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Completed

NCT Number: NCT03494881

Mepolizumab for the Treatment of Chronic Spontaneous Urticaria

This is an exploratory study designed to generate preliminary data in evaluating the efficacy of Nucala in the treatment of chronic spontaneous urticaria.

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Key information

Conditions

Chronic Spontaneous Urticaria Chronic Disease Chronic Urticaria Disease Attributes Hypersensitivity Hypersensitivity, Immediate Immune System Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms Skin Diseases Skin Diseases, Vascular Skin and Connective Tissue Diseases Urticaria

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Early Phase 1

Primary location

Mayo Clinic in Florida

Jacksonville, Florida, 32224, United States

About this study

This is an open-label, single arm exploratory study of mepolizumab in the treatment of CSU. The primary endpoint will be the mean reduction in the seven day urticaria activity score (UAS7) before and after 10 weeks of treatment with mepolizumab. Secondary endpoints will be the mean reduction of the urticaria control test (UCT) score and the weekly itch severity score (ISS) before and after treatment. Enrollment examination will include a standardized history and examination, baseline UCT score, CBC with differential, serum IgE level, chronic urticaria index, IgE Fc receptor antibody functional assay, and a 4 mm punch biopsy of lesional skin to confirm the urticarial tissue reaction includes eosinophils and is not neutrophilic predominant. Patients will discontinue all anti-histamines and start cetirizine 10 mg PO BID which may be continued throughout the study duration. Patients will be provided with a log book to track daily urticaria signs and symptoms in a standardized manner for UAS scoring. At week 0 (enrollment visit +7 days), baseline UAS7 and ISS score will be assessed and skin biopsy results reviewed. Patients with a confirmatory skin biopsy will receive 200 mg SC of mepolizumab at week 0,2,4,6,and 8. UAS-7 and weekly ISS score will be calculated at week 0, 4, 8, and 10. UCT scoring will be calculated at week 0 and at week 10. Repeat CBC with differential, serum IgE level, and measures of basophil serum activation (chronic urticaria index, IgE FC Receptor antibody functional assay) will be assessed at week 10. Attached to this document is a protocol summary.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male and female patients 18 years or older.
  • Clinical and/or histopathological diagnosis of conventional CSU
  • Unresponsive to oral antihistamine therapy
  • Good general health as confirmed by medical history
  • Patients who are willing and capable of cooperating to the extent and degree required by the protocol; and
  • Patients who read and sign an approved informed consent for this study

Exclusion criteria

  • Vulnerable study population
  • If you are female and pregnant
  • Biopsy proven neutrophilic rich urticaria
  • Known history of adverse reaction to mepolizumab (Nucala)

Treatment and study plan

Nucala

Drug

All study participants will receive Nucala (2) 100mg SQ injections administered at two different anatomical sites at week zero, 2,4,6, and 8 for a total of 5 doses.

Other names: Mepolizumab

Primary outcomes

  1. Reduction in Urticaria Activity Score (UAS7)

    Time frame: Baseline to 10 Weeks

    Study participants documented their chronic spontaneous urticaria (CSU) symptoms using a diary, daily scoring for a) the number of wheals [none (=0 points), <10 (=1 point), 10-50 (=2 points), or >50 per day (=3 points)], and b) the intensity of pruritus [none (=0 points), mild (=1 point), moderate (=2 points), severe (=3 points)]. The daily UAS score is summed over a week to calculate the UAS7 score (range: 0-42). Participants were considered responders if they had ≥ 95% reduction in baseline UAS7 score and non-responders if they had <95% reduction in baseline UAS7 score.

Secondary outcomes

  1. Change in Short Form Urticaria Control Test Score (S-UCT)

    Time frame: Baseline to 10 weeks

    The short form urticaria control test (S-UCT) is a more recently developed and validated outcome instrument to retrospectively assess urticaria control. The S-UCT consists of 4 questions with each question having 5 answer options scored 0-4 with low points indicating high disease activity and low disease control. The minimum and maximum S-UCT scores are 0-16 with 16 points indicating complete disease control. Participants were considered responders if they had ≥ 95% reduction in baseline S-UCT score and non-responders if they had <95% reduction in baseline S-UCT score.

  2. Change in Long Form Urticaria Control Test (L-UCT) Score

    Time frame: Baseline to 10 Weeks

    The long form urticaria control test (L-UCT) is a more recently developed and validated outcome instrument to retrospectively assess urticaria control. The L-UCT consists of 8 questions with each question having 5 answer options scored 0-4 with low points indicating high disease activity and low disease control. The minimum and maximum L-UCT scores are 0-32 with 32 points indicating complete disease control. Participants were considered responders if they had ≥ 95% reduction in baseline L-UCT score and non-responders if they had <95% reduction in baseline L-UCT score.

  3. Change in Itch Severity Score (ISS)

    Time frame: Baseline to 10 weeks

    The weekly itch severity score measures the intensity and impact of itching (pruritus). It is calculated using the pruritus score of the daily Urticaria Activity Score (UAS) score summed over a week. Scores range from 0 to 21 with higher scores indicating worse itching. Participants were considered responders if they had ≥ 95% reduction in baseline ISS score and non-responders if they had <95% reduction in baseline ISS score.

Sponsors and collaborators

Lead sponsor

Mayo Clinic

Other

Collaborators

  • GlaxoSmithKline

Registry information

Official study title

Mepolizumab for the Treatment of Chronic Spontaneous Urticaria: An Open-label, Single-arm, Exploratory Study

Important dates

Study start
2019
Primary completion
2023
Study completion
2025
First posted
Apr 11, 2018
Registry last updated
Aug 27, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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