Six Injections of Modified Adjuvanted PQ Grass Is Effective and Well-Tolerated in a Pivotal Phase III Trial.

IF 12.6 1区 医学 Q1 ALLERGY Allergy Pub Date : 2025-02-04 DOI:10.1111/all.16491
Stefan Zielen, Jonathan A Bernstein, Gunter J Sturm, Marek Jutel, Oliver Pfaar, Mohamed H Shamji, Ralph Mösges, Markus Berger, Uwe E Berger, Lawrence DuBuske, Janice A Layhadi, Ludger Klimek, Markus Ollert, Murray A Skinner, Matthias F Kramer, Pieter-Jan de Kam
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Abstract

Background: PQ Grass 27600 SU (PQ Grass) cumulative dose is a pre-seasonal, six-injection, aluminium-free, modified subcutaneous immunotherapy product under development for the treatment of allergic rhinitis (AR). A pivotal Phase III randomised double-blind, placebo-controlled clinical trial was performed to evaluate the efficacy and safety of PQ Grass in subjects with seasonal AR.

Methods: An adaptive group sequential trial PQGrass306 (G306) with one pre-defined interim analysis was designed, using 2 parallel groups applying a 1:1 active versus placebo randomisation of patients aged 18-65. The primary efficacy endpoint was the EAACI (European Academy of Allergy and Clinical Immunology) Combined Symptom and Medication Score (EAACI-CSMS0-6) averaged over the peak grass pollen season (GPS).

Results: 858 subjects were screened and 555 subjects were randomised. Based on the results of the pre-defined interim analysis, the trial was stopped for success showing superiority in favour of PQ Grass. The primary endpoint EAACI-CSMS0-6 (peak GPS) demonstrated a highly significant and clinically meaningful point difference of PQ Grass over placebo of -0.27 points (95% CI: -0.42 to -0.12), corresponding to a relative difference of -20.3% (p = 0.0005). Highly consistent and beneficial results were obtained for PQ Grass for all key secondary endpoints. Significant induction of blocking IgG4 and IgA antibody subclasses occurred. PQ Grass was well tolerated, and no unexpected safety signals occurred.

Conclusions: This pivotal Phase III trial demonstrated a significant and clinically meaningful effect on the primary endpoint as well as highly consistent secondary endpoint results and a supportive safety profile.

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背景:PQ Grass 27600 SU(PQ Grass)累积剂量是一种季节前注射、六次注射、不含铝的改良皮下免疫疗法产品,正在开发用于治疗过敏性鼻炎(AR)。为了评估 PQ Grass 对季节性 AR 患者的疗效和安全性,我们进行了一项关键的 III 期随机双盲安慰剂对照临床试验:设计了一项自适应分组序列试验 PQGrass306 (G306),其中包含一项预先确定的中期分析,采用 2 组平行试验,对 18-65 岁的患者进行 1:1 的活性与安慰剂随机分组。主要疗效终点是欧洲过敏与临床免疫学会(EAACI)症状与用药综合评分(EAACI-CSMS0-6)在草花粉高峰季节(GPS)的平均值:筛查了 858 名受试者,随机抽取了 555 名受试者。根据预先确定的中期分析结果,试验因成功显示 PQ Grass 的优越性而停止。主要终点 EAACI-CSMS0-6(GPS 峰值)显示,PQ Grass 与安慰剂相比,具有高度显著性和临床意义的点数差异为-0.27 点(95% CI:-0.42 至-0.12),相对差异为-20.3%(p = 0.0005)。在所有关键次要终点方面,PQ Grass 均获得了高度一致的有益结果。阻断 IgG4 和 IgA 抗体亚类的诱导效果显著。PQ Grass的耐受性良好,没有出现意外的安全信号:这项关键的 III 期试验表明,PQ 草对主要终点具有显著的临床意义,次要终点结果高度一致,安全性也很好。
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来源期刊
Allergy
Allergy 医学-过敏
CiteScore
26.10
自引率
9.70%
发文量
393
审稿时长
2 months
期刊介绍: Allergy is an international and multidisciplinary journal that aims to advance, impact, and communicate all aspects of the discipline of Allergy/Immunology. It publishes original articles, reviews, position papers, guidelines, editorials, news and commentaries, letters to the editors, and correspondences. The journal accepts articles based on their scientific merit and quality. Allergy seeks to maintain contact between basic and clinical Allergy/Immunology and encourages contributions from contributors and readers from all countries. In addition to its publication, Allergy also provides abstracting and indexing information. Some of the databases that include Allergy abstracts are Abstracts on Hygiene & Communicable Disease, Academic Search Alumni Edition, AgBiotech News & Information, AGRICOLA Database, Biological Abstracts, PubMed Dietary Supplement Subset, and Global Health, among others.
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