Clinical trial NCT05404763: Mepolizumab and Physical Activity in Severe Asthma
Official title: Evolution of Physical Activity in Severe Asthmatic Patients Treated With Mepolizumab
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Asthma
Asthma; Eosinophilic
Keywords: Severe asthma,
Physical activity
Exercise
Dyspnea
Lead sponsor: University Hospital, Lille
Sponsor class: OTHER
Collaborators: name: GlaxoSmithKline
First posted: 2022-06-03
Enrollment: 102
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: uncontrolled eosinophilic severe asthma with indication for treatment with mepolizumab

Brief summary: Severe asthma is a debilitating condition associated with frequent symptoms, life-threatening exacerbations and corticosteroid side-effects. Exercise limitation due to exercise-induced bronchoconstriction, dynamic lung hyperinflation and comorbidity may be a strong determinant of the disease burden. Mepolizumab is a monoclonal anti-interleukin-5 (IL-5) antibody that reduces the rate of severe exacerbations, asthma symptoms and oral glucocorticoid requirement, and improves quality of life and work productivity in severe eosinophilic asthma. However, its impact on physical activity and exercise tolerance is unknown. We hypothesize that a 6-month treatment with mepolizumab is associated with an improvement in daily life physical activity and exercise tolerance in relation with enhanced ventilatory mechanics.


Eligibility criteria: Inclusion Criteria:

* Age between 18 and 75 years at the time of inclusion
* Asthma diagnosed for at least one year including a history of

  1. FEV1 and/or FVC reversibility of more than 12% and than 200 ml documented in the patient's record
  2. OR FEV1 variability of more than 20% between two visits
  3. OR positive methacholine test
* Severe uncontrolled asthma monitored for at least six months in the investigation center with at least two assessments:

  1. high-dose of inhaled corticosteroids (ICS \>1,000 μg/day of beclometasone equivalent) in combination with another controller at a stable dosage for at least three months
  2. ACQ-5 score \>1.5 and/or more than two severe exacerbations (i.e exacerbation requiring ≥ 3 days of systemic corticosteroids, hospitalization or admission at the emergency department) in the past year
  3. Blood eosinohils ≥300/mm3 within the 12 past months
  4. Decision to introduce mepolizumab according to regulatory approval
  5. Patient agreement to receive Mepolizumab
* Body mass index (BMI) within the range \[18.5 - 35\] kg/m2.
* Able to give signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol

Exclusion Criteria:

* Body Mass Index \<18.5 or \>35 kg/m2
* Active smoker or active smoking during the last 6 months or cumulative \> 10 pack-years
* All conditions responsible for physical disability (neurological, orthopedic, psychiatric, non-exhaustive list) or other condition limiting exercise in the investigator's opinion
* Any chronic respiratory or cardiac pathology which may interfere with the assessment of asthma according to the investigator's opinion
* Prior treatment with mepolizumab or benralizumab
* Bronchial thermoplasty during the past 12 months
* Contraindication to mepolizumab
* Non-coverage by the social security insurance
* Pregnant, breastfeeding, or lactating women
* Patient unable to receive information
* Refusal to sign the consent form
* Unwillingness or inability to follow the study procedures, in the opinion of the investigator
* Person deprived of the liberty Person benefiting from a system of legal protection (guardianship...)

Primary outcomes:
measure: Number of daily steps
timeFrame: after 6 months of treatment with mepolizumab
Secondary outcomes:
measure: Time with moderate physical activity (between 3 and 6 METs) and intense activity (>6 METs)
timeFrame: Baseline, at 3 months and at 6 months
measure: Percentage of time spent with moderate physical activity (between 3 and 6 METs) and intense activity (>6 METs)
timeFrame: Baseline, at 3 months and at 6 months
measure: Ricci and Gagnon questionnaire score •
timeFrame: Baseline, at 3 months and at 6 months
measure: Endurance time during a sub-maximal exercise (80% of maximum load)
timeFrame: Baseline, at 3 months and at 6 months
measure: Baseline Dyspnea Index (BDI)
timeFrame: Baseline, at 3 months and at 6 months
measure: Transition Dyspnea Index (TDI) scores
timeFrame: Baseline, at 3 months and at 6 months
measure: The modified Medical Research Council (mMRC) scale
timeFrame: Baseline, at 3 months and at 6 months
measure: Multidimensional Dyspnea Profile (MDP) scores
timeFrame: Baseline, at 3 months and at 6 months
measure: ACQ-5 score
timeFrame: Baseline, at 3 months and at 6 months
measure: AQLQ score
timeFrame: Baseline, at 3 months and at 6 months
measure: Hospital Anxiety and Depression scores (HADS)
timeFrame: Baseline, at 3 months and at 6 months
measure: Respiratory capacity by Spirometry
timeFrame: Baseline, at 3 months and at 6 months
measure: Respiratory capacity by plethysmography
timeFrame: Baseline, at 3 months and at 6 months
measure: Forced inspiratory by Spirometry
timeFrame: Baseline, at 3 months and at 6 months
measure: Ventilatory function by Spirometry
timeFrame: Baseline, at 3 months and at 6 months
measure: Forced oscillation by impulse oscillometry (the Tremoflo ® oscillometry system)
timeFrame: Baseline, at 3 months and at 6 months
measure: Frequency of serious and non-serious side effects
timeFrame: Baseline, at 3 months and at 6 months
Other outcomes:
Locations:
city: Lille
country: France
facility: Lille University Hospital
Study officials:
affiliation: University Hospital, Lille
name: Cécile Chenivesse, MD,PhD
role: PRINCIPAL_INVESTIGATOR
References: