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Cystic FibrosisPhase 2ALPINENCT01375049

Aztreonam Lysine for Pseudomonas Infection Eradication Study

A Phase 2 study testing Aztreonam for Inhalation Solution (AZLI) in people with Cystic Fibrosis, run by Gilead Sciences at 58 sites in 9 countries.

Completed

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

Official record
Search all trials

Trial summary

This is an open-label, multi-center study in pediatric patients age 3 months to less than 18 years with cystic fibrosis (CF) and newly detected Pseudomonas aeruginosa (PA) pulmonary colonization/infection. Read more about this study

Who is it for?
Ages 3 months to 17 years
Conditions the study is for
Cystic Fibrosis
What is being tested?
Aztreonam for Inhalation Solution (AZLI)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
105 participants
Where
58 sitesin 9 countries
Study dates
Aug 2011to May 2013
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 3 months to 17 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Males or females age 3 months to less than 18 years
  • Diagnosis of CF as determined by the 1997 CF Consensus Conference criteria:
  • Documented sweat chloride ≥ 60 mEq/L by quantitative pilocarpine iontophoresis test OR
  • Abnormal nasal transepithelial potential difference test OR
  • Two well-characterized, disease-causing genetic mutations in the CF transmembrane conductance regulator (CFTR) gene AND
  • One or more clinical features consistent with CF
Show all 12Show fewer
  • Documented new onset of positive lower respiratory tract culture (e.g., throat swab, sputum, or BAL) for PA within 30 days of study entry (prior to screening visit) defined as either first lifetime documented PA-positive culture OR PA recovered after at least a 2 year history of PA-negative respiratory cultures (at least 2 cultures per year)
  • Forced expiratory volume in 1 second (FEV1) ≥ 80% predicted at screening visit (subjects ≥ 6 years of age)
  • Clinically stable with no evidence of significant respiratory symptoms or, if obtained for clinical evaluation, no chest radiograph findings at screening that would have required administration of IV antipseudomonal antibiotics, oxygen supplementation, or hospitalization.
  • All sexually active females who were of childbearing potential must agree to use a highly effective method of contraception during heterosexual intercourse throughout the study. Females utilizing hormonal contraceptives as a birth control method must have used the same method for at least 3 months prior to study drug dosing.
  • Males must agree to use barrier contraception (condom with spermicide) during heterosexual intercourse from screening through to study completion and for 90 days from the last dose of study investigational medicinal product
  • Participants and/or parent/guardian must be able to give written informed consent prior to any study related procedure

Who cannot join

  • Use of IV or inhaled antipseudomonal antibiotics within 2 years of study entry (screening visit)
  • Use of oral antipseudomonal antibiotics within 30 days of study entry (screening visit)
  • History of sputum or throat swab culture yielding Burkholderia spp. within 2 years prior to screening visit
  • History of local or systemic hypersensitivity to monobactam antibiotics
  • History of intolerance to inhaled short acting beta 2 agonists
  • History of lung transplantation
Show all 20Show fewer
  • History of AZLI (or Cayston®) administration
  • Administration of any investigational drug or device within 28 days prior to screening visit or within 6 half-lives of the investigational drug (whichever is longer)
  • Current use of oral corticosteroids in doses exceeding the equivalent of 10 mg prednisone per day or 20 mg prednisone every other day
  • Current requirement for daily continuous oxygen supplementation or requirement of more than 2 L/minute at night
  • Hospitalization for pulmonary-related illness within 28 days prior to screening visit
  • Changes in or initiation of chronic azithromycin treatment within 28 days prior to screening visit
  • Changes in antimicrobial, bronchodilator (BD), corticosteroid, dornase alfa, or hypertonic saline medications within 7 days prior to screening visit; for participants on a stable regimen of hypertonic saline (28 days on/28 days off), beginning or ending a cycle of hypertonic saline is allowed
  • Changes in physiotherapy technique or schedule within 7 days prior to screening visit
  • Abnormal renal or hepatic function results at most recent test within the previous 12 months, defined as:
  • Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 5 times upper limit of normal (ULN), or
  • Serum creatinine > 2 times ULN for age
  • Pregnant or lactating females; a negative urine pregnancy test is required for all females of childbearing potential (unless surgically sterile), and confirmatory serum pregnancy test in the event of an initial positive urine test result
  • Any serious or active medical or psychiatric illness (including drug or alcohol abuse), which in the opinion of the investigator, would interfere with treatment, assessment, or compliance with the protocol
  • Presence of a condition or abnormality that would compromise the patient's safety or the quality of study data, in the opinion of the investigator

Trial locations and contacts

58 sites in 9 countries.

58 sites in 9 countries

United States23 sites
  • Akron Children's Hospital

    Akron, Ohio, 44308

  • University of Michigan

    Ann Arbor, Michigan, 48109

  • Children's Hospital Boston

    Boston, Massachusetts, 02115

  • UNC Chapel Hill

    Chapel Hill, North Carolina, 27599

  • Children's Memorial Hospital

    Chicago, Illinois, 60614

  • Cincinnati Children's Hospital

    Cincinnati, Ohio, 45229

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • Cohen Children's Medical Center of NY

    Great Neck, New York, 11021

  • PennState Milton S. Hershey Medical Center

    Hershey, Pennsylvania, 17033

  • Baylor College of Medicine

    Houston, Texas, 77030

  • Riley Hospital for Children

    Indianapolis, Indiana, 46202

  • Nemours Children's Clinic- Jacksonville

    Jacksonville, Florida, 32207

  • Children's Mercy Hospital and Clinics

    Kansas City, Missouri, 64108

  • Children's Hospital of Wisconsin

    Milwaukee, Wisconsin, 53201

  • Vanderbilt Children's Hospital

    Nashville, Tennessee, 37232

  • Nemours Childrens Clinic Orlando

    Orlando, Florida, 32801

  • St. Christopher's Hospital for Children

    Philadelphia, Pennsylvania, 19134

  • Phoenix Children's Hospital

    Phoenix, Arizona, 85016

  • Children's Hospital of Pittsburgh of UPMC

    Pittsburgh, Pennsylvania, 15224

  • University of Utah

    Salt Lake City, Utah, 84108

  • Saint Louis University

    St Louis, Missouri, 63104

  • SUNY Upstate Medical University

    Syracuse, New York, 13210

  • Toledo Children's Hospital CF Research Center

    Toledo, Ohio, 43606

Other trials in United States

France7 sites
  • CHU de Boredaux Hôpital des Enfants - Pellegrin CEDRE

    Bordeaux, 33076

  • CRCM mixte / CHU ESTAING

    Clermont-Ferrand, 63003

  • CHI de Créteil Departement pediatrie

    Créteil, 94000

  • Centre hospitalier Robert Bissons CRCM - service pédiatrie

    Lisieux, 14100

  • Service pédiatrie II Hôpital Necker Enfants Malades

    Paris, 75743

  • Hopital Robert Debre

    Paris

  • Centre de Ressources et de Compétences sur la Mucoviscidose ( CRCM), Roscoff, France

    Roscoff, 29684

Other trials in France

Germany7 sites
  • Charité Campus Virchow Klinikum, Universitätsmedizin Berlin, Klinik für Pädiatrie mit Schwerpunkt Pneumologie/Immunolgie Prof. Wahn

    Berlin, 13353

  • Klinik fur Kinder- und Jugendmedizinim St Josef-Hopsital

    Bochum

  • Universitätsklinikum Essen, Zentrum für Kinderheilkunde - Abteilung Allg. Kinderheilkunde/Neuropaediatrie

    Erlangen, 91054

  • Universitaetsklinikum Bonn-Zentrum fuer Kinderheikunde

    Essen

  • Christiane Herzog CF-Center, Goethe University Hospital

    Frankfurt, 60590

  • Universitätsklinikum Gießen und Marburg GmbH

    Giessen, 35392

  • University Children's Hospital

    Tübingen, 72076

Other trials in Germany

Italy5 sites
  • Azienda Ospedaliero-Universitaria di Catania, Dipartimento di Pediatria, UO Broncopneumologia Pediatrica

    Catania, 95123

  • Cystic Fibrosis Centre Paediatric Department, A. Meyer Children Hospital Florence

    Florence, 50139

  • Universita' Federico II di Napoli

    Naples, 80131

  • Fondazione IRCCS, Ospedale Pediatrico, Bambino Gesu' di Roma

    Rome, 00165

  • Centro Fibrosi Cistica di Verona, Azienda Ospedaliera Universitaria Integrata di Verona

    Verona, 37126

Other trials in Italy

Spain5 sites
  • Hospital Vall D' Hebron Pediatric Pneunmonology and Cystic Fibrosis Clinic

    Barcelona, 08035

  • Hospital infantil Universitario Niño Jesus, Servicio de Neumología Pediatrica

    Madrid, 28009

  • Hospital Ramon y Cajal

    Madrid, 28049

  • Hospital Infantil La Paz

    Madrid

  • Hospital Materno-Infantil Carlos Haya, Servicio de Neumología Pediatrica

    Málaga, 29011

Other trials in Spain

Belgium4 sites
  • Hôpital Universitaire des Enfants Reine Fabiola Brussels

    Brussels, 1020

  • Paediatrics, University Hospital Brussels (UZB)

    Brussels, 1090

  • Pediatric Respiratory Department, Ghent University Hospital

    Ghent, 9000

  • Pediatric Pulmonology, Dept Pediatrics University Hospital Gasthuisberg

    Leuven, 3000

Other trials in Belgium

Poland4 sites
  • ISPL Centrum Medyczne

    Bialystok, 15-003

  • Specjalistyczny Zespół Opieki Zdrowotnej nad Matką i Dzieckiem, Poradnia Leczenia Mukowiscydozy

    Gdansk, 80-308

  • Instytut Gruźlicy i Chorób Płuc, Klinki Pneumologii i Mukowiscydozy

    Rabka-Zdrój, 34-700

  • Instytut Matki i Dziecka Klinika Pediatrii

    Warsaw, 01-211

Other trials in Poland

Netherlands2 sites
  • Division of Respiratory Medicine and Allergology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands

    Rotterdam, 3015 GJ

  • Longziekten Universitair Medisch (PEDIATRIC), Ultrecht

    Utrecht, 3584 EA

Other trials in Netherlands

Austria1 site
  • Medizinische Universität Innsbruck Abt. für Kinder- und Jugendheilkunde, Pädiatrie III (Zystische Fibrose)

    Innsbruck, 6020

Other trials in Austria

About this study

Official title: Open-Label Phase 2 Trial to Evaluate the Safety and Efficacy of Aztreonam 75 mg Powder and Solvent for Nebuliser Solution/Aztreonam for Inhalation Solution (AZLI) in Pediatric Patients With Cystic Fibrosis (CF) and New Onset Lower Respiratory Tract Culture Positive for Pseudomonas Aeruginosa (PA)

This is an open-label, multi-center study in pediatric patients age 3 months to less than 18 years with cystic fibrosis (CF) and newly detected Pseudomonas aeruginosa (PA) pulmonary colonization/infection. All eligible participants will be treated with a 28-day course of Aztreonam for Inhalation Solution (AZLI) 75 mg 3 times daily. After completion of study drug, subjects will be followed up through Day 196 for safety and recurrence of PA.

The primary objective is to evaluate the proportion of participants with PA-negative cultures at all time points during a 6-month monitoring period (through Day 196) after cessation of AZLI treatment. Microbiological cultures will be obtained at Baseline, Day 28 (end of AZLI treatment), Day 56 (1 month after completing AZLI treatment), Day 112 (3 months after completing AZLI treatment), and Day 196 (6 months after completing AZLI treatment).

Conditions
Cystic Fibrosis
Being tested
Aztreonam for Inhalation Solution (AZLI)
Keywords
Cystic fibrosis, CF, PA, Pseudomonas aeruginosa, AZLI, aztreonam
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 Cayston®

    AZLI 75 mg administered 3 times daily via the investigational eFlow® nebulizer

Study groups in NCT01375049
Study groupRoleWhat they receive
Aztreonam for Inhalation Solution (AZLI)ExperimentalParticipants will receive one 28-day course of AZLI, then will be followed for a 24-week period (through Day 196).
Receives: Drug: Aztreonam for Inhalation Solution (AZLI)

What is being measured

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

  1. Percentage of Participants With PA-negative Cultures at All Time Points After Cessation of Active Treatment (Evaluable Analysis Set)

    The percentage of participants with PA-negative cultures at all time points after cessation of active treatment at Day 28 (assessed at Days 56, 112, and 196) was summarized for the Evaluable Analysis Set.

    Measured: Day 28 to Day 196

  2. Percentage of Participants With PA-negative Cultures at All Time Points After Cessation of Active Treatment (Sensitivity Analysis Set)

    The percentage of participants with PA-negative cultures at all time points after cessation of active treatment at Day 28 (assessed at Days 56, 112, and 196) was summarized for the Sensitivity Analysis Set.

    Measured: Day 28 to Day 196

Secondary outcomes (8)
  1. Change From Baseline in FEV1% Predicted

    Spirometry assessments were performed only in participants ≥ 6 years of age. Forced expiratory volume in 1 second (FEV1) % predicted was defined as FEV1 of the participant divided by the average FEV1 in the population for any person of similar age, sex and body composition.

    Measured: Baseline to Days 28, 56, 112, and 196

  2. Change From Baseline in CFQ-R RSS Score

    Respiratory symptoms (eg, coughing, congestion, wheezing) were assessed with the Cystic Fibrosis Questionnaire - Revised (CFQ-R) Respiratory Symptoms Scale (RSS) only in participants ≥ 6 years of age. The range of scores (units) is 0 to 100 with higher scores indicating fewer symptoms.

    Measured: Baseline to Days 28, 56, 112, and 196

  3. Percentage of Participants With PA-negative Cultures

    The percentage of participants with a PA-negative culture was summarized at each visit.

    Measured: Days 28, 56, 112, and 196

  4. Use of Additional (Non-study) Antipseudomonal Antibiotics

    The percentage of participants who used additional (non-study) antipseudomonal antibiotics (an indication of PA exacerbation) while on treatment and posttreatment was summarized.

    Measured: Baseline to Day 196

  5. Change From Baseline in Weight

    Measured: Baseline to Days 28, 56, 112, and 196

  6. Change From Baseline in Height

    Measured: Baseline to Days 28, 56, 112, and 196

  7. Change From Baseline in Body Mass Index (BMI)

    Measured: Baseline to Days 28, 56, 112, and 196

  8. Pharmacokinetics (PK) Peak and Trough Plasma Concentrations of Aztreonam

    The plasma concentration of aztreonam for participants < 6 years of age was obtained 1 hour after the first dose of AZLI on Day 1 and immediately prior to the last dose of AZLI on Day 28.

    Measured: Day 1 (1 hour postdose) and Day 28 (immediately prior to dosing)

Timeline

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

  1. First posted17 Jun 2011 (estimated)
  2. Study startAug 2011
  3. Primary completionMay 2013
  4. Study completionMay 2013

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
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
105 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01375049
Sponsor's protocol ID
GS-US-205-0162
Acronym
ALPINE
Status last verified
Jul 2014
First submitted
15 Jun 2011
Last updated
17 Jul 2014
Data monitoring committee
Yes

Publications

  • Tiddens HA, De Boeck K, Clancy JP, Fayon M, H G M A, Bresnik M, Derchak A, Lewis SA, Oermann CM; ALPINE study investigators. Open label study of inhaled aztreonam for Pseudomonas eradication in children with cystic fibrosis: The ALPINE study. J Cyst Fibros. 2015 Jan;14(1):111-9. doi: 10.1016/j.jcf.2014.06.003. Epub 2014 Aug 1.

    PubMed 25091537

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Aztreonam for Inhalation Solution (AZLI) in people with Cystic Fibrosis, run by Gilead Sciences at 58 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 12 inclusion and 20 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 17 Jul 2014. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 58 sites in United States, France, Germany, Italy, Spain 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. 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 1 Jul 2014). 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?

Percentage of Participants With PA-negative Cultures at All Time Points After Cessation of Active Treatment (Evaluable Analysis Set) (time frame: Day 28 to Day 196). 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 NCT01375049, 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 17 Jul 2014.

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