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Cystic FibrosisPhase 2CHOICESNCT06468527

Clinical Trial to Evaluate the Efficacy and Safety of Dirocaftor/Posenacaftor/Nesolicaftor in Adults With CF

A Phase 2 study testing Diponecaftor in people with Cystic Fibrosis, run by Kors van der Ent at 16 sites in 9 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

CF is caused by mutations in the gene that encodes the 'Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)' channel. To re-establish the function of this complex chloride channel, typically two to three drug modes of action are needed. 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?
Diponecaftor
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
41 participants
Where
16 sitesin 9 countries
Study dates
3 Jun 2024to 26 Jun 2025
Phase
Phase 2
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • A subject must meet ALL the following criteria in order to participate:
  • Male or female subjects who completed the HIT-CF Organoid Study and are 18 years of age or older on the date of informed consent
  • Confirmed diagnosis of CF as follows:
  • Sweat chloride value of ≥60 mmol/L based on quantitative pilocarpine iontophoresis (at screening) OR 2 CF-causing mutations AND
  • chronic sinopulmonary disease or gastrointestinal/nutritional abnormalities
  • Clinically stable CF disease in the opinion of the investigator with no significant changes in health status within 28 days prior to Day 1
Show all 14Show fewer
  • Forced expiratory volume in one second (FEV1) ≥40% of predicted to ≤90% of predicted at the Screening Visit, based on the Global Lung Function Initiative (GLI) -2012 multi-ethnic all-age reference equations
  • Body mass index (BMI) ≥16 kg/m2 and ≤30 kg/m2
  • Non-smoker and non-tobacco user (including all inhalational nicotine delivery systems) for a minimum of 30 days prior to screening, and subject agrees not to smoke or use tobacco for the duration of the study
  • Subjects of childbearing potential must meet contraception requirements (Section 13.3.1)
  • Willing to remain on a stable medication regimen for CF from 28 days before Day 1 through the last study visit
  • Willing and able to comply with scheduled visits, treatment plan, study restrictions, laboratory tests, and other study procedures
  • Selected by an unblinded coordinating team based on organoid response or random selection
  • Subject will sign and date an informed consent form (ICF

Who cannot join

  • A subject who meets ANY of the following criteria will be excluded from participation:
  • Subject has at least one of the following CFTR-mutations: F508del, G551D, G1244E, G1349D, G178R, G551S, S1251N, S1255P, S549N, S549R, R117H, A455E, 3849+10kbC>T OR A combination of any two of the following mutations: any nonsense mutation, 1717-1G>A, 621+1G>T, 3120+1G>A, 1898+1G->A, CFTRdele2,3, and 2183AA->G
  • History or current evidence of any clinically significant cardiac (eg, heart failure, left ventricular hypertrophy, myocardial infarction, and arrhythmia), endocrinologic, hematologic, hepatobiliary (eg, clinically significant cirrhosis with or without portal hypertension, hepatitis B or hepatitis C), immunologic, metabolic, urologic, pulmonary (besides CF), neurologic (eg, subarachnoid haemorrhage, intracranial haemorrhage, cerebrovascular accident, intracranial trauma, and autonomic neuropathy), dermatologic, psychiatric, renal, or other major disease, that is unstable or could interfere with the subject's participation in or completion of the study, in the opinion of the investigator
  • Clinically significant screening results that would exclude subject from the study (eg, medical history, physical examination, ECG, vital sign, pulse oximetry, and laboratory profiles) or any conditions that, would make the subject unsuitable for enrolment or could interfere with the subject's participation in or completion of the study, in the opinion of the investigator. The medical monitor must be contacted for review of any subjects with screening results or conditions that may make them unsuitable for enrolment or could interfere with participation in or completion of the study.
  • Prolonged QTcF >450 msec at screening
  • Abnormal liver function as defined by AST, ALT, gamma-glutamyl transferase (GGT), or alkaline phosphatase ≥3 times or total bilirubin ≥2 times upper limit of the normal range
Show all 20Show fewer
  • Haemoglobin <10 g/dL
  • Platelet count <150,000 cells/mm3
  • Abnormal renal function at screening defined as creatinine clearance <60 mL/min using the Modified Diet in Renal Disease (MDRD)
  • Hospitalisation, sinopulmonary infection, CF exacerbation, or other clinically significant infection or illness (in the opinion of the investigator) requiring an increase or addition of medication, such as antibiotics or corticosteroids, within 28 days of Day 1
  • Lung infection with organisms associated with a more rapid decline in pulmonary status (eg, Burkholderia cenocepacia, Burkholderia dolosa, and Mycobacterium abscessus). Subjects who have a current or past history of a positive culture must be reviewed with the medical monitor to confirm clinical stability.
  • Subject is currently taking or has taken a CFTR modulator within 28 days prior to Day 1
  • Participation in another clinical trial or treatment with an investigational agent within 28 days or 5 half-lives, whichever is longer, prior to screening. The duration of the elapsed time may be longer if required by local regulations
  • History of cancer (excluding cervical carcinoma in situ and non-melanoma skin cancer with curative therapy for at least 5 years prior to screening)
  • History of organ or hematologic transplantation
  • History or current evidence of alcohol or drug abuse or dependence within 12 months of screening, in the opinion of the investigator
  • Initiation of any new chronic therapy (eg, ibuprofen, hypertonic saline, azithromycin, dornase alfa, aztreonam for inhalation solution, and tobramycin) or any change in chronic therapy (excluding pancreatic enzyme replacement therapy) within 28 days prior to Day 1
  • Known or suspected hypersensitivity or idiosyncratic reaction to the study drugs or any components thereof
  • Pregnant or nursing women
  • Special or vulnerable status (e.g. institutionalized, or person related to or an employee of the sponsor, FAIR Therapeutics, or investigator)

Trial locations and contacts

16 sites in 9 countries.

16 sites in 9 countries

Italy4 sites
  • Instituto Giannina Gaslini

    Genova

  • Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico

    Milan

  • Ospedale Pediatrico Bambino Gesù

    Rome

  • Azienda Ospedaliera Universitaria Integrata

    Verona

Other trials in Italy

United Kingdom3 sites
  • University Hospitals Birmingham NHS Foundation Trust

    Birmingham

  • Royal Brompton Hospital

    London

  • University Hospital Southampton

    Southampton

Other trials in United Kingdom

France2 sites
  • CHU de Nice

    Nice

  • Hôpital Larrey CHU Toulouse

    Toulouse

Other trials in France

Germany2 sites
  • Charité Universitätsmedizin Berlin

    Berlin

  • Medizinische Hochschule Hannover

    Hanover

Other trials in Germany

Belgium1 site
  • UZ Leuven

    Leuven, Vlaams-Brabant

Other trials in Belgium

Netherlands1 site
  • UMC Utrecht

    Utrecht, Utrecht, 3584 CX

Other trials in Netherlands

Portugal1 site
  • Hospital de Santa Maria

    Lisbon

Other trials in Portugal

Spain1 site
  • Hospital Vall d'Hebron

    Barcelona

Other trials in Spain

Sweden1 site
  • Sahlgrenska University Hospital, Gothenburg CF center

    Gothenburg

Other trials in Sweden

About this study

Official title: A Phase IIb, Multicentre, Randomised, Double-Blind, Placebo-Controlled, Crossover Study to Evaluate the Efficacy and Safety of Dirocaftor/Posenacaftor/Nesolicaftor in Subjects With Cystic Fibrosis Aged 18 Years or Older

CF is caused by mutations in the gene that encodes the 'Cystic Fibrosis Transmembrane Conductance Regulator (CFTR)' channel. To re-establish the function of this complex chloride channel, typically two to three drug modes of action are needed. To date, clinical studies of CFTR modulators have focused on patients carrying the F508del CFTR mutation, which is present in approximately 80% of CF patients, or gating mutations which are present in 5% of CF patients (gating mutations result in a reduced opening of the CFTR-channel at the cell surface which limits the flow of chloride ions through the CFTR channel). Although CF is a monogenetic disease, the 15% remaining patients represent more than 2000 different rare and mostly uncharacterized CFTR mutations. Multiple pharma companies have one or more CF drugs in their developmental pipeline. However, it is not known which patients may respond to the drugs in the pipeline. It is hypothesized that by using individual patient's intestinal organoids to screen for drug response, a subset of patients with rare CFTR mutations can be identified who will clinically respond to drugs in the developmental pipeline. The Human Individualized Therapy of CF (HIT-CF) project has been designed to further evaluate this hypothesis. The project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement No 755021. The core of the project consists of a two-step approach to identify patients outside the existing drug label who may also benefit from CFTR-modulator treatment. In the first step of the project (HIT-CF Organoid Study, NTR7520), novel CFTR modulators and their combinations were tested on organoids from over 500 European and Israeli CF patients with rare CFTR mutations to identify patients who are predicted to clinically benefit from these treatments. The second step will evaluate the predicted clinical effect of the CFTR modulators in subjects identified by their organoid response to investigational products. CFTR modulators from the HIT-CF participating pharmaceutical company, FAIR Therapeutics, will be evaluated in the CHOICES clinical study described in this protocol. Data from this clinical study will be compared with the HIT-CF Organoid Study results to validate the organoid model.

Conditions
Cystic Fibrosis
Being tested
Diponecaftor, Placebo
Keywords
Cystic Fibrosis, CFTR modulator, Intestinal organoids
Medical subject headings
Cystic Fibrosis

What participants receive

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

  • DiponecaftorDrug

    Diponecaftor is a triple combination of DIR/POS/NES. The combination therapy will be administered orally during 8 weeks. The daily dose contains:

    • DIR 300 mg/day
    • POS 600 mg/day
    • NES 10 mg/day
  • PlaceboDrug

    Placebo once daily for 8 weeks. Oral administration.

Study groups in NCT06468527
Study groupRoleWhat they receive
Diponecaftor/PlaceboOtherDiponecaftor once daily for 8 weeks followed by placebo once daily for 8 weeks. In between both periods there will be a washout period to minimize a possible carryover effect.
Receives: Drug: Diponecaftor; Drug: Placebo
Placebo/DiponecaftorOtherPlacebo once daily for 8 weeks followed by diponecaftor once daily for 8 weeks. In between both periods there will be a washout period to minimize a possible carryover effect.
Receives: Drug: Diponecaftor; Drug: Placebo

What is being measured

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

  1. Mean percent predicted forced expiratory volume in 1 second (ppFEV1)

    The primary endpoint in both groups is the mean percent predicted forced expiratory volume in 1 second (ppFEV1) of measurements taken after 4, 6 and 8 weeks of treatment. Period baseline values will be corrected for in the analysis.

    Measured: Measurements taken at 4, 6 and 8 weeks of treatment

Secondary outcomes (39)
  1. Sweat chloride

    The average of the sweat chloride measurements taken after 4, 6 and 8 weeks of treatment.

    Measured: Measurements taken at 4, 6 and 8 weeks of treatment

  2. Body weight

    The average of the body weight measurements taken after 4, 6 and 8 weeks of treatment

    Measured: Measurements taken at 4, 6 and 8 weeks of treatment

  3. Cystic Fibrosis Questionnaire Revised (CFQ R) respiratory domain

    The average of the Cystic Fibrosis Questionnaire Revised (CFQ R) respiratory domain measurements taken after 4, 6 and 8 weeks of treatment. Scores range from 0 to 100, with higher scores indicating better health.

    Measured: Measurements taken at 4, 6 and 8 weeks of treatment

  4. Safety and tolerability assessments

    Safety and tolerability assessments based on treatment-emergent Adverse Events (AEs)

    Measured: Through study completion, an average of 30 weeks

  5. Safety and tolerability assessments

    Safety and tolerability assessments based on treatment-emergent Serious Adverse events (SAEs)

    Measured: Through study completion, an average of 30 weeks

  6. Safety and tolerability assessments

    Platelet count

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  7. Safety and tolerability assessments

    Liver function (total bilirubin)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  8. Safety and tolerability assessments

    Liver function (alkaline phosphatase (ALP))

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  9. Safety and tolerability assessments

    Liver function (alanine transaminase (ALT))

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  10. Safety and tolerability assessments

    Liver function (gamma-glutamyl transferase (GGT))

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  11. Safety and tolerability assessments

    Anemia (Haemoglobin (Hb))

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  12. Safety and tolerability assessments

    Anemia (Haematocrit)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  13. Safety and tolerability assessments

    Anemia (Red blood cell count)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  14. Safety and tolerability assessments

    White blood cell count (including differential)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  15. Safety and tolerability assessments

    Glucose measured in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  16. Safety and tolerability assessments

    Sodium in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  17. Safety and tolerability assessments

    Cholesterol in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  18. Safety and tolerability assessments

    Total protein in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  19. Safety and tolerability assessments

    Potassium in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  20. Safety and tolerability assessments

    Chloride in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  21. Safety and tolerability assessments

    Bicarbonate in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  22. Safety and tolerability assessments

    Lactate dehydrogenase in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  23. Safety and tolerability assessments

    Albumine in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  24. Safety and tolerability assessments

    Calcium in blood

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  25. Safety and tolerability assessments

    GFR MDRD (equation based on sex, ethnicity, age, blood urea nitrogen (BUN), creatinine)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  26. Safety and tolerability assessments

    Ketonuria (ketones measured by urine dipstick)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  27. Safety and tolerability assessments

    Proteinuria (protein measured by urine dipstick)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  28. Safety and tolerability assessments

    Hematuria (blood measured by urine dipstick)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  29. Safety and tolerability assessments

    Glucosuria (glucose measured by urine dipstick)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  30. Safety and tolerability assessments

    pH of urine (pH measured by urine dipstick)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  31. Safety and tolerability assessments

    Specific gravitiy of urine (measured by urine dipstick)

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  32. Safety and tolerability assessments

    Coagulation (activated partial thromboplastin time (aPTT))

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  33. Safety and tolerability assessments

    Coagulation (prothrombin time international normalized ratio (PT-INR))

    Measured: Measurement taken at 4, 6 and 8 weeks of treatment

  34. Safety and tolerability assessments

    ECG QT Interval

    Measured: Measurement taken at 4 weeks of treatment

  35. Safety and tolerability assessments

    Systolic and diastolic blood pressure

    Measured: Measurement taken at start of treatment and at 4, 6 and 8 weeks of treatment

  36. Safety and tolerability assessments

    Heart rate

    Measured: Measurement taken at start of treatment and at 4, 6 and 8 weeks of treatment

  37. Safety and tolerability assessments

    Respiratory rate

    Measured: Measurement taken at start of treatment and at 4, 6 and 8 weeks of treatment

  38. Safety and tolerability assessments

    Body temperature

    Measured: Measurement taken at start of treatment and at 4, 6 and 8 weeks of treatment

  39. Safety and tolerability assessments

    Pulse oximetry measurements

    Measured: Measurement taken at start of treatment and at 4, 6 and 8 weeks of treatment

Timeline

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

  1. First posted21 Jun 2024
  2. Study start3 Jun 2024
  3. Primary completion26 Jun 2025
  4. Study completion26 Jun 2025

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
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
41 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06468527
Sponsor's protocol ID
HIT-CF-001
Acronym
CHOICES
Status last verified
Nov 2025
First submitted
3 Jun 2024
Last updated
24 Nov 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Diponecaftor in people with Cystic Fibrosis, run by Kors van der Ent at 16 sites in 9 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 14 inclusion and 20 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 24 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in Italy, United Kingdom, France, Germany, Belgium and 4 more countries. 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 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?

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?

Mean percent predicted forced expiratory volume in 1 second (ppFEV1) (time frame: Measurements taken at 4, 6 and 8 weeks of treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 24 Nov 2025.

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