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Cystic FibrosisPhase 4HyPOINTNCT04259970

Hyperpolarized Imaging for New Treatments

A Phase 4 study testing Initiation of CFTR Modulator in people with Cystic Fibrosis, run by Children's Hospital Medical Center, Cincinnati at 4 sites in 2 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

The introduction of triple combination CFTR modulator therapy for patients with Cystic Fibrosis (CF) with at least one copy of the deltaF508 mutation is expected to provide major health benefits, but will also require novel outcome measures that can detect CF lung disease at an early stage, capture the efficacy of new… Read more about this study

Who is it for?
Ages 6 to 18 years
Conditions the study is for
Cystic Fibrosis
What is being tested?
Initiation of CFTR Modulator
Could I receive a placebo?
No, everyone receives an active treatment
How many people
47 participants
Where
4 sitesin 2 countries
Study dates
13 Jan 2020to 1 May 2026
Phase
Phase 4
Are there results?
None posted in the registry

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 6 to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Written informed consent (and assent when applicable) obtained from subject or subject's legal representative.
  • Willingness and ability to adhere to the study visit schedule and other protocol requirements.
  • Documentation of a CF diagnosis as evidenced by one or more clinical features consistent with the CF phenotype and one or more of the following criteria:
  • Sweat chloride equal to or greater than 60 mEq/liter by quantitative pilocarpine iontophoresis test
  • Two well-characterized mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene
  • Phase 1 only: Age 6 to 18 years, inclusive, at the time of consent.
Show all 13Show fewer
  • Phase 2 only: Ages 9 to 18 years, inclusive, at the time of consent.
  • Clinically stable with no acute antibiotic usage in the 14 days prior to the first visit.
  • Genotype with F508del on at least one allele.
  • No change in chronic pulmonary medications or therapies in the 28 days prior to the first visit.
  • Stable CFTR modulator therapy (TEZ/IVA or LUM/IVA) for at least 28 days prior to the first visit or currently not receiving CFTR modulator therapy.
  • Ability to cooperate with MRI procedures.
  • Phase 1 only: FEV1 greater than or equal to 80% predicted based on GLI reference equations.

Who cannot join

  • Standard MRI exclusions (Metal implants, claustrophobia).
  • For females of childbearing potential: Positive urine pregnancy test at Screening or Visit 1 or Lactating.
  • Any other condition that, in the opinion of the Site Investigator/designee, would preclude informed consent or assent, make study participation unsafe, complicate interpretation of study outcome data, or otherwise interfere with achieving the study objectives.

Trial locations and contacts

4 sites in 2 countries.

4 sites in 2 countries

United States3 sites
  • University of Virginia School of Medicine

    Charlottesville, Virginia, 22908

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229-3019

  • University of Wisconsin

    Madison, Wisconsin, 53792

Other trials in United States

Canada1 site
  • The Hospital for Sick Kids

    Toronto, Ontario, M5G 1X8

Other trials in Canada

About this study

Official title: Hyperpolarized Imaging for New Treatments (HyPOINT) Study

The introduction of triple combination CFTR modulator therapy for patients with Cystic Fibrosis (CF) with at least one copy of the deltaF508 mutation is expected to provide major health benefits, but will also require novel outcome measures that can detect CF lung disease at an early stage, capture the efficacy of new therapies when disease manifestations are limited, as well as determine whether stopping existing chronic maintenance therapies does not have negative effects.

In the past decade, research has focused on the multiple breath washout (MBW) test, as a sensitive outcome measure, especially if highly-effective modulator therapies are initiated in early childhood. Even LCI, however, may not adequately capture early lung function changes, thus warranting investigation of even more sensitive outcome measures.

Read more

Magnetic resonance imaging (MRI) has the advantage of being a radiation-free modality, making it more suitable for assessing response to therapy in a shorter time frame with repeated imaging. Inhalation of a hyperpolarized gas enables the visualization and quantification of regional ventilation in the lung and can be combined with structural MRI to assess both structure and function in parallel.

The main Investigator and others have recently formed an international consortium (the 129Xe MRI Clinical Trial Consortium), comprised of both imaging experts and pulmonary clinicians to standardize imaging procedures, thus facilitating multi-site implementations. Data from this proposed study (HyPOINT; Hyperpolarized Imaging for New Treatments) will inform the future utility of MRI for both longitudinal studies to track disease progression over time as well as for future interventional trials. Further, the current study could inform the design of future trials of interventions of patients for whom currently no effective CFTR modulator therapy is available and for patients with rare genotypes thus laying the groundwork for a more personalized medicine approach in the near-term future.

Read the detailed description

The HyPOINT (HyperPOlarized Imaging for New Therapies) trial is a multicenter prospective, two phase study involving four sites with proven expertise 129Xe MRI and CF clinical care. The study sites are: University of Virginia, University of Wisconsin, and SickKids in Toronto, Canada. University of Virginia and University of Wisconsin sites will be reliant on CCHMC's IRB. SickKids in Toronto, Canada, will submit their review through their institution's Research Ethics Board (REB).

Phase 1 will include implementation of a centralized analysis program of repeated 129Xe MRI scanning in CF patients with mild lung disease to define the intra-subject variability of the primary outcome ventilation defect percentage (VDP). Patients will undergo baseline 129Xe MRI scanning and repeated measurements the same day, as well as at 28 days (± 7 days). Phase 1 will establish the intra-subject reproducibility to facilitate future use of 129Xe MRI in multi-site studies. Furthermore, the reproducibility limits defined will inform the overall design of future studies and will compare to established pulmonary function and multiple-breath washout testing (via measurement of the lung clearance index, LCI).

Safety of 129Xe MRI will be assessed by recording adverse events during the study visit (see 8.3 Adverse Events and Serious Adverse Events), which will be followed until resolved. Vital signs (heart rate, SPO2) will be recorded before, immediately following inhalation, and 2 minutes after each 129Xe inhalation; O2 saturation will be monitored continuously throughout the 129Xe portion of the MRI, and the time and duration of nadir will be recorded.

Phase 2 will be an observational study of patients assessed before and after the clinical initiation of triple-combination modulator therapy (after presumed FDA and Health Canada approval). The primary endpoint for Phase 2 is the change of VDP after 28 days of triple-combination modulator therapy. Within Phase 2, this study will also address how highly-effective modulator therapies affect lung function trajectories by measuring 129Xe MRI at 28 days (± 7 days), 6 months (± 28 days), and 12 months (± 28 days) after start of therapy (paralleling time points of the PROMISE study). Finally, to understand how 129Xe MRI can be used in combination with existing measures of lung function (e.g. spirometry, multiple breath washout), Investigators will directly compare the repeated data collected in both Phase 1 and Phase 2 to these established measures of lung function that are currently used in observational and interventional studies.

The overarching goal of this study is to define the role of structural and functional MRI imaging to facilitate future CF research studies.

Conditions
Cystic Fibrosis
Being tested
Initiation of CFTR Modulator
Keywords
Cystic Fibrosis, CFTR modulator therapy, 129Xe MRI, hyperpolarized xenon, LCI
Medical subject headings
Cystic Fibrosis

What participants receive

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

  • Initiation of CFTR ModulatorDrug

    Also called 129Xe

    Inhaled contrast for MRI occurring at each 4 visits.

Study groups in NCT04259970
Study groupRoleWhat they receive
Phase 1ExperimentalPhase 1 will include implementation of a centralized analysis program of repeated 129Xe MRI scanning in CF patients with mild lung disease to define the intra-subject variability of the primary outcome ventilation defect percentage (VDP). Patients will undergo baseline 129Xe MRI scanning and repeated measurements the same day, as well as at 28 days (± 7 days). Phase 1 will establish the intra-subject reproducibility to facilitate future use of 129Xe MRI in multi-site studies. Furthermore, the reproducibility limits defined will inform the overall design of future studies and will compare to established pulmonary function and multiple-breath washout testing (via measurement of the lung clearance index, LCI).
Receives: Drug: Initiation of CFTR Modulator
Initiation of CFTR ModulatorExperimentalPhase 2 will be an observational study of patients assessed before and after the clinical initiation of triple-combination modulator therapy (after presumed FDA and Health Canada approval). The primary endpoint for Phase 2 is the change of VDP after 28 days of triple-combination modulator therapy. Within Phase 2, this study will also address how highly-effective modulator therapies affect lung function trajectories by measuring 129Xe MRI at 28 days (± 7 days), 6 months (± 28 days), and 12 months (± 28 days) after start of therapy (paralleling time points of the PROMISE study). Finally, to understand how 129Xe MRI can be used in combination with existing measures of lung function (e.g. spirometry, multiple breath washout), the investigators will directly compare the repeated data collected in both Phase 1 and Phase 2 to these established measures of lung function that are currently used in observational and interventional studies.
Receives: Drug: Initiation of CFTR Modulator

What is being measured

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

  1. Xe VDP Assessment

    The primary analysis will use a paired, non-parametric test (e.g., Wilcoxson Rank sum) to determine if the change in VDP from baseline to 28 days is statistically different from no change in VDP.

    Measured: 28 days

  2. The change in Xe VDP after 28 days of triple modulator CFTR therapy

    To understand how triple combination therapy affects lung function in the long term, we will compare the changes in VDP (summarized as the average change from baseline at 6 months and 12 months), using the same non-parametric matched analysis. This will inform the natural history of VDP and whether future studies of hyperpolarized 129Xe MRI should be designed to show an improvement in VDP or maintenance of VDP. Exploratory analyses using a mixed-effects regression model will be done to define the rate of change of VDP over the 12-month study period.

    Measured: 28 days

Secondary outcomes (3)
  1. Overall UTE MRI reader score analysis

    The primary analysis will use a paired, non-parametric test (e.g., Wilcoxson Rank sum) to determine if the change in VDP from baseline to 28 days is statistically different from no change in VDP.

    Measured: 28 days

  2. The change in overall MRI reader score for UTE MRI 28 days after triple combination therapy is initiated

    To understand how triple combination therapy affects lung function in the long term, we will compare the changes in VDP (summarized as the average change from baseline at 6 months and 12 months), using the same non-parametric matched analysis. This will inform the natural history of VDP and whether future studies of hyperpolarized 129Xe MRI should be designed to show an improvement in VDP or maintenance of VDP. Exploratory analyses using a mixed-effects regression model will be done to define the rate of change of VDP over the 12-month study period.

    Measured: 28 days

  3. Fev1 and LCI Correlation

    A Spearman correlation will be used to determine the correlation between VDP and LCI at each study time points. A similar correlation analysis will be repeated for the change in LCI from baseline and change in VDP from baseline at each of the study time-points. With the treatment data, we will determine the concordance between the two outcomes at detecting an improvement in lung function and investigate where the two tests are discordant. A receiver operator characteristic curve will compare the diagnostic accuracy of the 129Xe MRI, and LCI. Similar analysis will be performed comparing VDP to the FEV1 and comparing the UTE MRI reader score to both LCI and FEV1. Secondary analysis will compare these changes in PFTs and LCI to changes in UTE MRI reader score and to sub-categories of regional ventilation using 129Xe MRI.

    Measured: 28 days

Timeline

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

  1. First posted7 Feb 2020
  2. Study start13 Jan 2020
  3. Primary completion1 May 2026
  4. Study completion1 May 2026

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 4
Primary purpose
Diagnosis
Allocation
Non-randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
47 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04259970
Sponsor's protocol ID
2019-1051
Acronym
HyPOINT
Status last verified
Oct 2026
First submitted
15 Jan 2020
Last updated
7 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wielputz MO, Puderbach M, Kopp-Schneider A, Stahl M, Fritzsching E, Sommerburg O, Ley S, Sumkauskaite M, Biederer J, Kauczor HU, Eichinger M, Mall MA. Magnetic resonance imaging detects changes in structure and perfusion, and response to therapy in early cystic fibrosis lung disease. Am J Respir Crit Care Med. 2014 Apr 15;189(8):956-65. doi: 10.1164/rccm.201309-1659OC.

    PubMed 24564281

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Initiation of CFTR Modulator in people with Cystic Fibrosis, run by Children's Hospital Medical Center, Cincinnati at 4 sites in 2 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 13 inclusion and 3 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 7 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States, Canada. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Xe VDP Assessment (time frame: 28 days). 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 NCT04259970, 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 7 Oct 2026.

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