Overview

The trial involves two interventions: (i) exposure to HDM in the ACC and (ii) administration of dupilumab/placebo for dupilumab.

Eligibility

Inclusion Criteria:

1. Will demonstrate understanding of the study and will provide a signed and dated informed consent.
2. Will be male or female, 18 to 65 years of age at the time of the screening visit.
3. Will have symptoms consistent with perennial nasal allergy for a minimum of 2 years prior to the screening visit.
4. Will have a positive standard skin prick test (SPT) to D. pteronyssinus within 24 months of screening. A positive SPT is defined as a wheal diameter of at least 5 mm larger than the negative control (normal saline).
5. Will have asthma with a documented FEV1 reversibility of ≥10% within 12 months of screening.
6. If a participant manifests symptoms suggestive of COVID-19, the participant must have a negative SARS-CoV-2 rapid antigen nasopharyngeal swab test before each HDM exposure visit.
7. A woman of childbearing potential, must have a negative urine pregnancy test at Visit 1 and prior to each exposure in the ACC. All women of childbearing potential must agree to a medically acceptable form of birth control throughout the study duration and for at least 2 months prior to Visit 1. Acceptable methods of birth control for this study include:
   1. oral, patch, or intra-vaginal contraceptives
   2. Norplant System® or other implant system
   3. Depo-Provera®
   4. IUD
   5. double barrier method
   6. abstinence
   7. surgical sterility (hysterectomy, tubal ligation, or uterine ablation)

             Post-menopausal women defined as women without a menstrual cycle for at least 12
             consecutive months qualify as non-childbearing for this study.
          8. Will have never smoked or will be an ex-smoker (<20 pack year history and no cigarette
             or smokeless tobacco use in the past year).
        Exclusion Criteria:
          1. Have a chronic lung disease other than asthma.
          2. Have atopic dermatitis.
          3. Have any ocular disease that is not associated with allergic rhinoconjunctivitis.
          4. Are on home oxygen requirement.
          5. Have a history of rebound nasal congestion (brought on by extended use of topical
             decongestants), chronic rhinosinusitis with or without nasal polyps, nasal septal
             perforation, or severe nasal tract malformations noted on physical exam.
          6. Have FEV1 <70% predicted as determined by pre-bronchodilator spirometry at visit 1.
          7. Are unwilling/unable to withhold intranasal steroids or asthma medications before
             specified visits.
          8. Are unwilling/unable to abstain from protocol-defined prohibited medications for the
             protocol-specified times before and during screening/selection and ACC HDM exposure
             visits.
          9. Have received any oral or other form of systemic glucocorticosteroids within 1 month
             prior to the screening visit.
         10. Have received JAK-1 inhibitors within 3 months prior to the screening visit.
         11. Have known hypersensitivity to dupilumab or any of its excipients.
         12. Have an ongoing helminth infection.
         13. Have received a live vaccine within 30 days of screening or are planned to receive one
             during study participation.
         14. Are pregnant or nursing.
         15. Have a history of keratoconjunctivitis sicca.
         16. Have indoor pet exposure causing upper or lower symptoms.
         17. Have received allergen immunotherapy of any form within 12 months of screening visit.
         18. Have received biologics, for any indication within 12 months of screening visit.
         19. Have participated in a trial with an investigational drug in the past 30 days.
         20. Have past or current medical problems or findings from physical examination or
             laboratory testing that are not listed above, that, in the opinion of the
             investigator, may pose additional risks from participation in the study, may interfere
             with the participant's ability to comply with study requirements, or may impact the
             quality or interpretation of the data obtained from the study.