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NCT05545072: ADAPT

Add-on Dupilumab for AFRS as Postoperative Therapy (ADAPT)

Terminated Phase 3 Results posted Last updated 8 May 2025
What this trial tests

Phase 3 trial testing Dupilumab in Allergic Fungal Rhinosinusitis in 5 participants. Terminated before completion.

Timeline
26 October 2023
Primary endpoint
10 July 2024
10 July 2024

Quick facts

Lead sponsorEmory University
PhasePhase 3
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment5
Start date26 October 2023
Primary completion10 July 2024
Estimated completion10 July 2024
Sites3 locations across United States

Drugs / interventions tested

Conditions studied

Sponsor

Emory University

Who can join

18 and older, any sex, with Allergic Fungal Rhinosinusitis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Incidence of Oral/Topical Corticosteroid Utilization Per Participant Primary · Baseline and End of Treatment at Week 52

The number of participants who, during study treatment and off-treatment follow-up, based on clinical evaluation, present worsening signs and/or symptoms and are started on oral corticosteroids rescue treatment.

Baseline
GroupValue95% CI
Dupilumab3
Placebo2
Week 12
GroupValue95% CI
Dupilumab0
Placebo0
Week 24
GroupValue95% CI
Dupilumab0
Prevalence of Revision Sinus Surgery for Recurrent Nasal Polyps, and Comparison of Survival Curves Secondary · Up to End of Treatment at Week 52

Documentation of the number of revision sinus surgery per participant, that are deemed clinically necessary for the treatment of an acute exacerbation of chronic rhinosinusitis (AECRS)

GroupValue95% CI
Dupilumab0± 0
Placebo0± 0
Endoscopic Nasal Polyp Score (NPS) Secondary · Baseline and End of Treatment at Week 52

NPS is a physician-reported tool to grade the extent/severity of nasal polyps based on evaluation by nasal endoscopy. Each nostril is scored on a scale of 0 (no polyps visible) to 4 (massive polyposis completely obstructing the nasal cavity), with the total score being the sum of left and right nostril scores (range: 0-8). The total NPS is the sum of scores from the right and left nostrils.

Baseline
GroupValue95% CI
Dupilumab4.33± 0.47
Placebo5± 1
Week 12
GroupValue95% CI
Dupilumab1± 0
Placebo0± 0
Week 24
GroupValue95% CI
Dupilumab2± 0
Percent Predicted Forced Vital Capacity (%FVC) Following Sinus Surgery in the Subgroup of Participants With Asthma (~25%) Secondary · Baseline and End of Treatment at Week 52

Spirometry is a common office test used to assess how well the participant's lungs work by measuring how much air the participant inhales, how much the participant exhales, and how quickly the participant exhales. Forced vital capacity (FVC) refers to the maximal volume of air that can be expired following maximum inspiration. It is the total of tidal volume, inspiratory reserve volume, and expiratory reserve volume. The percent FVC is the FVC compared to a predicted FVC based on age, sex, and height.

Baseline
GroupValue95% CI
Dupilumab107± 3
Placebo104± 0
Forced Expiratory Volume in 1 Second (FEV1) Following Sinus Surgery in the Subgroup of Participants With Asthma (~25%) Secondary · Baseline and End of Treatment at Week 52

Forced expiratory volume in one second (FEV1) is measured during a spirometry test, also known as a pulmonary function test, which involves forcefully breathing out into a mouthpiece connected to a spirometer machine. FEV1 is the amount of air forced from the lungs in one second.

Baseline
GroupValue95% CI
Dupilumab3.55± 0.76
Placebo2.80± 0
Forced Vital Capacity (FVC) Following Sinus Surgery in the Subgroup of Participants With Asthma (~25%) Secondary · Baseline and End of Treatment at Week 52

Forced vital capacity (FVC) is measured during a spirometry test, also known as a pulmonary function test, which involves forcefully breathing out into a mouthpiece connected to a spirometer machine. FVC is the total amount of air exhaled during the FEV test.

Baseline
GroupValue95% CI
Dupilumab4.67± 1.07
Placebo3.53± 0
FEV1/FVC Ratio Following Sinus Surgery in the Subgroup of Participants With Asthma (~25%) Secondary · Baseline and End of Treatment at Week 52

The FEV1/FVC ratio is the ratio of the forced expiratory volume in the first one second to the forced vital capacity of the lungs. The normal value for this ratio is above 0.75-85, though this is age-dependent, values less than 0.70 are suggestive of airflow limitation with an obstructive pattern.

Baseline
GroupValue95% CI
Dupilumab0.76± 0.01
Placebo0.79± 0
The 22-item Sinonasal Outcomes Test (SNOT-22) Score Secondary · 52 weeks and 64 weeks

The SNOT-22 score is a validated disease-specific questionnaire quantifying the quality of life among participants with chronic rhinosinusitis. The individual question scores range from 0 (no problem) to 4 (as bad as it can be) among 22 separate questions. Scoring 0 to 110. Higher scores = more severe symptoms and poorer quality of life.

Baseline
GroupValue95% CI
Dupilumab37± 14.73
Placebo17± 5.66
Week 12
GroupValue95% CI
Dupilumab13± 0
Placebo2± 0
Week 24
GroupValue95% CI
Dupilumab12± 0
Change in Asthma Control Questionnaire (ACQ) Score Among Participants With Asthma Secondary · 52 weeks and 64 weeks

The Asthma Control Questionnaire (ACQ) is a validated, self-administered survey used to assess a participants' perception of disease control over the preceding week using Likert scale responses with a range of 0 (well controlled) to 6 (extremely poorly controlled). The ACQ consists of 7 items surveying the frequency of asthma related symptoms, the need for rescue medications, and perceived control of disease. The items are equally weighted and the ACQ score is the mean of the 7 items. Total scores range from 0 to 6 with lower scores indicating better control of asthma symptoms. A score change

Baseline
GroupValue95% CI
Dupilumab5.5± 0.5
Placebo6± 0
Prevalence of Oral/Topical Corticosteroid Utilization Per Treatment Cohort Secondary · 52 weeks and 64 weeks

The number of participants who, during study treatment and off-treatment follow-up, based on clinical evaluation, have to continue on oral corticosteroid rescue treatment due to worsening signs and/or symptoms.

Baseline
GroupValue95% CI
Dupilumab0
Placebo0
Week 12
GroupValue95% CI
Dupilumab0
Placebo0
Week 24
GroupValue95% CI
Dupilumab0
Incidence of Oral/Topical Antibiotic Utilization Per Participant Secondary · 52 weeks and 64 weeks

The number of participants who, during study treatment and off-treatment follow-up, based on clinical evaluation, present worsening signs and/or symptoms and are started on oral/topical antibiotic rescue treatment.

Baseline
GroupValue95% CI
Dupilumab0
Placebo0
Week 12
GroupValue95% CI
Dupilumab0
Placebo0
Week 24
GroupValue95% CI
Dupilumab0
Prevalence of Oral/Topical Antibiotic Utilization Per Treatment Cohort Secondary · 52 weeks and 64 weeks

The number of participants who, during study treatment and off-treatment follow-up, based on clinical evaluation, have to continue on oral/topical antibiotic rescue treatment due to worsening signs and/or symptoms.

Baseline
GroupValue95% CI
Dupilumab0
Placebo0
Week 12
GroupValue95% CI
Dupilumab0
Placebo0
Week 24
GroupValue95% CI
Dupilumab0

Adverse events — posted to ClinicalTrials.gov

Time frame: Information on adverse events was collected beginning at run-in (Week -6) and continued through the final assessment at Week 24 until the study premature termination.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Dupilumab
Serious: 0/3 (0%)
Deaths: 0/3
Placebo
Serious: 0/2 (0%)
Deaths: 0/2
Other adverse events (4 terms — click to expand)

ReactionSystemDupilumabPlacebo
Injection Site ReactionSkin and subcutaneous tissue disorders
OtherGeneral disorders
HeadacheNervous system disorders
Joint PainMusculoskeletal and connective tissue disorders

Data from ClinicalTrials.gov NCT05545072 adverse events section.

Sponsor's own description

The purpose of this study is to find a more effective treatment for allergic fungal rhinosinusitis (AFRS). Most people suffering from nasal polyps have elevated levels of white blood cells called eosinophils that are involved in inflammation of the air passages. Despite appropriate treatment with oral/topical corticosteroids, saline irrigations, and surgery, nasal polyps return frequently within months of surgery. Participants will be administered a placebo or dupilumab every two weeks for 52 weeks.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Single-cell analysis of human nasal mucosal IgE antibody secreting cells reveals a newly minted phenotype.
    Ramonell RP, Brown M, Woodruff MC, Levy JM, et al · · 2023 · cited 22× · PMID 36931600 · DOI 10.1016/j.mucimm.2023.02.008
  2. Biologic Therapies across Nasal Polyp Subtypes.
    Bolk KG, Wise SK. · · 2024 · cited 2× · PMID 38673059 · DOI 10.3390/jpm14040432
  3. Prostaglandin E Receptor 2 (EP2) Dysregulation in Allergic Fungal Rhinosinusitis Nasal Polyp Epithelium.
    Smith-Davidson P, Altartoor K, Kabongo MM, Claussen H, et al · · 2025 · cited 1× · PMID 39487665 · DOI 10.1002/lary.31868

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing