Evidence map›Paper›PMID 41981420›Full record

Trial reportRespiratory research2026

Elarekibep, an inhaled anti-IL-4 receptor alpha Anticalin, in moderate-to-severe asthma: a randomized, placebo-controlled phase 2a study (APATURA).

Tania Hugo, Andrew R Harper, Jacob Leander, Philip Gardiner, Robert Palmér, Pål Lundin, David Bock, Xiao-Hong Zhou, Irina Bondarenko, Steve Burns and 7 more

Registry-linked trialAbstract readRandomized Controlled TrialClinical Trial, Phase IIMulticenter Study
In one paragraph

Trial report in Respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04643158 (A Two-part Phase IIa Randomised, Double-blind, Placebo-controlled, Dose-ranging, Multi-centre Study to Assess Efficacy and Safety of Inhaled AZD1402 Administered as a Dry Powder for Four Weeks in Adults With Asthma on Medium-to-High Dose Inhaled Corticosteroids), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04643158 phase2terminatednot on this map

A Two-part Phase IIa Randomised, Double-blind, Placebo-controlled, Dose-ranging, Multi-centre Study to Assess Efficacy and Safety of Inhaled AZD1402 Administered as a Dry Powder for Four Weeks in Adults With Asthma on Medium-to-High Dose Inhaled Corticosteroids

TypeinterventionalSponsorAstraZenecaRan2021 to 2023Enrolled72ConditionsAsthmaArmsAZD1402, Placebo, Short acting beta agonist (SABA) (rescue medication), Run-in medications (ICS-LABA combination)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Tania HugoResearch and Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK. tania.hugo@astrazeneca.com.
Andrew R HarperResearch and Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
Jacob LeanderClinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden.
Philip GardinerClinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden.
Robert PalmérClinical Pharmacology and Quantitative Pharmacology, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Gothenburg, Sweden.
Pål LundinResearch and Development, Respiratory & Immunology, Biopharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
David BockBiometrics and Statistical Innovation, Respiratory and Immunology, BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
Xiao-Hong ZhouPatient Safety Biopharma, Chief Medical Office, Oncology R&D, AstraZeneca, Gothenburg, Sweden.
Irina BondarenkoGlobal Medical Services. Parexel, Dublin, Ireland.
Steve BurnsResearch and Early Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Macclesfield, UK.
Erol WiegertPieris Pharmaceuticals, Boston, MA, USA.
Mary F FitzgeraldPieris Pharmaceuticals, Boston, MA, USA.
David R CloseResearch and Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
David J KeelingResearch and Early Development, Respiratory & Immunology, Biopharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
Hitesh PandyaResearch and Development, Respiratory & Immunology, BioPharmaceuticals R&D, AstraZeneca, Cambridge, UK.
Maria G BelvisiResearch and Development, Respiratory & Immunology, Biopharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden.
Paul M O'ByrneMcMaster University, Hamilton, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe pro-inflammatory cytokines interleukin (IL)-4 and IL-13 and their cognate receptor IL-4 receptor-alpha are key targets for asthma therapy. Elarekibep is an inhaled Anticalin protein developed to inhibit IL-4 receptor-alpha signalling in patients with moderate-to-severe asthma not controlled with standard-of-care therapies. APATURA was a phase 2a study (NCT04643158) investigating the efficacy and safety of elarekibep in patients with moderate-to-severe asthma.

methodsThis was a randomized, placebo-controlled, double-blinded, multicentre, two-part study investigating elarekibep administered via dry powder inhaler twice daily for 4 weeks. Part 1 evaluated the safety and pharmacokinetics of elarekibep in patients with controlled moderate asthma, and part 2 evaluated the efficacy of elarekibep compared with placebo in those with uncontrolled moderate-to-severe asthma.

resultsIn total, 72 patients were included (part 1: n = 50; part 2: n = 22) in the study. In part 1, approximately half of the patients receiving elarekibep (n = 20; 58.8%) or placebo (n = 8; 50.0%) experienced at least one treatment-emergent adverse event. Most of the treatment-emergent adverse events reported were of mild intensity. Elarekibep was steadily absorbed, with a median time to peak drug concentration of approximately 3–4 hours post-dose. In part 2, there was a mean increase from baseline in pre-bronchodilator forced expiratory volume in 1 second of 196 mL with elarekibep 3 mg compared with placebo (95% confidence interval: 14.3, 378; p = 0.035 vs placebo) at week 4. Improvements in Asthma Control Questionnaire-6 scores at week 4 were numerically superior with elarekibep 1 mg and 3 mg than with placebo.

conclusionElarekibep was clinically well tolerated with no identified short-term safety concerns. Development of elarekibep was terminated due to lung pathology findings in a 13-week non-human primate inhalation toxicology study, which were considered to be adverse and relevant for chronic clinical dosing. Nonetheless, the overall data demonstrate that there remains potential for the development of inhaled biologic therapies for patients with asthma that may offer advantages over systemically administered biologics.

trial registrationNCT04643158 (ClinicalTrials.gov). Registered 23 November 2020.

Indexed as

Anti-Asthmatic AgentsAsthmaInterleukin-4 Receptor alpha SubunitSeverity of Illness IndexAdministration, InhalationAdultAgedDouble-Blind MethodDry Powder InhalersFemaleHumansMaleMiddle AgedTreatment OutcomeAnti-Asthmatic AgentsInterleukin-4 Receptor alpha SubunitIL-4Rαinhaled biologicsmoderate-to-severe asthma

Identifiers

PMID41981420
PMCPMC13262092

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.