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Chronic Obstructive Pulmonary Disease (COPD)Phase 2COURSENCT04039113

Tezepelumab COPD Exacerbation Study

A Phase 2 study testing Tezepelumab in people with Chronic Obstructive Pulmonary Disease (COPD), run by AstraZeneca at 91 sites in 10 countries.

Completed

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

Official record
Search all trials

Trial summary

A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase 2a Study to Explore the Efficacy and Safety of Tezepelumab in Adults with Moderate to Very Severe Chronic Obstructive Pulmonary Disease (COPD) Read more about this study

Who is it for?
Ages 40 to 80 years
What is being tested?
Tezepelumab
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
337 participants
Where
91 sitesin 10 countries
Study dates
30 Jul 2019to 31 Jan 2024
Phase
Phase 2
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 40 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • History of moderate to very severe physician-diagnosed COPD for at least 12 months prior to enrolment with a post-bronchodilator FEV1/FVC<0.70 and a post-bronchodilator FEV1 ≥20% and ≤80% of predicted normal value.
  • History of at least 2 documented moderate to severe COPD exacerbations within 2 to 52 weeks prior to enrollment.
  • CAT score of ≥15 at enrollment and on day of randomization.
  • Documented treatment with triple therapy for COPD (medium or high dose ICS/LABA/LAMA) throughout the year prior to enrollment. The dose of ICS should be stable for 3 months prior to enrollment.

Who cannot join

  • Clinically important pulmonary disease other than COPD, as judged by the Investigator (including current or historic asthma diagnosis).
  • Any disorder, including, but not limited to, cardiovascular, gastrointestinal, hepatic, renal, neurological, musculoskeletal, infectious (including risk factors for pneumonia), endocrine, metabolic, hematological, psychiatric, or major physical impairment that is not stable.
  • Major surgery within 8 weeks before enrollment.
  • History of clinically significant infection requiring antibiotics or antiviral medication within 14 days before enrollment.
  • Pregnant or breastfeeding.
  • The chest/lungs with pathology that precludes the patient's ability to complete the study
  • The patient has active COVID 19 infection during screening period.

Trial locations and contacts

91 sites in 10 countries.

91 sites in 10 countries

United States27 sites
  • Research Site

    Abingdon, Virginia, 24210

  • Research Site

    Albuquerque, New Mexico, 87108

  • Research Site

    Brandon, Florida, 33511

  • Research Site

    Buckley, Michigan, 49620

  • Research Site

    Charlotte, North Carolina, 28277

  • Research Site

    Columbus, Ohio, 43215

  • Research Site

    Dothan, Alabama, 36305

  • Research Site

    Edmond, Oklahoma, 73034

  • Research Site

    Everett, Washington, 98208

  • Research Site

    Huntington Beach, California, 92647

  • Research Site

    McKinney, Texas, 75069

  • Research Site

    Medford, Oregon, 97504

  • Research Site

    Mooresville, North Carolina, 28117

  • Research Site

    Mt. Pleasant, South Carolina, 29464

  • Research Site

    New Bern, North Carolina, 28562

  • Research Site

    New Haven, Connecticut, 06510

  • Research Site

    Newport Beach, California, 92663

  • Research Site

    Orlando, Florida, 32819

  • Research Site

    Panama City, Florida, 32405

  • Research Site

    Philadelphia, Pennsylvania, 19140

  • Research Site

    Pittsburgh, Pennsylvania, 15213

  • Research Site

    Rapid City, South Dakota, 57702

  • Research Site

    Rock Hill, South Carolina, 29732

  • Research Site

    Tampa, Florida, 33607

  • Research Site

    Upland, California, 91786

  • Research Site

    Westminster, California, 92683

  • Research Site

    Winter Park, Florida, 32789-4681

Other trials in United States

Canada11 sites
  • Research Site

    Burlington, Ontario, L7N 3V2

  • Research Site

    Calgary, Alberta, T2N 4Z6

  • Research Site

    Hamilton, Ontario, L8N 3Z5

  • Research Site

    Montreal, Quebec, H1M 1B1

  • Research Site

    Québec, Quebec, G1V 4G5

  • Research Site

    Québec, Quebec, G3K 2P8

  • Research Site

    Saint-Charles-Borromée, Quebec, J6E 2B4

  • Research Site

    Sherwood Park, Alberta, T8L 0N2

  • Research Site

    Trois-Rivières, Quebec, G8T 7A1

  • Research Site

    Truro, Nova Scotia, B2N 1L2

  • Research Site

    Vancouver, British Columbia, V5Z 1M9

Other trials in Canada

South Korea10 sites
  • Research Site

    Daegu, 42415

  • Research Site

    Incheon, 21431

  • Research Site

    Jeonju, 54907

  • Research Site

    Seoul, 03312

  • Research Site

    Seoul, 03722

  • Research Site

    Seoul, 05030

  • Research Site

    Seoul, 05505

  • Research Site

    Seoul, 06591

  • Research Site

    Seoul, 06973

  • Research Site

    Uijeongbu-si, 11765

Other trials in South Korea

Denmark7 sites
  • Research Site

    Aalborg, 9000

  • Research Site

    Aarhus N, 8200

  • Research Site

    Hvidovre, 2650

  • Research Site

    København NV, 2400

  • Research Site

    Odense C, 5000

  • Research Site

    Roskilde, 4000

  • Research Site

    Vejle, 7100

Other trials in Denmark

France7 sites
  • Research Site

    Amiens, 80054

  • Research Site

    Brest, 29609

  • Research Site

    Grenoble, 38043

  • Research Site

    Lyon, 69317

  • Research Site

    Marseille, 13015

  • Research Site

    Montpellier, 34090

  • Research Site

    Nantes, 44093

Other trials in France

Israel7 sites
  • Research Site

    Ashkelon, 7830604

  • Research Site

    Beersheba, 84101

  • Research Site

    Haifa, 34362

  • Research Site

    Jerusalem, 91031

  • Research Site

    Jerusalem, 91120

  • Research Site

    Kfar Saba, 49281

  • Research Site

    Rehovot, 7661041

Other trials in Israel

United Kingdom7 sites
  • Research Site

    Bradford, BND9 6RJ

  • Research Site

    Chertsey, KT16 0PZ

  • Research Site

    Cottingham, HU16 5JQ

  • Research Site

    Glasgow, G12 0YN

  • Research Site

    London, SW10 9NH

  • Research Site

    Newcastle upon Tyne, NE1 4LP

  • Research Site

    Wakefield, WF1 4DG

Other trials in United Kingdom

Germany5 sites
  • Research Site

    Berlin, 12203

  • Research Site

    Frankfurt, 60596

  • Research Site

    Großhansdorf, 20927

  • Research Site

    Lübeck, 23552

  • Research Site

    Mainz, 55131

Other trials in Germany

Netherlands5 sites
  • Research Site

    Eindhoven, 5623 EJ

  • Research Site

    Heerlen, 6419 PC

  • Research Site

    Rotterdam, 3045 PM

  • Research Site

    Rotterdam, 3083 AN

  • Research Site

    Zutphen, 7207 AE

Other trials in Netherlands

Spain5 sites
  • Research Site

    Alzira, 46410

  • Research Site

    Barcelona, 08025

  • Research Site

    Granada, 18014

  • Research Site

    Málaga, 29010

  • Research Site

    Mérida (Badajoz), 06800

Other trials in Spain

About this study

Official title: A Randomized, Double-blind, Placebo-controlled, Parallel Group, Multicenter Phase 2a Study to Explore the Efficacy and Safety of Tezepelumab in Patients With Moderate to Very Severe Chronic Obstructive Pulmonary Disease (COPD) (COURSE)

A Multicenter, Randomized, Double-blind, Placebo-controlled, Parallel Group, Phase 2a Study to Explore the Efficacy and Safety of Tezepelumab in Adults with Moderate to Very Severe Chronic Obstructive Pulmonary Disease (COPD)

Read the detailed description

This is a Phase 2a, multicenter, randomized, double-blind, placebo-controlled, parallel group study to evaluate the safety and efficacy of tezepelumab in adults with moderate to very severe chronic obstructive pulmonary disease (COPD) receiving triple inhaled maintenance therapy, and having had 2 or more documented COPD exacerbations in the 12 months prior to Visit 1. Approximately, 338 subjects will be randomized globally. Subjects will be stratified by region and prior number of exacerbations (2 vs. 3 or more). Subjects will receive tezepelumab, or placebo, administered via subcutaneous injection at the study site, over a 52 week treatment period. The study also includes a post-treatment follow-up period of 12 weeks.

Being tested
Tezepelumab, Placebo
Keywords
COPD, Moderate COPD, Severe COPD, chronic obstructive pulmonary disease
Medical subject headings
Pulmonary Disease, Chronic Obstructive

What participants receive

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

  • TezepelumabBiological

    Tezepelumab subcutaneous injection

  • PlaceboOther

    Placebo subcutaneous injection

Study groups in NCT04039113
Study groupRoleWhat they receive
TezepelumabActive comparatorTezepelumab, SC, Q4W
Receives: Biological: Tezepelumab
Matching PlaceboPlacebo comparatorMatching placebo, SC, Q4W
Receives: Other: Placebo

What is being measured

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

  1. Rate of Moderate or Severe COPD Exacerbations in Participants With Moderate to Very Severe COPD.

    A COPD exacerbation was defined as a change in the participant's usual COPD symptoms that is beyond normal day-to-day variation, is acute in onset, lasts 2 or more days, and may warrant a change in regular medication and leads to any of the following: Use of systemic corticosteroids for at least 3 days, use of antibiotics for at least 3 days, an inpatient hospitalisation due to COPD, or results in death.

    Analysis was done using a negative binomial model with the response variable as the number of COPD exacerbations experienced during the follow-up for exacerbations. The model included covariates of treatment group, region, and number of exacerbations reported at randomisation as recorded in IWRS (2, >=3). The logarithm of the time at risk (in years) for exacerbation in the study is used as an offset variable.

    Measured: From randomisation up to Week 52

Secondary outcomes (11)
  1. Time to First Moderate/Severe COPD Exacerbation

    Time to first moderate/severe COPD exacerbation post-randomisation, presented as number of subjects with at least one moderate/severe COPD exacerbation.

    Measured: From randomisation up to Week 52

  2. Proportion of Participants COPD Exacerbation Free at Week 52

    An exacerbation event was defined as described in primary analysis. A participant was exacerbation free if they did not experience any moderate or severe exacerbations from randomisation to Week 52 (EOT).

    Measured: From randomisation up to Week 52

  3. Comparison of Annual Severe COPD Exacerbation Rates Over 52 Weeks

    An exacerbation was considered severe if it results in at least 1 of the following: Hospitalisation due to the COPD exacerbation (defined as a participant being admitted for ≥ 24 hours to an observation area, the emergency department, or other equivalent healthcare facility), or death related to COPD or COPD exacerbation.

    Measured: From randomisation up to Week 52

  4. Proportion of Participants With >=1 Severe COPD Exacerbations Over 52 Weeks

    An exacerbation was considered severe if it results in at least 1 of the following: Hospitalisation due to the COPD exacerbation (defined as a participant being admitted for ≥ 24 hours to an observation area, the emergency department, or other equivalent healthcare facility), or death related to COPD or COPD exacerbation.

    Measured: From randomisation up to Week 52

  5. Time to First Severe COPD Exacerbation

    Time to first severe COPD exacerbation post-randomisation, presented as number of subjects with at least one severe COPD exacerbation.

    Measured: From randomisation up to Week 52

  6. Least Square (LS) Mean Difference in Change From Baseline in Pre-bronchodilator Forced Expiratory Volume in 1 (FEV1) at Week 52

    Pre-Bronchodilator FEV1 (L) was determined by spirometry at the clinic visit. FEV1 is defined as the volume of air exhaled from the lungs in the first second of a forced expiration.

    Change from baseline was obtained as an absolute difference between Week 52 measure and the baseline value.

    Baseline was defined as the last assessment recorded prior to the first dose of study treatment.

    Measured: Baseline and Week 52

  7. Lease Square (LS) Mean Difference in Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score at Week 52

    The SGRQ is a 50-item PRO instrument to measure the health status of participants with airway obstruction diseases. The total score indicates the impact of disease on overall health status. This total score is expressed as a percentage of overall impairment, in which 100 represents the worst possible health status and 0 indicates the best possible health status.

    Baseline is the measurement recorded at Week 0 (Visit 3).

    Measured: Baseline and Week 52

  8. Proportion of Participants Achieving a Minimum Clinically Important Difference of 4 Units or More in St. George's Respiratory Questionnaire (SGRQ) Total Score at Week 52

    The SGRQ is a 50-item PRO instrument to measure the health status of participants with airway obstruction diseases. The total score indicates the impact of disease on overall health status. This total score is expressed as a percentage of overall impairment, in which 100 represents the worst possible health status and 0 indicates the best possible health status.

    A responder was defined as an individual who had "improvement" at Week 52 (>=4 point decrease in SGRQ total score).

    Measured: Baseline and Week 52

  9. Least Square (LS) Mean Difference in Change From Baseline in COPD Assessment Tool (CAT) Total Score at Week 52

    The CAT is an 8-item PRO developed to measure the impact of COPD on health status. A CAT total score is the sum of item responses. Scores range from 0-40 with higher scores indicative of greater COPD impact on health status.

    Baseline was defined as the value at the randomisation visit (Visit 3). If the Visit 3 measurement was missing, the screening value was used as baseline instead.

    Measured: Baseline and Week 52

  10. Serum Concentration of Tezepelumab

    Blood samples were collected to determine the serum concentration of Tezepelumab.

    With the exception of Week 0 and Week 64, only pre-dose data from samples collected between 21 and 35 days after previous dose of investigational product were included.

    Measured: Pre-dose at weeks 0, 4, 12, 24, 36 and also at weeks 52 and 64 where no dosing was scheduled

  11. Number of Participants With Anti-Drug Antibody (ADA) Response to Tezepelumab

    Blood samples were measured for the presence of ADAs for tezepelumab using validated assays. Treatment-induced ADA positive was defined as ADA negative at baseline and post-baseline ADA positive. Treatment-boosted ADA positive was defined as baseline positive ADA titre that was boosted to a 4 fold or higher level following IP administration. TE-ADA positive was defined as the sum of treatment-induced ADA positive and treatment-boosted ADA positive. ADA incidence is the proportion of TE-ADA positive subjects in a population. ADA persistently positive was defined as ADA positive at >= 2 post-baseline assessments or ADA positive at last post-baseline assessment. ADA transiently positive was defined as having at least one post-baseline ADA positive assessment and not fulfilling the conditions of ADA persistently positive. Treatment-induced nAb positive was defined as nAb negative or ADA negative at baseline and nAb positive at any post-baseline visit.

    Measured: Pre-dose at weeks 0, 4, 12, 24, 36 and also at weeks 52 and 64 where no dosing was scheduled

Timeline

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

  1. First posted31 Jul 2019
  2. Study start30 Jul 2019
  3. Primary completion10 Nov 2023
  4. Study completion31 Jan 2024

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Subjects will be randomized in a 1:1 ratio to either tezepelumab or matching placebo both administered subcutaneously.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
337 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04039113
Sponsor's protocol ID
D5241C00001
Other IDs
2019-001363-67, 2019
Acronym
COURSE
Status last verified
Feb 2025
First submitted
29 Jul 2019
Last updated
18 Feb 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Publications

  • Singh D, Brightling CE, Rabe KF, Han MK, Christenson SA, Drummond MB, Papi A, Pavord ID, Molfino NA, Almqvist G, Kotalik A, Hellqvist A, Golabek M, Sindhwani NS, Ponnarambil SS; COURSE study investigators. Efficacy and safety of tezepelumab versus placebo in adults with moderate to very severe chronic obstructive pulmonary disease (COURSE): a randomised, placebo-controlled, phase 2a trial. Lancet Respir Med. 2025 Jan;13(1):47-58. doi: 10.1016/S2213-2600(24)00324-2. Epub 2024 Dec 6.

    PubMed 39653044

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Tezepelumab in people with Chronic Obstructive Pulmonary Disease (COPD), run by AstraZeneca at 91 sites in 10 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 4 inclusion and 7 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 18 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 91 sites in United States, Canada, South Korea, Denmark, France and 5 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. Some participants in this study may receive a placebo. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 18 Feb 2025). 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?

Rate of Moderate or Severe COPD Exacerbations in Participants With Moderate to Very Severe COPD. (time frame: From randomisation up to Week 52). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04039113, which also lists 1 linked publication.

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 18 Feb 2025.

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Tezepelumab COPD Exacerbation Study (NCT04039113) | AzTrials