Inhaled Amikacin Treatment for Nontuberculous Mycobacterial Lung Disease
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Purpose
The incidence of chronic pulmonary disease caused by nontuberculous mycobacteria (NTM) in human immunodeficiency virus (HIV)-negative patients has been increasing worldwide. In Korea, the common etiologic pathogens for this disease are Mycobacterium avium complex (MAC) and Mycobacterium abscessus. Treating NTM lung diseases can be extremely difficult and may require multiple drugs.
Amikacin is an effective antibiotic for NTM infection. However, intravenous amikacin treatment is limited by its systemic route of administration and a lot of adverse events. Amikacin inhalation treatment could overcome these limitations and also could be effective for treatment of NTM pulmonary disease due to maintaining a high lung concentration. The purpose of this study is to determine whether amikacin inhalation treatment is effective in patients with MAC infection who experienced treatment failure after standard treatment for more than 6 months or with M. abscessus infection.
| Condition | Intervention | Phase |
|---|---|---|
|
Pulmonary Non-tuberculous Mycobacterial Lung Disease |
Drug: Amikacin |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Inhaled Amikacin for Treatment of Intractable Nontuberculous Mycobacterial Lung Disease |
- Culture conversion rates at 6 months [ Time Frame: 6 months after starting treatment ] [ Designated as safety issue: No ]
- Culture conversion rates at 12 months [ Time Frame: 12 months after starting treatment ] [ Designated as safety issue: No ]
- Culture conversion rates at 24 months [ Time Frame: 24 months after starting treatment ] [ Designated as safety issue: No ]
- Assessment of abnormal lab values [ Time Frame: For 24 months of treatment ] [ Designated as safety issue: Yes ]
- Assessment of adverse events related to the study drug or study device [ Time Frame: For 24 months of treatment ] [ Designated as safety issue: Yes ]
| Enrollment: | 0 |
| Study Start Date: | February 2012 |
| Estimated Study Completion Date: | April 2016 |
| Estimated Primary Completion Date: | December 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Amikacin for inhalation
Drug: Amikacin
|
Drug: Amikacin
500 mg, once daily for 2 years
|
Eligibility| Ages Eligible for Study: | 20 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of NTM lung lung disease in accordance with the 2007 ATS/IDSA criteria.
- MAC lung disease with persistent sputum culture positive after 6 months of standard treatment
- M. abscessus lung disease with persistent sputum culture positive after 6 months of standard treatment
- New case of M. abscessus pulmonary disease after completion of initial 4 weeks intravenous antibiotics treatment
Exclusion Criteria:
- Subjects with negative sputum culture before starting of this study
- Forced expiratory volume in 1 second (FEV1) <30% of predicted at screening.
- Positive in HIV test.
- Subjects with chronic renal insufficient state (serum creatinine level is more than 2.0 mg/dL)
- Subjects with decreased liver function (serum total bilirubin level is more than 2 mg/dL or AST or ALT are more than 1.5 times of upper normal limits)
- Active any malignancy requiring chemotherapy or radiation therapy within one year prior to screening.
- Subjects with history of allergy to amikacin.
- Subjects with pregnant state or women of childbearing age with no appropriate contraception.
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Won-Jung Koh, Principal Investigator, Samsung Medical Center |
| ClinicalTrials.gov Identifier: | NCT01528930 History of Changes |
| Other Study ID Numbers: | 2011-10-104-001 |
| Study First Received: | January 30, 2012 |
| Last Updated: | December 14, 2012 |
| Health Authority: | South Korea: Institutional Review Board |
Keywords provided by Samsung Medical Center:
|
Lung Diseases Anti-Infective Agents Therapeutic Uses Amikacin |
Additional relevant MeSH terms:
|
Lung Diseases Respiratory Tract Diseases Amikacin Anti-Infective Agents |
Anti-Bacterial Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 23, 2013