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Cystic Fibrosis (CF)SPICE-CFNCT07879651

SPutum Induction and Nebuliser deviCEs for Patients With CF

A study testing Sputum induction in people with Cystic Fibrosis (CF) and Cystic Fibrosis Lung Disease, run by Royal Brompton & Harefield NHS Foundation Trust at 1 site in United Kingdom.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The goal of the SPICE-CF feasibility trial is to learn whether it is feasible to recruit and retain people with cystic fibrosis (CF) who are unable to produce sputum spontaneously in a study comparing two different nebuliser devices for sputum induction. Read more about this study

Who is it for?
Ages 16 years and older
What is being tested?
Sputum induction
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited Kingdom
Study dates
Oct 2026to Jul 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 16 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Diagnosis of CF (confirmed by standard criteria)
  • Sixteen years of age or over

Who cannot join

  • History of intolerance to hypertonic saline 3% or 7%
  • Lung function impairment (<30%pp FEV1)
  • Hypoxia (oxygen saturations of less than 90% on room air)
  • Any haemoptysis within past 2 weeks
  • Pneumothorax within 6 weeks
  • Unstable cardiovascular status as determined by clinical assessment
Show all 18Show fewer
  • Any known history or known family history of thoracic or cerebral aneurysm
  • Acute pulmonary emboli (within 6 weeks)
  • Acute undifferentiated chest pain
  • Fractured ribs or other chest trauma in the past 6 weeks
  • Recent eye surgery within past 6 weeks
  • Inability to perform spirometry
  • Treatment for a pulmonary exacerbation within 21 days of screening visit
  • Inability to give consent
  • Current participation in another interventional medicinal study
  • Spontaneous sputum production
  • Inability/unwillingness to expectorate
  • Pregnancy or currently trying to conceive

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Gemma Stanford, BSc (Hons), PhD contact

+44 20 7351 8071

gemma.stanford2@nhs.net

Afrasiab Ahmad, BSc (Hons) contact

+44 20 7351 8071

afrasiab.ahmad2@nhs.net

United Kingdom1 site
  • Royal Brompton Hospital

    London, SW3 6NP

    Gemma Stanford, BSc (Hons), PhD, 07824636504, gemma.stanford2@nhs.net

    Afrasiab Ahmad, BSc (Hons), afrasiab.ahmad2@nhs.net

Other trials in United Kingdom

About this study

Official title: SPICE-CF: Sputum Induction and Nebuliser Devices for Patients With Cystic Fibrosis - a Feasibility Trial

The goal of the SPICE-CF feasibility trial is to learn whether it is feasible to recruit and retain people with cystic fibrosis (CF) who are unable to produce sputum spontaneously in a study comparing two different nebuliser devices for sputum induction. The study will also assess how acceptable and practical the sputum induction procedures are.

The main questions it aims to answer are:

Read more
  • Is it feasible to recruit and retain people with cystic fibrosis in a study comparing two nebuliser devices for sputum induction?
  • Can sputum be successfully obtained using each nebuliser device?
  • How acceptable are the two nebuliser devices to participants?
  • How long does sputum induction take with each device?
  • What microorganisms are identified in sputum collected using each device?
  • Can a visual scoring system be used to distinguish sputum from saliva and describe sputum characteristics?

Researchers will compare a jet nebuliser with an E-flow Rapid nebuliser. Each participant will undergo sputum induction using both devices, with the order in which the devices are used determined at random.

Participants will:

  • Attend two study visits, separated by at least 2 weeks
  • Receive a bronchodilator before sputum induction
  • Inhale hypertonic saline using either the jet nebuliser or E-flow Rapid nebuliser
  • Perform their usual airway clearance technique with supervision from a physiotherapist
  • Have their lung function, oxygen levels, heart rate, and chest sounds monitored
  • Provide sputum produced during the procedure for assessment and routine microbiological testing
  • Complete a brief questionnaire about their experience and the acceptability of each nebuliser device
Read the detailed description

SPICE-CF is a non-commercial feasibility trial evaluating sputum induction using two different nebuliser devices in people with cystic fibrosis (CF) who are unable to spontaneously expectorate sputum.

With the increasing use of CFTR modulator therapies, many people with CF produce less spontaneous sputum. However, obtaining lower respiratory tract samples remains important for microbiological surveillance and clinical management. Sputum induction using nebulised hypertonic saline provides a non-invasive method of obtaining respiratory samples when spontaneous sputum is unavailable. There is currently limited evidence comparing nebuliser technologies for sputum induction in people with CF.

This is a prospective, randomised, open-label, two-period crossover feasibility trial comparing a jet nebuliser with the E-flow Rapid vibrating mesh nebuliser. Each participant will undergo sputum induction using both devices and will therefore act as their own control. The order of device use will be randomised, with a minimum two-week washout period between study visits.

Sputum induction will follow a standardised protocol using nebulised hypertonic saline together with physiotherapist supervised airway clearance. The primary focus of the study is to assess the feasibility of recruiting and retaining people with CF who are unable to spontaneously expectorate sputum in a randomised crossover trial comparing two nebuliser systems for sputum induction. The study will also assess the acceptability and deliverability of the procedures and collect preliminary information on successful sputum collection, procedure duration, participant experience, microbiological yield, and the use of a visual scoring system to characterise sputum colour and viscosity and differentiate sputum from saliva. The findings will help inform the design of a future definitive randomised controlled trial.

Being tested
Sputum induction
Keywords
sputum induction, cystic fibrosis, nebuliser, e-flow, jet nebuliser
Medical subject headings
Cystic Fibrosis

What participants receive

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

  • Sputum inductionDiagnostic test

    Also called induced sputum

    Sputum induction is a non-invasive procedure used to obtain a lower respiratory tract sputum sample from individuals who are unable to expectorate sputum spontaneously. Participants inhale nebulised hypertonic saline (3% or 7%) to help mobilise airway secretions and stimulate sputum production. Nebulisation is performed in up to three five-minute periods and is combined with physiotherapist supervised airway clearance using the participant's usual airway clearance technique. Participants are encouraged to expectorate sputum throughout the nebulisation and airway clearance procedure for collection and subsequent microbiological analysis.

Study groups in NCT07879651
Study groupRoleWhat they receive
Sputum induction completed via E-flow Rapid nebuliser deviceActive comparatorNot described
Receives: Diagnostic Test: Sputum induction
Sputum induction completed via jet compressor nebuliser deviceActive comparatorNot described
Receives: Diagnostic Test: Sputum induction

What is being measured

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

  1. Feasibility of participant recruitment and retention

    Feasibility will be assessed by the number of eligible participants who consent to participate and the number of enrolled participants who complete both study visits. Recruitment and retention rates will be calculated to determine the feasibility of conducting a future definitive randomised controlled trial comparing nebuliser devices for sputum induction in adults with cystic fibrosis.

    Measured: From participant enrolment to completion of the second study visit, assessed up to 3 months from first visit

Secondary outcomes (4)
  1. Successful sputum sample collection

    Sputum induction success will be assessed as whether a sputum sample of at least 1 mL is successfully obtained during each sputum induction procedure (yes/no). Success will be recorded separately for sputum induction performed using the jet nebuliser and the E-flow Rapid nebuliser.

    Measured: During sputum induction at Visits 1 and 2, assessed within 90 minutes per visit, up to 3 months after enrolment

  2. Classification of collected samples as sputum or saliva

    Collected samples will be assessed using a study-specific standardised visual sputum scoring system. Samples will be characterised using macroscopic features including colour and viscosity to determine the presence of sputum and differentiate sputum from saliva. Assessments will be performed independently by the physiotherapist and laboratory personnel using direct assessment and the corresponding video recording

    Measured: Following sample collection at Visits 1 and 2, up to 3 months after enrolment

  3. Participant-reported acceptability of sputum induction

    Participant experience of sputum induction using each nebuliser device will be assessed using a study-specific questionnaire completed after each study visit. The questionnaire assesses participant preference, ease of use, comfort, tolerance, and overall acceptability. Responses will be recorded using a five-point Likert scale ranging from "strongly agree" to "strongly disagree", where appropriate.

    Measured: Immediately following sputum induction at Visits 1 and 2, up to 3 months after enrolment

  4. Duration of sputum induction procedure

    The duration of the sputum induction procedure will be recorded for each nebuliser device. Procedure duration will be assessed separately for sputum induction performed using the jet nebuliser and the E-flow Rapid nebuliser.

    Measured: During sputum induction at Visits 1 and 2, assessed within 90 minutes per visit, up to 3 months after enrolment

Timeline

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

  1. First posted19 Oct 2026
  2. Study startOct 2026 (estimated)
  3. Primary completionJun 2027 (estimated)
  4. Study completionJul 2027 (estimated)

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07879651
Sponsor's protocol ID
371802
Acronym
SPICE-CF
Status last verified
Oct 2026
First submitted
25 Sep 2026
Last updated
19 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Collins N. (2021) Guideline for Administration of Inhaled Medication for Sputum Induction in Cystic Fibrosis via Patient Specific Direction. Unpublished internal document. London: Royal Brompton Hospital.

  • Ahmad A., Simmonds N., Stanford G. (2026) Benchmarking sputum induction (SI) practice across UK cystic fibrosis (CF) centres. [Poster]. Royal Brompton Hospital, London.

  • Ahmad A., Tobin T., Stanford G., Simmonds N. (2025) "Another one?" - dealing with an increase in sputum induction referrals in a large adult uk cystic fibrosis (CF) centre: a quality improvement initiative. [Poster]. Royal Brompton Hospital, London.

  • European Cystic Fibrosis Society Clinical Trials Network (2024) Sputum Induction for Non-expectorating Older Children and Adults. Unpublished internal document. Unknown: European Cystic Fibrosis Society.

  • Flament MP, Leterme P, Gayot A. Study of the technological parameters of ultrasonic nebulization. Drug Dev Ind Pharm. 2001 Aug;27(7):643-9. doi: 10.1081/ddc-100107320.

    PubMed 11694011
  • Ratjen F, Bell SC, Rowe SM, Goss CH, Quittner AL, Bush A. Cystic fibrosis. Nat Rev Dis Primers. 2015 May 14;1:15010. doi: 10.1038/nrdp.2015.10.

    PubMed 27189798
  • Wong HH, Fahy JV. Safety of one method of sputum induction in asthmatic subjects. Am J Respir Crit Care Med. 1997 Jul;156(1):299-303. doi: 10.1164/ajrccm.156.1.9610114.

    PubMed 9230765
  • Hunter CJ, Ward R, Woltmann G, Wardlaw AJ, Pavord ID. The safety and success rate of sputum induction using a low output ultrasonic nebuliser. Respir Med. 1999 May;93(5):345-8. doi: 10.1016/s0954-6111(99)90317-7.

    PubMed 10464902
  • Murray MP, Pentland JL, Turnbull K, MacQuarrie S, Hill AT. Sputum colour: a useful clinical tool in non-cystic fibrosis bronchiectasis. Eur Respir J. 2009 Aug;34(2):361-4. doi: 10.1183/09031936.00163208.

    PubMed 19648517
  • Wong LK, Barry AL, Horgan SM. Comparison of six different criteria for judging the acceptability of sputum specimens. J Clin Microbiol. 1982 Oct;16(4):627-31. doi: 10.1128/jcm.16.4.627-631.1982.

    PubMed 7153311
  • Oxford University Hospitals NHS Foundation Trust (2025) Sputum. Available at: https://www.ouh.nhs.uk/microbiology/a-z/sputum/

  • Davidson WJ, Dennis J, The S, Litoski B, Pieron C, Leigh R. Identification and validation of nebulized aerosol devices for sputum induction. Can Respir J. 2014 Mar-Apr;21(2):101-6. doi: 10.1155/2014/925305. Epub 2013 Nov 28.

    PubMed 24288700
  • Loh LC, Eg KP, Puspanathan P, Tang SP, Yip KS, Vijayasingham P, Thayaparan T, Kumar S. A comparison of sputum induction methods: ultrasonic vs compressed-air nebulizer and hypertonic vs isotonic saline inhalation. Asian Pac J Allergy Immunol. 2004 Mar;22(1):11-7.

    PubMed 15366653
  • Nie S, Wang L, Ma S, Sun H. Impact of silicone midline catheter tip location on catheter-related complications and indwelling duration: results from a multicentre randomised clinical trial in China. BMJ Open. 2025 Mar 12;15(3):e086717. doi: 10.1136/bmjopen-2024-086717.

    PubMed 40074277
  • Paggiaro PL, Chanez P, Holz O, Ind PW, Djukanovic R, Maestrelli P, Sterk PJ. Sputum induction. Eur Respir J Suppl. 2002 Sep;37:3s-8s. doi: 10.1183/09031936.02.00000302. No abstract available.

    PubMed 12361361

Questions about this trial

What is this clinical trial studying?

A study testing Sputum induction in people with Cystic Fibrosis (CF) and Cystic Fibrosis Lung Disease, run by Royal Brompton & Harefield NHS Foundation Trust at 1 site in United Kingdom.

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 2 inclusion and 18 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: opening soon, as of the sponsor's last update on 19 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 1 site in United Kingdom. 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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Gemma Stanford, BSc (Hons), PhD (+44 20 7351 8071, gemma.stanford2@nhs.net), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Feasibility of participant recruitment and retention (time frame: From participant enrolment to completion of the second study visit, assessed up to 3 months from first visit). 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 NCT07879651, which also lists 25 linked publications.

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 19 Oct 2026.

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