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Idiopathic Pulmonary FibrosisPhase 3PRECISIONSNCT04300920

Prospective Treatment Efficacy in IPF Using Genotype for Nac Selection (PRECISIONS) Trial

A Phase 3 study testing N-acetyl cysteine in people with Idiopathic Pulmonary Fibrosis, run by Fernando J Martinez at 25 sites 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 purpose of this study is to compare the effect of n-acetylcysteine (NAC) plus standard care with matched placebo plus standard of care in patients diagnosed with idiopathic pulmonary fibrosis (IPF) who have the TOLLIP rs3750920 TT genotype. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
Idiopathic Pulmonary Fibrosis
What is being tested?
N-acetyl cysteine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
202 participants
Where
25 sitesUnited States
Study dates
17 Dec 2020to 2 Mar 2026
Phase
Phase 3
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 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥ 40 years of age
  • Diagnosed with IPF according to 2018 ATS/ERS/JRS/ALAT, confirmed by enrolling investigator
  • Signed informed consent
  • If taking pirfenidone or nintedanib, must be on stable dose for at least 6 weeks prior to enrollment visit
  • Confirmed rs3570920 TT TOLLIP genotype

Who cannot join

  • Pregnancy or planning to become pregnant
  • Women of childbearing potential not willing to remain abstinent (refrain from heterosexual intercourse) or use two adequate methods of contraception, including at least one method with a failure rate of <1% per year during study participation
  • Significant medical, surgical or psychiatric illness that in the opinion of the investigator would affect subject safety, including liver and renal failure
  • Receipt of an investigational drug or biological agent within the previous 4 weeks of the screening visit or 5 times the half-life, if longer
  • Supplemental or prescribed NAC therapy within 60 days of enrollment
  • Listed for lung transplantation at the time of screening
Show all 10Show fewer
  • History of lung cancer
  • Inability to perform spirometry
  • Forced vital capacity (FVC) less than 45% predicted, using the global lung function index (GLI) equation at Visit 1
  • Active respiratory infection requiring treatment with antibiotics within 4 weeks of Visit 1

Trial locations and contacts

25 sites in 1 country.

25 sites in 1 country

United States25 sites
  • University of Michigan

    Ann Arbor, Michigan, 48109

  • University of Colorado

    Aurora, Colorado, 80045

  • Piedmont Healthcare

    Austell, Georgia, 30106

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • University of Virginia

    Charlottesville, Virginia, 22908

  • University of Chicago

    Chicago, Illinois, 60637

  • Ohio State University

    Columbus, Ohio, 43221

  • University of Texas Southwestern

    Dallas, Texas, 75390

  • Indiana University

    Indianapolis, Indiana, 46202

  • University of Kansas Medical Center

    Kansas City, Kansas, 66160

  • University of Southern California

    Los Angeles, California, 90033

  • Loyola University

    Maywood, Illinois, 60153

  • University of Minnesota

    Minneapolis, Minnesota, 55455

  • Lisa Lancaster

    Nashville, Tennessee, 37204

  • Tulane University

    New Orleans, Louisiana, 70112

  • Weill Cornell Medicine

    New York, New York, 10016

  • Temple University

    Philadelphia, Pennsylvania, 19140

  • Mayo Clinic

    Rochester, Minnesota, 55905

  • University of Rochester

    Rochester, New York, 14642

  • University of Utah Health

    Salt Lake City, Utah, 84108

  • University of Texas Health San Antonio

    San Antonio, Texas, 78229

  • University of Washington

    Seattle, Washington, 98195

  • Stanford University

    Stanford, California, 94305

  • University of Arizona

    Tucson, Arizona, 85724

Other trials in United States

About this study

The purpose of this study is to compare the effect of n-acetylcysteine (NAC) plus standard care with matched placebo plus standard of care in patients diagnosed with idiopathic pulmonary fibrosis (IPF) who have the TOLLIP rs3750920 TT genotype. The study will compare the time to a composite endpoint of relative decline in lung function [10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplantation, or all-cause mortality]

The secondary objectives will be to examine the effect of NAC on the components of the primary composite endpoint, the rates of clinical events, change in physiology, change in health status, and change in respiratory symptoms.

Read the detailed description

This is a multi-center, randomized, double-blind, placebo-controlled trial of NAC or placebo in about 200 participants with IPF with a TOLLIP rs3750920 TT genotype.

Eligible participants will be randomized in a 1:1 fashion to NAC or placebo, stratified by stable concomitant IPF therapy use (i.e., pirfenidone or nintedanib administered for at least 6 weeks prior to screening) versus no pirfenidone or nintedanib use. Participants will receive 600 mg NAC orally or matched placebo to take three times daily for 24 months.

Being tested
N-acetyl cysteine, Placebo
Keywords
IPF, Pulmonary Fibrosis, n-acetylcysteine, NAC
Medical subject headings
Idiopathic Pulmonary Fibrosis, Pulmonary Fibrosis

What participants receive

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

  • N-acetyl cysteineDrug

    Also called NAC

    600 mg N-acetylcysteine (NAC) oral tablets three times daily for 24 months.

  • PlaceboDrug

    Matching oral placebo tablet three times daily for 24 months.

Study groups in NCT04300920
Study groupRoleWhat they receive
N-acetylcysteineExperimental600 mg oral N-acetylcysteine (NAC) three times daily for 24 months.
Receives: Drug: N-acetyl cysteine
PlaceboPlacebo comparatorPlacebo tablet three times daily for 24 months.
Receives: Drug: Placebo

What is being measured

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

  1. Time to one of the following composite endpoint criteria: 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplant or death from any cause.

    This is a composite endpoint of time to 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplant or death from any cause. Respiratory hospitalizations will be determined by a blinded clinical events classification (adjudication) committee.

    Measured: 24 months

Secondary outcomes (34)
  1. Time to one of the following composite criteria: 10% relative decline in FVC % predicted, first respiratory hospitalization, lung transplant or death from any cause.

    This is a composite endpoint of time to 10% relative decline in FVC % predicted, based on the global lung initiative (GLI) reference equation, first respiratory hospitalization, lung transplant or death from any cause. Respiratory hospitalizations will be determined by a blinded clinical events classification (adjudication) committee.

    Measured: 24 months

  2. Time to death from any cause

    Measured: 24 months

  3. Time to first respiratory hospitalization, lung transplant, or death from any cause

    Respiratory hospitalizations will be determined by a blinded clinical events classification (adjudication) committee.

    Measured: 24 months

  4. Time to 10% relative decline in FVC, lung transplant or death from any cause

    Measured: 24 months

  5. Time to lung transplant, or death from any cause

    Measured: 24 months

  6. Time to 10% relative decline in FVC %predicted, lung transplant, or death from any cause

    Measured: 24 months

  7. Time to first all-cause hospitalization, lung transplant, or death from any cause

    Measured: 24 months

  8. Annualized rate of respiratory hospitalizations

    Measured: 24 months

  9. Annualized rate of non-elective, all-cause hospitalizations

    Measured: 24 months

  10. Absolute change in FVC % predicted from randomization at 12 months

    Measured: 12 months

  11. Absolute change in FVC % predicted from randomization at 24 months

    Measured: 24 months

  12. Absolute change in FVC from randomization at 12 months

    Measured: 12 months

  13. Absolute change in FVC from randomization at 24 months

    Measured: 24 months

  14. Absolute change in diffusing capacity of the lung for carbon monoxide (DLCO) uncorrected for hemoglobin from randomization at 12 months

    Measured: 12 months

  15. Absolute change in DLCO uncorrected from randomization at 24 months

    Measured: 24 months

  16. Absolute change in patient reported outcomes scores for the Leicester Cough Questionnaire (LCQ) from randomization at 12 months.

    Measured: 12 months

  17. Absolute change in patient reported outcomes scores for the EuroQoL EQ-5D Questionnaire from randomization at 12 months.

    Measured: 12 months

  18. Change in patient reported outcomes scores for the University of California, San Diego Shortness of Breath (UCSD-SOB) Questionnaire from randomization at 12 months.

    Measured: 12 months

  19. Change in patient reported outcomes scores for the King's Brief Interstitial Lung Disease (K-BILD) Questionnaire from randomization at 12 months.

    Measured: 12 months

  20. Change in patient reported outcomes scores for the St. George's Respiratory Questionnaire (SGRQ) from randomization at 12 months.

    Measured: 12 months

  21. Change in patient reported outcomes scores for the Leicester Cough Questionnaire (LCQ) from randomization at 24 months

    Measured: 24 months

  22. Change in patient reported outcomes scores for the EuroQoL EQ-5D Questionnaire from randomization at 24 months

    Measured: 24 months

  23. Change in patient reported outcomes scores for the University of California, San Diego Shortness of Breath (UCSD-SOB) Questionnaire from randomization at 24 months

    Measured: 24 months

  24. Change in patient reported outcomes scores for the King's Brief Interstitial Lung Disease (K-BILD) Questionnaire from randomization at 24 months

    Measured: 24 months

  25. Change in patient reported outcomes scores for the St. George's Respiratory Questionnaire (SGRQ) from randomization at 24 months

    Measured: 24 months

  26. Proportion of participants with and number of treatment-emergent adverse events, serious adverse events, adverse events leading to discontinuation, and unanticipated problems

    Measured: 24 months

  27. Estimated time per six months free of 10% relative decline in FVC, first respiratory hospitalization, lung transplant or death from any cause.

    Measured: 24 months

  28. Estimated time per six months free of 10% relative decline in FVC % predicted, first respiratory hospitalization, lung transplant or death from any cause.

    Measured: 24 months

  29. Estimated time lived per six months (based on all-cause mortality).

    Measured: 24 months

  30. Average time per six months free of first respiratory hospitalization, lung transplantation or death from any cause.

    Measured: 24 months

  31. Average time per six months free of 10% relative decline in FVC, lung transplant, or death from any cause.

    Measured: 24 months

  32. Average time per six months free of lung transplant, or death from any cause.

    Measured: 24 months

  33. Average time per six months free of 10% relative decline in FVC % predicted, lung transplant, or death from any cause.

    Measured: 24 months

  34. Average time per six months free of all-cause hospitalization, lung transplant, or death from any cause.

    Measured: 24 months

Timeline

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

  1. First posted9 Mar 2020
  2. Study start17 Dec 2020
  3. Primary completion2 Mar 2026
  4. Study completion2 Mar 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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Eligible participants will be randomized in a 1:1 fashion to NAC or placebo, stratified by stable concomitant IPF therapy use (i.e., pirfenidone or nintedanib administered for at least 6 weeks prior to screening) versus no pirfenidone or nintedanib use. Participants will receive 600 mg NAC orally three times daily or matched placebo for 24 months.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
202 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04300920
Sponsor's protocol ID
19-12021232
Other IDs
1U24HL145265-01A1
Acronym
PRECISIONS
Status last verified
Mar 2026
First submitted
6 Mar 2020
Last updated
20 Mar 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: The de-identified analytic data will be prepared as SAS transport files or ASCII comma-delimited files with accompanying codebooks that describe the data and data structure. The redaction will employ best practices and will be consistent with NHLBI data sharing policies.

Publications

  • Podolanczuk AJ, Kim JS, Cooper CB, Lasky JA, Murray S, Oldham JM, Raghu G, Flaherty KR, Spino C, Noth I, Martinez FJ; PRECISIONS Study Team. Design and rationale for the prospective treatment efficacy in IPF using genotype for NAC selection (PRECISIONS) clinical trial. BMC Pulm Med. 2022 Dec 13;22(1):475. doi: 10.1186/s12890-022-02281-8.

    PubMed 36514019

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing N-acetyl cysteine in people with Idiopathic Pulmonary Fibrosis, run by Fernando J Martinez at 25 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 5 inclusion and 10 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 20 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 25 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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?

Time to one of the following composite endpoint criteria: 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplant or death from any cause. (time frame: 24 months). 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 NCT04300920, 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 20 Mar 2026.

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