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Bullous PemphigoidPhase 3FJORDNCT04612790

A Study to Investigate the Use of Benralizumab in Patients With Bullous Pemphigoid.

A Phase 3 study testing Benralizumab in people with Bullous Pemphigoid, run by AstraZeneca at 39 sites in 11 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to investigate the use of benralizumab is effective in the treatment of patients symptomatic Bullous Pemphigoid (BP). Read more about this study

Who is it for?
Ages 18 to 130 years
Conditions the study is for
Bullous Pemphigoid
What is being tested?
Benralizumab
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
67 participants
Where
39 sitesin 11 countries
Study dates
31 Mar 2021to 26 Oct 2023
Phase
Phase 3
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 to 130 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants are eligible to be included in the study only if all of the following criteria apply:
  • Informed Consent/Age
  • Capable of giving signed informed consent as described in Appendix A which includes compliance with the requirements and restrictions listed in the ICF and in this protocol.
  • Adult participants ≥ 18 years of age at the time of signing the ICF.
  • Type of Participant and Disease Characteristics
  • Participants must have clinical features of BP (eg, urticarial or eczematous or erythematous plaques, bullae, pruritus) at the screening visit and confirmed diagnosis with histology, direct immunofluorescence, and serology at randomization. Required for inclusion:
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  • Histology.
  • Positive direct immunofluorescence (from skin biopsy) (IgG and/or C3 at the basement membrane zone).
  • AND at least one of the following serologic assessments positive (all assessed from participant's blood sample):
  • indirect immunofluorescence (IgG on the roof of salt- split skin). (ii) positive serology on ELISA for BPAG1 (230-kd). (iii) positive serology on ELISA for BPAG2 (180-kd).
  • BPDAI activity score ≥ 24 at the screening and randomization visits.
  • Candidate for systemic corticosteroid therapy.
  • Able to complete PRO assessments on a tablet and on a handheld device. Some participants may be exempted from completing home PROs on the handheld device upon agreement with the AstraZeneca physician (eg, if the patient has a medical condition such as BP lesions of the fingers/hand, a neurologic condition affecting fingers/hand, or severe visual impairment).
  • Sex 7 Male or female.
  • Reproduction 8 Female participants capable of having children must meet both of the following conditions ([a] and [b]):
  • Have a negative urine pregnancy test at screening and (b) Must agree to use a highly effective method of birth control (confirmed by the investigator) from randomization throughout the study duration and within 12 weeks after last dose of IP. Highly effective forms (those that can achieve a failure rate of less than 1% per year when used consistently and correctly) of birth control include: (i) Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation - oral, intravaginal, or transdermal.
  • Progestogen-only hormonal contraception associated with inhibition of ovulation - oral, injectable, or implantable.
  • Intrauterine device. (iv) Intrauterine hormone-releasing system. (v) Bilateral tubal occlusion. (vi) Sexual abstinence, ie, refraining from heterosexual intercourse (the reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical study and the preferred and usual lifestyle of the participant).
  • Vasectomized sexual partner provided that partner is the sole sexual partner of the female of childbearing potential (FOCBP) study participant and that the vasectomized partner has received medical assessment of the surgical success.
  • Females not of childbearing potential are defined as females who are either permanently sterilized (hysterectomy, bilateral oophorectomy, or bilateral salpingectomy), or who are postmenopausal. Females will be considered postmenopausal if they have been amenorrhoeic for ≥ 12 months prior to the planned date of randomization without an alternative medical cause. The following age-specific requirements apply: (i) Females < 50 years old will be considered postmenopausal if they have been amenorrhoeic for 12 months or more following cessation of exogenous hormonal treatment and follicle-stimulating hormone (FSH) levels in the postmenopausal range. Until FSH is documented to be within menopausal range, treat the participant as a female of childbearing potential.
  • Females ≥ 50 years old will be considered postmenopausal if they have been amenorrhoeic for 12 months or more following cessation of all exogenous hormonal treatment.

Who cannot join

  • Participants are excluded from the study if any of the following criteria apply:
  • Medical Conditions
  • Forms of BP other than classic, predominantly cutaneous BP: eg, mucous membrane BP, epidermolysis bullosa acquisita, Brunsting-Perry BP, p200 BP, p105 BP, BP with concomitant pemphigus vulgaris, and drug-induced BP.
  • Comorbid disease that in the Investigator's judgement might interfere with the evaluation of the IP or safety of the participant. This includes any disorder that in the opinion of the Investigator is not stable (eg, cardiovascular, gastrointestinal, hepatic, renal, neurological, musculoskeletal, infectious, endocrine, metabolic, hematological, psychiatric, or major physical impairment).
  • Current or history of malignancy within 5 years before the screening visit with the following exceptions:
  • Participants treated for in situ carcinoma of the cervix who have completed curative therapy and are in remission for at least 12 months prior to signing the informed consent and
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  • Participants with superficial basal cell or squamous skin cancer.
  • Participants who have had other malignancies are eligible provided that the participant is in remission and curative therapy was completed at least 5 years prior to the date informed consent was obtained.
  • History of anaphylaxis to any biologic therapy or vaccine.
  • A helminth parasitic infection diagnosed within 24 weeks prior to the date informed consent is obtained that has not been treated with, or has failed to respond to standard of care therapy.
  • Any clinically significant abnormal findings in physical examination, vital signs, electrocardiogram (ECG), hematology, or clinical chemistry during screening, which in the opinion of the Investigator, may put the participant at risk because of his/her participation in the study, or may influence the results of the study.
  • Current active liver disease.
  • Chronic stable hepatitis B and C (including positive testing for hepatitis B surface antigen or hepatitis C antibody), or other stable chronic liver disease are acceptable if participant otherwise meets eligibility criteria. Stable chronic liver disease should generally be defined by the absence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, or persistent jaundice, or cirrhosis.
  • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level ≥3 times the upper limit of normal, confirmed by repeated testing during screening period. Transient increase of AST/ALT level that resolves by the time of randomization is acceptable if in the Investigator's opinion the participant does not have an active liver disease and meets other eligibility criteria.
  • A history of known immunodeficiency disorder including a positive human immunodeficiency virus (HIV) test.
  • Prior/Concomitant Therapy
  • Use of immunosuppressive medication, including, but not limited to: methotrexate, cyclosporine, azathioprine, within 4 weeks or 5 half-lives prior to the date informed consent is obtained, whichever is longer.
  • Other Exclusions
  • Receipt of immunoglobulin or blood products within 30 days prior to the date informed consent is obtained.
  • Receipt of any marketed or investigational biologic within 4 months or 5 half-lives prior to the date informed consent is obtained, whichever is longer. Participants on stable therapy for at least 3 months before randomization who intend to stay on treatment throughout the study with marketed biologics that are not likely to interfere with the assessment of safety and/or efficacy of benralizumab (eg, for the treatment of osteoporosis, migraine, pain, diabetes, obesity, ocular, cardiovascular, or metabolic diseases) can participate in the study.
  • Known history of allergy or reaction to any component of the IP formulation.
  • Receipt of live attenuated vaccines 30 days prior to the date of randomization.
  • Previously received benralizumab (MEDI-563, FASENRA).
  • Change to allergen immunotherapy or new allergen immunotherapy within 30 days prior to the date of informed consent and anticipated changes in immunotherapy throughout the study.
  • Planned elective major surgical procedures during the conduct of the study.
  • Previous randomization in the present study.
  • Concurrent enrollment in another interventional (eg, investigational drug or device) clinical trial.
  • Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site).
  • For females only: Currently pregnant, breastfeeding, or lactating females.
  • A urine pregnancy test must be performed for FOCBP at Visit 1. A positive urine test result must be confirmed with a serum pregnancy test. If serum test is positive, the participant should be excluded.
  • Participant is unable to complete PRO assessments because of cognitive function (eg, dementia).

Trial locations and contacts

39 sites in 11 countries.

39 sites in 11 countries

Japan7 sites
  • Research Site

    Iruma-Gun, 350-0495

  • Research Site

    Kitakyusyu-shi, 806-8501

  • Research Site

    Kurume-shi, 830-0011

  • Research Site

    Okayama, 700-8558

  • Research Site

    Ōta-ku, 143-8541

  • Research Site

    Sapporo, 060-8648

  • Research Site

    Urayasu-shi, 279-0021

Other trials in Japan

United States6 sites
  • Research Site

    Atlanta, Georgia, 30322

  • Research Site

    Beverly, Massachusetts, 01915

  • Research Site

    Centennial, Colorado, 80112

  • Research Site

    Margate, Florida, 33063

  • Research Site

    Phoenix, Arizona, 85006

  • Research Site

    Scottsdale, Arizona, 85260

Other trials in United States

China4 sites
  • Research Site

    Beijing, 100730

  • Research Site

    Guangzhou, 510515

  • Research Site

    Hohhot, 10050

  • Research Site

    Shanghai, 200025

Other trials in China

France4 sites
  • Research Site

    Lille, 59037

  • Research Site

    Marseille, 13008

  • Research Site

    Nice, 06200

  • Research Site

    Rouen, 76031

Other trials in France

Germany4 sites
  • Research Site

    Bad Bentheim, 48455

  • Research Site

    Bielefeld, 33647

  • Research Site

    Dresden, 01307

  • Research Site

    Leipzig, 04103

Other trials in Germany

Australia3 sites
  • Research Site

    Kogarah, 2217

  • Research Site

    Parkville, 3050

  • Research Site

    Westmead, 2145

Other trials in Australia

Italy3 sites
  • Research Site

    Catania, 95123

  • Research Site

    Florence, 50121

  • Research Site

    Rome, 168

Other trials in Italy

Spain3 sites
  • Research Site

    Alicante, 03010

  • Research Site

    Madrid, 28034

  • Research Site

    Madrid, 28041

Other trials in Spain

Bulgaria2 sites
  • Research Site

    Haskovo, 6300

  • Research Site

    Sofia, 1431

Other trials in Bulgaria

Israel2 sites
  • Research Site

    Ramat Gan, 5262000

  • Research Site

    Tel Aviv, 64239

Other trials in Israel

Greece1 site
  • Research Site

    Thessaloniki, 56249

Other trials in Greece

About this study

Official title: A Multinational, Randomized, Double-blind, Parallel-group, Placebo-controlled Study to Investigate the Use of Benralizumab as a Treatment Option for Patients With Bullous Pemphigoid (FJORD)

The purpose of this study is to investigate the use of benralizumab is effective in the treatment of patients symptomatic Bullous Pemphigoid (BP).

Read the detailed description

Bullous pemphigoid (BP) is a rare disease mainly affecting the elderly. BP is associated with significant morbidity and increased mortality secondary to increased risk of secondary infections, comorbid conditions, and serious side effects from high-dose steroids and immunosuppressants. The aim of this study is to investigate the use of benralizumab as a treatment for patients symptomatic with Bullous Pemphigoid (BP).

Being tested
Benralizumab, Placebo
Keywords
Bullous pemphigoid, rare disease, skin eruptions, itching autoimmune blistering disorder, eosinophilia, urticarial or eczematous or erythematous plaques, bullae, pruritus
Medical subject headings
Pemphigoid, Bullous, Rare Diseases, Eosinophilia, Urticaria, Blister, Pruritus

What participants receive

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

  • BenralizumabBiological

    Also called Benralizumab, Benra, Fasenra

    Benralizumab subcutaneously (SC) loading dose followed by repeat dosing of SC benralizumab plus Oral Corticosteroids per SoC tapering.

    Open-Label (OLE): after completion of the double-blind treatment period, all participants will have the option of entering an OLE period, starting at week 36 benralizumab SC until study closure.

  • PlaceboBiological

    Placebo plus Oral Corticosteroids per SoC tapering. Open-Label (OLE): after completion of the double-blind treatment period, all participants will have the option of entering an OLE period, starting at week 36 benralizumab SC until study closure.

Study groups in NCT04612790
Study groupRoleWhat they receive
BenralizumabExperimentalBenralizumab subcutaneously (SC) loading dose followed by repeat dosing of SC benralizumab plus Oral Corticosteroids per SoC tapering. Open-Label (OLE): after completion of the double-blind treatment period, all participants will have the option of entering an OLE period, starting at week 36 benralizumab SC until study closure.
Receives: Biological: Benralizumab
PlaceboExperimentalPlacebo plus Oral Corticosteroids per SoC tapering. Open-Label (OLE): after completion of the double-blind treatment period, all participants will have the option of entering an OLE period, starting at week 36 benralizumab SC until study closure.
Receives: Biological: Placebo

What is being measured

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

  1. Percentage of Responders at Week 36

    A responder was defined as a participant who was in complete remission while off OCS for ≥2 months at Week 36.

    Measured: At Week 36

Secondary outcomes (5)
  1. Percentage of Participants Who Remained Relapse-Free up to Week 36

    Relapse was defined as the appearance of 3 or more new lesions per month (blisters, eczematous lesions, or urticarial plaques); or at least 1 large (>10 centimeter [cm] diameter) eczematous lesion or urticarial plaques that did not heal within 1 week; or the extension of established lesions or daily pruritus in participants who had achieved disease control.

    Measured: Up to Week 36

  2. Cumulative OCS Exposure From Baseline to Week 36

    The cumulative OCS exposure was estimated as the sum over the relevant 4-week periods from the mixed-effect model for repeated measures (MMRM) model. Baseline was defined as the last recorded value on or prior to the date of randomization. Equivalents were prednisone equivalents (converted from mg).

    Measured: Baseline (Day 1) and Week 36

  3. Change From Baseline in Bullous Pemphigoid Disease Area Index (BPDAI) Activity Score at Week 36

    BPDAI is a clinician completed tool that is used for independent disease severity assessment to measure disease extent in BP. The total BPDAI activity score is calculated as the arithmetic sum of the 3 subcomponents - cutaneous blisters/erosions, cutaneous urticaria/erythema, and mucosal blisters/erosions. The BPDAI total activity gives an indication of disease activity, with score range from 0 (no disease activity) to 360 (severe disease activity). Higher scores indicating greater disease activity. Baseline was defined as the last recorded value on or prior to the date of randomization.

    Measured: Baseline (Day 1) and Week 36

  4. Change From Baseline in BPDAI-Pruritus Score at Week 36

    The BPDAI-Pruritus is a separate component of the BPDAI that asks the participant to grade the severity of pruritus over the past 24 hours, the past week, and the past month. For each recall period, severity of pruritus is rated on a numeric rating scale (NRS) ranging from 0 for no itch to 10 for maximal itching. The BPDAI-Pruritus score was computed as the sum of 3 components ranging from 0 to 30. Higher scores indicated worse condition. Baseline was defined as the last recorded value on or prior to the date of randomization.

    Measured: Baseline (Day 1) and Week 36

  5. Cumulative OCS Exposure From Baseline to Week 16

    The cumulative OCS exposure was estimated as the sum over the relevant 4-week periods from the MMRM model. Baseline was defined as the last recorded value on or prior to the date of randomization. Equivalents were prednisone equivalents (converted from mg).

    Measured: Baseline (Day 1) and Week 16

Timeline

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

  1. First posted3 Nov 2020
  2. Study start31 Mar 2021
  3. Primary completion26 Oct 2023
  4. Study completion26 Oct 2023

Why it stopped: Independent Data Monitoring Committee recommended terminating the study following a pre-planned analysis as the efficacy results did not meet the pre-defined futility guidelines. There were no new safety concerns identified from this analysis.

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
67 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04612790
Sponsor's protocol ID
D325AC00002
Other IDs
2023-505033-27-00, 2020-000287-32, 2023
Acronym
FJORD
Status last verified
Nov 2024
First submitted
12 Oct 2020
Last updated
29 Nov 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Benralizumab in people with Bullous Pemphigoid, run by AstraZeneca at 39 sites in 11 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 21 inclusion and 31 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: stopped early, as of the sponsor's last update on 29 Nov 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 39 sites in Japan, United States, China, France, Germany and 6 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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 29 Nov 2024). 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?

Percentage of Responders at Week 36 (time frame: At Week 36). 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 29 Nov 2024.

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