Resumen

Objetivo primario: Evaluar la eficacia de itepekimab en comparación con placebo sobre la tasa anualizada de exacerbaciones agudas de EPOC moderadas o graves en ex fumadores con EPOC moderada a grave. Objetivos secundarios: * Evaluar la eficacia de itepekimab en comparación con placebo sobre la función pulmonar en ex fumadores con EPOC moderada a grave. * Evaluar la eficacia de itepekimab en comparación con placebo sobre la ocurrencia de exacerbaciones agudas de EPOC (AECOPD) en ex fumadores con EPOC moderada a grave. * Evaluar la eficacia de itepekimab en comparación con placebo sobre las AECOPD graves en ex fumadores con EPOC moderada a grave. * Evaluar la eficacia de itepekimab en comparación con placebo sobre las AECOPD tratadas con corticosteroides en ex fumadores con EPOC moderada a grave. * Evaluar la eficacia de itepekimab en comparación con placebo sobre los síntomas respiratorios en ex fumadores con EPOC moderada a grave. * Evaluar la eficacia de itepekimab en comparación con placebo sobre la pendiente del Volumen Espiratorio Forzado en 1 segundo (FEV1) en ex fumadores con EPOC moderada a grave. * Evaluar la eficacia de itepekimab en comparación con placebo sobre la calidad de vida relacionada con la salud (CVRdS) evaluada mediante el Cuestionario Respiratorio de St. George (SGRQ) en ex fumadores con EPOC moderada a grave. * Evaluar la seguridad y tolerabilidad de itepekimab en ex fumadores con EPOC moderada a grave. * Evaluar el perfil farmacocinético (PK) de itepekimab en ex fumadores con EPOC moderada a grave. * Evaluar la inmunogenicidad frente a itepekimab en ex fumadores con EPOC moderada a grave.

Descripción detallada

Duración del estudio por participante: * El período de selección es de 3 a 5 semanas. * El período de tratamiento controlado con placebo es de 52 semanas para los primeros aproximadamente 960 participantes aleatorizados, y de 24 a 52 semanas para posibles participantes aleatorizados adicionales. * El período de seguimiento posterior al medicamento en investigación (IMP) es de 20 semanas para los participantes que no pasen al estudio de extensión LTS18133. Nota: Se implementará un estudio de extensión a largo plazo, doble ciego (LTS18133), para permitir que los participantes de este estudio continúen recibiendo el IMP activo durante un período adicional. Solo los participantes que completen su visita de Fin de Tratamiento (EOT) según el protocolo de este estudio serán invitados a participar en el estudio LTS18133.

Elegibilidad

Edad mínima: 40 YearsEdad máxima: 85 YearsSexo: ALL

Criterios de inclusión

Participant must be 40 to 85 years of age inclusive.
Physician diagnosis of COPD for at least 1 year (based on Global Initiative for Chronic Obstructive Lung Disease \[GOLD\] definition).
Smoking history of ≥10 pack-years, but who are not currently smoking, and smoking cessation must have occurred ≥6 months prior to Screening (Visit 1A) with an intention to quit permanently.
Participants with moderate-to-severe COPD
Participant-reported history of signs and symptoms of chronic bronchitis (chronic productive cough for at least 3 months in the year prior to screening in a participant in whom other causes of chronic cough \[eg, inadequately treated gastroesophageal reflux or chronic rhinosinusitis; or clinical diagnosis of bronchiectasis\] has been excluded).
Documented history of high exacerbation risk defined as having had ≥2 moderate or ≥1 severe exacerbations within the year prior to Screening (Visit 1A), with at least 1 exacerbation treated with systemic corticosteroids. At least one exacerbation must have occurred while participants were on their current controller therapy:
Moderate exacerbations will be recorded by the Investigator and are defined as acute worsening of respiratory symptoms that requires either systemic corticosteroids (IM, IV, or oral) and/or antibiotics.
Severe exacerbations will be recorded by the Investigator and are defined as AECOPD that require hospitalization or observation for \>24 hours in emergency department/urgent care facility.
Participants with standard of care controller therapy, for ≥3 months prior to Screening (Visit 1A) and at a stable dose of controller therapy for at least 1 month prior to the screening, including either: inhaled corticosteroid (ICS) + long-acting beta-agonist (LABA), long-acting muscarinic antagonist (LAMA) + LABA or LAMA + LABA + ICS.
Body mass index (BMI) ≥18.0 kg/m\^2, or BMI ≥16.0 kg/m\^2 for participants enrolled in East-Asian countries.
Female participant is not pregnant, not breastfeeding, and at least one of the following conditions applies:
not a women of child-bearing potential (WOCBP) OR
a WOCBP who agrees to follow the contraceptive guidance during the intervention period and for at least 20 weeks after the last dose of study intervention.

Criterios de exclusión

Current diagnosis of asthma according to the Global Initiative for Asthma (GINA) guidelines, or documented history of asthma unless asthma resolved before 18 years of age and has not recurred.
Active smoking or vaping of any products (eg, nicotine, tetrahydrocannabinol \[THC\]) within 6 months prior to Screening (Visit 1A).
Clinically significant new abnormal electrocardiogram (ECG) within 6 months prior to, or at Screening (Visit 1A) that may affect the participant's participation in the study.
Clinically significant and current pulmonary disease other than COPD, eg, sarcoidosis, interstitial lung disease, bronchiectasis (clinical diagnosis), diagnosis of α-1 anti-trypsin deficiency, or another diagnosed pulmonary disease.
Diagnosis of cor pulmonale, evidence of right cardiac failure, or moderate-to-severe pulmonary hypertension.
Hypercapnia requiring bilevel positive airway pressure (BiPAP).
Moderate or severe exacerbation of COPD (AECOPD) within 4 weeks prior to Screening (Visit 1A).
Prior history of / planned: lung pneumonectomy for any reason, or lung volume reduction procedures (including bronchoscopic volume reduction) for COPD. Note: Surgical biopsy, or segmentectomy, or wedge resection, or lobectomy for other diseases would not be excluded.
Unstable ischemic heart disease, including acute myocardial infarction within the past 1 year prior to Screening, or unstable angina in the 6 months prior to Screening (Visit 1A).
Cardiac arrhythmias including paroxysmal (eg, intermittent) atrial fibrillation.
Uncontrolled hypertension (ie, systolic blood pressure \[BP\] \>180 mm Hg or diastolic BP \>110 mm Hg with or without use of anti-hypertensive therapy).
Participants with active tuberculosis (TB), latent TB, a history of incompletely treated TB, suspected extrapulmonary TB infection (TBI), or who are at high risk of contracting TB (such as close contact with individuals with active or latent TB) or received Bacillus Calmette-Guérin (BCG)-vaccination within 12 weeks prior to Screening (Visit 1A).
History of human immunodeficiency virus (HIV) infection or positive HIV 1/2 serology at Screening (Visit 1A).
Suspicion of, or confirmed, coronavirus disease 2019 (COVID-19) infection or in contact with known exposure to COVID-19 at Screening (Visit 1A); known history of COVID-19 infection within 4 weeks prior to Screening (Visit 1A); history of requiring mechanical ventilation or extracorporeal membrane oxygenation (ECMO) secondary to COVID-19 within 3 months prior to sScreening (Visit 1A); participants who have had a COVID-19 infection prior Screening (Visit 1A) who have not yet sufficiently recovered to participate in the procedures of a clinical trial.
Evidence of acute or chronic infection requiring systemic treatment with antibacterial, antiviral, antifungal, antiparasitic, or antiprotozoal medications within 4 weeks before Screening (Visit 1A), significant viral infections within 4 weeks before Screening (Visit 1A) that may not have been treated with antiviral treatment (eg, influenza receiving only symptomatic treatment).
Participants with active autoimmune disease or participants using immunosuppressive therapy for autoimmune disease (eg, rheumatoid arthritis, inflammatory bowel disease, primary biliary cirrhosis, systemic lupus erythematosus, multiple sclerosis.
History of malignancy within 5 years before Screening (Visit 1A), except completely treated in situ carcinoma of the cervix, completely treated and resolved nonmetastatic squamous or basal cell carcinoma of the skin.
Previous use of itepekimab.
The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Ubicaciones

Investigational Site Number : 0320001

CABA, Buenos Aires, Argentina

Investigational Site Number : 0320002

CABA, Buenos Aires, Argentina

Investigational Site Number : 0320005

La Plata, Buenos Aires, Argentina

Investigational Site Number : 0320003

Rosario, Santa Fe Province, Argentina

Investigational Site Number : 0320004

Mendoza, Argentina

Estudio de fase 3, aleatorizado, doble ciego, controlado con placebo, de grupos paralelos, para evaluar la eficacia, seguridad y tolerabilidad de SAR440340/REGN3500/itepekimab (mAb anti-IL-33) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) moderada a grave.