Tokyo, Dec. 1 -- UMIN Clinical Trials Registry (UMIN-CTR) received information related to the study (UMIN000059913) titled 'Efficacy and safety of short-course corticosteroid treatment with biologics for difficult-to-treat allergic bronchopulmonary aspergillosis complicating asthma' on Dec. 1.
Study Type:
Interventional
Study Design:
Basic Design - Parallel
Randomization - Randomized
Blinding - Open -no one is blinded
Control - Active
Primary Sponsor:
Institute - Tokai University
Condition:
Condition - Allergic bronchopulmonary aspergillosis complicating asthma
Classification by malignancy - Others
Genomic information - NO
Objective:
Narrative objectives1 - The standard treatment for acute allergic bronchopulmonary aspergillosis (ABPA) consists of 4-6 months of oral corticosteroid therapy. Although the initial therapeutic response is generally favorable, tapering or discontinuation of treatment is often difficult, resulting in high treatment failure rate. In this study, acute ABPA will be stratified into refractory and mild cases using the difficult-to-treat ABPA score developed by the investigators. The primary objective is to evaluate the efficacy and safety of short-course corticosteroid therapy combined with biologics (anti-IL-5 antibody/anti-TSLP antibody) in refractory ABPA cases through a multicenter randomized controlled trial.
Basic objectives2 - Safety,Efficacy
Intervention:
Interventions/Control_1 - Standard corticosteroid treatment
Oral prednisolone administration for 16 weeks.
Interventions/Control_2 - Short-course corticosteroid treatment + anti-IL-5 antibody
Oral prednisolone administration for 10 weeks, combined with mepolizumab (100 mg subcutaneous injection every 4 weeks, administered three times at weeks 2, 6, and 10).
Eligibility:
Age-lower limit - 18
years-old
<=
Age-upper limit - Not applicable
Gender - Male and Female
Key inclusion criteria - 1. Age 18 years or older.
2. Patients receiving treatment for asthma with at least a medium dose of inhaled corticosteroids plus one or more additional long-term controller medications.
3. Fulfillment of 6 or more items of the Asano's diagnostic criteria for ABPA (J Allergy Clin Immunol. 2021;147:1261).
4. Serum Aspergillus fumigatus-specific IgE antibody level 0.35 UA/mL or higher.
5. At the time of initial onset or exacerbation of ABPA.
6. Written informed consent obtained after sufficient explanation, based on the participant's free will.
7. Refractory ABPA score (Allergy. 2025;80:2531) is 2 or more.
Note: If enrollment in Refractory Group 1 fulfilling criteria 1-7 is insufficient, patients who also meet criteria 1-6 and experience an exacerbation of ABPA within six months after standard corticosteroid therapy may be enrolled as Refractory Group 2, with up to five cases permitted in each group. Randomization will be stratified by Refractory Group 1 and Refractory Group 2.
Key exclusion criteria - 1. Systemic corticosteroid administration within the past 1 month.
2. Treatment with immunosuppressive agents other than corticosteroids, antifungal agents (oral or intravenous), or biologics within the past 6 months.
3. Comorbidities precluding oral corticosteroid use (e.g., uncontrolled diabetes mellitus, glaucoma, active peptic ulcer disease, or active infection).
4. History of allergic reaction to mepolizumab (Nucala) or tezepelumab (Tezspire).
5. Currently undergoing treatment for malignancy, or history of treatment within the past year.
6. Severe cardiac disorders (e.g., heart failure, arrhythmia).
7. Any other condition deemed inappropriate by the principal investigator or study physician.
Target Size - 30
Recruitment Status:
Recruitment status - Preinitiation
Date of protocol fixation - 2025 Year 10 Month 30 Day
Date of IRB - 2025 Year 11 Month 05 Day
Anticipated trial start date - 2025 Year 12 Month 01 Day
Last follow-up date - 2030 Year 03 Month 31 Day
To know more, visit https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000068398
Disclaimer: Curated by HT Syndication.