Trial Outcomes & Findings for A Pilot Study of the Use of 129Xe and 1H MRI to Measure the Modulation of Eosinophil-Related Inflammation by Mepolizumab In COPD (NCT NCT05138250)

NCT ID: NCT05138250

Last Updated: 2026-05-07

Results Overview

The within subject change in VDP assessed by XeMRI from baseline to 12 weeks of treatment with mepolizumab. Since the protocol was written, the convention has been to report ventilation defect, the percentage of lung that is not ventilated, rather than %VV, the percentage that is ventilated. A decrease in ventilation defect is an improvement in ventilation.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

31 participants

Primary outcome timeframe

Baseline to 12 weeks of treatment

Results posted on

2026-05-07

Participant Flow

This is not a randomised controlled trial, so all participants who were confirmed as eligible after the screening visit were allocated to receive the study drug.

Participant milestones

Participant milestones
Measure
Participants Who Received the Study Drug (All Eligible Participants)
Participants who received the study drug (All eligible participants)
Participants completing assessment 1
STARTED
31
Participants completing assessment 1
COMPLETED
31
Participants completing assessment 1
NOT COMPLETED
0
Participants completing assessment 2
STARTED
31
Participants completing assessment 2
COMPLETED
25
Participants completing assessment 2
NOT COMPLETED
6
Participants completing assessment 3
STARTED
27
Participants completing assessment 3
COMPLETED
21
Participants completing assessment 3
NOT COMPLETED
6

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Pilot Study of the Use of 129Xe and 1H MRI to Measure the Modulation of Eosinophil-Related Inflammation by Mepolizumab In COPD

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Participants Completing Assessment 2
n=25 Participants
Participants who completed the 12 week MRI assessment visit
Age, Continuous
67.6 years
STANDARD_DEVIATION 9.77 • n=54 Participants
Sex: Female, Male
Female
12 Participants
n=54 Participants
Sex: Female, Male
Male
13 Participants
n=54 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=54 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
25 Participants
n=54 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=54 Participants

PRIMARY outcome

Timeframe: Baseline to 12 weeks of treatment

The within subject change in VDP assessed by XeMRI from baseline to 12 weeks of treatment with mepolizumab. Since the protocol was written, the convention has been to report ventilation defect, the percentage of lung that is not ventilated, rather than %VV, the percentage that is ventilated. A decrease in ventilation defect is an improvement in ventilation.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=25 Participants
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Change in Percentage Ventilated Defect Percent (VDP)
-0.14 % change in VDP
Standard Deviation 6.5

PRIMARY outcome

Timeframe: From Baseline to 12 weeks of treatment

Population: There was missing data for 4 participants for this measure.

The within participant change in membrane (M)/gas (the ratio of xenon dissolved in the alveolar membrane to gaseous xenon in the airspaces, a measure of alveolar membrane absorption) assessed by XeMRI from baseline to 12 weeks of mepolizumab as an index of pulmonary inflammation. M/gas is a measure of alveolar thickness, which is an index of pulmonary inflammation. An decrease in M/gas indicates reduced inflammation.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=21 Participants
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Change in Pulmonary Inflammation
-0.00009 ratio
Interval -0.00025 to 0.00026

SECONDARY outcome

Timeframe: From Baseline to 12 weeks of treatment

Population: Moderate and severe exacerbations were counted for the 20 participants who completed the full 52 weeks of the study, of these data was collected for this outcome measure in 17 participants. The two groups were similar in terms of age, sex, smoking status, breathlessness, CAT score, and spirometry. Baseline eosinophil count and FeNO was similar and only differed in exacerbation number.

Comparison of change in MRI metrics (Longitudinal relaxation time (T1)) from baseline to 12 weeks in groups with a) low or b) high total 52 week exacerbation (groups defined by median split of total exacerbations over 52 weeks assessed by EXACT-Pro). Longitudinal relaxation time (T1) is intrinsic MRI relaxation time affected by changes in tissue water content, this measure is expected to increase with inflammation.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=11 Participants
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
n=6 Participants
Participants who had \> 2 moderate or severe exacerbations in 12months
Change in MRI Metrics in Low and High Exacerbation Groups - Longitudinal Relaxation Time (T1)
53 ms
Standard Deviation 147
-4 ms
Standard Deviation 81

SECONDARY outcome

Timeframe: From Baseline to 12 weeks of treatment

Population: Moderate and severe exacerbations were counted for the 20 participants who completed the full 52 weeks of the study, data for this outcome measure was collected in 17 participants. The two groups were similar in terms of age, sex, smoking status, breathlessness, CAT score, and spirometry. Baseline eosinophil count and FeNO was similar and only differed in exacerbation number.

Comparison of change in MRI metrics (Proton spin density (M0)) from baseline to 12 weeks in groups with a) low or b) high total 52 week exacerbation (groups defined by median split of total exacerbations over 52 weeks assessed by EXACT-Pro). Proton spin density (M0) is a measure of parenchymal density affected by changes in tissue water content, this measure is expected to increase with inflammation.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=11 Participants
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
n=6 Participants
Participants who had \> 2 moderate or severe exacerbations in 12months
Change in MRI Metrics in Low and High Exacerbation Groups - M0
36 arbitrary units
Standard Deviation 206
-3 arbitrary units
Standard Deviation 130

OTHER_PRE_SPECIFIED outcome

Timeframe: From Baseline to 52 weeks of treatment

Change in MRI indices of ventilation. %VV at 52 weeks compared to baseline, as measured by Xenon MRI scan. An increase in ventilated volume indicates an increase in the area of lung that oxygen can reach.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=20 Participants
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Change in MRI Indices of Ventilation - 52 Weeks
68.1 % Ventilated lung volume
Standard Deviation 13.9

OTHER_PRE_SPECIFIED outcome

Timeframe: From Baseline to 12 weeks of treatment

Population: 25 individuals had usable data for this outcome measure at week 12. 286 correlations were made between physiological measures and MRI measures of lung function

Correlation of change in physiological measures and MRI measures of lung function and inflammation at 12 weeks. Correlations were made between the change in 13 lung function measurements and 22 MRI measurements between 0-12 weeks.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=286 correlations
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Correlation of Changes to Measures of Lung Function and Inflammation (MRI and Physiological)
14 significant correlations

OTHER_PRE_SPECIFIED outcome

Timeframe: From Baseline to 12 weeks of treatment

Population: 25 participants had usable data at this time point 188 correlations were made between ken physiological measures and MRI determined measures of ventilation, perfusion and inflammation

Correlations of change in 4 key physiological and MRI determined measures of ventilation, perfusion and inflammation (47 measures) at 12 weeks from baseline were calculated.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=188 correlations
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Various Correlations of Change of Ventilation, Perfusion and Inflammation Measures
15 significant correlations

OTHER_PRE_SPECIFIED outcome

Timeframe: From Baseline to 12 weeks of treatment

Population: 25 participants had usable data at this timepoint CAT was correlated with 36 measures of lung function by physiology and MRI.

Comparison of change of COPD Assessment Test from baseline to 12 weeks within participants compare to changes in measures of lung function by physiology and MRI.

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=36 correlations
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Overall Impact of Mepolizumab Treatment on HRQoL in COPD (12 Weeks)
0 significant correlations

OTHER_PRE_SPECIFIED outcome

Timeframe: From Baseline to 52 weeks of treatment

Population: 20 participants had usable data at this timepoint CAT scores were correlated with 36 measures of lung function by physiology and MRI

Comparison of change of COPD Assessment Test from baseline to 52 weeks within participants compare to changes in measures of lung function by physiology and MRI (36 measures).

Outcome measures

Outcome measures
Measure
Treatment Arm (All Participants, Not Randomised)
n=36 correlations
All participants will be treated with mepolizumab, a 100mg dose every 4 weeks for 1 year (13 doses) Mepolizumab 100 MG: participants will receive 100mg of mepolizumab every 4 weeks for 52 weeks
High Exacerbators
Participants who had \> 2 moderate or severe exacerbations in 12months
Overall Impact of Mepolizumab Treatment on HRQoL in COPD (52 Weeks)
4 significant correlations

Adverse Events

All Participants Entering the Study

Serious events: 7 serious events
Other events: 31 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
All Participants Entering the Study
n=31 participants at risk
All participants from the point of consent (31) whether or not they received study drug.
Nervous system disorders
Hemiplegic Migraine
3.2%
1/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Immune system disorders
Anaphylaxis
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Renal and urinary disorders
Renal Failure
3.2%
1/31 • Number of events 1 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
Pneumonia
3.2%
1/31 • Number of events 1 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Renal and urinary disorders
Pyelonephritis
3.2%
1/31 • Number of events 1 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Renal and urinary disorders
Benign prostatic hyperplasia (BPH)
3.2%
1/31 • Number of events 1 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Gastrooesophageal reflux disease
3.2%
1/31 • Number of events 1 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Acute Cholecystitis
3.2%
1/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Constipation
3.2%
1/31 • Number of events 1 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data

Other adverse events

Other adverse events
Measure
All Participants Entering the Study
n=31 participants at risk
All participants from the point of consent (31) whether or not they received study drug.
Injury, poisoning and procedural complications
Arthropod bite
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Investigations
Blood pressure increased
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Investigations
Weight decreased
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Respiratory, thoracic and mediastinal disorders
Cough
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
General disorders
Chest pain
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
COVID-19
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
Diverticulitis
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
Urinary tract infection
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Musculoskeletal and connective tissue disorders
Back pain
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Nervous system disorders
Syncope
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Psychiatric disorders
Anxiety
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Psychiatric disorders
Claustrophobia
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Psychiatric disorders
Insomnia
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Cardiac disorders
Atrioventricular block first degree
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Abdominal distension
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Gastrooesophageal reflux disease
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
General disorders
Injection site pain
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
General disorders
Vaccination site bruising
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Hepatobiliary disorders
Cholecystitis acute
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
Oral candidiasis
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
Tonsillitis
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Infections and infestations
Upper respiratory tract infection
38.7%
12/31 • Number of events 12 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Respiratory, thoracic and mediastinal disorders
Dyspnoea
35.5%
11/31 • Number of events 11 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Nervous system disorders
Headache
25.8%
8/31 • Number of events 8 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Vomiting
16.1%
5/31 • Number of events 5 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Injury, poisoning and procedural complications
Fall
16.1%
5/31 • Number of events 5 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Injury, poisoning and procedural complications
Contusion
12.9%
4/31 • Number of events 4 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Musculoskeletal and connective tissue disorders
Arthralgia
12.9%
4/31 • Number of events 4 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Renal and urinary disorders
Haematuria
12.9%
4/31 • Number of events 4 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Vascular disorders
Haematoma
12.9%
4/31 • Number of events 4 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Cardiac disorders
Cardiac failure
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Constipation
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Diarrhoea
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Gastrointestinal disorders
Gastritis
9.7%
3/31 • Number of events 3 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Respiratory, thoracic and mediastinal disorders
Pulmonary mass
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Skin and subcutaneous tissue disorders
Pruritus
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Surgical and medical procedures
Cataract operation
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data
Vascular disorders
Deep vein thrombosis
6.5%
2/31 • Number of events 2 • Consent to end of participant involvement. maximum 16months
Definitions as per clinicaltrials.gov definitions Acute exacerbations of COPD were not included in AE assessment as these were captured as endpoint data

Additional Information

Dr Lisa Watson

Sheffield Teaching Hospitals

Phone: 01142265424

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place