Asthma Intervention Research 2 (AIR2) Trial

This study has been completed.
Sponsor:
Collaborator:
Boston Scientific Corporation
Information provided by (Responsible Party):
Asthmatx, Inc.
ClinicalTrials.gov Identifier:
NCT00231114
First received: September 30, 2005
Last updated: March 28, 2014
Last verified: March 2014
  Purpose

The objective of this randomized, double blind, sham-controlled study is to demonstrate the safety and effectiveness of the Alair System in a population of subjects with severe asthma who are still symptomatic despite being managed on conventional therapy of high doses of inhaled corticosteroids and long-acting β2-agonists.

The primary efficacy endpoint will be the difference between Study groups in the change in Asthma Quality of Life Questionnaire (AQLQ) score from Baseline and the average score from the 6-, 9-, and 12-month follow-up visits.

All other outcome measures assessed at 12 months post-treatment.

This will be a multicenter, randomized, double-blind, sham-controlled study comparing the effects of treatment with the Alair System to conventional therapy of inhaled corticosteroids (ICS) and long-acting β2-agonists (LABA).

A Bayesian adaptive approach to sample size selection is used with a randomization scheme of 2:1 (two Alair Group Subjects for every one Control Group Subject).


Condition Intervention
Asthma
Device: Alair System

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Safety and Effectiveness of the Alair® System for the Treatment of Asthma: A Multicenter Randomized Clinical Trial(Asthma Intervention Research (AIR2) Trial)

Resource links provided by NLM:


Further study details as provided by Asthmatx, Inc.:

Primary Outcome Measures:
  • Integrated Asthma Quality of Life Questionnaire (AQLQ) Score (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: No ]
    Change between Baseline and the average of 6-, 9-, and 12-month Follow-Up Visits. The AQLQ consists of 32 questions (scale from 1 to 7, where 7 reflects a higher quality of life). An increase in the AQLQ score indicates a better quality of life. The average of the 6-, 9-, and 12-month differences in the AQLQ Score are referred to as the "Integrated AQLQ Score."


Secondary Outcome Measures:
  • Percent Symptom-Free Days (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: No ]
    Change between Baseline and 12-month Follow-Up Visit. Symptom-Free Days were defined as days when Subject reported no cough, wheeze, breathlessness, or sputum during the daytime, and no wheeze, cough, or awakenings due to asthma symptoms during nighttime.

  • Total Symptom Score (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: No ]
    Change from Baseline and 12-month Follow-Up Visit. Total Symptom Score comprises the sum of these six asthma symptom measurements: wheeze during the night, cough during the night, wheeze during the day, cough during the day, breathlessness during the day, and sputum production during the day. Each of these symptoms is scored on a scale of 0 to 3 each day by the subject. The sum of the scores for these 6 symptoms comprises the Total Symptom Score, which measures overall asthma symptoms. The maximum score possible is 18. A lower Total Symptom score represents better asthma control.

  • Number of Puffs of Rescue Medication Used (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: No ]
    Change between Baseline and 12-Month Follow-up Visit. Average number of puffs per week. Rescue medications for asthma are short-acting beta-agonists that bring quick relief of asthma symptoms.

  • Percent Days Rescue Medication Used (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: No ]
    Change between Baseline and 12-Month Follow-up Visit. Rescue medications for asthma are short-acting beta-agonists that bring quick relief of asthma symptoms.

  • Asthma Control Questionnaire (ACQ) Score (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: No ]
    Change between Baseline and 12-month Follow-Up Visit. The ACQ is a self-administered patient questionnaire that also includes the patient's FEV1 value (% Predicted) that assesses individual subject asthma control. The ACQ comprises 6 questions that relate to the patient's asthma symptoms, activity limitations, and daily rescue bronchodilator use, and FEV1. Each question is scored from 0 (Better) to 6 (Worse). A decrease in the ACQ score indicates better asthma control.

  • Morning Peak Expiratory Flow (amPEF) (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: Yes ]
    Change between Baseline and 12-month Follow-Up Visit. The peak expiratory flow rate measures the maximal rate at which a person can exhale air.

  • Pre-Bronchodilator FEV1 (Percent Predicted) (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: Yes ]
    Change between Baseline and 12-month Follow-Up Visit. The FEV1 is the volume of air expired during the first second of a maximal effort expiration started at total lung capacity.

  • Post-Bronchodilator FEV1 (Percent Predicted) (Change From Baseline) [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: Yes ]
    Change between Baseline and 12-month Follow-Up Visit. The FEV1 is the volume of air expired during the first second of a maximal effort expiration started at total lung capacity.


Other Outcome Measures:
  • Rate of Severe Exacerbations Requiring Systemic Corticosteroids [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: Yes ]
    Rate of occurrence of worsening of asthma requiring treatment with oral or intravenous corticosteroids, OR a doubling of the baseline inhaled corticosteroid dose for at least 3 days, OR any temporary increase in the dosage of oral corticosteroids for a Subject taking maintenance oral corticosteroids at Study entry.

  • Percentage of Subjects With Severe Exacerbations Requiring Systemic Corticosteroids [ Time Frame: Baseline, 12 Months ] [ Designated as safety issue: Yes ]
    Percent of subjects experiencing worsening of asthma requiring treatment with oral or intravenous corticosteroids, OR a doubling of the baseline inhaled corticosteroid dose for at least 3 days, OR any temporary increase in the dosage of oral corticosteroids for a Subject taking maintenance oral corticosteroids at Study entry.

  • Days Lost From Work/School/Other Activities Due to Asthma [ Time Frame: 12 Months ] [ Designated as safety issue: No ]
  • Unscheduled Physician Office Visits for Respiratory Symptoms [ Time Frame: 12 Months ] [ Designated as safety issue: Yes ]
  • Emergency Room Visits for Respiratory Symptoms [ Time Frame: 12 Months ] [ Designated as safety issue: Yes ]
  • Hospitalizations for Respiratory Symptoms [ Time Frame: 12 Months ] [ Designated as safety issue: Yes ]

Enrollment: 297
Study Start Date: September 2005
Study Completion Date: April 2013
Primary Completion Date: August 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Alair
Treatment of airways with the Alair System
Device: Alair System
Treatment of airways with the Alair System
Sham Comparator: Sham
Sham treatment of airways
Device: Alair System
Sham treatment of airways with the Alair System

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Subject is an adult between the ages of 18 to 65 years.
  • Subject has asthma and is taking regular maintenance medication that includes Inhaled corticosteroid (ICS) AND long acting ß2-agonist (LABA).
  • Subject has a Pre-bronchodilator Forced Expiratory Volume in one second (FEV1) of greater than or equal to 60% of predicted after medication stabilization during the Baseline Period.
  • Subject has a PC20 < 8 mg/ml per methacholine inhalation test using standardized methods. PC20 is a provocative concentration of Provocholine® (a brand of methacholine chloride) resulting in a drop of FEV1 of 20% or more from Baseline.
  • Subject has at least two days of asthma symptoms during the 4-weeks of the Baseline Diary Period.
  • Subject is a non-smoker for 1 year or greater (if former smoker, less than 10 pack years total smoking history).

Exclusion Criteria:

  • Subject has a Post-bronchodilator FEV1 of less than 65%.
  • Subject has 3 or more hospitalizations for exacerbations of asthma in the previous year; OR a history of life-threatening asthma, defined by past intubations for asthma, or ICU admission for asthma within the prior 24 months.
  • Subject has a history of recurrent lower respiratory tract infections requiring antibiotics (more than 3 in the past 12 months).
  • Subject has a history of recurrent oral steroid use for asthma (4 or more pulses of oral steroids in the past 12 months).
  • Subject has a known sensitivity to medications required to perform bronchoscopy (such as lidocaine, atropine and benzodiazepines).
  • Subject has known systemic hypersensitivity or contraindication to Methacholine chloride or other parasympathomimetic agents.
  • Subject has other medical criteria.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00231114

  Hide Study Locations
Locations
United States, Arizona
Pulmonary Associates, PA
Phoenix, Arizona, United States, 85020
United States, California
University of Southern California, Adult Asthma and Allergy Center
Los Angeles, California, United States, 90033
United States, Colorado
National Jewish Medical and Research Center
Denver, Colorado, United States, 80206
United States, Illinois
University of Chicago
Chicago, Illinois, United States, 60637
Peoria Pulmonary Associates, Ltd.
Peoria, Illinois, United States, 61603
United States, Iowa
University of Iowa Hospitals and Clinics
Iowa City, Iowa, United States, 52242
United States, Kansas
Veritas Clinical Specialties
Topeka, Kansas, United States, 66606
United States, Maryland
Johns Hopkins University School of Medicine
Baltimore, Maryland, United States, 21205
United States, Massachusetts
Brigham and Womens's Hospital
Boston, Massachusetts, United States, 02115
Beth Israel Deaconess Medical Center
Boston, Massachusetts, United States, 02215
United States, Michigan
Henry Ford Medical Center
Detroit, Michigan, United States, 48202
United States, Minnesota
HealthPartners Specialty Center, Lung and Sleep Health
St. Paul, Minnesota, United States, 55101
United States, Missouri
Washington University School of Medicine
St. Louis, Missouri, United States, 63110-1093
United States, New York
Saint Vincent Catholic Medical Center
New York, New York, United States, 10011
United States, North Carolina
Duke University Medical Center
Durham, North Carolina, United States, 27710
United States, Ohio
Cleveland Clinic Foundation
Cleveland, Ohio, United States, 44195
United States, Pennsylvania
Hospital of the University of Pennyslvania
Philadelphia, Pennsylvania, United States, 19104
United States, Tennessee
Clinical Research Solutions, PC - Baptist Hospitals of East Tennesse
Knoxville, Tennessee, United States, 37920
United States, Texas
Baylor College of Medicine
Houston, Texas, United States, 77030
United States, Virginia
Virginia Hospital Center
Arlington, Virginia, United States, 22205-3698
United States, Washington
Swedish Medical Center
Seattle, Washington, United States, 98104
United States, Wisconsin
University of Wisconsin Hospital
Madison, Wisconsin, United States, 53792
Australia, New South Wales
John Hunter Hospital
New Lambton Heights, New South Wales, Australia, 2035
Australia, Western Australia
Sir Charles Gairdner Hospital
Perth, Western Australia, Australia, 6009
Australia
Royal Adelaide Hospital
Adelaide, Australia
Brazil
Hospital Sao Lucas da PUCRS
Porto Alegre, RS, Brazil, CEP 90610-00
Irmandade Santa Casa de Miscericordia de Porto Alegre
Porto Alegre, Brazil, CEP 90035-074
Hospital Universitario Clementino Fraga Filho
Rio de Janeiro, Brazil
Faculdade da Medicina do ABC
Sao Paulo, Brazil, CEP 09060-650
Canada, Ontario
Firestone Institute of Respiratory Health, St. Joseph's Healthcare
Hamilton, Ontario, Canada, L8N 4A6
Canada, Quebec
Montreal Chest Institute, McGill University
Montreal, Quebec, Canada, H2X 2P4
Hopital Laval, Centre de Pneumologie
Sainte-Foy, Quebec, Canada, G1V 4GS
Denmark
Odense Universitets Hospital, University of Odense
Odense, Denmark, 5000 Odense C
Netherlands
Universitair Medisch Centrum
Groningen, Netherlands, 9700 RB
United Kingdom
Gartnavel General Hospital, University of Glasgow
Glasgow, Scotland, United Kingdom, G12 0YN
Birmingham Heartlands Hospital
Birmingham, United Kingdom, B9 5SS
Glenfield General Hospital, Univ. Hospitals of Leicester
Leicester, United Kingdom, LE3 9QP
Chelsea & Westminster Healthcare NHS Trust
London, United Kingdom, SW10 9NH
Northwest Lung Research Center, Univ. of Manchester
Manchester, United Kingdom, M23 9LT
Sponsors and Collaborators
Asthmatx, Inc.
Boston Scientific Corporation
Investigators
Study Director: Narinder S Shargill, PhD Asthmatx, Inc.
  More Information

Additional Information:
Publications:

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Asthmatx, Inc.
ClinicalTrials.gov Identifier: NCT00231114     History of Changes
Other Study ID Numbers: 04-02
Study First Received: September 30, 2005
Results First Received: August 31, 2010
Last Updated: March 28, 2014
Health Authority: United States: Food and Drug Administration

Keywords provided by Asthmatx, Inc.:
Asthma

Additional relevant MeSH terms:
Asthma
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Hypersensitivity
Immune System Diseases

ClinicalTrials.gov processed this record on September 15, 2014