A Study of the Efficacy and Safety of Brensocatib in Participants With Chronic Rhinosinusitis Without Nasal Polyps (CRSsNP)

Study Overview
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Brief Summary
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The primary purpose of the study is to evaluate the efficacy of brensocatib at 10 and 40 milligrams (mg) once daily (QD) compared with placebo in improving clinical symptoms of CRSsNP.

Official Title
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A Phase 2b, Randomized, Double-Blind, Placebo-Controlled, Multicenter Study of the Efficacy and Safety of Brensocatib in Participants With Chronic Rhinosinusitis Without Nasal Polyps - The BiRCh Study

Conditions
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Chronic Rhinosinusitis Without Nasal Polyps

Intervention / Treatment
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* Drug: Brensocatib
* Drug: Placebo
* Drug: Mometasone furoate nasal spray (MFNS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants who have at least a 12-week history before Screening Visit of CRSsNP and confirmed by endoscopy at Visit 1 (Screening). Participants must have a NCS of ≥2 at Visit 1 (Screening Visit) and Visit 2 (weekly average score). Participants must have sTSS (nasal congestion [NC], anterior/posterior rhinorrhea, facial pain/pressure) ≥5 at Visit 1 (Screening) and at Visit 2 (Baseline) (average score in the week prior to randomization). Participants who have at least 1 of the 3 following features: Previous sinonasal surgery for CRS, including but not limited to fenestrated endoscopic sinus surgery and balloon sinuplasty. Received medical treatment with systemic corticosteroids (SCS) to treat symptoms of CRS as defined by any dose and duration within 1 year of Screening Visit or intolerance/contraindication to SCS. Received a course of antibiotics to treat symptoms of CRS within 1 year before the Screening Visit. Participants who have a blood eosinophil count ≤750 cells/microliter (μL) at Visit 1 (Screening). Participants who have bilateral inflammation of paranasal sinuses in the CT scan performed during Screening and bilateral ethmoid and/or maxillary opacification before randomization as confirmed by the central reader. Participants who have a SNOT-22 score of ≥20 at Visit 1 (Screening) and Visit 2 (Baseline). Participants who have received a stable daily dose regimen of MFNS for at least 4 weeks before Visit 2 (Baseline). Exclusion Criteria: Diagnosis of unilateral or bilateral chronic rhinosinusitis with nasal polyps (CRSwNP). Clinical diagnosis of cystic fibrosis (CF) or primary ciliary dyskinesia. Scheduled sinus surgery at any time during the study. Participants who have had nasal surgery within 4 weeks of Visit 1 (Screening) and during the Screening Period. Significant oral maxillofacial structural abnormalities or severe septal deviation. Participants with radiological suspicion or confirmed invasive fungal rhinosinusitis, odontogenic sinusitis, osteomas, or nasal tumors. Participants with acute change in symptoms consistent with acute rhinosinusitis. Participants with seasonal allergic rhinitis whose symptoms coincide with the treatment period of the study. Participants with moderate to severe atopic dermatitis requiring treatment with high potency topical steroids or topical calcineurin inhibitors or biologics. Clinical diagnosis of Papillon-Lefèvre syndrome. Note: Other inclusion/exclusion criteria may apply.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Brensocatib 40 mg<br>Participants will receive brensocatib 40 mg tablet, orally, QD for 24 weeks along with mometasone furoate nasal spray (MFNS) by nasal route as background therapy at a stable dose according to the Investigator's discretion and local guidance. | Drug: Brensocatib<br>* Film-coated tablet.<br>* Other names: INS1007;Drug: Mometasone furoate nasal spray (MFNS)<br>* Nasal spray suspension.<br>|
| Experimental: Brensocatib 10 mg<br>Participants will receive brensocatib 10 mg tablet, orally, QD for 24 weeks along with MFNS by nasal route as background therapy at a stable dose according to the Investigator's discretion and local guidance. | Drug: Brensocatib<br>* Film-coated tablet.<br>* Other names: INS1007;Drug: Mometasone furoate nasal spray (MFNS)<br>* Nasal spray suspension.<br>|
| Placebo Comparator: Placebo<br>Participants will receive a brensocatib-matching placebo tablet, orally, QD for 24 weeks along with MFNS by nasal route as background therapy at a stable dose according to the Investigator's discretion and local guidance. | Drug: Placebo<br>* Film-coated tablet.<br>Drug: Mometasone furoate nasal spray (MFNS)<br>* Nasal spray suspension.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline to the 28-day Average of Daily Sinus Total Symptom Score (sTSS) at Week 24 |  | Baseline and Week 24 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change From Baseline in Percentage of Sinus (Maxillary and Ethmoid) Opacification as Measured by Volumetry at Week 24 | The computed tomography (CT) scan performed during Screening (considered as Baseline) and at Week 24 will be used for the volumetric assessment of maxillary and ethmoid sinus opacification. | Baseline and Week 24 | 
| Change From Baseline in Modified Lund-MacKay (LMK) Computed Tomography (CT) Score at Week 24 |  | Baseline and Week 24 | 
| Participant Status Indicator Assessed as Percentage of Participants Requiring Rescue (Antibiotics, Systemic Corticosteroids [SCS], and/or Nasal Surgery) due to Worsening of any Chronic Rhinosinusitis (CRS) Symptoms |  | Baseline to Week 24 | 
| Change From Baseline to the 28-day Average of Daily Nasal Congestion Score (NCS) at Week 24 |  | Baseline and Week 24 | 
| Change From Baseline to the 28-day Average of Daily Peak Nasal Inspiratory Flow (PNIF) at Week 24 |  | Baseline and Week 24 | 
| Change From Baseline in Sino-Nasal Outcome Test (SNOT-22) Total Score at Week 24 |  | Baseline and Week 24 | 
| Plasma Concentration of Brensocatib |  | Pre-dose and at multiple timepoints post-dose up to Week 24 | 
| Percentage of Participants who Experienced at Least One Adverse Event (AE) | Determination of the safety and tolerability of brensocatib compared with placebo. | Up to 28 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CRSsNP