A Phase 1b/2a, Dose Escalation Trial of Safety, Pharmacokinetic/Pharmacodynamic and Preliminary Clinical Activity of Briquilimab in Adult Patients with Chronic Spontaneous Urticaria (CSU) Who Remain Symptomatic Despite Treatment with H1 Antihistamines And/or Omalizumab, or Who Cannot Tolerate Omalizumab
This trial will be performed as a three-part dose escalating clinical trial where Parts 1 is open label and Parts 2 and 3 are randomized, double-blinded, and placebo-controlled. The trial is intended to determine the safety and tolerability and assess the preliminary efficacy of briquilimab in adult participants with chronic spontaneous urticaria (CSU), who remain symptomatic despite treatment with H1 antihistamines and omalizumab. Additionally, pharmacokinetic (PK) properties of briquilimab, and other pharmacodynamic (PD) parameters (such as effects on mast cells (MC), serum tryptase levels, and on allergic skin reactivity) will be investigated.
• Written informed consent after the nature of the trial has been fully explained and before performing any trial related assessments
• Males and females, ≥18 years old
• i. For Cohorts 1, 2, 3, 4a, 4b, 5, 5b, 6 and 7: Diagnosis of symptomatic CSU despite treatment as defined by:
‣ Diagnosis of CSU for ≥ 6 months
⁃ The presence of itch and hives for ≥ 8 consecutive weeks at any time prior to Screening despite current use of H1-antihistamines (as reported by the participant)
⁃ The presence of itch and hives for ≥ 8 consecutive weeks at any time prior to Screening despite treatment with omalizumab or intolerance to omalizumab (as reported by the participant)
⁃ UAS7 of ≥ 16 and ISS7 of ≥ 8 on 7 consecutive days between Day -10 through Day-1 of Screening
• ii. For Cohorts 8 and 9: Diagnosis of symptomatic CSU despite treatment as defined by:
⁃ Diagnosis of CSU for ≥ 6 months (as per local and international guidance)
⁃ The presence of itch and hives for ≥ 8 consecutive weeks at any time prior to Screening despite current use of H1-antihistamines (as reported by the participant)
⁃ Participants may be omalizumab naïve or have been previously exposed to omalizumab independent of treatment duration or response
⁃ UAS7 of ≥ 16 and ISS7 of ≥ 8 on 7 consecutive days between Day -10 through Day -1 of Screening
• Use of H1-antihistamines on stable dose up to four-fold of the approved dose since Screening and not expected to change during first 12 weeks of the trial
• Blood counts at Screening with:
‣ Hemoglobin: ≥ 11 g/dl
⁃ Platelets: ≥ 100,000/mm3
⁃ Leucocytes: ≥ 3,000/mm3
⁃ Neutrophils: ≥ 2,000/mm3
• Willing and able to complete a daily diary for the duration of the trial and adhere to the trial visit schedule