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Cystic FibrosisPhase 2NCT01746095

Efficacy and Safety Study of AeroVanc for the Treatment of Persistent MRSA Lung Infection in Cystic Fibrosis Patients

A Phase 2 study testing Vancomycin hydrochloride inhalation powder in people with Cystic Fibrosis, run by Savara Inc. at 38 sites in United States.

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

The purpose of this study is to determine whether AeroVanc treatment is safe and effective in reducing the number of MRSA colony forming units in the lungs of cystic fibrosis patients. Read more about this study

Who is it for?
Ages 12 years and older
Conditions the study is for
Cystic Fibrosis
What is being tested?
Vancomycin hydrochloride inhalation powder
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
87 participants
Where
38 sitesUnited States
Study dates
Mar 2013to Nov 2014
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 12 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Adults ≥18 years old (and the legally authorized representatives of children ≥12 but <18 years old): Able to communicate with site personnel and to understand and voluntarily sign the Informed Consent Form (ICF). Children ≥12 but <18 years old: Able to communicate with site personnel and to understand and voluntarily sign the Assent Form.
  • Able and willing to comply with the protocol, including availability for all scheduled study visits.
  • Have a confirmed diagnosis of CF, determined by having clinical features consistent with the CF phenotype, plus one of the following: a) Positive sweat chloride test (value ≥60 mEq/L), or b) Genotype with two mutations consistent with CF (ie, a mutation in each of the cystic fibrosis transmembrane conductance regulator [CFTR] genes).
  • Be ≥12 years old at time of ICF/Assent Form signing.
  • Have sputum culture positive for MRSA at Screening, with at least 10,000 CFUs/mL of MRSA.
  • In addition to the screening sample, have at least two historical respiratory tract cultures (i.e., sputum and/or throat swab) positive for MRSA prior to Screening and evidence that the MRSA lung infection has persisted for at least 6 months prior to Screening.
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  • Have forced expiratory volume in 1 second (FEV1) ≥30% and ≤100% of predicted that is normalized for age, gender, and height at Screening.
  • Evidence, defined as one or both of the following, that the persistent MRSA lung infection is suspected to be causing health consequences.
  • Have had at least one episode of acute pulmonary infection treated with non-maintenance antibiotics within 12 months from Screening. Initiation of treatment with intermittent inhaled anti-Pseudomonas therapy will not qualify as treatment with non-maintenance antibiotics.
  • Requires anti-MRSA treatment as part of a maintenance regimen to prevent pulmonary exacerbations or other respiratory symptoms.
  • Be able to perform all the techniques necessary to use the AeroVanc inhaler and measure lung function.
  • Be able to produce expectorated sputum samples or be able and willing to undergo standardized sputum induction.
  • Agree not to smoke from Screening through the end of the study.
  • Female patients of child-bearing potential are eligible to participate in this study only if they are NOT pregnant or lactating, and if the patient is using a highly effective method of birth control.
  • Patients with P. aeruginosa co-infection must either be stable on a regular suppression regimen of inhaled antibiotics or must be, in the opinion of the investigator, stable despite the lack of such treatment. Patients on a Cayston based therapy must have received at least 2 cycles of Cayston prior to Baseline (can be 2 consecutive months or 2 cycles over 4 months).

Who cannot join

  • Administration of any investigational drug or device within 28 days prior to ICF/Assent Form signing.
  • Use of iv or inhaled anti-MRSA drugs within 28 days or oral anti-MRSA drugs within 14 days prior to Visit 2 (ie, randomization, Baseline and AeroVanc/placebo treatment initiation).
  • A history of previous allergies or sensitivity to vancomycin, or other component(s) of the study drug or placebo except for a history of red-man syndrome.
  • History of severe cough/bronchospasm upon inhalation of dry powder inhalation product, or nebulized vancomycin.
  • Resistance to vancomycin at Screening (vancomycin resistant Staphylococcus aureus [VRSA], or vancomycin intermediate resistant Staphylococcus aureus [VISA], with minimum inhibitory concentration [MIC] ≥4 mcg/mL).
  • Oral corticosteroids in doses exceeding 10 mg prednisone per day or 20 mg prednisone every other day, or equipotent doses of another corticosteroid.
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  • History of sputum culture or throat swab culture yielding B. cepacia or gladioli in the previous two years, or nontuberculosis mycobacteria in the previous six months.
  • An acute upper or lower respiratory infection, or pulmonary exacerbation within 7 days prior to Randomization.
  • Changes in antimicrobial, bronchodilator, anti-inflammatory or corticosteroid medications within 7 days prior to ICF/Assent Form signing.
  • Current daily continuous oxygen supplementation or requirement for more than 2 L/min at night.
  • Changes in physiotherapy technique or schedule within 7 days prior to ICF/Assent Form signing.
  • History of lung or other solid organ transplantation or currently on the list to receive lung or other solid organ transplantation.
  • A chest X-Ray at Screening with abnormalities indicating a significant acute finding (eg, pneumothorax, or pleural effusion).
  • Lactating female or female with a positive pregnancy test result. All women of childbearing potential will be tested.
  • Renal insufficiency, defined as creatinine clearance <50 mL/min using the Cockcroft-Gault equation for adults or Schwartz equation in children, at Screening.
  • Diagnosed with clinically significant hearing loss.
  • Abnormal liver function, defined as ≥4x upper limit of normal (ULN), of serum aspartate aminotransferase (AST) or serum alanine aminotransferase (ALT), or known cirrhosis at the time of Screening.
  • Serum hematology or chemistry screening results which in the judgment of the Investigator would interfere with completion of the study.
  • Positive for human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV).
  • Other findings or medical history at screening that, in the Investigator's opinion, would compromise the safety of the patient or the quality of the study data.

Trial locations and contacts

38 sites in 1 country.

38 sites in 1 country

United States38 sites
  • Dell Children's Medical Center of Central Texas

    Austin, Texas, 78723

  • Massachusetts General Hospital Pediatric Cystic Fibrosis Center

    Boston, Massachusetts, 02114

  • Boston Children's Hospital Cystic Fibrosis Center

    Boston, Massachusetts, 02115

  • University of North Carolina

    Chapel Hill, North Carolina, 27599

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • Ann & Robert H. Lurie Children's Hospital of Chicago

    Chicago, Illinois, 60611

  • Northwestern University Feinberg School of Medicine

    Chicago, Illinois, 60611

  • Rainbow Babies and Children's Hospital / University Hospitals Case Medical Center

    Cleveland, Ohio, 44106

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • University of Texas Southwestern Medical Center

    Dallas, Texas, 75390

  • The Children's Medical Center of Dayton

    Dayton, Ohio, 45404

  • National Jewish Health

    Denver, Colorado, 80206

  • Wayne State University, Harper Hospital, Children's Hospital of Michigan

    Detroit, Michigan, 48201

  • Duke University Medical Center

    Durham, North Carolina, 27710

  • The Cystic Fibrosis Center of Chicago

    Glenview, Illinois, 60025

  • Joe DiMaggio Children's Hospital

    Hollywood, Florida, 33021

  • Baylor College of Medicine and Texas Children's Hospital

    Houston, Texas, 77030

  • University of Kansas Medical Center

    Kansas City, Kansas, 66160

  • University of Kentucky Cystic Fibrosis Clinic

    Lexington, Kentucky, 40536

  • University of Arkansas for Medical Science

    Little Rock, Arkansas, 72205

  • Children's Hospital Los Angeles, Division of Pediatric Pulmonology

    Los Angeles, California, 90027

  • University of Louisville

    Louisville, Kentucky, 40202

  • University of Miami - Miller School of Medicine

    Miami, Florida, 33136

  • Pulmonary Associates of Mobile

    Mobile, Alabama, 36608

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232

  • Rutgers Robert Wood Johnson Medical School

    New Brunswick, New Jersey, 08901

  • Hofstra North Shore - Long Island Jewish School of Medicine

    New Hyde Park, New York, 11040

  • Columbia University Medical Center

    New York, New York, 10032

  • Santiago Reyes, MD

    Oklahoma City, Oklahoma, 73112

  • Central Florida Pulmonary Group

    Orlando, Florida, 32803

  • Nemours Children's Clinic and Hospital

    Orlando, Florida, 32806

  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Children's Hospital of Pittsburgh of UPMC

    Pittsburgh, Pennsylvania, 15224

  • University of Utah, Intermountain Cystic Fibrosis Center

    Salt Lake City, Utah, 84132

  • University of Washington Medical Center

    Seattle, Washington, 98195

  • Washington University School of Medicine

    St Louis, Missouri, 63110

  • New Lung Associates, PA; Lung Transplant, Adult Cystic Fibrosis, and the Center for Advanced Lung Diseases, Tampa General Hospital

    Tampa, Florida, 33606

  • University of Texas Health Science Center at Tyler

    Tyler, Texas, 75708

Other trials in United States

About this study

Official title: A Phase 2, Randomized, Double Blind, Placebo-controlled Study of AeroVanc for the Treatment of Persistent Methicillin-resistant Staphylococcus Aureus Lung Infection in Cystic Fibrosis Patients

The purpose of this study is to determine whether AeroVanc treatment is safe and effective in reducing the number of MRSA colony forming units in the lungs of cystic fibrosis patients.

Read the detailed description

This is a Phase 2a randomized, multicenter, double-blind, placebo-controlled, parallel group study to examine the safety and efficacy of AeroVanc in the treatment of persistent MRSA lung infection in CF patients. Pharmacokinetics will be evaluated in a subgroup by measuring plasma and sputum concentrations of vancomycin.

Prior to treatment, patients will be randomized to receive either AeroVanc twice daily (bid), or placebo bid. Patients will be stratified based on the presence of a Pseudomonas aeruginosa (P. aeruginosa) co-infection that is being treated with a chronic suppression regimen. Patients with P. aeruginosa co-infection can be on any chronic inhaled suppression regimen (or nothing if the patient is considered stable in the opinion of the investigator despite the lack of treatment). Regardless of treatment regimen, if there is an off month, screening should be scheduled so that AeroVanc or placebo administration can be given during this time. Patients with no off month should be screened so that the AeroVanc or placebo administration period coincides with a treatment cycle other than TOBI (e.g., Cayston or colistin). All patients must have at least a 24-hour washout period after stopping their anti-Pseudomonas therapy and prior to the Visit 2 (Baseline) pre-dose microbiology sputum sample. The AeroVanc or placebo treatment duration is 28 days, during which efficacy and safety parameters will be measured, and after which patients will be followed up for 56 days.

There will be two treatment cohorts in this study, each comprised of 40 randomized (1:1 active to placebo) and treated patients (adults ≥18 and children ≥12 years of age). In Cohort 1, patients will be enrolled and randomized to receive the 32 mg dose of AeroVanc bid or placebo bid. Prior to starting enrollment in Cohort 2, a safety evaluation will be carried out by the Data Monitoring Committee (DMC) based on treatment data from the first 20 patients in Cohort 1. Subject to the Sponsor's written communication of the DMC's opinion of acceptable safety, the dose for the active arm in Cohort 2 will be escalated to 64 mg bid. Optionally, the active arm for Cohort 2 may also be kept the same (32 mg bid), or reduced to 16 mg bid, depending on the outcome of the DMC's safety evaluation.

Conditions
Cystic Fibrosis
Being tested
Vancomycin hydrochloride inhalation powder, Placebo inhalation powder
Keywords
Cystic Fibrosis, MRSA, Methicillin-resistant Staphylococcus aureus, Lung infection, AeroVanc, Vancomycin
Medical subject headings
Cystic Fibrosis

What participants receive

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

  • Vancomycin hydrochloride inhalation powderDrug

    Also called AeroVanc

    There will be two treatment cohorts in this study, each comprised of 40 randomized (1:1 active to placebo) and treated patients (adults ≥18 and children ≥12 years of age). In Cohort 1, patients will be enrolled and randomized to receive the 32 mg dose of AeroVanc bid or placebo bid. Prior to starting enrollment in Cohort 2, a safety evaluation will be carried out by the Data Monitoring Committee (DMC) based on treatment data from the first 20 patients in Cohort 1. Subject to the Sponsor's written communication of the DMC's opinion of acceptable safety, the dose for the active arm in Cohort 2 will be escalated to 64 mg bid. Optionally, the active arm for Cohort 2 may also be kept the same (32 mg bid), or reduced to 16 mg bid, depending on the outcome of the DMC's safety evaluation.

  • Placebo inhalation powderDrug

Study groups in NCT01746095
Study groupRoleWhat they receive
Vancomycin hydrochloride inhalation powderExperimental32 or 64 mg twice daily (BID)
Receives: Drug: Vancomycin hydrochloride inhalation powder
Placebo inhalation powderPlacebo comparatorMatching placebo inhalation powder BID
Receives: Drug: Placebo inhalation powder

What is being measured

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

  1. Change From Baseline in MRSA Sputum Density.

    Change from Baseline at Day 29 of the dosing period (start of AeroVanc/Placebo administration is considered Day 1 of the dosing period) in the number of MRSA colony forming units (CFU) in sputum culture.

    Measured: Day 29 of treatment period

Secondary outcomes (9)
  1. Change From Baseline in MRSA Sputum Density.

    Measured: Day 8 of treatment period

  2. Change From Baseline in MRSA Sputum Density.

    Measured: Day 15 of treatment period

  3. Change From Baseline in FEV1

    Absolute change from baseline in FEV1 percent predicted

    Measured: Day 29 of treatment period

  4. Change From Baseline in FVC

    Absolute change from baseline in FVC percent predicted

    Measured: Day 29 of treatment period

  5. Change From Baseline in Cystic Fibrosis Respiratory Symptom Diary (CFRSD-CRISS) Scores

    Change from Baseline in Cystic Fibrosis Respiratory Symptom Diary (CFRSD) Chronic Respiratory Infection Symptom Scores (CRISS). The minimum score is 0 and the maximum is 100, where a higher score means a worse outcome.

    Measured: Day 29 of treatment period

  6. Time From Start of Dosing to First Administration of Other Antimicrobial Medications (Oral, Intravenous and/or Inhaled) Due to Respiratory Symptoms.

    Measured: Entire study: Day 1 of treatment period through 8 week post-treatment follow up visit

  7. Time From Start of Dosing to Exacerbation of Signs/Symptoms (Fuchs Criteria).

    Measured: Entire study: Day 1 of treatment period through 8 week post-treatment follow up visit

  8. Change From Baseline in High Sensitivity CRP

    Measured: Day 29 of the dosing period

  9. Change From Baseline in Blood Neutrophils

    Measured: Day 29 of the dosing period

Timeline

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

  1. First posted10 Dec 2012 (estimated)
  2. Study startMar 2013
  3. Primary completionNov 2014
  4. Study completionNov 2014

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
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
87 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01746095
Sponsor's protocol ID
SAV005-02
Status last verified
Dec 2019
First submitted
6 Dec 2012
Last updated
13 Jan 2020
Data monitoring committee
Yes

Publications

  • Lo DK, Muhlebach MS, Smyth AR. Interventions for the eradication of meticillin-resistant Staphylococcus aureus (MRSA) in people with cystic fibrosis. Cochrane Database Syst Rev. 2022 Dec 13;12(12):CD009650. doi: 10.1002/14651858.CD009650.pub5.

    PubMed 36511181

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Vancomycin hydrochloride inhalation powder in people with Cystic Fibrosis, run by Savara Inc. at 38 sites in United States.

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 15 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 13 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 38 sites in United States. 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 13 Jan 2020). 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?

Change From Baseline in MRSA Sputum Density. (time frame: Day 29 of treatment period). 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 NCT01746095, 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 13 Jan 2020; AzTrials last refreshed its copy on 8 Nov 2026.

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