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AzTrials

Cystic FibrosisPhase 3NCT00757237

Aztreonam for Inhalation Solution vs Tobramycin Inhalation Solution in Patients With Cystic Fibrosis & Pseudomonas Aeruginosa

A Phase 3 study testing Aztreonam for Inhalation Solution (AZLI) and Tobramycin Inhalation Solution (TIS) in people with Cystic Fibrosis, run by Gilead Sciences at 92 sites in 13 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study was to assess the comparative safety and effectiveness of aztreonam for inhalation solution versus tobramycin inhalation solution in adult and pediatric patients with cystic fibrosis (CF) and pulmonary Pseudomonas aeruginosa (PA) infection. Read more about this study

Who is it for?
Ages 6 years and older
Conditions the study is for
Cystic Fibrosis
What is being tested?
Aztreonam for Inhalation Solution (AZLI) and Tobramycin Inhalation Solution (TIS)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
274 participants
Where
92 sitesin 13 countries
Study dates
Aug 2008to Nov 2010
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Males or females aged 6 years and older
  • Subjects with CF as diagnosed by one of the following: documented sweat chloride >= 60 mEq/L by quantitative pilocarpine iontophoresis test, or documented sweat sodium >= 60 mmol/L, or 2 well characterized genetic mutations in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene, or abnormal nasal potential difference with accompanying symptoms characteristic of CF
  • Documented PA in an expectorated sputum or throat swab culture within 3 months prior to Visit 1 or at Visit 1
  • Subjects must be able to provide written informed consent/assent prior to any study related procedures; parent/guardian must be able to give written informed consent as necessary prior to any study related procedure
  • Subjects must have received previous treatment with aerosolized antibiotics without demonstration of drug intolerance
  • FEV1 <= 75% predicted at Visit 1
  • Ability to perform reproducible pulmonary function tests
  • Chest radiograph at Visit 1 without significant acute findings (eg, infiltrates [lobar or diffuse interstitial], pleural effusion, pneumothorax); or chest radiograph or magnetic resonance image (MRI) obtained within the 180 days prior to Visit 1 without acute findings and no significant intercurrent illness; chronic, stable findings (eg, chronic scarring or atelectasis) are allowed

Who cannot join

  • Current use of oral corticosteroids in doses exceeding the equivalent of 10 mg prednisone a day or 20 mg prednisone every other day
  • History of sputum or throat swab culture yielding B. cepacia in the previous 2 years
  • Current requirement for daily continuous oxygen supplementation or requirement for more than 2 L/minute at night
  • Administration of any investigational drug or device within 28 days of Visit 1 or within 6 half-lives of the investigational drug (whichever is longer)
  • Known local or systemic hypersensitivity to monobactam antibiotics
  • Known allergies/intolerance to tobramycin
Show all 16Show fewer
  • Inability to tolerate inhalation of a short acting beta agonist
  • Changes in or initiation of chronic azithromycin treatment within 28 days prior to Visit 1
  • Administration of antipseudomonal antibiotics by inhalation, intravenous or oral routes within the 14 days prior to Randomization/Visit 2
  • Changes in antimicrobial, bronchodilator (BD), dornase alfa, or corticosteroid medications within 7 days prior to Visit 1
  • Changes in physiotherapy technique or schedule within 7 days prior to Visit 1
  • History of lung transplantation
  • Abnormal renal or hepatic function or serum chemistry at Visit 1, defined as aspartate aminotransferase (AST), alanine aminotransferase (ALT) > 5 times upper limit of normal range (ULN) or creatinine > 2 times ULN
  • Positive pregnancy test at Visit 1; all women of childbearing potential will be tested
  • Female of childbearing potential who is lactating or is not (in the opinion of the investigator) practicing an acceptable method of birth control; female subjects who utilize hormonal contraceptives as one of their birth control methods must have used the same method for at least 3 months before study dosing
  • Any serious or active medical or psychiatric illness, which in the opinion of the investigator, would interfere with patient treatment, assessment, or compliance with the protocol

Trial locations and contacts

92 sites in 13 countries.

92 sites in 13 countries

United States29 sites
  • Study site

    Albany, New York, 12208

  • Study site

    Anchorage, Alaska, 99508

  • Study site

    Aurora, Colorado, 80045

  • Study site

    Boston, Massachusetts, 02115

  • Study site

    Charleston, South Carolina, 29425

  • Study site

    Chicago, Illinois, 60637

  • Study site

    Cincinnati, Ohio, 45229

  • Study site

    Columbia, Missouri, 65212

  • Study site

    Dayton, Ohio, 45404

  • Study site

    Denver, Colorado, 80206

  • Study site

    Glenview, Illinois, 60025

  • Study site

    Hershey, Pennsylvania, 17033

  • Study site

    Houston, Texas, 77030

  • Study site

    Las Vegas, Nevada, 89107

  • Study site

    New Hyde Park, New York, 11040

  • Study site

    Niles, Illinois, 60714

  • Study site

    Oklahoma City, Oklahoma, 73112

  • Study site

    Orange, California, 92868

  • Study site

    Orlando, Florida, 32801

  • Study site

    Philadelphia, Pennsylvania, 19102

  • Study site

    Philadelphia, Pennsylvania, 19104

  • Study site

    Phoenix, Arizona, 85006

  • Study site

    Richmond, Virginia, 23298

  • Study site

    Salt Lake City, Utah, 84132

  • Study site

    San Antonio, Texas, 78212

  • Study site

    Tampa, Florida, 33606

  • Study site

    Toledo, Ohio, 43606

  • Study site

    Tuscon, Arizona, 85724

  • Study site

    Wilmington, Delaware, 19803

Other trials in United States

France11 sites
  • Study site

    Amiens, 80054

  • Study site

    Bordeaux, 33076

  • Study site

    Caen, 14000

  • Study site

    Créteil, 94000

  • Study site

    Lille, 59037

  • Study site

    Lisieux, 14100

  • Study site

    Montpellier, 34295

  • Study site

    Nice, 06202

  • Study site

    Paris, 75743

  • Study site

    Pessac, 33604

  • Study site

    Rennes, 35033

Other trials in France

Germany11 sites
  • Study site

    Berlin, 123353

  • Study site

    Berlin, 13125

  • Study site

    Bochum, 44791

  • Study site

    Essen, 45122

  • Study site

    Essen, 45239

  • Study site

    Giessen, 35392

  • Study site

    Hamburg, 22763

  • Study site

    Leipzig, 04103

  • Study site

    Magdeburg, 39120

  • Study site

    Mainz, 55101

  • Study site

    München, 80336

Other trials in Germany

Italy9 sites
  • Study site

    Ancona, 60123

  • Study site

    Catania, 95123

  • Study site

    Milan, 20122

  • Study site

    Naples, 80131

  • Study site

    Palermo, 90134

  • Study site

    Parma, 43100

  • Study site

    Rome, 00161

  • Study site

    Rome, 00165

  • Study site

    Verona, 37126

Other trials in Italy

United Kingdom8 sites
  • Study site

    Belfast, BT9 7AB

  • Study site

    Cambridge, CB23 3RE

  • Study site

    Cardiff, CF64-2XX

  • Study site

    Leeds, LS9 7TF

  • Study site

    Liverpool, L14 3PE

  • Study site

    London, SW3 6NP

  • Study site

    Sheffield, West Yorkshire, S10 2TH

  • Study site

    Southampton, SO16 6YD

Other trials in United Kingdom

Belgium5 sites
  • Study site

    Antwerp, 2650

  • Study site

    Brussels, 1070

  • Study site

    Brussels, 1090

  • Study site

    Ghent, 9000

  • Study site

    Leuven, 3000

Other trials in Belgium

Ireland5 sites
  • Study site

    Dublin, 24

  • Study site

    Dublin, 4

  • Study site

    Dublin, 9

  • Study site

    Dublin

  • Study site

    Galway

Other trials in Ireland

Spain5 sites
  • Study site

    Madrid, 28009

  • Study site

    Madrid, 28034

  • Study site

    Madrid, 28041

  • Study site

    Madrid, 28046

  • Study site

    Málaga, 29011

Other trials in Spain

Austria2 sites
  • Study site

    Innsbruck, A-6020

  • Study site

    Salzburg, A-5020

Other trials in Austria

Netherlands2 sites
  • Study site

    Maastricht, 6229

  • Study site

    The Hague, 2504 LN

Other trials in Netherlands

Portugal2 sites
  • Study site

    Lisbon, 1649-035

  • Study site

    Porto, 4200 319

Other trials in Portugal

Switzerland2 sites
  • Study site

    Zurich, CH - 8032

  • Study site

    Zurich, CH - 8091

Other trials in Switzerland

Denmark1 site
  • Study site

    Copenhagen, DK-2100

Other trials in Denmark

About this study

Official title: An Open-Label, Randomized, Phase 3 Trial to Evaluate the Efficacy and Safety of Aztreonam for Inhalation Solution (AZLI) Versus Tobramycin Inhalation Solution (TIS) in an Intermittent Aerosolized Antibiotic Regimen in Subjects With Cystic Fibrosis Followed by an Open-Label, Single Arm Extension (European Union [EU] Only)

The purpose of this study was to assess the comparative safety and effectiveness of aztreonam for inhalation solution versus tobramycin inhalation solution in adult and pediatric patients with cystic fibrosis (CF) and pulmonary Pseudomonas aeruginosa (PA) infection.

Read the detailed description

Number of Subjects Planned: Approximately 240 randomized patients

Target Population: CF patients >= 6 years of age with stable pulmonary disease, who at study entry had a recent positive sputum culture for PA and had been previously treated with aerosolized antibiotics without demonstration of drug intolerance.

The randomized phase of this study, used for hypotheses testing, enrolled participants from both the United States (US) and EU. An open-label, single-arm extension was available for participants in the EU who completed at least one course of AZLI or TIS during the randomized portion of the study. These participants were eligible to receive 3 additional cycles of AZLI in a 28-day, intermittent, repeating treatment regimen. Results of the extension phase will be available the first quarter (Q1) of 2012.

Randomized Phase Study Design (US and EU): This was an open-label, multicenter, randomized, parallel group study. The study design consisted of 2 treatment arms of 28-day, intermittent, repeating treatment regimens: aztreonam for inhalation solution (AZLI) or tobramycin inhalation solution (TIS). The total study period was 26 weeks. The study schedule included 9 visits - Screening, Baseline, Day 14, Day 28, followed by visits every 28 days through the end of the study.

Conditions
Cystic Fibrosis
Being tested
Aztreonam for Inhalation Solution (AZLI), Tobramycin Inhalation Solution (TIS)
Keywords
aztreonam lysine, tobramycin inhalation solution, tobramycin nebuliser solution, cystic fibrosis, pseudomonas aeruginosa, lung infection, CFQ-R, inhaled antibiotic
Medical subject headings
Cystic Fibrosis, Pseudomonas Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aztreonam for Inhalation Solution (AZLI)Drug

    Also called aztreonam, AZLI, inhaled antibiotic

    Aztreonam for inhalation solution (75 mg) was administered 3 times a day (TID) for 28 days for each treatment cycle via the PARI eFlow electronic nebulizer.

  • Tobramycin Inhalation Solution (TIS)Drug

    Also called tobramycin, TNS, inhaled antibiotic

    Tobramycin inhalation solution (300 mg) was administered 2 times a day (BID) for 28 days for each treatment cycle via the PARI LC Plus nebulizer with compressor or via another nebulizer compatible with country-specified labeling.

Study groups in NCT00757237
Study groupRoleWhat they receive
AZLI 75 mg 3 times a day (TID)ExperimentalNot described
Receives: Drug: Aztreonam for Inhalation Solution (AZLI)
TIS 300 mg 2 times a day (BID)Active comparatorNot described
Receives: Drug: Tobramycin Inhalation Solution (TIS)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Relative Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Percent Predicted at Day 28

    Spirometry was performed according to American Thoracic Society (ATS) guidelines at each visit. FEV1 percent predicted is a normalized value of FEV1 calculated using the Knudson equation and based upon participant age, gender, and height. Treatment effect on the relative change from baseline in FEV1 percent predicted at Day 28 (Visit 4) was tested using an analysis of covariance (ANCOVA) model-based method.

    Measured: Baseline and end of treatment Course 1 (Day 28)

  2. Mean Actual Change From Baseline in FEV1 Percent Predicted Across 3 Treatment Courses

    Spirometry was performed according to ATS guidelines at each visit. FEV1 percent predicted is a normalized value of FEV1 calculated using the Knudson equation and based upon participant age, gender, and height.

    Treatment effect on the average adjusted means for the actual change in FEV1 percent predicted at Visits 4, 6, and 8 (Weeks 4, 12, and 20) was tested by mixed-effect model repeated measures (MMRM) analysis using the ITT population analysis set.

    Measured: Baseline, and end of treatment Courses 1 (Week 4), 2 (Week 12), and 3 (Week 20)

Secondary outcomes (4)
  1. Relative Change From Baseline in FEV1 Percent Predicted at Day 28 in Subjects Who Received Inhaled Tobramycin for >= 84 Days in the 12 Months Prior to Randomization

    Spirometry was performed according to ATS guidelines. FEV1 percent predicted is a normalized value of FEV1 calculated using the Knudson equation and based upon participant age, gender, and height. Treatment effect on the relative change from baseline in FEV1 percent predicted at Day 28 (Visit 4) was tested using an ANCOVA model-based method, using the population of participants with prior inhaled tobramycin use of >= 84 days in the previous 12 months.

    Measured: Baseline and end of treatment Course 1 (Day 28)

  2. Mean Actual Change From Baseline in FEV1 Percent Predicted Across 3 Treatment Courses in Subjects Who Received Inhaled Tobramycin for >= 84 Days in the 12 Months Prior to Randomization

    Spirometry was performed according to ATS guidelines at each visit. FEV1 percent predicted is a normalized value of FEV1 calculated using the Knudson equation and based upon participant age, gender, and height.

    Treatment effect on the average adjusted means for the actual change in FEV1 percent predicted at Visits 4, 6, and 8 (Weeks 4, 12, and 20) was tested by MMRM analysis using the population of participants with prior inhaled tobramycin use of >=84 days in the previous 12 months.

    Measured: Baseline and end of treatment Courses 1 (Week 4), 2 (Week 12), and 3 (Week 20)

  3. Time to Need for Intravenous (IV) Antipseudomonal Antibiotics for Respiratory Events

    IV antipseudomonal antibiotic use for a respiratory event was determined through the adjudication of events by a sponsor-independent, blinded review committee.

    Use was compiled from data recorded on the concomitant medications electronic case report form (eCRF) and compared to reported adverse events (AEs) to determine use for a respiratory event. The time to IV antipseudomonal antibiotic use was measured in days from baseline (Visit 2) to the date of first IV antipseudomonal antibiotic use or the date of study completion (last visit)/or early withdrawal if censored.

    Measured: Day 0 to Day 168 (end of study)

  4. Time to First Respiratory Hospitalization

    This endpoint was determined through the adjudication of events by a sponsor-independent, blinded review committee. Committee members reviewed all hospitalizations and determined which were related to respiratory events.

    Details of all hospitalizations, including the dates of admission and discharge, were recorded on the serious adverse event (SAE) eCRF.

    Time to first respiratory hospitalization was the number of days from baseline (Visit 2) to the date of first respiratory hospitalization or the date of study completion (last visit) /or early withdrawal if censored.

    Measured: Day 0 to Day 168 (end of study)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Sep 2008 (estimated)
  2. Study startAug 2008
  3. Primary completionMay 2010
  4. Study completionNov 2010

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
274 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00757237
Sponsor's protocol ID
GS-US-205-0110
Status last verified
Jun 2011
First submitted
22 Sep 2008
Last updated
4 Jul 2011
Data monitoring committee
Yes

Publications

  • Assael BM, Pressler T, Bilton D, Fayon M, Fischer R, Chiron R, LaRosa M, Knoop C, McElvaney N, Lewis SA, Bresnik M, Montgomery AB, Oermann CM; AZLI Active Comparator Study Group. Inhaled aztreonam lysine vs. inhaled tobramycin in cystic fibrosis: a comparative efficacy trial. J Cyst Fibros. 2013 Mar;12(2):130-40. doi: 10.1016/j.jcf.2012.07.006. Epub 2012 Sep 15.

    PubMed 22985692

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Aztreonam for Inhalation Solution (AZLI) and Tobramycin Inhalation Solution (TIS) in people with Cystic Fibrosis, run by Gilead Sciences at 92 sites in 13 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Jul 2011. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 92 sites in United States, France, Germany, Italy, United Kingdom and 8 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 4 Jul 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Relative Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Percent Predicted at Day 28 (time frame: Baseline and end of treatment Course 1 (Day 28)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00757237, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jul 2011.

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