Safety and Efficacy Study of Aztreonam for Inhalation Solution (AZLI) in Cystic Fibrosis Patients With P. Aeruginosa (AIR-CF2)
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|ClinicalTrials.gov Identifier: NCT00104520|
Recruitment Status : Completed
First Posted : March 2, 2005
Results First Posted : March 11, 2011
Last Update Posted : March 11, 2011
|Condition or disease||Intervention/treatment||Phase|
|Cystic Fibrosis||Drug: AZLI 75 mg two times a day (BID)/three times a day (TID) Drug: Placebo two times a day (BID)/three times a day (TID)||Phase 3|
Patients with CF often have lung infections that occur repeatedly or worsen over time. The lung infections are often caused by a bacteria called PA. Treatment with antibiotics can stop or slow down the growth of the bacteria. The antibiotics may be given by mouth, intravenously (IV), or by inhalation as a mist. The purpose of this study was to evaluate the safety and efficacy of aztreonam for inhalation solution (AZLI), an investigational formulation of the antibiotic administered using the eFlow® Electronic Nebulizer by PARI GmbH, in CF patients with PA.
In this study, participants were screened for eligibility at Visit 1 (Day -42) and returned to the center for Visit 2 after a 14-day evaluation period. At Visit 2 (Day -28), participants began a 28-day course of open-label Tobramycin Inhalation Solution (TIS). At Visit 3 (Day 0), following completion of the 28-day course of TIS, participants began randomized, blinded treatment with either AZLI twice a day (BID) or three times a day (TID) or placebo BID or TID, and continued treatment for a total of 28 days, with a clinic visit at Day 14 (Visit 4) and at the end of treatment (Visit 5 [Day 28]). Participants returned for visits every 2 weeks for 8 weeks after the end of the blinded treatment (Visits 6 to 9 [Days 42 to 84]).
Two hundred and forty-seven participants were treated in the TIS phase of this study. Two hundred and eleven subjects completed the TIS phase and were treated in the placebo-controlled phase with study drug (AZLI or placebo).
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||211 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)|
|Official Title:||A Phase 3, Double-Blind, Multicenter, Randomized, Placebo-Controlled Trial With Aztreonam Lysinate for Inhalation in Cystic Fibrosis Patients With Pulmonary P. Aeruginosa Requiring Frequent Antibiotics (AIR-CF2)|
|Study Start Date :||February 2005|
|Actual Primary Completion Date :||September 2006|
|Actual Study Completion Date :||September 2006|
|Placebo Comparator: Placebo (pooled two times a day [BID]/three times a day [TID])||
Drug: Placebo two times a day (BID)/three times a day (TID)
|Experimental: AZLI (pooled two times a day [BID]/three times a day [TID])||
Drug: AZLI 75 mg two times a day (BID)/three times a day (TID)
- Time to Need for Inhaled or Intravenous (IV) Antipseudomonal Antibiotics [ Time Frame: Day 0 to Day 84 (end of study) ]The primary endpoint was time to need for a course of inhaled or IV antipseudomonal antibiotics with documented physician assessment of need for antibiotics. Antipseudomonal Antibiotic need was documented based on the presence of at least one of the following four symptoms predictive of pulmonary exacerbation: decreased exercise tolerance, increased cough, increased sputum / chest congestion, decreased appetite, or other.
- Change in Cystic Fibrosis Questionnaire - Revised (CFQ-R) Respiratory Symptoms Scale (RSS) Score [ Time Frame: Day 0 to Day 28 ]The CFQ-R was administered at Day -28, baseline, Day 14, Day 28, and Day 84 (end of study). The endpoint was change in respiratory symptoms from baseline, assessed with the CFQ-R RSS (range of scores [units]: 0-100; higher scores indicate fewer symptoms).
- Percent Change in Forced Expiratory Volume in 1 Second (FEV1) (L) [ Time Frame: Day 0 to Day 28 ]
Spirometry was performed at each visit. FEV1 was recorded according to American Thoracic Society (ATS) guidelines.
FEV1(L) is the measurement of the volume of air (expressed in liters) exhaled in 1 second.
The percent change in this parameter from Day 0 to Day 28 was determined for each treatment group.
- Number of Hospitalization Days [ Time Frame: Day 0 to Day 84 ]Details of all hospitalizations, including the dates of admission and discharge, were recorded on the electronic case report form (eCRF).
- Change From Baseline in Pseudomonas Aeruginosa (PA) Log10 Colony Forming Units (CFU) Per Gram of Sputum [ Time Frame: Day 0 to Day 28 ]Sputum samples were collected at all participant visits of the study for analysis of microbiology endpoints. Sputum samples were processed for qualitative and quantitative culture of PA (each morphotype). Due to the skewness of the distribution of CFU data, the data were transformed using the base 10 logarithm, in an attempt to normalize the data and allow for parametric tests, before calculating changes. To account for zero values, 1 was added to each CFU measurement before being transformed. Any CFU data values where PA was not isolated from a valid culture were set to zero.
- Number of Participants With Other Pathogens [ Time Frame: Day 0 and Day 28 ]
Sputum samples were collected at all visits for quantitative and qualitative culture for Staphylococcus aureus, Burkholderia cepacia, Stenotrophomonas maltophilia, and Achromobacter xylosoxidans.
Number of participants with other pathogens at baseline and at the end of treatment (28 days) are reported.
- Minimum Concentration of Aztreonam Inhibiting 50% (MIC50) and 90% (MIC90) of All PA Isolates (μg/mL) [ Time Frame: Day 0 to Day 28 ]
The aztreonam susceptibility of PA isolates from sputum samples (collected at all visits) was assessed.
MIC50 = minimum inhibitory concentration (minimum concentration of an agent that inhibits 50% of isolates from a particular organism).
MIC90 = minimum inhibitory concentration (minimum concentration of an agent that inhibits 90% of isolates from a particular organism).
MIC50 and MIC90 values are single measurements for the entire population and not measured on a per-participant basis.
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): NCT00104520
|Principal Investigator:||Karen McCoy, MD||Nationwide Children's Hospital|