Efficacy of Remibrutinib versus Dupilumab at Early Timepoints in Chronic Spontaneous Urticaria: US Phase 3b Study Design (RECLAIM).
Gil Yosipovitch, Giselle Mosnaim, Christine-Elke Ortmann...
https://pubmed.ncbi.nlm.nih.gov/41854973/Actively Recruiting
Led by Novartis Pharmaceuticals · Updated on 2026-07-10
400
Participants Needed
130
Research Sites
12 weeks
Total Duration
Researchers are evaluating the effectiveness of remibrutinib compared to dupilumab as add-on treatments for adults with moderate to severe chronic spontaneous urticaria CSU that is not well controlled by second generation H1-antihistamines sgH1-AH. This Phase 3b, multi-center, randomized, double-blind, double-dummy study focuses on early treatment effects within 4 weeks. The study addresses the need for better management of CSU symptoms such as hives and itch. Participants will be assigned to one of two treatment groups one group will receive remibrutinib tablets twice daily plus placebo injections, while the other group will receive dupilumab injections with matching placebo tablets. Both groups continue their stable background therapy of sgH1-AH daily. The study includes a screening period up to 4 weeks, a 12-week core double-blind treatment period, and an optional 12-week open-label extension where all participants may receive remibrutinib if it is not commercially available. After treatment, safety follow-up occurs for up to 12 weeks, with phone calls and possible site visits. Participants will be monitored through regular assessments including symptom severity scores, urticaria activity scores, and daily diaries. Safety follow-up includes phone calls and visits depending on treatment continuation. The main outcome is the change in weekly urticaria activity score at Week 4. Other measures include severity of hives and itch at Weeks 1 and 4. Total study participation may last up to 24 weeks, including optional extension and follow-up phases.
CONDITIONS
A Study to Evaluate Efficacy of Remibrutinib Compared to Dupilumab at Early Timepoints in Adults With Chronic Spontaneous Urticaria Inadequately Controlled by Second Generation H1-antihistamines
N
Novartis Pharmaceuticals
N
Novartis Pharmaceuticals
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Novartis Pharmaceuticals
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | Remibrutinib (oral BTK inhibitor) + antihistamine | Dupilumab (IL‑4Rα antagonist) + antihistamine | Omalizumab (anti‑IgE biologic) + antihistamine |
|---|---|---|---|
| What it is | An investigational oral Bruton’s tyrosine kinase (BTK) inhibitor added to antihistamine background therapy. | An interleukin‑4 receptor α (IL‑4Rα) antagonist injection added to antihistamine background therapy. | A currently guideline‑recommended anti‑IgE biologic add‑on therapy for antihistamine‑refractory CSU. |
| Role in the trial | Actual randomized investigational treatment arm. | Actual randomized active‑comparator treatment arm. | Not part of this trial; shown for clinical context only. |
| Primary use | Add‑on treatment to improve itch and hive symptoms in antihistamine‑refractory CSU. | Add‑on treatment to reduce symptoms in antihistamine‑refractory CSU. | Add‑on biologic therapy of established use to control symptoms when antihistamines alone are insufficient. |
| How it is given or performed | Oral film‑coated tablet, 25 mg twice daily, plus matched injection placebo. | Subcutaneous injection: 600 mg loading dose, then 300 mg every 2 weeks, plus oral placebo. | Subcutaneous anti‑IgE biologic, typically administered every 2 to 4 weeks depending on label. |
| Evidence status | Phase 3 REMIX trials showed significant UAS7 improvement versus placebo, with fast onset and sustained effect through 24 weeks. | Phase 3 LIBERTY‑CSU CUPID trials demonstrated reduction in UAS7 and improved itch/hive control versus placebo. | Longstanding evidence supports its use as guideline‑recommended option for CSU refractory to antihistamines. |
| Important risks | Pooled safety data showed good tolerability with fast and sustained efficacy; mild mucocutaneous bleeding events were more common. | Generally well tolerated in CSU trials; safety profile consistent with other indications. | Well‑characterized safety profile from long clinical experience; risks include injection‑site reactions and rare anaphylaxis. |
| Important limitations | Phase 3b study aims at early timepoints; long‑term effectiveness beyond study period and real‑world data pending. | Focused on symptom reduction in trial timeframe; may have slower onset compared to oral agents. | Requires clinic‑based injection; slower onset of effect compared to emerging agents like remibrutinib. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - Up to 4 weeks
Participants are screened for eligibility to participate in the trial.
Duration - 12 weeks
Participants receive either remibrutinib tablets plus placebo injections or dupilumab injections plus placebo tablets along with their standard antihistamine therapy.
Visits every 2 weeks for injections and regular assessments
Duration - 12 weeks
Participants may choose to continue taking remibrutinib tablets for an additional 12 weeks if it is not commercially available yet.
Visits every 3 months for safety follow-up and treatment dispensation
Duration - Up to 12 weeks
Participants who do not enter the extension or complete treatment will have safety follow-up phone calls and possible visits to monitor health after treatment ends.
Phone calls at Week 16 and Week 24; possible site visits depending on treatment continuation
Study Type
INTERVENTIONAL
Masking
TRIPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
2
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Gil Yosipovitch, Giselle Mosnaim, Christine-Elke Ortmann...
https://pubmed.ncbi.nlm.nih.gov/41854973/Novartis Pharmaceuticals
Lead Sponsor