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European Trial of Pirfenidone in BOS, A European Multi-center Study (EPOS)

This study is currently recruiting participants. (see Contacts and Locations)
Verified December 2016 by Rigshospitalet, Denmark
Information provided by (Responsible Party):
Michael Perch, Rigshospitalet, Denmark Identifier:
First received: September 21, 2014
Last updated: December 8, 2016
Last verified: December 2016

A European multi-centre, randomised, double-blind placebo-controlled trial of Pirfenidone in bronchiolitis-obliterans-syndrome grade 1-2 in lung transplant recipients.

Randomized double blinded, placebo controlled study. Eligible patients are to be randomized in a 1:1 ratio to receive either Pirfenidone 2403 mg/d or the matching placebo treatment for 6 months.

Primary objective To evaluate the effect of Pirfenidone on the change in FEV1 in liters over 6 months in lung transplant recipients with bronchiolitis obliterans syndrome.

Condition Intervention Phase
Disorder Related to Lung Transplantation
CLAD, Bronchiolitis Obliterans
Drug: Pirfenidone
Drug: Placebo
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Treatment
Official Title: A European Multi-center, Randomised, Double-blind Trial of Pirfenidone in Bronchiolitis-obliterans-syndrome Grade 1-2 in Lung Transplant Recipients

Resource links provided by NLM:

Further study details as provided by Rigshospitalet, Denmark:

Primary Outcome Measures:
  • To evaluate the effect of Pirfenidone on the change in FEV1 in liters over 6 months in lung transplant recipients with bronchiolitis obliterans syndrome. [ Time Frame: 6 months ]

Secondary Outcome Measures:
  • - Categorical percentage change in FEV1 [ Time Frame: 6 months ]
  • - Change in Forced Vital Capacity (FVC) [ Time Frame: 6 months ]
  • - Change in Total Lung Capacity (TLC) [ Time Frame: 6 months ]
  • - Change in FEV1/FVC ratio [ Time Frame: 6 months ]
  • - Number of patients with treatment failure [ Time Frame: 6 months ]
  • - Change in BOS grade [ Time Frame: 6 months ]
  • - Change in percent predicted diffusion capacity (DLCO) [ Time Frame: 6 months ]
  • - Change in functional level as assessed by the 6MWT [ Time Frame: 6 months ]
  • - Hospital admission for any reason [ Time Frame: 6 months ]
  • - Death or re-transplantation rates [ Time Frame: 6 months ]
  • - Change in QoL as assessed by EQ5D [ Time Frame: 6 months ]

Estimated Enrollment: 80
Study Start Date: May 2015
Estimated Study Completion Date: October 2019
Estimated Primary Completion Date: October 2018 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Placebo
Receive placebo tablets
Drug: Placebo
Recieve tablets with placebo
Active Comparator: Pirfenidone
Upon enrollment, subjects will be randomized to either the treatment group (Pirfenidone) or to the placebo group (1:1 ratio). The trial medication will be administered as 267-mg oral capsules and titrated to a maintenance dose of 2403 mg/d (3 capsules TID, for a total of 9 capsules/day).
Drug: Pirfenidone
Receive tablets with pirfenidone
Other Name: Esbriet

  Show Detailed Description


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

Inclusion Criteria:

  • Patients >18 years of age
  • Azithromycin therapy for at least 4 weeks prior to study start, with an Azithromycin dose of minimum 250 mg/day at least 3 times per week as this is considered standard therapy for bronchiolitis obliterans syndrome.
  • Double lung transplantation is required.
  • Patients must be at least 6 months after transplantation and must have documented post-transplant baseline value of FEV1 (mean of the 2 highest values measured at least 3 weeks apart according to ISHLT criteria).
  • Patients must have BOS grade 1 to BOS grade 3.
  • Patients must have documented progressive disease as demonstrated by all of the following criteria:
  • Patients must have at least 3 FEV1-measurements in the last 6 months, each at least 3 weeks apart
  • a total decline of at least 200ml in FEV1 i
  • a decline of at least 50 ml in the last two measurements

Exclusion Criteria

  • Patients with lung redo transplantation, combined transplantation (including heart and lung transplantation) or single lung recipients.
  • Patients with any severe comorbidity complicating BOS which might determine the prognosis and functional level of the patient (e.g. invasive aspergillosis, active malignant disease) within the last 12 months.
  • FEV1 decline related to other non BOS causes (eg pneumothorax, bronchial stenosis, effusion, etc.)
  • Patients who have developed BOS grade 3.
  • Patients who on Thorax CT at entry demonstrate new significant findings which are not compatible with BOS like interstitial fibrosis, consolidation, appearances suggesting Restrictive Allograft Syndrome (RAS) and acute pulmonary infection as cause of decline in lung function.
  • Documented acute perivascular rejection higher than grade A1 or findings compatible with antibody mediated rejection
  • Pregnancy or lactation (women of childbearing capacity are required to have a negative serum pregnancy test before treatment and must agree to maintain highly effective contraception by practicing abstinence or by using at least two methods of birth control from the date of consent through the end of the study).
  • Renal insufficiency (Creatinine clearance <30 ml/min calculated by the CKD-Epi formula.
  • Any of the following liver test criteria above the specified limit:
  • Total bilirubin above the upper limit of the normal range (ULN), except in patients with predominantly unconjugated hyperbilirubinemia (e.g., Gilbert's syndrome)
  • Aspartate or alanine aminotransferase (AST or ALT) >3 × ULN
  • Known allergy or hypersensitivity to Pirfenidone
  • Ongoing use or expected use of any of the following therapies:
  • Strong inhibitors of CYP1A2 (e.g. fluvoxamine or enoxacin)
  • Moderate inhibitors of CYP1A2 (e.g. mexiletine, thiabendazole, or phenylpropanolamine [Note: ciprofloxacin will be allowed only at doses ≤500 mg BID])
  • Previous treatment with Pirfenidone after transplantation
  • Patients who have resumed smoking after transplantation
  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 identifier: NCT02262299

Contact: Michael Perch, MD 004535449702
Contact: Hans Henrik Schultz, MD 004535453545

University Hospital Gasthuisberg, Katholike Universiteit Leuven Recruiting
Leuven, Belgium, 300
Contact: Geert Verleden, MD, PhD    003216346800   
Principal Investigator: Geert Verleden, MD, PhD         
Sub-Investigator: Robin Vos, MD, PhD         
Rigshospitalet, Copenhagen University Hospital Recruiting
Copenhagen, Denmark, 2100
Contact: Michael Perch, MD    004535459702   
Sub-Investigator: Michael Perch, MD         
Sub-Investigator: Hans Henrik Schultz, MD         
University Hospital Essen, Department of Pneumonology Recruiting
Essen, Germany, 45239
Contact: Urte Sommerwerck, MD    00492014334352   
Principal Investigator: Urte Sommerwerck, MD         
Medizinische Hochschule Hannover, Klinik für Pneumonologie Recruiting
Hannover, Germany, 30625
Contact: Jens Gottlieb, MD    00495115324681   
Principal Investigator: Jens Gottlieb, MD         
Sub-Investigator: Mark Greer, MD         
Klinikum Grosshadern, Division of Pulmonary Diseases Recruiting
Munich, Germany, 81377
Contact: Claus Neurohr, MD, PhD    004989440073071   
Principal Investigator: Claus Neurohr, MD, PhD         
Groningen University Medical Center, Lung Transplant Team Recruiting
Groningen, Netherlands, 9700
Contact: Erik Verschuuren, MD, PhD    0031503614932   
Principal Investigator: Erik Verschuuren, MD, PhD         
Rikshospitalet, National University Hospital Recruiting
Oslo, Norway, 0424
Contact: Inga Leuckfeld, MD    00479152770   
Principal Investigator: Inga Leuckfeld, MD         
Sahlgrenska University Hospital, Department of respiratory diseases Recruiting
Gothenburg, Sweden, 41345
Contact: Jesper Magnusson, MD    0046313427866   
Principal Investigator: Jesper Magnusson, MD         
Lund University Hospital, Department of Respiratory Diseases Recruiting
Lund, Sweden, 20502
Contact: Ingrid Skog, MD    004646172807   
Principal Investigator: Ingrid Skog, MD         
United Kingdom
Harefield Hospital, Lung Transplant Unit Recruiting
Harefield, United Kingdom, UB9 6HJ
Contact: Martin Carby, MD    00442073518736   
Contact: Patrik Pettersson    00442073518736      
Principal Investigator: Martin Carby, MD         
Freeman Hospital Recruiting
Newcastle, United Kingdom, NE7 7DN
Contact: Paul Corris    00441912137462   
Principal Investigator: Paul Corris, MD, PhD         
Sponsors and Collaborators
Rigshospitalet, Denmark
Principal Investigator: Michael Perch, MD Rigshospitalet, Denmark
  More Information

Responsible Party: Michael Perch, Medical Director Danish National Lung Transplant Program, Rigshospitalet, Denmark Identifier: NCT02262299     History of Changes
Other Study ID Numbers: RH-HJE-2014-09
Study First Received: September 21, 2014
Last Updated: December 8, 2016

Additional relevant MeSH terms:
Bronchiolitis Obliterans
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Tract Infections
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Anti-Inflammatory Agents
Antirheumatic Agents
Antineoplastic Agents processed this record on March 29, 2017