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Potency of HDM Sublingual AIT Tablets in Assuring the Persistency of Asthma Control in HDM Allergic Patients With Severe Asthma, Treated With Tezepelumab

NCT07013123

Not Yet RecruitingPhase 3

Sponsor: University Hospital, Montpellier

Conditions: Severe Asthma, Allergy to House Dust Mites

Interventions: Tezepelumab, Acarizax, Placebo

The aim of this drug trial is to evaluate the annualized asthma exacerbation rate under treatment with Acarizax versus placebo. The trial is intended for adults aged 18 to 65 with severe uncontrolled asthma and a house dust mite allergy. The study will involve 32 patients (up to 38 with study dropouts) recruited from French hospitals, in pulmonology and allergology departments. Initially, all participants will receive Tezepelumab for 3 to 6 months (M-3/-6) to control asthma symptoms. If asthma is not controlled after 6 months, the participant will be excluded from the study and will continue on standard treatment. Once their asthma is controlled, patients will be randomized in two groups: * Group A: Tezepelumab + Acarizax® * Group B: Tezepelumab + Placebo After 6 months of treatment with Acarizax or placebo (M6), Tezepelumab will be stopped and participants will continue treatment with Acarizax or placebo alone for a further 12 months (up to M18/End of search). The study will include 5 visits during regular consultations (M-3/M-6, D0, M6, M12 and M18), as well as 2 follow-up telephone calls M3 and M9).

Eligibility overview

Sex: ALL

Age: 18 Years to 65 Years

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria

Inclusion Criteria:

* Patients aged ≥ 18 years and ≤ 65 years.
* Patient followed by a specialist in allergy and/or respiratory diseases working at one of the investigating sites in France.
* Patient allergic to HDM and with a clinical history of HDM-allergic asthma.
* Positive specific IgE (≥ 0.35 kUA/L, ImmunoCAP®) and positive skin prick test for Dermtophagoides pteronyssinus and/or Dermtophagoides farinae at screening.
* Patients satisfying diagnostic criteria for severe asthma, according to GINA international guidelines.
* A clinical history of asthma exacerbations in the past two years.
* A history of at least 2 asthma exacerbations during the previous 12 months.
* Uncontrolled asthma (ACT \<20/25)
* Lung function measured by FEV1 ≥ 70% of predicted value or according to local requirements.
* Patients with persistent severe asthma who meet the Marketing Authorization criteria for Tezspire® (Tezepelumab) and Acarizax® prescriptions.

Exclusion Criteria:

* Patients sensitized and regularly exposed to animal dander, molds, and/or cockroach or any another perennial allergen.
* Patients treated with a monoclonal antibody for asthma within the previous 3 months or 5 half-lives.
* Patients who have received Sublingual immunotherapy (SLIT) or Sub-Cutaneous Immunotherapy (SCIT) treatment with DermatophagoIdes pteronyssinus and/or Dermatophagoïdes farinae within the previous 5 years.
* Patients received any education provided by a medical indoor environment counselor during the 12 months before the study, or and educational program is programmed during the study.
* Patients with acute respiratory tract infections.
* The patient who have performed any specific measure for mites' avoidance during the 12 months before the study or plan to implement such measures during the study.
* Pregnant, breastfeeding or lactating women.
* Patients with a history of tumor, autoimmune, or immune deficiency pathology.
* Patients with hematological pathology (coagulation disorders, anemia) that could interfere with the blood test.
* The patient reports any previous hypersensitivity reaction to the active substance or excipients present in Tezspire® or Acarizax®.
* Patients unable to read and/or write French language.
* Absence of signed consent.
* Patients who are not beneficiaries of the French social security system.
* Presence of any condition (physical, psychological or other) that might, in the investigator's opinion, hinder study performance.
* The patient is unavailable or unwilling to participate in future visits or is unable to comply with trial protocol.
* Women of childbearing potential and fertile men not using effective contraception.
* The patient is participating in another study for asthma and/or allergy treatment.
* Patients in an exclusion period determined by a previous study or is currently participating to any other allergy/asthma trial.
* Patients under legal protection (guardianship or curatorship)
* Patients with a business or personal relationship with trial staff or sponsor who is directly involved with the conduct of the trial.