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Chronic Obstructive Pulmonary DiseasePhase 2NCT03085485

The Topic Trial - Study to Determine the Safety and Efficacy of Ivacaftor

A Phase 2 study testing Ivacaftor 150 MG in people with Chronic Obstructive Pulmonary Disease and Chronic Bronchitis, run by University of Alabama at Birmingham at 1 site in United States.

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 study is a Phase 2 Study to establish the safety and efficacy of a drug called Ivacaftor (VX-770) in patients with chronic obstructive pulmonary disease (COPD), chronic bronchitis, and acquired CFTR dysfunction as detected by sweat chloride analysis. Read more about this study

Who is it for?
Ages 40 to 80 years
What is being tested?
Ivacaftor 150 MG
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
40 participants
Where
1 siteUnited States
Study dates
16 Mar 2017to 30 Sep 2022
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 40 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or Female age 40-80
  • A Clinical diagnosis of COPD as defined by GOLD
  • At Least a 10 pack year smoking history
  • Exhibit symptoms of chronic bronchitis as defined by the Medical Research Council
  • FEV1% predicted ≥ 35% and ≤70% Post Bronchodilator
  • Clinically stable in the last 4 weeks with no evidence of COPD exacerbation
Show all 10Show fewer
  • Weight of 40 kg-120 kg
  • Willingness to use at least one form of acceptable birth control including abstinence, condom with spermicide, or hormonal contraceptives from time of signing ICF through study follow up visit
  • Willing to monitor blood glucose if known history of diabetes mellitus requiring insulin or medical therapy
  • Element of CFTR Dysfunction, as defined by Sweat Chloride > 30 mEq/L)

Who cannot join

  • Current Diagnosis of Asthma
  • Known Diagnosis of Cystic Fibrosis
  • Use of Continuous Oxygen Therapy of greater than 2 liters per minute - patients on 2 liters of Oxygen or less will be excluded if they have been hospitalized for COPD in the prior year or had more than 2 exacerbations requiring steroids and/or antibiotics in the prior year.
  • Documented history of drug abuse within the last year
  • Subjects should not have a pulmonary exacerbation or changes in therapy for pulmonary disease within 28 days before receiving the first dose of study drug.
  • Cirrhosis or elevated liver transaminases > 3X ULN
Show all 13Show fewer
  • GFR < 50 estimated by Cockroft-Gault
  • Any illness or abnormal lab finding that, in the opinion of the investigator might confound the results of the study or pose an additional risk in administering study drug to the subject.
  • Pregnant or Breastfeeding
  • Subjects taking moderate or strong inhibitors or inducers of CYP3A4, including certain herbal medications and grapefruit juice. (Excluded medications and foods including the drugs and foods listed in the IRB HSP application.)
  • Uncontrolled Diabetes
  • Recent (e.g 1year) arterial thrombotic events (peripheral arterial disease, thrombotic stroke)
  • Clinically significant arrhythmias requiring anti-arrhythmic agent(s) or conduction abnormalities that in the opinion of the investigator that affect patient safety such as the abnormalities listed below (patients with stable coronary artery disease are eligible) : (1) Angina symptoms (2) History of MI (3) Revascularization procedure in the last year prior to screening (4) Clinically significant congestive heart failure (known LVEF <= 45%, cor pulmonale, diastolic heart failure, etc)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UAB Lung Health Center

    Birmingham, Alabama, 35294

Other trials in United States

About this study

Official title: A Randomized, Double-blind, Phase 2, Placebo Controlled Study to Determine the Safety and Efficacy of Ivacaftor (VX-770) for the Treatment of Chronic Obstructive Pulmonary Disease (The Topic Trial)

The study is a Phase 2 Study to establish the safety and efficacy of a drug called Ivacaftor (VX-770) in patients with chronic obstructive pulmonary disease (COPD), chronic bronchitis, and acquired CFTR dysfunction as detected by sweat chloride analysis. The design is a pilot, randomized (3:1, active:placebo), double-blind, placebo-controlled study. Approximately 40 subjects with COPD will be randomized.

Read the detailed description

Like CF, COPD is characterized by small airway mucus obstruction that is associated with accelerated loss of lung function and mortality. Preliminary data indicate that cigarette smoke exerts deleterious effects on airway epithelial function including the reduction of CFTR activity, enhanced mucus expression, and a pronounced reduction in mucociliary transport (MCT). Preliminary data also indicate that approximately 50% of patients with COPD have reduced CFTR activity, as detected in the upper airways, lower airways and sweat glands. Furthermore, CFTR dysfunction is independently associated with chronic bronchitis, can persist despite smoking cessation, and can be reversed by the CFTR potentiator ivacaftor (VX-770) in vitro by activating wild-type CFTR, resulting in a robust increase in MCT. Combined with unprecedented clinical improvement via augmented mucociliary clearance in CF patients with a responsive CFTR mutation treated with ivacaftor, these data indicate that CFTR represents a viable therapeutic target to address mucus stasis in a large subset of COPD patients (potentially representing over 4 million patients in the U.S. alone). This project will investigate the hypothesis that ivacaftor can augment CFTR activity in individuals with COPD who exhibit chronic bronchitis, resulting in meaningful improvements in epithelial function and respiratory health. The investigators' initial pilot study in patients with COPD and chronic bronchitis demonstrated that ivacaftor was safe, demonstrated stable pharmacokinetics, and exhibited a trend towards efficacy in measures of PROs and sweat chloride. The current trial will test the safety, pharmacokinetics, and pharmacodynamics of ivacaftor in a larger number of COPD patients with chronic bronchitis and for a longer treatment period, evaluating the potential of CFTR potentiator therapy to address acquired CFTR dysfunction in this population and set the stage for larger and longer-term trials in the future. Based on an IND already in place in the Rowe laboratory, an IRB familiar with the proposed study, an experienced clinical investigation team with expertise in all of the endpoints proposed, and a well characterized COPD population prioritized for the presence chronic bronchitis, CFTR dysfunction, and the absence of congenital CFTR mutations, the investigators are poised to deliver the trial.

Enrollment is planned at a single center, The University of Alabama at Birmingham. Patients will be randomized 3:1 to active drug (n=30) and placebo (10) to achieve the enrollment goal.

A sufficient number of subjects will be screened to randomize up to 50 subjects to achieve 40 completed subjects to receive either ivacaftor 150 mg BID (n=30) or placebo (n=10) for 84 days.

Ivacaftor and matching placebo will be orally administered as capsules according to the following guidelines:

Between study visit Day 1 and study visit Day 84, subjects will take 1 dose of study drug each day in the morning, beginning any time between 08:00 h (8:00 AM) and 12:00 h (12:00 PM). Whenever possible, subjects should take the study drug at the same time each day.

On the study visit days when PK samples are collected (study visit Days 1, 28, 56, and 84), the study drug is to be taken by the subject while he/she is at the study site

For visits after the Day 1 visit, subjects will be instructed to bring all remaining study drug materials to the site; study drug will be dispensed at each visit.

Ivacaftor will be prepared and dispensed by an unblinded pharmacist.

Subjects will be instructed to continue their standard COPD medication regimen.

Being tested
Ivacaftor 150 MG, Placebo
Keywords
COPD, CFTR, ivacaftor, topic trial
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Bronchitis, Chronic

What participants receive

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

  • Ivacaftor 150 MGDrug

    Also called KALYDECO

    Ivacaftor is a CFTR potentiator

  • PlaceboDrug

    placebo pills

Study groups in NCT03085485
Study groupRoleWhat they receive
IvacaftorActive comparatorIvacaftor, 150 mg PO every 12 hrs for 84 days
Receives: Drug: Ivacaftor 150 MG
PlaceboPlacebo comparatormatching placebo
Receives: Drug: Placebo

What is being measured

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

  1. Safety of Ivacaftor - Number of Participants With Adverse Events

    Safety of ivacaftor will be determined by number of participants with adverse events (including serious adverse events).

    Measured: From Screening to Day 98

  2. Safety of Ivacaftor - Number of Participants With Abnormal Serum Chemistry

    Number of participants with abnormal serum chemistry values compared to screening values will also be used to determine safety of ivacaftor.

    Measured: From Screening to Day 98

  3. Safety of Ivacaftor - Number of Participants With Abnormal Hematology

    Safety of ivacaftor will also be determined by number of participants with abnormal changes in their screening hematology values.

    Measured: From Screening to Day 98

  4. Safety of Ivacaftor - Number of Participants With Abnormal ECG (Prolonged QT Intervals)

    Number of participants with abnormal changes in their screening ECGs is another factor that will be used to evaluate the safety of ivacaftor.

    Measured: From Screening to Day 98

Secondary outcomes (7)
  1. Central CFTR Activity Measured by Mucociliary Clearance (MCC) Percentage Clearance at 60 Mins

    Clearance of Tc99 sulfur colloid is a measure of MCC of the lungs, and is calculated by a standard protocol developed by the Cystic Fibrosis Therapeutics Development Network. The method provides a robust measure of MCC, and has been sensitive to the effects of inhaled pharmacologic agents in CF and COPD including improvements of an unprecedentedly large magnitude in CF patients with the G551D-CFTR mutation treated with ivacaftor measured in a multicenter study. The technique allows estimates of MCC in both the small and large airway compartments.

    Measured: From Screening to Day 84

  2. Peripheral CFTR Activity Measured by Change in Sweat Chloride

    Sweat chloride abnormality is correlated with COPD severity and symptoms, and is a highly sensitive outcome measure for CFTR-directed therapeutics. We have shown sweat chloride is sensitive to the presence of cigarette smoking and COPD, and the test has been successfully used as an endpoint in multiple CF trials, including studies to detect the efficacy of ivacaftor therapy.

    Measured: From Screening to Day 84

  3. Indicators of Respiratory Function and COPD Health : Change in FEV1 Predict %

    Spirometry is a standard outcome measure in COPD and a major indicator of efficacy and safety in COPD clinical trials. Post-bronchodilator spirometry will be performed by ATS criteria. FEV1 will be measured in predict percentage.

    Measured: From Screening to Day 84

  4. San Diego Shortness of Breath Questionnaire (SOBQ)

    The SOBQ is a self-reported questionnaire that assesses shortness of breath while performing a variety of activities of daily living. The Minimum Clinically Important Difference (MCID) is 5.

    The SOBQ includes 24 items, using 6-point scale with 0 = "not at all" to 5 = "maximal or unable to do because of breathlessness". The sum of SOBQ score ranges from 0 to 120, with higher score indicating more breathlessness.

    Measured: From D1 to Day 84

  5. Breathlessness, Cough, and Sputum Scale (BCSS)

    The BCSS is a three-item questionnaire rating breathlessness, cough and sputum on a 5-point Likert scale from 0 (no symptoms) to 4 (severe symptoms).

    The BCSS score ranges from 0 to 12; the higher the score indicates the worse of symptoms.

    Measured: From D1 to Day 84

  6. COPD Assessment Test (CAT)

    CAT is a self-reported questionnaire that measures COPD related quality of life. The MCID is 2.

    CAT composes of 8 questions, and the scores range from 0 - 40. Higher scores denote a more severe impact of COPD on a patient's life.

    Measured: From D1 to Day 84

  7. St. George Respiratory Questionnaire (SGRQ)

    The SGRQ is a disease-specific measure of health status for use in COPD with an MCID of 4.

    The scores range from 0 to 100, with higher scores indicating more limitations.

    Measured: From D1 to Day 84

Timeline

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

  1. First posted21 Mar 2017
  2. Study start16 Mar 2017
  3. Primary completion30 Sep 2022
  4. Study completion30 Sep 2022

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
Model description
The design is a pilot, randomized (3:1, active:placebo), double-blind, placebo-controlled study
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
40 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03085485
Sponsor's protocol ID
F160920009
Other IDs
1R34HL127166-01
Status last verified
Dec 2024
First submitted
16 Feb 2017
Last updated
12 Dec 2024
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vijaykumar K, Solomon GM, Guimbellot J, Acosta EP, Bhambhavni PG, White S, Kim H, Raju SV, Rasmussen LW, Harris N, Liu B, Hathorne H, Rowe SM, Dransfield MT. Ivacaftor for Chronic Obstructive Pulmonary Disease: Results from a Phase 2, Randomized Controlled Trial. Am J Respir Crit Care Med. 2025 May;211(5):823-831. doi: 10.1164/rccm.202407-1302OC.

    PubMed 39316773

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Ivacaftor 150 MG in people with Chronic Obstructive Pulmonary Disease and Chronic Bronchitis, run by University of Alabama at Birmingham at 1 site 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 10 inclusion and 13 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 12 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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 21 Dec 2023). 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?

Safety of Ivacaftor - Number of Participants With Adverse Events (time frame: From Screening to Day 98). The study lists 4 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 NCT03085485, 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 12 Dec 2024.

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