GSK2245035 belongs to a novel class of agonist drugs targeted at toll like receptors (TLR). T-helper cell 2 (Th2) driven inflammation is a key patho-physiological mechanism in allergic asthma. The clinical manifestations and inflammatory pathways of allergic asthma are sensitive to corticosteroid therapy. However, GSK2245035 reduces Th2-driven airway inflammation and thereby controls asthma symptoms. This study aims to determine whether intranasal GSK2245035 maintains biological and clinical control of allergic asthma using 'tapering of ICS' study design. This study will assess the efficacy and safety of GSK2245035 in subjects with allergic asthma treated with ICS. This will be a randomised, double-blind (sponsor open), placebo-controlled, parallel group, 8-week study treatment period. The study will consist of a screening period of up to approximately 5 weeks, blinded treatment period of 8 weeks, followed by a follow-up period of 7 weeks. A total of 60 subjects will be included in this study and duration of time for each subject will therefore be 141 days including screening and study ICS dose adjustment period. Diskus® is a registered trademark of GlaxoSmithKline group of companies.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
GSK2245035 will be administered weekly once as a nasal spray solution with dosing strength of 10 ng per actuation. GSK2245035 will be available as a saline formulation, preserved with benzalkonium chloride and disodium edetate in an amber glass bottle fitted with a screw-fit atomizing pump.
Placebo will be administered weekly once as a nasal spray solution. Placebo will be available as a saline formulation, preserved with benzalkonium chloride and disodium edetate in an amber glass bottle fitted with a screw-fit atomizing pump.
FP will be administered using Diskus inhaler with dosing strengths of 500, 250, 100, 50 µg twice daily per actuation.
Albuterol/Salbutamol MDI will be administered for symptom relief from screening to the end of the study.
Subjects will record all the alerts indicative of worsening of asthma in eDairy.
ACQ-6 will include six questions which enquire about the frequency and/or severity of symptoms. The response options for all these questions consist of a zero (no impairment/limitation) to six (total impairment/limitation) scale.
Change from Baseline in fractional exhaled breath nitric oxide (FeNO) level
FeNO level will be measured to determine efficacy of GSK2245035 in reducing asthma (airway) inflammation. The measurements will be performed using a handheld electronic device. 'Primary Endpoint Visit' (PEPV) will be 1-week post 8th dose. Subjects withdrawn from the study before PEPV because of protocol defined asthma worsening will attend a 'treatment withdrawal visit'.
Time frame: Baseline and up to Week 9
Number of subjects experiencing worsening of asthma from Baseline to PEPV
Asthma worsening is defined as one or more of the following: an increase in asthma control questionnaire 6 (ACQ-6) \>0.5 from Baseline; a daily asthma symptom score of \>=4 for 2 consecutive days; nocturnal awaking(s) due to asthma requiring short-acting beta agonist (SABA) use on 2 consecutive nights; an increase from Baseline of \>=4 puffs per day of rescue medication use on 2 consecutive days; \>=20 percent reduction in morning peak expiratory flow (PEF) from Baseline and \>=20 percent reduction in evening PEF from Baseline for 2 consecutive days; visit to emergency room / department, hospitalization or oral corticosteroid therapy for severe asthma exacerbation.
Time frame: Baseline and up to Week 9
Time for FeNO to increase by 10 parts per billion (ppb)
Increase in FeNO by 10 ppb will be calculated from first dose of GSK2245035 or placebo up to the 'study completion visit'.
Time frame: Up to Week 15
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