Chronic Spontaneous Urticaria (CSU)Phase 3RECLAIMNCT06868212
A Study to Evaluate Efficacy of Remibrutinib Compared to Dupilumab at Early Timepoints in Adults With Chronic Spontaneous Urticaria Inadequately Controlled by Second Generation H1-antihistamines
A Phase 3 study testing Remibrutinib and Dupilumab in people with Chronic Spontaneous Urticaria (CSU), run by Novartis Pharmaceuticals at 121 sites in United States.
Trial summary
This is a US, multi-center, randomized, double-blind, double-dummy, Phase 3b study to evaluate efficacy of remibrutinib (25 mg twice daily [b.i.d.] by mouth [p.o.]) compared to dupilumab (600 mg loading dose administered subcutaneously (s.c.) followed by 300 mg every 2 weeks s.c.) at early timepoints (4 weeks and… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Chronic Spontaneous Urticaria (CSU)
- What is being tested?
- Remibrutinib and Dupilumab
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 409 participants
- Where
- 121 sitesUnited States
- Study dates
- 11 Jul 2025to 17 May 2027
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
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
- Adults ≥ 18 years of age at the time of signing the informed consent
- CSU duration for ≥ 6 months prior to screening (defined as the onset of CSU determined by the Investigator based on all available supporting documentation)
- Diagnosis of CSU inadequately controlled by sgH1-AH at the time of randomization, defined as:
- The presence of itch and hives for ≥ 6 consecutive weeks prior to screening despite the use of sgH1-AH during the 7 days prior to randomization (Day 1):
- UAS7 score (range, 0-42) ≥ 16, and
- ISS7 score (range, 0-21) ≥ 6, and
Show all 10Show fewer
- HSS7 score (range, 0-21) ≥ 6
- Documentation of hives within 3 months before randomization (either at screening and/or at randomization); or documented in the participants medical history
- Willing and able to complete an Urticaria Patient Daily Diary (UPDD) for the duration of the study and adhere to the study protocol
- Participants must not have had more than one missing UPDD entry (either morning or evening) in the 7 days prior to randomization (Day 1)
Who cannot join
- Previous use of remibrutinib or other bruton's tyrosine kinase (BTK) inhibitors
- Previous use of dupilumab
- Evidence of clinically significant cardiovascular (such as but not limited to myocardial infarction, unstable ischemic heart disease, NYHA Class III/IV left ventricular failure, arrhythmia and uncontrolled hypertension within 12 months prior to Visit 1), neurological, psychiatric, pulmonary, renal, hepatic (past history or current), endocrine or metabolic disorder, or immunodeficiency that, in the investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant.
- Evidence of hematological disorders (including coagulation disorders or significant bleeding risk)
- History or evidence of gastrointestinal disease (including gastrointestinal bleeding, e.g., in association with use of nonsteroidal anti-inflammatory drugs (NSAID), that was clinically relevant (e.g., where intervention was indicated or requiring hospitalization or blood transfusion)
- Requirement for anti-platelet medication, except for acetylsalicylic acid up to 100 mg/d or clopidogrel up to 75 mg/d. The use of dual anti-platelet therapy (e.g., acetylsalicylic acid + clopidogrel) is prohibited.
- Requirement for anticoagulant medication (for example, warfarin or Novel Oral Anti-Coagulants [NOAC])
- History or current hepatic disease including but not limited to acute or chronic hepatitis, cirrhosis or hepatic failure or hepatic parameters at screening: Aspartate Aminotransferase (AST)/ Alanine Aminotransferase (ALT) levels more than 1.5x ULN or International Normalized Ratio (INR) > 1.5 at screening
Trial locations and contacts
121 sites in 1 country.
121 sites in 1 country
United States121 sites
McFarland Clinic PC
Ames, Iowa, 50010
ClinSite Inc
Ann Arbor, Michigan, 48106-0525
Arlington Center for Dermatology
Arlington, Texas, 76011
Allergy Partners Of West NC
Asheville, North Carolina, 28801
University of Colorado Hospital - Aurora
Aurora, Colorado, 80045
Orion Clinical Research
Austin, Texas, 78759
Florida Ctr Allergy Asthma Research
Aventura, Florida, 33180
Johns Hopkins U School of Med
Baltimore, Maryland, 21205
Chesapeake Clinical Research Inc
Baltimore, Maryland, 21236
Ochsner Health Center
Baton Rouge, Louisiana, 70816
Bellaire Dermatology Associates
Bellaire, Texas, 77401
Bellingham Asthma Allergy and Immunology
Bellingham, Washington, 98225
Allervie Clinical Research
Birmingham, Alabama, 35209
Cahaba Derm and skin hlth ctr 27
Birmingham, Alabama, 35244
Skin Care Research Inc
Boca Raton, Florida, 33486
Boston Specialists LLC
Boston, Massachusetts, 02111
Equity Medical LLC
Bowling Green, Kentucky, 42104
Derm Institute West Michigan PLLC
Caledonia, Michigan, 49316
UNC DermatologyandSkinCancer Ctr
Chapel Hill, North Carolina, 27516
Institute for Asthma and Allergy PC
Chevy Chase, Maryland, 20815
NW Uni C and T Sciences Ins
Chicago, Illinois, 60611
Rush University Medical Center
Chicago, Illinois, 60612
Bernstein Clinical Research Center
Cincinnati, Ohio, 45231
Asthma and Allergy Associates P C
Colorado Springs, Colorado, 80907
Colorado ENT and Allergy
Colorado Springs, Colorado, 80909
ENT and Allergy Center of Missouri
Columbia, Missouri, 65201
AllerVie Clin Res Columbus GA
Columbus, Georgia, 31904
CR Services Acquisition US
Columbus, Ohio, 43213
Cleaver Medical Group
Cumming, Georgia, 30040
Reveal Research Institute
Dallas, Texas, 75230
Pharma Research and Amp Consult
Dallas, Texas, 75231
Henry Ford Hospital
Detroit, Michigan, 48202
Omnicure Clinical Research
Doral, Florida, 33172
Southeast Dermatology Specialists
Douglasville, Georgia, 30135
Western Sky Medical Research
El Paso, Texas, 79924
Deaconess Clin Allerg Res Inst
Evansville, Indiana, 47715
Wright State University
Fairborn, Ohio, 45324
FXM Clinical Research Ft Laud
Fort Lauderdale, Florida, 33308
First OC Dermatology
Fountain Valley, California, 92708
Ctr for Dermatology Clinical Res
Fremont, California, 95438
Goodlettsville Dermatology Research
Goodlettsville, Tennessee, 37072-2301
Tribe Clinical Research LLC
Greenville, South Carolina, 29601
Allergic Disease and Asthma Center
Greenville, South Carolina, 29607
Circuit Clinical Mercer Algy Pulm
Hamilton, New Jersey, 08619
Skin Care Research LLC
Hollywood, Florida, 33021
Center for Clinical Studies
Houston, Texas, 77030
Allergy and Asthma Specialists Group
Huntington Beach, California, 92647
Jacksonville Center for Clinical Research
Jacksonville, Florida, 32216
Sante Clinical Research
Kerrville, Texas, 78028
Velocity Clinical Research
Lafayette, Louisiana, 70508
Allergy and Asthma Center of Las Vegas
Las Vegas, Nevada, 89128
Las Vegas Dermatology
Las Vegas, Nevada, 89144
Somnos Clinical Research
Lincoln, Nebraska, 68510
Research Solutions of Arizona
Litchfield Park, Arizona, 85340
Acuro Research Inc
Little Rock, Arkansas, 72205
Allergy Asthma Assoc Monmouth
Little Silver, New Jersey, 07739
Orso Health
Long Beach, California, 90808
Ark Clinical Research
Long Beach, California, 90815
California Allergy and Asthma Medical Group
Los Angeles, California, 90025
Dermatology Research Associates
Los Angeles, California, 90045
Family Allergy And Asthma Rsch Inst
Louisville, Kentucky, 40215
The Allergy Group-Meridian Clinic
Meridian, Idaho, 83642
University of MiamiHealth System
Miami, Florida, 33125
FXM Clinical Res Miami LLC
Miami, Florida, 33175
Miami Dade Medical Research
Miami, Florida, 33176
Clinical Research Institute
Minneapolis, Minnesota, 55402
University of Minnesota
Minneapolis, Minnesota, 55455
Eminat LLC
Miramar, Florida, 33027
International Clinical Research Tennessee LCC
Murfreesboro, Tennessee, 37130
University Of Utah
Murray, Utah, 84107
One Of A Kind Clinical Research
Napa, California, 94558
Southern IN Clinical Trials
New Albany, Indiana, 47150
Midwest Allergy Sinus Asthma SC
Normal, Illinois, 61761
Charleston ENT and Allergy
North Charleston, South Carolina, 29406
National Allergy and Asthma Research LLS
North Charleston, South Carolina, 29420
Ziaderm Research LLC
North Miami Beach, Florida, 33162
Clinical Res Ctr of S Illinois
O'Fallon, Illinois, 62269
Allergy Partners of New Jersey PC
Ocean Township, New Jersey, 07712
Unity Clinical Research
Oklahoma City, Oklahoma, 73118
Allergy and Asthma Specialist P S C
Owensboro, Kentucky, 42301
Stanford University Medical Center
Palo Alto, California, 94304
AllerVie Health
Panama, Florida, 32405
Peak Dermatology
Payson, Arizona, 85541
Premier Allergy Asthma And Immunology
Phoenix, Arizona, 85032
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, 15213
Allergy and Clinical Immunology Associates
Pittsburgh, Pennsylvania, 15241
Empire Clinical Research
Pomona, California, 91767
Oregon Medical Research Center
Portland, Oregon, 97223
Oregon Health Sciences University
Portland, Oregon, 97239
Allergy and Asthma Consultants
Redwood City, California, 94063
Asthma and Allergy Center of Chicago S C
River Forest, Illinois, 60305
Mayo Clinic - Rochester
Rochester, Minnesota, 55905
Norcal Clinical Research
Rocklin, California, 95765
Peninsula Research Associates
Rolling Hills Estates, California, 90274
Integrative Skin Science and Res
Sacramento, California, 95815
UC Davis Neuromuscular Research Center
Sacramento, California, 95817
RFSA Dermatology
San Antonio, Texas, 78213
Andante Research
San Antonio, Texas, 78229
Therapeutics Clinical Research
San Diego, California, 92123
Allergy Associates of Utah
Sandy City, Utah, 84093
Dermatology Institute and Skin Care
Santa Monica, California, 90403
Sarasota Clinical Research
Sarasota, Florida, 34233
Aeroallergy Research Laboratories
Savannah, Georgia, 31406
Orso Health
Scottsdale, Arizona, 85254
Endeavor Health Clinical Trials Center
Skokie, Illinois, 60077
The Clinical Research Center
St Louis, Missouri, 63141
Washington University
St Louis, Missouri, 63141
Lenus Research and Med Group LLC
Sweetwater, Florida, 33172
Asthma Allergy Immunology Clin Res
Tampa, Florida, 33613
Equity Medical
The Bronx, New York, 10455
Montefiore Medical Center
The Bronx, New York, 10467
Toledo Institute of Clinical Research
Toledo, Ohio, 43617
Revival Research Institute
Troy, Michigan, 48084
Somerset Skin Centre
Troy, Michigan, 48084
Vital Prospects Clinical Research Institute
Tulsa, Oklahoma, 74136
Integrated Research of Inland Inc
Upland, California, 91786
Forefront Dermatology
Vienna, Virginia, 22182
Allergy and Asthma Clin Res Inc
Walnut Creek, California, 94598
Howard University Hospital Division of Geriatrics
Washington D.C., District of Columbia, 20059
Accellacare Duly Health and Care
Wheaton, Illinois, 60189
Conquest Research
Winter Park, Florida, 32789
About this study
Official title: A US Phase 3b, Multi-center, Randomized, Double-blind, Double-Dummy Study to Evaluate Efficacy of Remibrutinib Compared to Dupilumab at Early Timepoints in Adults With Chronic Spontaneous Urticaria Inadequately Controlled by Second Generation H1-Antihistamines
This is a US, multi-center, randomized, double-blind, double-dummy, Phase 3b study to evaluate efficacy of remibrutinib (25 mg twice daily [b.i.d.] by mouth [p.o.]) compared to dupilumab (600 mg loading dose administered subcutaneously (s.c.) followed by 300 mg every 2 weeks s.c.) at early timepoints (4 weeks and earlier), when administered as an add-on treatment to second generation H1-antihistamines (sgH1-AH) (standard label dose as background therapy) in adult US participants with moderate to severe chronic spontaneous urticaria (CSU) inadequately controlled by sgH1-AHs.
Read the detailed description
This study consists of a screening period (up to 4 weeks), a core treatment period (12 weeks double-blind, double-dummy), an optional open-label extension [OLE] period, and safety follow-up period.
Screening period: participants will have a screening period of a minimum of 7 days up to a maximum of 28 days to establish eligibility for the study. Participants meeting all the inclusion criteria and none of the exclusion criteria will be eligible to participate in the study.
Core treatment period (double-blind, double-dummy): approximately, 400 participants diagnosed with CSU inadequately controlled by sgH1-AH will be randomized in this study. Participants will be stratified based on prior exposure to anti-IgE biologics.
Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib and placebo solution for injection or dupilumab and remibrutinib matching placebo, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit.
Additionally, all participants will be on a stable, standard label dose of a sgH1-AH ("background therapy") throughout the entire core treatment period (starting a minimum of 7 days prior to randomization until the end of Week 12). To treat unbearable symptoms of CSU, participants will be allowed to add more of the same sgH1-AH on an as-needed basis ("rescue therapy"). The total maximum daily dose of sgH1-AH (background plus rescue) should not exceed 4 tablets/day (4-fold the standard label dose).
Optional open-label extension [OLE] period: At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional OLE safety period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).
Safety follow-up period:
- For participants who do not enter the OLE period: there will be a safety follow-up for 12 weeks with safety follow-up phone calls at Week 16 and Week 24 (Week 24 will be end of study).
- For participants who enter the OLE period: there will be 2 options at the end of Week 24:
- If remibrutinib is commercially available: participants will discontinue study treatment, perform their EOT visit and receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
- If remibrutinib is not commercially available, participants may continue on remibrutinib 25 mg b.i.d. until its commercial availability and return for site visits for safety follow up and treatment dispensation every 3 months. When remibrutinib becomes commercially available, the participant will be contacted for a site visit to complete the EOT visit and will receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
- Conditions
- Chronic Spontaneous Urticaria (CSU)
- Being tested
- Remibrutinib, Remibrutinib matching placebo, Dupilumab, Placebo solution for injection
- Keywords
- BTK inhibitor, chronic spontaneous urticaria, Urticaria activity score, Hives severity score, Itch severity score
- Medical subject headings
- Chronic Urticaria
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RemibrutinibDrug
Film-coated tablet, oral administration, 25 mg b.i.d.
Remibrutinib matching placeboDrug
Film-coated tablet, oral administration, b.i.d.
DupilumabDrug
Solution for injection in pre-filled syringe 600 mg loading dose followed by 300 mg dose every 2 weeks
Placebo solution for injectionDrug
Solution for injection in pre-filled syringe every 2 weeks
| Study group | Role | What they receive |
|---|---|---|
| Treatment group 1: Remibrutinib + Placebo | Experimental | Remibrutinib tablet (25 mg b.i.d. p.o.) + placebo solution for injection in pre-filled syringe (2 s.c. injections at baseline and then 1 s.c. injection every other week [Weeks 2-10]) Receives: Drug: Remibrutinib; Drug: Placebo solution for injection |
| Treatment group 2: Dupilumab + remibrutinib matching placebo | Active comparator | Dupilumab pre-filled syringe (600 mg loading dose [2 x 300 mg dupilumab s.c. injection] at baseline visit followed by dupilumab 300 mg s.c. injection every other week [Weeks 2-10]) + remibrutinib matching placebo tablet (1 tablet b.i.d. p.o.) Receives: Drug: Remibrutinib matching placebo; Drug: Dupilumab |
What is being measured
The primary outcome is the main question the study is designed to answer.
Absolute change from baseline in Weekly Urticaria Activity Score (UAS7) at Week 4
The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit.
Measured: Baseline, Week 4
Secondary outcomes (6)
Improvement of severity of hives, assessed as absolute change from baseline in HSS7 score at Week 4
The hives (wheals) severity score, defined by number of hives, will be recorded by the participant twice daily in their eCOA device, on a scale of 0 (none) to 3. A weekly score (HSS7) is derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score is therefore 0 - 21.
Measured: Baseline, Week 4
Improvement of severity of itch, assessed as absolute change from baseline in ISS7 score at Week 4
The severity of the itch will be recorded by the participant twice daily in their eCOA device, on a scale of 0 (none) to 3 (severe). A weekly score (ISS7) is derived by adding up the average daily scores of the 7 days preceding the visit. The possible range of the weekly score is therefore 0 - 21.
Measured: Baseline, Week 4
Improvement of UAS7, assessed as absolute change from baseline in UAS7 score at Week 1
The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit.
Measured: Baseline, Week 1
Percentage of participants with UAS7 ≤ 6 at Week 4
Percentage of participants who achieved UAS7 ≤ 6 at Week 4. The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit.
Measured: Week 4
Percentage of participants with UAS7=0 at Week 4
Percentage of participants who achieved UAS7 = 0 at Week 4. The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit.
Measured: Week 4
Percentage of participants with UAS7 ≤ 6 at Week 2
Percentage of participants who achieved UAS7 ≤ 6 at Week 2. The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit.
Measured: Week 2
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Mar 2025
- Study start11 Jul 2025
- Primary completion22 Feb 2027 (estimated)
- Study completion17 May 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Chronic Spontaneous Urticaria (CSU)Studies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Model description
- Participants will be stratified based on prior exposure to anti-IgE biologics. Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib or dupilumab and remibrutinib matching placebo or placebo solution for injection, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit. At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional open label extension (OLE) period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).
- Masking
- Triple blind
- Who is masked
- Participant, Investigator, Outcomes assessor
- Enrolment
- 409 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06868212
- Sponsor's protocol ID
- CLOU064AUS02
- Acronym
- RECLAIM
- Status last verified
- Oct 2026
- First submitted
- 6 Mar 2025
- Last updated
- 13 Oct 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Publications
Yosipovitch G, Mosnaim G, Ortmann CE, Griswold N, Mast J, Martzloff ED, Rodrigues J, Hawkes JE. Efficacy of Remibrutinib versus Dupilumab at Early Timepoints in Chronic Spontaneous Urticaria: US Phase 3b Study Design (RECLAIM). Dermatol Ther (Heidelb). 2026 May;16(5):2575-2585. doi: 10.1007/s13555-026-01716-y. Epub 2026 Mar 19.
PubMed 41854973
Study at a glance
From the registry record, last updated by the sponsor on 13 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A US Phase 3b, Multi-center, Randomized, Double-blind, Double-Dummy Study to Evaluate Efficacy of Remibrutinib Compared to Dupilumab at Early Timepoints in Adults With Chronic Spontaneous Urticaria Inadequately Controlled by Second Generation H1-Antihistamines
- ClinicalTrials.gov ID
- NCT06868212
- Acronym / sponsor ID
- RECLAIM / CLOU064AUS02
- Conditions
- Chronic Spontaneous Urticaria (CSU)
- Keywords
- BTK inhibitor, chronic spontaneous urticaria, Urticaria activity score, Hives severity score, Itch severity score
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 409 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 11 Jul 2025 (actual)
- Primary completion
- 22 Feb 2027 (estimated)
- Study completion
- 17 May 2027 (estimated)
- First posted
- 10 Mar 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a US, multi-center, randomized, double-blind, double-dummy, Phase 3b study to evaluate efficacy of remibrutinib (25 mg twice daily [b.i.d.] by mouth [p.o.]) compared to dupilumab (600 mg loading dose administered subcutaneously (s.c.) followed by 300 mg every 2 weeks s.c.) at early timepoints (4 weeks and earlier), when administered as an add-on treatment to second generation H1-antihistamines (sgH1-AH) (standard label dose as background therapy) in adult US participants with moderate to severe chronic spontaneous urticaria (CSU) inadequately controlled by sgH1-AHs.
Detailed description
This study consists of a screening period (up to 4 weeks), a core treatment period (12 weeks double-blind, double-dummy), an optional open-label extension [OLE] period, and safety follow-up period.
Screening period: participants will have a screening period of a minimum of 7 days up to a maximum of 28 days to establish eligibility for the study. Participants meeting all the inclusion criteria and none of the exclusion criteria will be eligible to participate in the study.
Core treatment period (double-blind, double-dummy): approximately, 400 participants diagnosed with CSU inadequately controlled by sgH1-AH will be randomized in this study. Participants will be stratified based on prior exposure to anti-IgE biologics.
Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib and placebo solution for injection or dupilumab and remibrutinib matching placebo, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit.
Additionally, all participants will be on a stable, standard label dose of a sgH1-AH ("background therapy") throughout the entire core treatment period (starting a minimum of 7 days prior to randomization until the end of Week 12). To treat unbearable symptoms of CSU, participants will be allowed to add more of the same sgH1-AH on an as-needed basis ("rescue therapy"). The total maximum daily dose of sgH1-AH (background plus rescue) should not exceed 4 tablets/day (4-fold the standard label dose).
Optional open-label extension [OLE] period: At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional OLE safety period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).
Safety follow-up period:
- For participants who do not enter the OLE period: there will be a safety follow-up for 12 weeks with safety follow-up phone calls at Week 16 and Week 24 (Week 24 will be end of study).
- For participants who enter the OLE period: there will be 2 options at the end of Week 24:
- If remibrutinib is commercially available: participants will discontinue study treatment, perform their EOT visit and receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
- If remibrutinib is not commercially available, participants may continue on remibrutinib 25 mg b.i.d. until its commercial availability and return for site visits for safety follow up and treatment dispensation every 3 months. When remibrutinib becomes commercially available, the participant will be contacted for a site visit to complete the EOT visit and will receive a safety follow-up phone call 4 weeks after the last dose of remibrutinib (this will be the EOS).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Participants will be stratified based on prior exposure to anti-IgE biologics. Eligible participants will be randomized in a 1:1 ratio to receive remibrutinib or dupilumab and remibrutinib matching placebo or placebo solution for injection, both as an add-on treatment to once daily standard label dose of sgH1-AH background therapy, until the Week 12 visit. At the end of the 12-week double-blind treatment period, and in case remibrutinib is not commercially available, participants from both arms will be given the choice to roll over into an optional open label extension (OLE) period and receive remibrutinib (25 mg b.i.d. p.o.) for 12 weeks (up to Week 24).
| Arm | Type | Receives |
|---|---|---|
| Treatment group 1: Remibrutinib + Placebo | Experimental | Drug: Remibrutinib, Drug: Placebo solution for injectionRemibrutinib tablet (25 mg b.i.d. p.o.) + placebo solution for injection in pre-filled syringe (2 s.c. injections at baseline and then 1 s.c. injection every other week [Weeks 2-10]) |
| Treatment group 2: Dupilumab + remibrutinib matching placebo | Active comparator | Drug: Remibrutinib matching placebo, Drug: DupilumabDupilumab pre-filled syringe (600 mg loading dose [2 x 300 mg dupilumab s.c. injection] at baseline visit followed by dupilumab 300 mg s.c. injection every other week [Weeks 2-10]) + remibrutinib matching placebo tablet (1 tablet b.i.d. p.o.) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Adults ≥ 18 years of age at the time of signing the informed consent
- CSU duration for ≥ 6 months prior to screening (defined as the onset of CSU determined by the Investigator based on all available supporting documentation)
- Diagnosis of CSU inadequately controlled by sgH1-AH at the time of randomization, defined as:
- The presence of itch and hives for ≥ 6 consecutive weeks prior to screening despite the use of sgH1-AH during the 7 days prior to randomization (Day 1):
- UAS7 score (range, 0-42) ≥ 16, and
Key exclusion criteria (8 listed)
- Previous use of remibrutinib or other bruton's tyrosine kinase (BTK) inhibitors
- Previous use of dupilumab
- Evidence of clinically significant cardiovascular (such as but not limited to myocardial infarction, unstable ischemic heart disease, NYHA Class III/IV left ventricular failure, arrhythmia and uncontrolled hypertension within 12 months prior to Visit 1), neurological, psychiatric, pulmonary, renal, hepatic (past history or current), endocrine or metabolic disorder, or immunodeficiency that, in the investigator's opinion, would compromise the safety of the participant, interfere with the interpretation of the study results or otherwise preclude participation or protocol adherence of the participant.
- Evidence of hematological disorders (including coagulation disorders or significant bleeding risk)
- History or evidence of gastrointestinal disease (including gastrointestinal bleeding, e.g., in association with use of nonsteroidal anti-inflammatory drugs (NSAID), that was clinically relevant (e.g., where intervention was indicated or requiring hospitalization or blood transfusion)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RemibrutinibFilm-coated tablet, oral administration, 25 mg b.i.d. | Drug | Treatment group 1: Remibrutinib + Placebo |
| Remibrutinib matching placeboFilm-coated tablet, oral administration, b.i.d. | Drug | Treatment group 2: Dupilumab + remibrutinib matching placebo |
| DupilumabSolution for injection in pre-filled syringe 600 mg loading dose followed by 300 mg dose every 2 weeks | Drug | Treatment group 2: Dupilumab + remibrutinib matching placebo |
| Placebo solution for injectionSolution for injection in pre-filled syringe every 2 weeks | Drug | Treatment group 1: Remibrutinib + Placebo |
Primary outcome
Absolute change from baseline in Weekly Urticaria Activity Score (UAS7) at Week 4
Time frame: Baseline, Week 4
The UAS7 is the sum of the Weekly Hives Severity (HSS7) score and the Weekly Itch Severity (ISS7) score, and ranges from 0-42. Weekly scores (HSS7 and ISS7 scores) will be derived by adding up the average daily scores of the 7 days preceding the visit.
6 secondary outcomes
Improvement of severity of hives, assessed as absolute change from baseline in HSS7 score at Week 4
Time frame: Baseline, Week 4
Improvement of severity of itch, assessed as absolute change from baseline in ISS7 score at Week 4
Time frame: Baseline, Week 4
Improvement of UAS7, assessed as absolute change from baseline in UAS7 score at Week 1
Time frame: Baseline, Week 1
Percentage of participants with UAS7 ≤ 6 at Week 4
Time frame: Week 4
Percentage of participants with UAS7=0 at Week 4
Time frame: Week 4
Percentage of participants with UAS7 ≤ 6 at Week 2
Time frame: Week 2
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Oct 2026.
- Derived from this study: PubMed 41854973Yosipovitch G, Mosnaim G, Ortmann CE, Griswold N, Mast J, Martzloff ED, Rodrigues J, Hawkes JE. Efficacy of Remibrutinib versus Dupilumab at Early Timepoints in Chronic Spontaneous Urticaria: US Phase 3b Study Design (RECLAIM). Dermatol Ther (Heidelb). 2026 May;16(5):2575-2585. doi: 10.1007/s13555-026-01716-y. Epub 2026 Mar 19.
- Individual participant dataSharing planned: Yes. Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com
Related trials for Chronic Spontaneous Urticaria (CSU)
Not yet recruitingObservational study
Remibrutinib in Real-world Clinical Practice - a South Korea Sub-Study
Chronic Spontaneous Urticaria
Enrolling by invitationPhase 3
Long-term Efficacy and Safety Extension (LTE) Study of Barzolvolimab in Participants With Chronic Spontaneous Urticaria
Chronic Spontaneous Urticaria
RecruitingPhase 2
A Study to Assess the Efficacy and Safety of THB335 in Adults With Chronic Spontaneous Urticaria (CSU)
Chronic Spontaneous Urticaria (CSU), Chronic Idiopathic Urticaria
Active, not recruitingEarly Phase 1
A Trial of HRS-3095 in Healthy Volunteers
Chronic Spontaneous Urticaria
RecruitingPhase 2
A Study to Learn About Ritlecitinib for the Potential Treatment of Chronic Spontaneous Urticaria in Adults.
Chronic Spontaneous Urticaria
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
121 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Remibrutinib and Dupilumab in people with Chronic Spontaneous Urticaria (CSU), run by Novartis Pharmaceuticals at 121 sites in United States.
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 10 inclusion and 8 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: under way, not looking for participants, as of the sponsor's last update on 13 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 121 sites in United States. 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?
This study is still under way. Results are not available in the source record yet.
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?
Absolute change from baseline in Weekly Urticaria Activity Score (UAS7) at Week 4 (time frame: Baseline, Week 4). 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 NCT06868212, 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 13 Oct 2026.