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Study of Inhaled Carbon Monoxide to Treat Idiopathic Pulmonary Fibrosis

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ClinicalTrials.gov Identifier: NCT01214187
Recruitment Status : Completed
First Posted : October 4, 2010
Results First Posted : June 14, 2017
Last Update Posted : June 14, 2017
Information provided by (Responsible Party):

Study Description
Brief Summary:
The purpose of this study is to determine whether low concentration inhaled carbon monoxide is effective in treating idiopathic pulmonary fibrosis.

Condition or disease Intervention/treatment Phase
Idiopathic Pulmonary Fibrosis Drug: inhaled carbon monoxide Other: Oxygen Phase 2

Detailed Description:
Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease characterized by destruction of normal epithelial structure, proliferation of fibroblasts, and deposition of connective-tissue matrix proteins. There are currently no effective therapies for IPF. Over the past two decades, preclinical studies of inhaled low dose carbon monoxide (CO) have shown that this biologically active diatomic gas possesses properties that would make it a viable novel therapy for IPF. CO therapy has been well tolerated in Phase I and Phase II human trials to date. This phase II study is designed to investigate whether IPF patients show evidence of decreased peripheral blood levels of matrix metalloproteinase-7 (MMP7) and stability of secondary indicators of disease progression after 3 months of inhaled therapy.

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 58 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary Purpose: Treatment
Official Title: Phase II Study of Inhaled CO for the Treatment of Idiopathic Pulmonary Fibrosis
Study Start Date : July 2011
Primary Completion Date : October 2014
Study Completion Date : April 2015

Arms and Interventions

Arm Intervention/treatment
Experimental: carbon monoxide inhalation
The primary intervention will be inhaled CO at 100-200 ppm administered two times weekly for two hours per dose to complete 12 weeks of treatment.
Drug: inhaled carbon monoxide
The intervention will be inhaled CO at 100-200 ppm administered two times weekly for two hours per dose to complete 12 weeks of treatment.
Other Name: CO
Placebo Comparator: Oxygen 21% Other: Oxygen
Room air oxygen concentrations will be administered as placebo
Other Name: O2

Outcome Measures

Primary Outcome Measures :
  1. Serum MMP7 Level [ Time Frame: Baseline to Week 12 ]
    The primary study endpoint was the change in MMP7 serum concentration (ng/ml) from baseline to 12 weeks. Serum MMP7 concentrations in peripheral blood are easily measureable and reflect changes in the alveolar microenvironment. Thus, we have chosen to study mean serum MMP7 concentrations after three months of CO treatment as a surrogate biomarker of the effect of inhaled CO administration on disease progression.

Secondary Outcome Measures :
  1. Total Lung Capacity % Predicted Values (TLC) [ Time Frame: Baseline to Week 12 ]
    Total lung capacity % predicted values (TLC) is a major clinical determinant of restrictive lung disease in practice, with TLC measurement below the 5th percentile of the predicted value indicative of a restrictive ventilatory defect

  2. Diffusing Capacity for Carbon Monoxide (DLCO) % Predicted Values [ Time Frame: Baseline to Week 12 ]
    Interstitial changes associated with IPF can worsen diffusing capabilities across the alveolar-capillary membrane. As a result, diffusing capacity of carbon monoxide is an important outcome to assess architectural distortion and resultant decrements in diffusing capabilities

  3. Six Minute Walk Distance [ Time Frame: Baseline to Week 12 ]
    The six minute walk distance is commonly used both in research studies and in clinical practice as a measure of functional capabilities, and changes in six minute walk distance and oxygen use during testing over time often reflect clinically relevant disease progression. We will measure the distance travelled during six minutes (meters) in accordance with published guidelines

  4. St George's Respiratory Questionnaire [ Time Frame: Baseline to Week 12 ]
    St. George's Respiratory Questionnaire (SGRQ) is a validated self-reported instrument. In this instrument, scores range from 0 to 100, with higher scores reflective of worse quality of life.

Eligibility Criteria

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Ages Eligible for Study:   18 Years to 85 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Adults above the age of 18 and equal to or below the age of 85
  • Diagnosis of IPF by biopsy or
  • American Thoracic Society (ATS)/European Respiratory Society (ERS)/ Latin American Thoracic Association (ALAT) Guidelines (Am J Respir Crit Care Med Vol 183. pp 788-824,2011)
  • Forced vital capacity (FVC) greater than or equal to 50% predicted, greater than or equal to one month off all medications prescribed for IPF

Exclusion Criteria:

  • Evidence of active infection within the last month
  • Significant obstructive respiratory defect
  • Supplemental oxygen required to maintain an oxygen saturation over 88% at rest
  • History of myocardial infarction within the last year, heart failure within the last 3 years or cardiac arrhythmia requiring drug therapy
  • History of smoking within 4 weeks of screening
  • Pregnancy or lactation
  • Participation in another therapeutic clinical trial
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01214187

United States, California
University of California San Francisco
San Francisco, California, United States, 94143
United States, Illinois
University of Illinois Chicago
Chicago, Illinois, United States, 60612
University of Chicago
Chicago, Illinois, United States, 60637
United States, Louisiana
Tulane University
New Orleans, Louisiana, United States, 70112
United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115
United States, Michigan
University of Michigan
Ann Arbor, Michigan, United States, 48109
United States, New York
Columbia University
New York, New York, United States, 10032
United States, Washington
University of Washington
Seattle, Washington, United States, 98195
Sponsors and Collaborators
Brigham and Women's Hospital
National Heart, Lung, and Blood Institute (NHLBI)
University of California, San Francisco
University of Chicago
University of Illinois at Chicago
University of Michigan
Columbia University
Tulane University
University of Washington
Principal Investigator: Rosas O Ivan, MD Brigham and Women's Hospital
Principal Investigator: Joe GN Garcia, MD University of Illinois at Chicago
More Information

Responsible Party: Ivan O. Rosas, Overall Principle Investigator, Brigham and Women's Hospital
ClinicalTrials.gov Identifier: NCT01214187     History of Changes
Other Study ID Numbers: 1U01HL105371 ( U.S. NIH Grant/Contract )
First Posted: October 4, 2010    Key Record Dates
Results First Posted: June 14, 2017
Last Update Posted: June 14, 2017
Last Verified: May 2017

Keywords provided by Ivan O. Rosas, Brigham and Women's Hospital:
idiopathic pulmonary fibrosis
pulmonary fibrosis
carbon monoxide

Additional relevant MeSH terms:
Pulmonary Fibrosis
Idiopathic Pulmonary Fibrosis
Idiopathic Interstitial Pneumonias
Pathologic Processes
Lung Diseases
Respiratory Tract Diseases
Lung Diseases, Interstitial
Carbon Monoxide
Molecular Mechanisms of Pharmacological Action
Neurotransmitter Agents
Physiological Effects of Drugs