Bacterial Disease CarrierPhase 1/2NCT05453578
A Phase 1b/2 Trial of the Safety and Microbiological Activity of Bacteriophage Therapy in Cystic Fibrosis Subjects Colonized With Pseudomonas Aeruginosa
A Phase 1/2 study testing WRAIR-PAM-CF1 in people with Bacterial Disease Carrier and Cystic Fibrosis, run by National Institute of Allergy and Infectious Diseases (NIAID) at 19 sites in United States.
Trial summary
This is a phase 1b/2 study of a single dose of intravenous (IV) bacteriophage in males and non-pregnant females, at least 18 years old, diagnosed with Cystic Fibrosis (CF). This clinical trial is designed to assess the safety and microbiological activity of bacteriophage product Walter Reed Army Institute of Research… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Bacterial Disease Carrier, Cystic Fibrosis
- What is being tested?
- WRAIR-PAM-CF1
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 73 participants
- Where
- 19 sitesUnited States
- Study dates
- 3 Oct 2022to 10 Apr 2025
- Phase
- Phase 1/2
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
- Subjects must meet all the inclusion criteria to be eligible to participate in the study:
- Adult (>/= 18 years) at the time of screening.
- Confirmed Cystic Fibrosis (CF) diagnosis based on a compatible clinical syndrome confirmed by either an abnormal sweat chloride testing or CFTR gene variations.*
- Can be obtained from documentation in medical records; actual test results not necessary.
- Likely able to produce at least 2 mL of sputum during a 30-minute sputum collection following a hypertonic saline treatment or other approach to increase sputum production.**
- Determined by investigator or their designee judgement. Approaches for obtaining sputum may include, but are not limited to, inhaled hypertonic saline (e.g., 3%, 7%, or 10%), inhaled hypertonic bicarbonate, inhaled mannitol, or spontaneously expectorated sputum. The same approach is recommended, whenever possible, for all sputum collections for a given subject.
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- Pseudomonas aeruginosa (regardless of Colony Forming Units (CFU)/mL) isolated from a sputum, throat culture, or other respiratory specimen in the past 12 months.
- Confirmed P. aeruginosa isolation from a sample of expectorated sputum at the Screening Visit.
- Capable of providing informed consent.
- Capable and willing to complete all study visits and perform all procedures required by the protocol.
Who cannot join
- Subjects who meet any of the exclusion criteria will not be enrolled in the study:
- Body weight < 30 kg.
- Forced Expiratory Volume in 1 second (FEV1) < 20% of predicted value at screening, using the Hankinson equations.
- Elevated Elevated liver function tests (LFTs) obtained at screening.*
- a. Alanine aminotransferase (ALT) > 5 x the upper limit of normal (ULN) or aspartate transaminase (AST) > 5 x ULN or total bilirubin > 3 x ULN, OR b. Total bilirubin > 1.5 x ULN combined with either ALT > 3 x ULN or AST > 3 x ULN. ULN reflects local laboratory ranges.
- Acute clinical illness requiring a new (oral, parenteral), or inhaled antibiotic(s) </= 30 days prior to the baseline visit.*
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- Does not include chronic suppressive medications or cyclic dosing medications such as inhaled antibiotics.
- Women who are pregnant, planning to become pregnant during the study period, or breastfeeding.* *Women of childbearing potential must have a negative serum beta-human chorionic gonadotropin test during screening and agree to use an effective method of contraception for the duration of the trial.*
- A female is considered of childbearing potential unless postmenopausal, or surgically sterilized and at least 3 months has passed since sterilization procedure.
- Female surgical sterilization procedures include tubal ligation, bilateral salpingectomy, hysterectomy, or bilateral oophorectomy.
- Female is considered postmenopausal if she is >45 years old and has gone at least 12 months without a spontaneous menstrual period without other known or suspected cause.
- Effective methods of contraception include (a) abstinence, (b) partner vasectomy, (c) intrauterine devices, (d) hormonal implants (such as Implanon), or (e) other hormonal methods (birth control pills, injections, patches, vaginal rings).
- Active treatment of any mycobacterial or fungal organisms </=30 days prior to baseline. Chronic treatment for suppression of fungal populations is allowable.
- Anticipated need to change chronic antibiotic regimens during the study period.*
- Subjects on cyclic dosing medications such as inhaled antibiotics, must be able and express willingness to keep the therapies at the time of screening constant (either remain on the therapy or not remain on the therapy) for the duration of the follow-up period (approximately 30 days). Subjects on chronic suppressive antimicrobial therapy must be able and express willingness to stay on the therapies for the duration of their follow-up period. This includes chronic azithromycin therapy.
- Known allergy to any component of the study product.
- Any significant finding that, in the opinion of the investigator, would make it unsafe for the subject to participate in this study.
- Enrolled in a clinical trial within </=30 days of the baseline/dosing visit, or participating in a clinical trial while enrolled in this clinical trial (inclusive of vaccine trials).
- Currently or previously enrolled in this trial.
Trial locations and contacts
19 sites in 1 country.
19 sites in 1 country
United States19 sites
Michigan Medicine
Ann Arbor, Michigan, 48109
Emory University - Adult Cystic Fibrosis Program
Atlanta, Georgia, 30324
Johns Hopkins University
Baltimore, Maryland, 21205
University of Virginia
Charlottesville, Virginia, 22908
Case Western Reserve University
Cleveland, Ohio, 44106
University of Texas Southwestern Medical Center
Dallas, Texas, 75390
Duke University Medical Center
Durham, North Carolina, 27710
Baylor College of Medicine
Houston, Texas, 77030-3411
University of California, San Diego
La Jolla, California, 92037
University of California, San Diego (UCSD) - Antiviral Research Center (AVRC)
La Jolla, California, 92121
University of California Los Angeles Medical Center - Westwood Clinic
Los Angeles, California, 90095
University of Minnesota Medical Center
Minneapolis, Minnesota, 55455-0341
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
Northwell Health
New Hyde Park, New York, 11050
Yale North Haven Medical Center- Winchester Center for Lung Disease
North Haven, Connecticut, 06473
University of California Davis Health
Sacramento, California, 95816
Stanford University
Stanford, California, 94305
University of South Florida/Tampa General Hospital
Tampa, Florida, 22612
The University of Arizona - Banner University Medical Center Tucson Campus - Tucson
Tucson, Arizona, 85724-0001
About this study
Official title: A Phase 1b/2, Multi-Centered, Randomized, Double-Blind, Placebo-Controlled Trial of the Safety and Microbiological Activity of a Single Dose of Bacteriophage Therapy in Cystic Fibrosis Subjects Colonized With Pseudomonas Aeruginosa
This is a phase 1b/2 study of a single dose of intravenous (IV) bacteriophage in males and non-pregnant females, at least 18 years old, diagnosed with Cystic Fibrosis (CF). This clinical trial is designed to assess the safety and microbiological activity of bacteriophage product Walter Reed Army Institute of Research- PAM-Cystic Fibrosis1 (WRAIR-PAM-CF1), directed at Pseudomonas aeruginosa in clinically stable CF individuals chronically colonized with P. aeruginosa. WRAIR-PAM-CF1 is a 4 component anti-pseudomonal bacteriophage mixture containing between 4 x 10^7 and 4 x 10^9 Plaque Forming Units (PFU) of bacteriophage. Enrollment will occur at up to 20 clinical sites in the United States. In stage 1, two eligible subjects will be assigned to each of the three dosing arms receiving a single dosage of the IV bacteriophage therapy (4 x 10^7 PFU, 4 x 10^8 PFU, and 4 x 10^9 PFU; total of 6 sentinel subjects), followed by 30 plus or minus 7 days observation period. If no Serious Adverse Events (SAEs)(related to the study product) are identified during the 96 hours after bacteriophage administration for all Sentinel Subjects in Stage 1, the study will proceed to Stage 2. In Stage 2a, 32 subjects will be enrolled into one of 4 arms (placebo IV, 4 x 10^7 PFU, 4 x 10^8 PFU, and 4 x 10^9 PFU) in a 1:1:1:1 allocation. An interim analysis will be performed after all subjects have completed follow up visit 5 on Day 8+3 to select the IV bacteriophage dose with the most favorable safety and microbiological activity profile. During Stage 2b, subjects will be randomized into the bacteriophage (dose selected based on Interim Analysis following Stage 2a) or placebo arm. The final sample size is expected to be up to 72 subjects total with up to 25 subjects in the placebo arm and up to 25 subjects in the Stage 2b bacteriophage dose.
Read the detailed description
This is a phase 1b/2, multicenter, randomized placebo-controlled double-blind study of a single dose of intravenous (IV) bacteriophage in males and non-pregnant females, at least 18 years old, diagnosed with Cystic Fibrosis (CF). This clinical trial is designed to assess the safety and microbiological activity of bacteriophage product Walter Reed Army Institute of Research- PAM-Cystic Fibrosis1 (WRAIR-PAM-CF1), directed at Pseudomonas aeruginosa (P. aeruginosa) in clinically stable CF individuals chronically colonized with P. aeruginosa. WRAIR-PAM-CF1 is a 4 component anti-pseudomonal bacteriophage mixture containing between 4 x 10^7 and 4 x 10^9 Plaque Forming Units (PFU) of bacteriophage. Enrollment will occur at up to 20 clinical sites in the United States. In stage 1, two sentinel subjects will be assigned to each of the three dosing arms receiving a single dosage of the IV bacteriophage therapy (4 x 10^7 PFU, 4 x 10^8 PFU, and 4 x 10^9 PFU; total of 6 sentinel subjects), followed by 30 plus or minus 7 days observation period. If no Serious Adverse Events (SAEs) (related to the study product) are identified during the 96 hours after bacteriophage administration for all Sentinel Subjects in Stage 1, the study will proceed to Stage 2. In Stage 2a, 32 subjects will be enrolled into one of 4 arms (placebo IV, 4 x 10^7 PFU, 4 x 10^8 PFU, and 4 x 10^9 PFU) in a 1:1:1:1 allocation. An interim analysis will be performed after all subjects have completed follow up visit 5 on Day 8+3 to select the IV bacteriophage dose with the most favorable safety and microbiological activity profile. During Stage 2b, subjects will be randomized into the bacteriophage (dose selected based on Interim Analysis following Stage 2a) or placebo arm. The final sample size is expected to be up to 72 subjects total with up to 25 subjects in the placebo arm and up to 25 subjects in the Stage 2b bacteriophage dose. The primary objectives of this study are to 1) describe the safety of a single dose of IV bacteriophage therapy in clinically stable CF subjects with P. aeruginosa in expectorated sputum; 2) describe the microbiological activity of a single dose of IV bacteriophage therapy in clinically stable CF subjects with P. aeruginosa in expectorated sputum; 3) describe the benefit to risk profile of a single dose of IV bacteriophage therapy in clinically stable CF subjects with P. aeruginosa in expectorated sputum.
- Conditions
- Bacterial Disease Carrier, Cystic Fibrosis
- Being tested
- Placebo, WRAIR-PAM-CF1
- Keywords
- Bacteriophage therapy, colonized, Cystic Fibrosis, double-blind, Microbiological Activity, placebo-controlled, Pseudomonas aeruginosa, randomized, Safety
- Medical subject headings
- Cystic Fibrosis, Pseudomonas Infections
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PlaceboOther
0.9 percent sodium chloride
WRAIR-PAM-CF1Biological
Bacteriophage combination composed of the following phages: PaWRA01Phi11, PaWRA01Phi39, PaWRA02Phi83, and PaWRA02Phi87.
| Study group | Role | What they receive |
|---|---|---|
| Stage 1/2a Arm 2 | Active comparator | 4x10^7 plaque forming units (PFU) of WRAIR-PAM-CF1 administered intravenously with approximately 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. Stage 1: N=2 (sentinel subjects); Stage 2a: N=8 Receives: Biological: WRAIR-PAM-CF1 |
| Stage 1/2a Arm 3 | Active comparator | 4x10^8 plaque forming units (PFU) of WRAIR-PAM-CF1 administered intravenously with approximately 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. Stage 1: N=2 (sentinel subjects); Stage 2a: N=8 Receives: Biological: WRAIR-PAM-CF1 |
| Stage 1/2a Arm 4 | Active comparator | 4x10^9 plaque forming units (PFU) of WRAIR-PAM-CF1 administered intravenously with approximately 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. Stage 1: N=2 (sentinel subjects); Stage 2a: N=8 Receives: Biological: WRAIR-PAM-CF1 |
| Stage 2a Arm 1 | Placebo comparator | 25 mL of 0.9 percent Sodium Chloride saline solution administered intravenously for 30 mins as a single dosage. N=8 Receives: Other: Placebo |
| Stage 2b Arm 1 | Placebo comparator | 25 mL of 0.9 percent Sodium Chloride saline solution administered intravenously for 30 mins as a single dosage. N=17 Receives: Other: Placebo |
| Stage 2b Arm 2 | Active comparator | WRAIR-PAM-CF1 concentration determined after post stage 2a analysis, administered intravenously with 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. N=17 Receives: Biological: WRAIR-PAM-CF1 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants That Experienced Grade 2 or Higher Treatment-emergent Adverse Events in the ITT Population
An event that occurred during the treatment period was considered a treatment-emergent AE if it was not present before the first dose of investigational product or was present before the first dose of investigational product and increased in severity during the treatment period.
Measured: Day 1 through Day 30
Change From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo in Stage 2a and 2b
Mean change from baseline in log10-transformed counts of P. aeruginosa colony forming units per milliliter (CFU/mL) is presented for each time point through Day 30 as well as for each participant's minimum and maximum change from baseline. Undetectable colony counts are substituted with the limit of detection (LOD) of the assay (1 x 10^4 CFU/mL).
Measured: Day 1 Post-infusion, Day 2, Day 5, Day 8, and Day 30
Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit in Stage 2a and 2b
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated by: Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1 x 10^4 CFU/mL)
Measured: Day 1 Post-infusion, Day 2, Day 5, and Day 8
Change From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo, Sensitivity Analysis for Stage 2a and 2b
Mean change from baseline in log10-transformed counts of P. aeruginosa colony forming units per milliliter (CFU/mL) is presented for each time point through Day 30 as well as for each participant's minimum and maximum change from baseline. Undetectable colony counts are treated as missing.
Measured: Day 1 Post-infusion, Day 2, Day 5, Day 8, and Day 30
Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit, Sensitivity Analysis for Stage 2a and 2b
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8:
Rank 1 = No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL.
Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL.
Rank 3 = No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL.
Rank 4 = SAE (related to study product).
The DOOR probability is estimated using:
Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.
Measured: Day 1 Post-infusion, Day 2, Day 5, and Day 8
Number of Susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated by: Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1 x 10^4 CFU/mL)
Measured: Baseline through Day 8
Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and >2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and <1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10^4 CFU/mL).
Measured: Baseline through Day 8
Number of Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and >2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and <1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10^4 CFU/mL).
Measured: Baseline through Day 8
Number of Not Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and >2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and <1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10^4 CFU/mL).
Measured: Baseline through Day 8
Number of Susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8:
Rank 1 = No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL.
Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL.
Rank 3 = No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL.
Rank 4 = SAE (related to study product).
The DOOR probability is estimated using:
Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.
Measured: Baseline through Day 8
Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8:
Rank 1 = No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL.
Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL.
Rank 3 = No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL.
Rank 4 = SAE (related to study product).
The DOOR probability is estimated using:
Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.
Measured: Baseline through Day 8
Number of Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8:
Rank 1 = No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL.
Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL.
Rank 3 = No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL.
Rank 4 = SAE (related to study product).
The DOOR probability is estimated using:
Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.
Measured: Baseline through Day 8
Number of Not Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8:
Rank 1 = No SAE (related to study product) and > 2 log10 reduction in P. aeruginosa CFU/mL.
Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL.
Rank 3 = No SAE (related to study product) and < 1 log10 reduction in P. aeruginosa CFU/mL.
Rank 4 = SAE (related to study product).
The DOOR probability is estimated using:
Pr[DOOR]= Pr[DOORIV > DOORP] + 1/2Pr[DOORIV = DOORP] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr[DOORIV > DOORP] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr[DOORIV = DOORP] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.
Measured: Baseline through Day 8
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jul 2022
- Study start3 Oct 2022
- Primary completion10 Apr 2025
- Study completion10 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Bacterial Disease CarrierStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 1/2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 73 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05453578
- Sponsor's protocol ID
- 20-0001
- Other IDs
- 2UM1AI104681-08
- Status last verified
- 1 Jul 2025
- First submitted
- 7 Jul 2022
- Last updated
- 16 Jul 2026
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Tamma PD, Souli M, Billard M, Campbell J, Conrad D, Ellison DW, Evans B, Evans SR, Greenwood-Quaintance KE, Filippov AA, Geres HS, Hamasaki T, Komarow L, Nikolich MP, Lodise TP, Nayak SU, Norice-Tra C, Patel R, Pride D, Russell J, Van Tyne D, Chambers HF, FowlerJr VG, Schooley RT; Antibacterial Resistance Leadership Group. Safety and microbiological activity of phage therapy in persons with cystic fibrosis colonized with Pseudomonas aeruginosa: study protocol for a phase 1b/2, multicenter, randomized, double-blind, placebo-controlled trial. Trials. 2022 Dec 28;23(1):1057. doi: 10.1186/s13063-022-07047-5.
PubMed 36578069