Deposition of Inhaled Prolastin in Cystic Fibrosis Patients (CF2)

This study has been completed.
Information provided by:
Grifols Therapeutics Inc. Identifier:
First received: June 13, 2007
Last updated: May 7, 2008
Last verified: April 2008

The objective of this trial is to determine the optimal region of the lung for depositing Prolastin (alpha-1 antitrypsin; AAT) by inhalation in order to treat cystic fibrosis (CF). The AKITA® nebulizer has settings which can be varied to target the inhaled drug to either the deep lung or to the upper airways in a one to one randomization. The study will measure how much of the activity of the enzyme elastase is inhibited by AAT.

Condition Intervention Phase
Cystic Fibrosis
Drug: Alpha1-Proteinase Inhibitor (Human)
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Multicenter, Randomized, Parallel Group Study to Investigate the Optimal Deposition Site for Inhaled Prolastin® in Patients With Cystic Fibrosis (CF)

Resource links provided by NLM:

Further study details as provided by Grifols Therapeutics Inc.:

Primary Outcome Measures:
  • change in free elastase in induced sputum [ Time Frame: baseline vs week 4 ]

Secondary Outcome Measures:
  • Standard lung function parameters (FEV1, FVC, FEV1/FVC, MEF) [ Time Frame: baseline vs week 4 ]
  • AAT activity in induced sputum [ Time Frame: baseline vs week 4 ]
  • total IgG fragments in induced sputum [ Time Frame: baseline vs week 4 ]
  • total bacterial load in induced sputum [ Time Frame: baseline vs week 4 ]
  • Pseudomonas load in induced sputum [ Time Frame: baseline vs week 4 ]
  • Neutrophil number in induced sputum [ Time Frame: baseline vs week 4 ]

Enrollment: 72
Study Start Date: December 2003
Study Completion Date: June 2004
Arms Assigned Interventions
Experimental: Group 1
Bronchial Deposition
Drug: Alpha1-Proteinase Inhibitor (Human)
Other Names:
  • Prolastin®
  • Alpha-1 antitrypsin (AAT)
  • BAY x 5747
  • BAY 10-5233
  • TAL-05-00007
  • A1AT
  • NDC 13533-601-30
  • NDC 13533-601-35
Experimental: Group 2
Peripheral Deposition
Drug: Alpha1-Proteinase Inhibitor (Human)
Other Names:
  • Prolastin®
  • Alpha-1 antitrypsin (AAT)
  • BAY x 5747
  • BAY 10-5233
  • TAL-05-00007
  • A1AT
  • NDC 13533-601-30
  • NDC 13533-601-35

Detailed Description:

The optimum deposition site (bronchial or peripheral) in CF patients for AAT will be investigated by measuring several parameters in induced sputum. The study will start with a 2 week run-in period in which the planned 60 patients inhale isotonic saline once daily. This period is followed by a 4 week treatment period where 30 patients inhale AAT for peripheral deposition and 30 patients inhale AAT for bronchial deposition. Six patients in each group will be asked to collect spontaneous sputum at home.

Twenty-five milligrams of AAT will be deposited at one of the two target sites using the AKITA® device. The inhalation should take place in the evening between 18.00 and 23.00 h.

Patients will inhale saline once daily for 2 weeks (run-in period) followed by 4 weeks of once daily inhalation of AAT. Induced sputum will be collected at visits to the clinic at the start of the run-in, at the start of AAT treatment, and at 2 and 4 weeks after the start of AAT treatment.


Ages Eligible for Study:   8 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patient with diagnosis of CF
  • Age >= 8 years
  • FEV1 > 25 % of predicted value
  • Free elastase activity checked at visit 1 must be positive (free elastolytic activity in the sample, 2 standard deviations above of the negative blank samples in the assay.) .
  • Patient must be positive at least 3 times for pseudomonas in the last 2 years
  • Patient must be positive for pseudomonas at Visit 1
  • Patient must be able to perform reliable spirometry
  • Patient must be on stable concomitant therapy at least 2 weeks prior to visit 1 and during the study
  • Written informed consent of the patient or legal representative(s)

Exclusion Criteria:

  • FEV1 < 25% of predicted value post-bronchodilator
  • History of lung transplant
  • Any lung surgery within the past 2 years
  • On any thoracic surgery waiting list
  • Severe concomitant disease (serious malignant disease, congestive heart failure NYHA III/IV, cor pulmonale with the need of oxygen therapy)
  • Severe liver cirrhosis with ascites, hypersplenism or grade III/IV esophageal varices.
  • Known selective IgA deficiency with known antibody against IgA (anti-IgA antibody)
  • Active pulmonary exacerbation within the 4 weeks prior to screening
  • Current Smoking
  • Pregnancy or lactation
  • Women of child-bearing age without adequate contraception
  • Any medical condition which the investigator feels will prohibit the patient from completing the trial
  • Participation in another clinical trial within 30 days prior to inclusion at visit 1
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Please refer to this study by its identifier: NCT00486837

Sponsors and Collaborators
Grifols Therapeutics Inc.
Principal Investigator: Matthias Griese, MD Kinderklinik und Kinderpoliklinik im Haunerschen Kinderspital
  More Information

Additional Information:
Publications: Identifier: NCT00486837     History of Changes
Other Study ID Numbers: 100452
Study First Received: June 13, 2007
Last Updated: May 7, 2008
Health Authority: Germany: Ethics Commission

Additional relevant MeSH terms:
Cystic Fibrosis
Pancreatic Diseases
Digestive System Diseases
Lung Diseases
Respiratory Tract Diseases
Genetic Diseases, Inborn
Infant, Newborn, Diseases
Pathologic Processes
Alpha 1-Antitrypsin
Protease Inhibitors
Trypsin Inhibitors
Serine Proteinase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions processed this record on July 20, 2014