A randomised, double-blind, placebo-controlled, parallel group study to evaluate the effect of treatment with GSK2190915, a FLAP inhibitor, as add-on to current inhaled corticosteroid therapy in patients with moderate to severe asthma with elevated sputum neutrophils.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
7
GSK2190915 is a high affinity 5-lipoxygenase-activating protein (FLAP) inhibitor.
Placebo : 2% (w/w) Ethanol, sucralose (5 mg/100 mL of oral solution) to 100 % (w/w) aqueous sodium carbonate buffer (0.010 M, pH 9-10)
GSK Investigational Site
Hamilton, Ontario, Canada
GSK Investigational Site
Kingston, Ontario, Canada
GSK Investigational Site
Montreal, Quebec, Canada
GSK Investigational Site
Sainte-Foy, Quebec, Canada
The Numbers of Neutrophils in Induced Sputum-Absolute Neutrophil Count
The neutrophils play an important role in participants with more severe asthma. The reduction in number of neutrophils in induced sputum was evaluated to study the effect of treatment with repeat oral doses of GSK2190915, in asthma participants. Sputum samples were evaluated at central laboratory. The samples were rejected, if the weight was less than 100 grams (g), or if excessive cell degeneration or due to excessive squamous cells and insufficient inflammatory cells. The total cell count of neutrophil was reported as total cell count × 10\^6 /g.
Time frame: Day -9 to -7, Day 1, Day 12 and follow-up (Day 24-28)
Percentage of Neutrophils in Induced Sputum
The neutrophils play an important role in participants with more severe asthma. The reduction in number of neutrophils in induced sputum was evaluated to study the effect of treatment with repeat oral doses of GSK2190915, in asthma participants. Sputum samples were evaluated at central laboratory. The samples were rejected, if the weight was less than 100 g, or if excessive cell degeneration or due to excessive squamous cells and insufficient inflammatory cells. The total cell count of neutrophil was reported as percentage of cells.
Time frame: Day -9 to -7, Day 1, Day 12 and follow-up (Day 24-28)
Assessment of FEV1 on Visit 2, 3 and Visit 4
FEV1 is the amount of air which can be forcefully exhaled in 1 second. It was assessed using a spirometry. Due to early termination of the study, the data of individual participants is reported.
Time frame: Visit 2 (Day 1), visit 3 (Day 5 to 7) and visit 4 (Day 12)
Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
An AE is defined as any untoward medical occurrence in a clinical investigation participant, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product. An SAE is defined as any untoward medical occurrence that, at any dose, results in death, is life threatening, requires hospitalization or prolongation of existing hospitalization, results in disability/incapacity, or is a congenital anomaly/birth defect, or is an important medical events that jeopardize the participants or may require medical or surgical intervention to prevent one of the other outcomes listed in the above definition, or a drug-induced liver injury.
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GSK Investigational Site
Glasgow, Lanarkshire, United Kingdom
GSK Investigational Site
Leicester, Leicestershire, United Kingdom
GSK Investigational Site
London, United Kingdom
GSK Investigational Site
Manchester, United Kingdom
Time frame: From visit 1 (Day -7 to Day -9) to upto follow-up (upto Day 28)
Number of Participants With Vital Sign of Potential Clinical Concern (PCC)
The vital sign measurement included measurement of systolic and diastolic blood pressure alongwith pulse rate. The PCC values reported for systolic blood pressure were \< 85 millimeter of mercury (mmHg) and \>160 mmHg; that for diastolic was \<45 mmHg and \>100 mmHg. The PCC values for pulse rate were \<40 and \> 110 beats per minute. The number of participants with values outside the PCC for systolic, diastolic blood pressure and vitals during the treatment duration were reported.
Time frame: Visit 2 (Day 1) to Upto follow-up (Day 28)
Number of Participants With Abnormal Electrocardiogram (ECG) Findings
The number of participants with abnormal ECG values were reported. The data was reported as Abnormal clinically significant (CS), abnormal not clinically significant (NCS), and No result.
Time frame: Visit 2 (Day 1) to Upto follow-up (Day 28)
Number of Participants With Clinical Chemistry Values of PCC
The clinical chemistry parameters evaluated were albumin, calcium, creatinine, glucose, magnesium, phosphorus, potassium, sodium, urea, gamma glutamyl transferase, and bicarbonate. The number of participants with values outside the PCC values were reported. The PCC value observed for bicarbonate was reported.
Time frame: Visit 2 (Day 1) to Upto follow-up (Day 28)
Number of Participants With Hematology Values of PCC
The hematology parameters evaluated were white blood cells, neutrophils, hemoglobin, hematocrit, platelets and lymphocytes. The number of participants with values outside the PCC values were reported. The PCC value observed for lymphocyte was reported.
Time frame: Visit 2 (Day 1) to Upto follow-up (Day 28)
Plasma Concentration of GSK2190915
The blood samples for analysis of pharmacokinetic parameters were collected at pre-dose and 2 hours post dose on Day 1 and pre-dose trough and 2 hour post dose on Day 12, to evaluate the concentration of the drug GSK2190915 in plasma.
Time frame: At Day 1, pre-dose; Day 1, 2 hour; Day 12, pre-dose; and Day 12, 2 hour
Percentage Change From Baseline Urine LTE4 Biomarker
The urine spot samples were collected from the participants at pre-dose on day 1 and trough day 12 for evaluation of LTE4 biomarker. This evaluated the level of inflammation in the airways of the asthma participants. The percentage change from baseline was calculated by dividing the post randomization change by the baseline value from the individual and multiplying by a 100. If either the baseline or post-randomization value is missing, the change from baseline is set to missing. Baseline was defined as Day 1(pre-dose).
Time frame: Day 1 and Day 12
Percentage Change From Baseline of LTB4 Biomarker in Plasma
The plasma samples were evaluated for presence of LTB4 biomarkers. The percentage change from baseline was calculated by dividing the post-randomization change by the baseline value from the individual and multiplying by a 100. If either the baseline or post-randomization value is missing, the change from baseline is set to missing. Baseline was defined as Day 1(pre-dose).
Time frame: Day 1 and Day 12
Concentration of LTB4 in Sputum
The concentration of LTB4 levels in sputum were evaluated. However due to early termination of the study, the data was not collected.
Time frame: Day 1 and Day 12
Concentration of Interleukin (IL)-17 and High-sensitivity C-reactive Protein (hsCRP) in Blood
The blood samples were collected to evaluate the concentration of IL-17 and hsCRP in blood. However due to early termination of the study, the data was not collected.
Time frame: Day 1 and Day 12
Assessment of Established Markers of Anti-inflammatory Activity in Sputum: the Measurements Will Include IL-17, Neutrophil Elastase, Myeloperoxidase and IL-8
During the study conduct it was observed that the levels of IL-17, measured in both blood and sputum were below limit of quantification; for neutrophil elastase, in sputum no inference could be made as most levels were above the limit of quantification. Thus due to limited amount of data the analysis was not summarized.
Time frame: Day 1 and Day 12
Asthma Control Questionnaire (ACQ) Assessment
ACQ measures the adequacy of asthma control. It includes 5 questions about symptoms of asthma, 1 question about the rescue medication used and 1 about lung function (FEV1% predicted). This is a 7-item scale where the items are equally weighted and the ACQ score is the mean of 7 items which ranges from 0 to 6. 0= Well controlled and 6=extremely poorly controlled. Mean scores of =\<0.75 indicate well-controlled asthma, scores between 0.76 and \< 1.5 indicate partly controlled asthma, and a score \>= 1.5 indicates uncontrolled asthma. Thus for ACQ a higher score indicates severe disease and a low score indicative of less severe disease.
Time frame: At Day 1, Day 5 to 7 and Day 12