Phase 2a, randomized, double‐blind, placebo‐controlled, multicentre, parallel‐group study of an H₄R‐antagonist (JNJ‐39758979) in adults with uncontrolled asthma

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Summary Background The effects of H 4 R antagonists in preclinical asthma models support the study of antagonists of the H 4 R in the treatment of asthma in humans. JNJ ‐39758979 is a potent and highly selective oral H 4 R antagonist. Objective We sought to evaluate the safety and efficacy of the H 4 R‐antagonist JNJ ‐39758979 in adult patients with uncontrolled asthma. Methods One hundred and fifteen eligible patients were randomly assigned to JNJ ‐39758979 300 mg or placebo once daily for 12 weeks in this phase 2a, double‐blind, multicenter, placebo‐controlled study. Primary efficacy was assessed via week‐12 change from baseline in pre‐bronchodilator forced expiratory volume in 1 second ( FEV 1 ). Secondary efficacy assessments included patient‐reported outcome ( PRO ) asthma assessments (Asthma Daily Diary data [ AM and PM peak expiratory flow rate, number of puffs of albuterol/salbutamol, the presence of nocturnal awakenings and asthma symptom score]). Results The study did not meet the primary end‐point. However, nominally significant improvements in pre‐bronchodilator FEV 1 were observed with JNJ ‐39758979 versus placebo at week 12 in pre‐specified subgroups with elevated exhaled nitric oxide, sputum eosinophils or blood eosinophils at baseline. Nominally significant improvements across PRO assessments were consistently observed in the overall population, as well as in eosinophilic subgroups. Safety, such as adverse event rates, was comparable between JNJ ‐39758979 and placebo. No serious adverse events were reported. No clinically relevant changes in laboratory values were observed. Conclusions and Clinical Relevance The findings suggest potential benefit of H 4 R antagonists on lung function and asthma control in eosinophilic asthma patients and warrant further evaluation of this mechanism in asthma with eosinophilic inflammation. NCT 00946569.