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Seasonal Allergic RhinoconjunctivitisPhase 4SKYNCT02761252

Efficacy of Co-administration of Bilastine and Montelukast in Patients With SARC and Asthma

A Phase 4 study testing Bilastine 20mg and Montelukast 10mg in people with Seasonal Allergic Rhinoconjunctivitis and Asthma, run by Menarini International Operations Luxembourg SA at 32 sites in 8 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to compare concomitant administration of Montelukast and Bilastine to Montelukast and Bilastine monotherapies in patients with SARC and asthma Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Seasonal Allergic Rhinoconjunctivitis, Asthma
What is being tested?
Bilastine 20mg and Montelukast 10mg
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
454 participants
Where
32 sitesin 8 countries
Study dates
13 Apr 2016to 24 Nov 2016
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients aged 18 years or older;
  • Patients with at least 2 years history of SARC prior to the study and mild to moderate asthma (GINA criteria 2 and 3) inadequately controlled on inhaled corticosteroids and in whom "as-needed" short acting beta-agonists provide inadequate clinical control;
  • Forced expiratory volume at one second (FEV1) > 70% of the predicted normal value demonstrable at least 6 hours after last short acting β-2 agonist use or 12 hours after last long acting β-2 agonist (LABA) use;
  • Nasal Symptoms Score (NSS) at baseline ≥ 3. Baseline NSS will be defined as the mean of the 6 last assessments of the patients' diary (3 last days before randomization);
  • Positive results of skin prick test on at least one seasonal allergen within the last 3 years;
  • Patients who provided a signed written informed consent form;
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  • Patients who are able and willing to complete web-based Patient's Diary;
  • Patients who agree to maintain consistency in their surroundings throughout the study period;
  • Women of childbearing potential (WOCBP) including peri-menopausal women who have had a menstrual period within 1 year have to have a negative pregnancy test. Results have to be available until the Visit 2 and negative for the patient to be entered in the study.
  • WOCBP have to use an effective method of birth control throughout the study period and for 4 weeks after study completion (defined as a method which results in a failure rate of less than 1% per year) such as:
  • combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal)
  • progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable)
  • intrauterine device (IUD)
  • intrauterine hormone-releasing system (IUS)
  • bilateral tubal occlusion
  • vasectomised partner (provided that partner is the sole sexual partner of the trial participant and that the vasectomised partner has received medical assessment of the surgical success)
  • sexual abstinence In each case of delayed menstrual period (over one month between menstruations) confirmation of absence of pregnancy is strongly recommended. This recommendation also applies to WOCBP with infrequent or irregular menstrual cycles.

Who cannot join

  • Patients with hypersensitivity to any component of the study medications;
  • Patients with non-allergic rhinoconjunctivitis (e.g. vasomotor, infectious, drug-induced);
  • Presence of nasal polyps or any clinically important nasal anomaly;
  • History of acute and/or chronic sinusitis within 30 days of Visit 2;
  • History of eye surgery within 3 months of Visit 2;
  • History of intranasal surgery within 3 months of Visit 2;
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  • Immunotherapy within 6 months prior to Visit 1;
  • Upper respiratory infections including cold and systemic infections within 3 weeks of Visit 2;
  • Patients with moderate to severe renal impairment and taking P-gp inhibitors (e.g. ketoconazole, erythromycin, cyclosporine, ritonavir, diltiazem) within 7 days prior to the first dose of study medication;
  • Patients requiring daily "controller" medications with cromolyn-type drugs or leukotriene antagonists;
  • Patient required daily "controller" medication with Inhaled corticosteroids (ICS) or LABA at medium /high dosage defined by GINA criteria;
  • Patients with clinically important (based on principal investigator's judgment) hepatic impairment;
  • Patients with severe concomitant disease (based on principal investigator's judgment) that could interfere with treatment response;
  • Patients with QT syndrome;
  • Patients with Galactose intolerance, Lapp lactase deficiency or glucose- galactose malabsorption;
  • Pregnant or breast-feeding women;
  • Patients with a mental condition rendering the subject unable to understand the nature, scope and possible consequences of the study (based on principal investigator's judgment);
  • Patients who had a recent history (within previous 12 months) of drug addiction or alcohol abuse based on Principal investigator's judgment ;
  • Patients participating in or having participated in another clinical trial within the previous three months;
  • Patients unable to take relief medications due to contraindications or intolerance;
  • Patients who are taking or have taken any of the following medications prior to randomisation in the study and have not complied with the specified washout period:
  • Antihistaminic drugs or montelukast (7 days)
  • Systemic or intranasal corticosteroids (4 weeks)
  • Delayed-release corticosteroids (3 months)
  • Ketotifen (2 weeks)
  • Macrolides antibiotics and imidazolic antifungals (systemic)(7 days)
  • Anticholinergics (7 days)
  • Drugs with antihistamine properties (phenothiazine) (7 days)
  • Intranasal and systemic decongestants (3 days)
  • Lodoxamide (7 days)
  • Patients who will be operating heavy machinery or need to drive motor vehicles as an essential part of their profession.
  • Patients who are planning to travel outside the study area during the course of the study.

Trial locations and contacts

32 sites in 8 countries.

32 sites in 8 countries

Poland12 sites
  • Study site

    Bialystok

  • Study site

    Bielsko-Biala

  • Study site

    Gdansk

  • Study site

    Katowice

  • Study site

    Krakow

  • Study site

    Lodz

  • Study site

    Lublin

  • Study site

    Nowy Duninów

  • Study site

    Poznan

  • Study site

    Rzeszów

  • Study site

    Tarnów

  • Study site

    Wroclaw

Other trials in Poland

Italy5 sites
  • Study site

    Catania

  • Study site

    Florence

  • Study site

    Modena

  • Study site

    Pavia

  • Study site

    Verona

Other trials in Italy

Romania4 sites
  • Study site

    Brasov

  • Study site

    Bucharest

  • Study site

    Cluj-Napoca

  • Study site

    Ploieşti

Other trials in Romania

Croatia3 sites
  • Study site

    Čakovec

  • Study site

    Rijeka

  • Study site

    Zagreb

Other trials in Croatia

Czechia3 sites
  • Study site

    Brno

  • Study site

    Ostrava Hrabuvka

  • Study site

    Teplice

Other trials in Czechia

Germany2 sites
  • Study site

    Dreieich

  • Study site

    Heidelberg

Other trials in Germany

Slovakia2 sites
  • Study site

    Bardejov

  • Study site

    Levice

Other trials in Slovakia

Latvia1 site
  • Study site

    Riga

Other trials in Latvia

About this study

Official title: Bilastine and Montelukast in Patients With Seasonal Allergic Rhinoconjunctivitis and Asthma: Efficacy of Concomitant Administration - the SKY Study

The purpose of this study is to compare concomitant administration of Montelukast and Bilastine to Montelukast and Bilastine monotherapies in patients with SARC and asthma

Read the detailed description

The present study (SKY) was designed to show if once daily oral combination therapy with Montelukast 10 mg and Bilastine 20 mg is superior to monotherapy with Bilastine 20 mg in patients with Seasonal Allergic RhinoConjunctivitis (SARC) and comorbid mild to moderate asthma on total symptom scores (TSS) and if the combination therapy reflects an improvement in quality of life as assessed via the Asthma Quality of Life Questionnaire (AQLQ) over a longer time period when compared to monotherapies with Montelukast 10 mg and Bilastine 20 mg. Mild to moderate asthma was defined according to the criteria of the Global Initiative for Asthma, i.e., GINA criteria 2 and 3 (GINA, 2012). The study population included patients inadequately controlled on inhaled corticosteroids and in whom "as-needed" short acting beta-agonists provided inadequate clinical control.

Being tested
Bilastine 20mg, Montelukast 10mg, Placebo Bilastine 20mg, Placebo Montelukast 10mg
Keywords
Bilastine, Montelukast, total symptom score, AQLQ
Medical subject headings
Asthma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Bilastine 20mgDrug

    Also called Robilas

  • Montelukast 10mgDrug

    Also called Montelukast

  • Placebo Bilastine 20mgDrug

    Also called Placebo Bilastine

  • Placebo Montelukast 10mgDrug

    Also called Placebo Montelukast

Study groups in NCT02761252
Study groupRoleWhat they receive
Bilastine+montelukastExperimentalBilastine 20 mg, 10 blister containing 10 tablets + Montelukast 10 mg, 10 blister containing 10 film coated tablets each for treatment
Receives: Drug: Bilastine 20mg; Drug: Montelukast 10mg
Bilastine+placebo montelukastActive comparatorBilastine 20 mg, 10 blister containing 10 tablets + Placebo Montelukast, 10 blister containing 10 film coated tablets each.
Receives: Drug: Bilastine 20mg; Drug: Placebo Montelukast 10mg
Montelukast+placebo bilastineActive comparatorPlacebo Bilastine, 10 blister containing 10 tablets + Montelukast 10 mg, 10 blister containing 10 film coated tablets each.
Receives: Drug: Montelukast 10mg; Drug: Placebo Bilastine 20mg

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline With Montelukast+Bilastine Compared With Bilastine Monotherapy in SARC Symptoms

    To demonstrate that concomitant administration of montelukast and bilastine is superior to bilastine monotherapy in SARC symptoms, as assessed by Total Symptoms Scores (TSS) after 4 weeks of treatment.

    Total Symptoms Scores (TSS) assesses nasal (nasal congestion, rhinorrhea, nasal itching, sneezing) and non nasal symptoms (ocular redness, ocular itching, tearing) of rhinoconjuctivits.

    Each of the 7 symptoms is scored from 0 (absent) to 3 (severe) as follows:

    • 0 (absent) Symptom not present
    • 1 (mild) Symptom is clearly present but easily tolerated, a nuisance, minimal awareness
    • 2 (moderate) Symptom is bothersome but tolerable, does not interfere with daily activities or sleep
    • 3 (severe) Symptom is hard to tolerate and interferes with daily activities or sleep.

    TSS assessment comprises of scoring (0-3) of all 7 above mentioned symptoms. Final TSS scores is in a range from 0-21.

    Measured: 4 weeks of treatment (from baseline to 4 weeks of treatment)

Secondary outcomes (5)
  1. Change From Baseline With Montelukast+Bilastine Compared With Montelukast and Bilastine Monotherapies in Asthma Control

    To evaluate the efficacy of concomitant montelukast and bilastine compared with montelukast and bilastine monotherapies in asthma control, as assessed by Asthma Quality of Life Questionnaire (AQLQ) after 4 weeks.

    The AQLQ was developed to measure the functional problems (physical, emotional, social and occupational) that are most troublesome to adults (17-70 years) with asthma.

    Each of the 32 questionnaire's items will be scored on a 7-point scale (where 7 means "not impaired at all" and 1 means "severely impaired"). The overall AQLQ score is the mean of all 32 responses (https://www.qoltech.co.uk/aqlq.html).

    The change in AQLQ score from baseline to 4 weeks after treatment - AQLQ score at baseline for patients with both available values has been the secondary endpoint.

    Measured: After 4 weeks of treatments

  2. Change From Baseline With Montelukast+Bilastine Compared With Montelukast and Bilastine Monotherapies in SARC Symptoms (DNSS)

    To evaluate the efficacy of concomitant montelukast and bilastine compared with montelukast and bilastine monotherapies in daytime symptoms of SARC, as assessed by Daytime Nasal Symptom Score (DNSS) after 4 weeks of treatment.

    Daytime Nasal Symptom Score (DNSS) is the average of individual scores of nasal congestion, rhinorrhea, nasal itching, sneezing of rhinoconjuctivits.

    Each of the 4 symptoms is scored from 0 (absent) to 3 (severe) as follows:

    • 0 (absent) Symptom not present
    • 1 (mild) Symptom is clearly present but easily tolerated, a nuisance, minimal awareness
    • 2 (moderate) Symptom is bothersome but tolerable, does not interfere with daily activities or sleep
    • 3 (severe) Symptom is hard to tolerate and interferes with daily activities or sleep.

    DNSS assessment comprises of scoring (0-3) of all 4 above mentioned symptoms. Final DNSS scores is in a range from 0-12.

    Measured: After 4 weeks of treatment (from baseline)

  3. Change From Baseline With Montelukast + Bilastine Compared With Montelukast and Bilastine Monotherapies in SARC Symptoms (DNNSS)

    To evaluate the efficacy of concomitant montelukast and bilastine compared with montelukast and bilastine monotherapies in daytime symptoms of SARC, as assessed by Daytime Non Nasal Symptom Score (DNNSS) after 4 weeks of treatment.

    Daytime Non Nasal Symptom Score (DNSS) is the average of individual scores of ocular redness, ocular itching and tearing of rhinoconjuctivits.

    Each of the 3 symptoms is scored from 0 (absent) to 3 (severe) as follows:

    • 0 (absent) Symptom not present
    • 1 (mild) Symptom is clearly present but easily tolerated, a nuisance, minimal awareness
    • 2 (moderate) Symptom is bothersome but tolerable, does not interfere with daily activities or sleep
    • 3 (severe) Symptom is hard to tolerate and interferes with daily activities or sleep.

    DNNSS assessment comprises of scoring (0-3) of all 3 above mentioned symptoms. Final DNNSS scores is in a range from 0-9.

    Measured: After 4 weeks of treatment (from baseline)

  4. Usage of Relief Medication for SARC

    Number of days without any relief medication for SARC

    Measured: From baseline to 4 weeks of treatment

  5. Usage of Relief Medication for Asthma

    Number of days without any relief medication for Asthma.

    Measured: From baseline to 4 weeks of treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 May 2016 (estimated)
  2. Study start13 Apr 2016
  3. Primary completion24 Nov 2016
  4. Study completion24 Nov 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
The study was a randomised (1:1:1), double-blind, double-dummy, interventional, active-controlled, parallel groups (three groups), multi-centre, multi-national, superiority clinical trial. The study plan included a 7-day (± 4) run-in period to ensure wash-out from previous forbidden treatments and to perform the tests required to ensure appropriate patient enrolment into the study. The active treatment period was 12 weeks (85 days) with a follow-up visit (phone call) at 28 days (± 4) after the End of Treatment.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
454 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02761252
Sponsor's protocol ID
MEIN/15/Bil-ARC/001
Other IDs
2015-004806-40, 2015
Acronym
SKY
Status last verified
Apr 2019
First submitted
28 Apr 2016
Last updated
12 Jul 2019
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Bilastine 20mg and Montelukast 10mg in people with Seasonal Allergic Rhinoconjunctivitis and Asthma, run by Menarini International Operations Luxembourg SA at 32 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 32 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Jul 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 32 sites in Poland, Italy, Romania, Croatia, Czechia and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 12 Jul 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline With Montelukast+Bilastine Compared With Bilastine Monotherapy in SARC Symptoms (time frame: 4 weeks of treatment (from baseline to 4 weeks of treatment)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jul 2019.

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