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BronchiectasisPhase 2NCT00775138

Safety and Tolerability Study of 2 Dose Level of Arikayce™ in Patients With Bronchiectasis and Chronic Infection Due to Pseudomonas Aeruginosa.

A Phase 2 study testing 280 mg Arikayce™ and 560 mg Arikayce™ in people with Bronchiectasis, run by Insmed Incorporated at 18 sites in 9 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

This is a study to determine the safety and tolerability of 28 days of daily dosing of two doses (280 mg and 560 mg) of Arikayce™ versus placebo in patients who have bronchiectasis and chronic infection due to Pseudomonas infection. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Bronchiectasis
What is being tested?
280 mg Arikayce™ and 560 mg Arikayce™
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
64 participants
Where
18 sitesin 9 countries
Study dates
24 Jun 2008to 11 May 2009
Phase
Phase 2
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female study subjects≥ 18 years of age
  • Confirmed diagnosis of multi-focal bronchiectasis in two or more lung segments by HRCT of the chest
  • History of chronic infection with P. aeruginosa
  • Confirmation of infection with P. aeruginosa at screening
  • SaO2 ≥ 90% at Screening while breathing room air
  • Ability to comply with study medication use, study visits, and study procedures as judged by the investigator
  • Ability to produce at least 0.5 grams sputum or be willing to undergo an induction to produce sputum for clinical evaluation

Who cannot join

  • Forced Expiratory Volume in 1 second (FEV1) < 50% of predicted at Screening
  • Patients with hemoptysis of ≥60 mL within 4 weeks prior to screening
  • Bronchiectasis due to cystic fibrosis (CF), bronchopulmonary Aspergillus, aspiration of foreign body, or secondary to lung compression from tumors
  • History of non-tuberculous mycobacterial and/or Aspergillus infection requiring treatment or treated within 2 years prior to screening
  • Pulmonary tuberculosis requiring treatment or treated within two years prior to screening
  • History of Lung transplantation
Show all 10Show fewer
  • Use of any inhalation or systemic antibiotics (IV antibiotics, or oral antibiotics) within 4 weeks prior to Study Day 1
  • Evidence of biliary cirrhosis with portal hypertension
  • Smoking tobacco or any substance within 6 months prior to screening, and throughout the study
  • History of alcohol, medication, or illicit drug abuse within the 1 year prior to screening

Trial locations and contacts

18 sites in 9 countries.

18 sites in 9 countries

India6 sites
  • Study site

    Bangalore

  • Study site

    Hyderabad

  • Study site

    Manipal

  • Study site

    Mumbai

  • Study site

    Nagpur

  • Study site

    New Delhi

Other trials in India

Serbia3 sites
  • Study site

    Belgrade

  • Study site

    Kragujevac

  • Study site

    Niš

Other trials in Serbia

United States2 sites
  • Study site

    Philadelphia, Pennsylvania

  • Study site

    Washington D.C., District of Columbia

Other trials in United States

United Kingdom2 sites
  • Study site

    Cambridge

  • Study site

    London

Other trials in United Kingdom

Bulgaria1 site
  • Study site

    Sofia

Other trials in Bulgaria

Greece1 site
  • Study site

    Athens

Other trials in Greece

Hungary1 site
  • Study site

    Mosdós

Other trials in Hungary

Poland1 site
  • Study site

    Rabka-Zdrój

Other trials in Poland

Ukraine1 site
  • Study site

    Kiev

Other trials in Ukraine

About this study

Official title: A Placebo Controlled, Randomized, Parallel Cohort, Safety And Tolerability Study Of 2 Dose Levels Of Liposomal Amikacin For Inhalation (Arikayce™) In Patients With Bronchiectasis Complicated By Chronic Infection Due To Pseudomonas Aeruginosa.

This is a study to determine the safety and tolerability of 28 days of daily dosing of two doses (280 mg and 560 mg) of Arikayce™ versus placebo in patients who have bronchiectasis and chronic infection due to Pseudomonas infection.

Read the detailed description

Bronchiectasis is a chronic disorder of the major bronchi and bronchioles characterized by permanent dilation, microbial infection, a persistent inflammatory response with the release of immune mediators and microbial toxins leading to destruction. The origin of bronchiectasis varies, but the presence of microbial infection and a persistent inflammatory response is typical of the disease. The chronic nature of the infection and the associated considerable morbidity provides the rationale for using aerosolized antibiotics for the treatment of bronchiectasis patients.

This is a multi-national Phase 2 study of safety and tolerability of 28 days of daily dosing with two dose levels (280 mg and 560 mg) of Arikayce™ versus placebo in subjects with bronchiectasis and chronic Pseudomonas infection. Study subjects will be randomized to receive either study drug or placebo by inhalation via a PARI eFlow® nebulizer. Each subject will complete 28 days of daily dosing. All study subjects will be followed for microbiologic activity for 14 days after completion of treatment and for safety for 28 days post completion of study treatment.

The total study duration will be 56 days, with the screening visit occurring within the preceding 14 days prior to study day 1. At Day 1 (baseline), subjects will be evaluated at pre-dose and during the first 4-5 hours post-dose. Subjects will return at Week 2 (day 14) after start of treatment and at the end of Week 4 (Day 28) treatment period to determine safety and efficacy of Arikayce™. Subjects will be followed up on study Days 42 and 56 (about 2 and 4 weeks after end of treatment) for safety determination. After completion of this study, subjects will be followed up for an additional 6 months via phone contacts and records review, if hospitalized or treated for pulmonary exacerbation (under the extension protocol).

Clinical laboratory parameters, audiology testing, clinical adverse events and pulmonary function will be evaluated for all study subjects in order to determine the qualitative and quantitative safety and tolerability of Arikayce™ compared to placebo. Serum, urine and sputum specimens will be collected at periodic intervals to assess pharmacokinetics (PK) in subjects who consent for the PK portion of the study. Additionally, sputum samples will be collected to determine changes in bacterial density. Total Pulmonary Symptom Severity Score (PSSS) will be assessed, and respiratory quality of life will be evaluated by using the St. George's Respiratory Questionnaire (SGRQ). Arikace™,Arikayce™, Liposomal Amikacin for Inhalation (LAI), and Amikacin Liposome Inhalation Suspension (ALIS) may be used interchangeably throughout this study and the other studies evaluating amikacin liposome inhalation suspension.

Conditions
Bronchiectasis
Being tested
280 mg Arikayce™, Matching Placebo for Cohort 1, 560 mg Arikayce™, Matching Placebo for Cohort 2
Keywords
Bronchiectasis, Respiratory Infections, Amikacin, Respiratory Tract Diseases, Respiratory Tract Infections, Lung Diseases, Pseudomonas aeruginosa, Amikacin liposome inhalation suspension (ALIS)
Medical subject headings
Bronchiectasis, Respiratory Tract Infections, Respiratory Tract Diseases, Lung Diseases, Pseudomonas Infections

What participants receive

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

  • 280 mg Arikayce™Drug

    Also called liposomal amikacin for inhalation

    Study subjects will receive Arikace™ 280 mg on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

  • Matching Placebo for Cohort 1Drug

    Study subjects will receive placebo on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

  • 560 mg Arikayce™Drug

    Also called liposomal amikacin for inhalation

    Study subjects will receive Arikace™ 560 mg on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

  • Matching Placebo for Cohort 2Drug

    Study subjects will receive placebo on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

Study groups in NCT00775138
Study groupRoleWhat they receive
Cohort 1 - 280 mg Arikayce™ExperimentalSubjects in this arm of the cohort 1 will receive 280 mg of Arikayce™
Receives: Drug: 280 mg Arikayce™
Cohort 1 - PlaceboPlacebo comparatorSubjects in this arm of the cohort 1 will receive matching placebo.
Receives: Drug: Matching Placebo for Cohort 1
Cohort 2 - 560 mg Arikayce™ExperimentalSubjects in this arm of the cohort 2 will receive 560 mg of Arikayce™
Receives: Drug: 560 mg Arikayce™
Cohort 2 - PlaceboPlacebo comparatorSubjects in this arm of the cohort 2 will receive matching placebo
Receives: Drug: Matching Placebo for Cohort 2

What is being measured

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

  1. Number of Participants Reporting Treatment-emergent AEs (TEAEs) up to End of Treatment

    Number of Subjects reporting TEAE in the Arikayce™ groups and the placebo groups during the study. The table shows the events incidents, not the number of participants.

    Measured: Day 1 through 56.

  2. Treatment-emergent Marked Laboratory Abnormalities up to 28 Days After Study Medication Discontinuation

    Number of subjects reporting Incidence of clinically significant abnormalities in clinical values (Common Terminology Criteria for Adverse Events [CTCAE] grade >= 3) in Arikayce™ and placebo groups.

    Measured: Day 1 through 56.

  3. Treatment-emergent Pulmonary Function Test (PFT) for Acute Tolerability Assessment

    Changes in PFT from pre-dose during the study were measured on Days 1, 14, and 28. Acute tolerability of the study treatment was assessed by examining the relative (rel.) changes in FEV1 from pre-dose assessments to 0-1 hour post-dose and 2-4 hours post-dose for each time point at which post-dose spirometry was conducted.

    Measured: Pre-dose, 0-1 hour post-dose and 2-4 hours post-dose on day 1, 0-1 hour post-dose and 2-4 hours post-dose on day 14, and 0-1 hour post-dose and 2-4 hours post-dose on day 28

  4. Treatment-emergent PFT Abnormalities up to the End of Study

    Number of Subjects with Decrease of >= 15% in FEV1 (L) from Pre- to Post-dose by Study Day

    Measured: Day 1, Day 14 and Day 28

  5. Number of Subjects With an Adverse Event Leading to Permanent Discontinuation of Study Medication

    Measured: Screening to Day 56

  6. Serious Adverse Events up to 28 Days After Study Medication Discontinuation

    Number of subjects with a SAE in the Arikace™ groups and the placebo group up to 28 days after study medication discontinuation. See SAE table in the safety section for details.

    Measured: Screening to Day 56

Secondary outcomes (4)
  1. Change From Baseline in Log10CFU Per Gram (Density) of Pseudomonas Aeruginosa in Sputum.

    The change in Pseudomonas aeruginosa density from from baseline to Day 14, 28, and 42 were evaluated.Treatment differences with respect to the changes from baseline to each measured study day, defined as the log10 of the sum of all morphotypes (colony-forming units [CFU]) per gram of sputum in (log10CFU/gram [g]), was estimated for each treatment group; standard deviations accompanied the treatment differences.

    Measured: Baseline to Day 14, Day 28 and Day 42.

  2. Total Pulmonary Symptom Severity Score (PSSS)

    Changes in the severity and intensity (frequency x severity) of individual symptoms and change in composite PSSS from baseline to Days 14, 28, 42 and 56.

    The Pulmonary Symptom Severity Score (PSSS) was assessed on patient's responses to the Patients Symptoms Questionnaire, which employs symptom frequency and severity scales described for the validated Memorial Symptoms Assessment Scale. Symptom severity was scored on a scale of 0 (not applicable or symptom not present) to 4 (very severe) for each of the 5 symptoms (cough, shortness of breath, sputum production [frequency and severity], fatigue, and wheezing), and a composite score (range, 0 to 20 [low score represents better outcome]) was obtained as the sum of the severity scores for each symptom.

    Measured: Baseline to Day 14, Day 28, Day 42 and Day 56.

  3. To Evaluate Change in St. George's Respiratory Questionnaire Measurements

    A composite total score is derived as the sum of domain scores for symptoms, activity, and impact, with 0 as the best possible score and 100 as the worst possible score. A reduction in score of 4 points is generally recognized as a clinically meaningful improvement in quality of life. This analysis compared the changes from Day 1 (prior to first dosing) to Days 14, 28, 42, and 56.

    Measured: Day 1 to Day 14, Day 28, Day 42 and Day 56.

  4. To Evaluate the Use of Systemic Antipseudomonal Rescue Therapy

    Measured: Screening to Day 56.

Timeline

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

  1. First posted17 Oct 2008 (estimated)
  2. Study start24 Jun 2008
  3. Primary completion11 May 2009
  4. Study completion11 May 2009

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00775138
Sponsor's protocol ID
TR02-107
Status last verified
Jun 2019
First submitted
15 Oct 2008
Last updated
10 Jul 2019
Data monitoring committee
Yes

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing 280 mg Arikayce™ and 560 mg Arikayce™ in people with Bronchiectasis, run by Insmed Incorporated at 18 sites in 9 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 7 inclusion and 10 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 10 Jul 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 18 sites in India, Serbia, United States, United Kingdom, Bulgaria and 4 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. Some participants in this study may receive a placebo. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 10 Jul 2019). 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?

Number of Participants Reporting Treatment-emergent AEs (TEAEs) up to End of Treatment (time frame: Day 1 through 56.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 10 Jul 2019.

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