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Cystic FibrosisPhase 2CARE-CF1NCT03000348

A Study of the Dosing, Efficacy, and Safety of Oral Cysteamine in Adult Patients With Cystic Fibrosis Exacerbations

A Phase 2 study testing Cysteamine in people with Cystic Fibrosis, run by NovaBiotics Ltd. at 17 sites in 3 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 study investigates the use of cysteamine in the treatment of adults with Cystic Fibrosis who are experiencing an exacerbation of CF-associated lung disease. There are six different potential dosing regimens, including one that is placebo. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Cystic Fibrosis
What is being tested?
Cysteamine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
91 participants
Where
17 sitesin 3 countries
Study dates
Dec 2016to Apr 2018
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

  • CF-associated lung disease with documented history of chronic infection with Gram-negative organism(s)
  • Established patient of the Principal Investigator's CF Multi Disciplinary Team (MDT)
  • Age ≥18 years
  • Weight >40 kg
  • FEV1 >30% of predicted within the 6 months prior to study exacerbation
  • At the baseline visit: experiencing a new exacerbation of CF-associated lung disease (based on Investigator assessment of ≥4 symptoms present on the Fuchs' criteria) requiring treatment that includes an aminoglycoside antibiotic
Show all 23Show fewer
  • Females of childbearing potential will be included if they are either sexually inactive (sexually abstinent for 14 days prior to the first study drug dose continuing through 28 days after the last study drug dose, or using one of the following highly effective contraceptive (i.e. results in <1% failure rate when used consistently and correctly) methods in this trial:
  • intrauterine device (IUD);
  • surgical sterilization of the partner (vasectomy for 6 months minimum);
  • combined (estrogen or progestogen containing) hormonal contraception associated with the inhibition of ovulation (either oral, intravaginal, or transdermal);
  • progestogen only hormonal contraception associated with the inhibition of ovulation (either oral, injectable, or implantable);
  • intrauterine hormone releasing system (IUS);
  • bilateral tubal occlusion.
  • Females of childbearing potential agree to remain sexually inactive or to keep the same birth control method for at least 28 days following the last dose.
  • A female of non-childbearing potential must have undergone one of the following sterilization procedures at least 6 months prior to the first study drug dose:
  • hysteroscopic sterilization;
  • bilateral tubal ligation or bilateral salpingectomy;
  • hysterectomy;
  • bilateral oophorectomy; or be postmenopausal with amenorrhea for at least 1 year prior to the first study drug dose and follicle stimulating hormone (FSH) serum levels consistent with postmenopausal status.
  • A non-vasectomized male subject agrees to use a condom with spermicide or abstain from sexual intercourse during the study until 90 days beyond the last dose of study medication and the female partner agrees to comply with inclusion 7 or 9. For a vasectomized male who has had his vasectomy 6 months or more prior to study start, it is required that they use a condom during sexual intercourse. A male who has been vasectomized less than 6 months prior to study start must follow the same restrictions as a non-vasectomized male.
  • If male, agrees not to donate sperm from the first study drug dose until 90 days after dosing.
  • Willing and able to comply with all protocol requirements and procedures, including induction of sputum, if necessary
  • Willing and able to provide signed and dated informed consent

Who cannot join

  • Hypersensitive to cysteamine or to any of the excipients
  • Hypersensitive to penicillamine
  • Transplant recipient
  • Participation in any other interventional clinical research study (participation in observational studies is not exclusionary) within 30 days of Baseline (Day 0), and any planned participation in an interventional clinical research study for the duration of this study
  • If female, pregnancy, planned pregnancy, or breast-feeding
  • Any other significant disease/disorder which, in the Investigator's opinion, either puts the patient at risk due to study participation, or may influence the results of the study or the patient's ability to participate in the study

Trial locations and contacts

17 sites in 3 countries.

17 sites in 3 countries

United States8 sites
  • Albany Medical College

    Albany, New York, 12208

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • University of Florida

    Gainesville, Florida, 32610

  • The Medical College of Wisconsin/Froedtert Hospital

    Milwaukee, Wisconsin, 53226

  • West Virginia University

    Morgantown, West Virginia, 26506

  • Central Florida Pulmonary

    Orlando, Florida, 32803

  • San Francisco Critical Care Medical Group California Pacific Medical Center

    San Francisco, California, 94115

  • Banner University of Arizona Medical Center

    Tucson, Arizona, 85724

Other trials in United States

United Kingdom7 sites
  • Aberdeen Royal Infirmary

    Aberdeen, Scotland, AB25 2ZN

  • Ninewells Hospital Scottish Adult Cystic Fibrosis Service

    Dundee, DD1 9SY

  • Western General Hospital Edinburgh, CF Adults / CF Unit

    Edinburgh, EH4 3HE

  • NHS GGC

    Glasgow, G51 4TF

  • Raigmore Hospital

    Inverness, IV2 3UJ

  • St. James University Hospital

    Leeds, LS9 7TF

  • Royal Victoria Infirmary Adult CF Centre

    Newcastle upon Tyne, NE1 4LP

Other trials in United Kingdom

Italy2 sites
  • Ospedale Padiatrico Bambino Gesu Centro Fibrosi Cistica

    Roma, 00165

  • Azienda Ospedaliera Universitaria Integrato di Verona Borgo Trento Centro Fibrosi Cistica

    Verona, 37126

Other trials in Italy

About this study

Official title: A Randomized, Double-Blind, Parallel Group, Placebo-Controlled Study Investigating the Optimal Dose Regimen, Efficacy, and Safety of Adding Oral Cysteamine in Adult Patients Being Treated for an Exacerbation of CF-associated Lung Disease

This study investigates the use of cysteamine in the treatment of adults with Cystic Fibrosis who are experiencing an exacerbation of CF-associated lung disease. There are six different potential dosing regimens, including one that is placebo.

Read the detailed description

This is a multicenter, double-blind, randomized, placebo-controlled, 6-arm study to investigate the optimal dose regimen, efficacy, and safety of cysteamine in the treatment of adult patients with CF who are experiencing an exacerbation of CF-associated lung disease. Patients will be screened for the study and eligible patients will be randomized to receive either cysteamine or placebo as add-on therapy to their standard of care treatment for CF-associated lung disease.

Conditions
Cystic Fibrosis
Being tested
Cysteamine, Placebo Oral Capsule
Keywords
Exacerbation, CF, Lung disease, Lung infection, Gram negative, Bacterial Infection, pneumonia, bronchitis
Medical subject headings
Cystic Fibrosis, Lung Diseases, Bacterial Infections, Pneumonia, Bronchitis

What participants receive

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

  • CysteamineDrug

    Also called Lynovex, NM001, Lynovex Oral

    Oral Cysteamine Capsule

  • Placebo Oral CapsuleDrug

    Placebo Oral Capsule

Study groups in NCT03000348
Study groupRoleWhat they receive
High Dose, Once per dayActive comparatorPatient takes one oral dose of Cysteamine (high dose) per day, in the morning. The patient takes two oral placebo doses, one at mid-day and one in the evening.
Receives: Drug: Cysteamine; Drug: Placebo Oral Capsule
High Dose, Twice per dayActive comparatorPatient takes two oral doses of Cysteamine (high dose) per day, one in the morning and one in the evening. The patient takes one oral placebo dose, at mid-day.
Receives: Drug: Cysteamine; Drug: Placebo Oral Capsule
High Dose, Three times per dayActive comparatorPatient takes three oral doses of Cysteamine (high dose) per day, one in the morning, one at mid-day and one in the evening.
Receives: Drug: Cysteamine
PlaceboPlacebo comparatorPatient takes three oral doses of placebo, one in the morning, one at mid-day and one in the evening.
Receives: Drug: Placebo Oral Capsule
Low Dose, Three times per dayActive comparatorPatient takes three oral doses of Cysteamine (low dose) per day, one in the morning, one at mid-day and one in the evening.
Receives: Drug: Cysteamine; Drug: Placebo Oral Capsule
Mid-Range Dose, Three times per dayActive comparatorPatient takes three oral doses of Cysteamine (mid-range dose) per day, one in the morning, one at mid-day and one in the evening.
Receives: Drug: Cysteamine; Drug: Placebo Oral Capsule

What is being measured

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

  1. Change From Baseline in Sputum Bacterial Load

    Change from baseline through to Day 21 in log10 cfu/ml transformed total gram negative sputum bacterial load

    Measured: Baseline through Day 21/End of Study

  2. Safety and Tolerability Assessed by the Number of Subjects With Adverse Events

    Assessed by variables such as adverse events (AEs), laboratory assessments, physical examinations, and vital signs.

    Measured: Baseline through Day 21/End of Study

Secondary outcomes (12)
  1. Change From Baseline in Neutrophil Elastase Levels

    Actual values and change from baseline in neutrophil elastase levels were summarized using descriptive statistics by visit for each treatment group and each TDD group for the ITT Population.

    Measured: Baseline through Day 21/End of Study

  2. Change From Baseline in Sputum IL8

    Sputum IL-8 Levels by Visit - Covariate Adjusted ANCOVA with Observed Data ITT Population

    Measured: Baseline through Day 21/End of Study

  3. Change From Baseline in FEV1

    Change from Baseline in FEV1 Percent Predicted (%) - Covariate Adjusted ANCOVA with Observed Data ITT Population

    Measured: Baseline through Day 21/End of Study

  4. Change From Baseline in BMI

    BMI (kg/m^2) by Visit - ANCOVA with Observed Data ITT Population

    Measured: Baseline through Day 21/End of Study

  5. Change From Baseline in C-Reactive Protein

    Change from baseline in C-Reactive Protein at visits 7, 14 and 21

    Measured: Baseline through Day 21

  6. Change From Baseline in Blood Leukocyte Count

    Blood Leukocyte Count (10^9 leucocytes/L) by Visit - ANCOVA with Observed Data ITT Population

    Measured: Baseline through Day 21/End of Study

  7. Assessment of Blood Cysteamine Levels

    Study Drug Plasma at Day 14 Safety Population

    Measured: Day 14

  8. Assessment of Sputum Cysteamine Levels

    Study Drug Sputum Concentrations at Day 14 Safety Population

    Measured: Day 14

  9. Change From Baseline in CFRSD-CRISS

    Mean Change from Baseline in Cystic Fibrosis Respiratory Symptom Diary (CFRSD)-Chronic Respiratory Infection Symptom Scale (CRISS) CRFSD-CRISS:The CFRSD is a 16-item PROM to evaluate the effect of treatment on the severity of symptoms of acute respiratory infections associated with CF (i.e., CFRSD-CRISS) and to assess the emotional and activity impacts of these symptoms. The overall CRISS score range is 0-100 with 100 being the most severe symptoms.The CFRSD-CRISS is a validated unidimensional scale based on a subset of 8 items from the CFRSD questionnaire that quantifies symptom severity for the previous 24 hours to capture the magnitude of symptoms in stable CF, during medically treated CF exacerbations, and during recover from an exacerbation. The 8 items on the CFRSD-CRISS were scored using a 5-point Likert scale ranging from 0 (no symptom) to 4 (the highest magnitude of severity). So score range of 0-32.

    Measured: Baseline through to Day 21

  10. Change From Baseline in CFQ-R

    The CFQ-R is a disease-specific HRQOL (Health related quality of life) measure containing both generic and CF-specific scales and measures functioning during the previous 2 weeks. Each CFQ-R scale yielded standardized scores ranging from 0 to 100; higher scores indicated better HRQOL

    Measured: Baseline through Day 21/End of Study

  11. Change From Baseline in Jarad and Sequeiros Symptom Score Questionnaire

    The Jarad and Sequeiros Symptom Questionnaire (Jarad, 2012) is a simple participant-completed questionnaire that assesses and evaluates change in participant symptoms related to different aspects of respiratory function during a CF exacerbation. The questionnaire consists of 4 questions, each answered on a 4-point scale ranging from 1 (best) to 4 (worst). A range of minimum 4 to maximum16.Jarad and Sequeiros Questionnaire Score - changes from baseline at day 7 and day 14

    Measured: changes from baseline at day 7 and day 14

  12. Change From Baseline in Weight

    Weight (kg) by visit - ANCOVA with observed data

    Measured: Baseline through Day 21/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 posted22 Dec 2016 (estimated)
  2. Study startDec 2016
  3. Primary completionApr 2018
  4. Study completionApr 2018

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
91 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03000348
Sponsor's protocol ID
NBTCS02
Acronym
CARE-CF1
Status last verified
Apr 2021
First submitted
11 Dec 2016
Last updated
14 Apr 2021
Data monitoring committee
Yes

Publications

  • Devereux G, Wrolstad D, Bourke SJ, Daines CL, Doe S, Dougherty R, Franco R, Innes A, Kopp BT, Lascano J, Layish D, MacGregor G, Murray L, Peckham D, Lucidi V, Lovie E, Robertson J, Fraser-Pitt DJ, O'Neil DA. Oral cysteamine as an adjunct treatment in cystic fibrosis pulmonary exacerbations: An exploratory randomized clinical trial. PLoS One. 2020 Dec 28;15(12):e0242945. doi: 10.1371/journal.pone.0242945. eCollection 2020.

    PubMed 33370348

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Cysteamine in people with Cystic Fibrosis, run by NovaBiotics Ltd. at 17 sites in 3 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 23 inclusion and 6 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 14 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in United States, United Kingdom, Italy. 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 14 Apr 2021). 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 Sputum Bacterial Load (time frame: Baseline through Day 21/End of Study). 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 NCT03000348, 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 14 Apr 2021.

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