only: participants who have a blood eosinophil count ≥300 cells/mm3 at Screening
  • Body weight ≥30 kg.

Exclusion Criteria:

  • Patients with nasal conditions/concomitant nasal diseases such as nasal polyposis in endoscopy at Visit 1 or with history of nasal polyposis etc., making them non-evaluable at Visit 1 or for the primary efficacy
  • Nasal cavity malignant tumor and benign tumors.
  • Forced expiratory volume (FEV1) ≤50% of predicted normal at Visit 1.
  • Radiologic suspicion or confirmed invasive or expansive fungal rhinosinusitis.
  • Severe concomitant illness(es) that, in the investigator’s judgment, would adversely affect the patient’s participation in the study
  • Active tuberculosis or non-tuberculous mycobacterial infection, or a history of incompletely treated tuberculosis unless documented adequately treated.
  • Diagnosed active endoparasitic infections; suspected or high risk of endoparasitic infection
  • Known or suspected immunodeficiency
  • History of malignancy within 5 years before Visit 1, except completely treated in situ carcinoma of the cervix, and completely treated and resolved nonmetastatic squamous or basal cell carcinoma of the skin.
  • Active chronic or acute infection requiring treatment with systemic antibiotics, antivirals, or antifungals within 2 weeks before the Screening Visit 1 or during the screening period.
  • History of systemic hypersensitivity or anaphylaxis to dupilumab or any of its excipients.
  • Patients in prior dupilumab clinical trial or have been treated with commercially available dupilumab.
  • Patients who are treated with intranasal corticosteroid drops; intranasal steroid emitting devices/stents; nasal spray using exhalation delivery system, such as Xhance™, during screening period.
  • Patients on unstable dose of intranasal corticosteroids (INCS) spray 4 weeks prior to Screening Visit (Visit1) and during screening period.
  • Patients who have undergone sinus intranasal surgery (including polypectomy) within 6 months prior to Visit 1.
  • Patients who have taken:
    • Biologic therapy/systemic immunosuppressant to treat inflammatory disease or autoimmune disease within 5 half-lives prior to Visit 1
    • Any investigational mAb within 5 half-lives prior to Visit 1
    • Anti-IgE therapy (omalizumab) within 4 months prior to Visit 1
  • Treatment with a live (attenuated) vaccine within 4 weeks prior to Visit 1
  • Leukotriene antagonists/modifiers unless patient is on a continuous treatment for at least 30 days prior to Visit 1.
  • Initiation of allergen immunotherapy within 3 months prior to Visit 1 or a plan to begin therapy or change its dose during the screening or treatment period.
  • Patients received SCS during screening period(between Visit 1 and Visit 2).
  • Either intravenous immunoglobulin therapy and/or plasmapheresis within 30 days prior to Screening Visit (Visit 1).

For more information please call 502.893.0159 and ask for Research