Multidose Safety and Tolerability Study of Liposomal Amikacin for Inhalation (Arikace™) In Cystic Fibrosis Patients - Full Text View

Purpose

This is a study to determine the safety and tolerability of 28 days of daily dosing of 560 mg of Arikace™ versus placebo in patients who have Cystic fibrosis.

Condition	Intervention	Phase
Cystic Fibrosis	Drug: Arikace™ Drug: Placebo	Phase 1 Phase 2


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment
Official Title:	Phase 1b/2a Multidose Safety and Tolerability Study of Liposomal Amikacin for Inhalation (Arikace™) in Cystic Fibrosis Patient With Chronic Infections Due to Pseudomonas Aeruginosa.

Resource links provided by NLM:

Genetics Home Reference related topics: cystic fibrosis

MedlinePlus related topics: Cystic Fibrosis

Drug Information available for: Amikacin sulfate

Genetic and Rare Diseases Information Center resources: Cystic Fibrosis

U.S. FDA Resources

Further study details as provided by Insmed Incorporated:

Primary Outcome Measures:

To evaluate the safety and tolerability of 28 days of daily dosing of nebulized Arikace™, liposomal amikacin for inhalation. [ Time Frame: 28 Days of daily dosing ]

Secondary Outcome Measures:

To access pharmacokinetics (PK) of Arikace™ in serum and urine, and evaluate sputum amikacin levels [ Time Frame: 28 Days of daily dosing ]
To evaluate change in Pulmonary function [ Time Frame: 28 Days of daily dosing ]
To evaluate change in density of Pseudomonas aeruginosa in sputum [ Time Frame: 28 Days of daily dosing ]
To evaluate time to and duration of systemic anti-Pseudomonal rescue therapy [ Time Frame: 28 Days of daily dosing ]
To evaluate change in CFQ-R measurements [ Time Frame: 28 Days of daily dosing ]
Exploratory evaluation of a Cystic Fibrosis Symptom Diary (CFSD) [ Time Frame: 28 Days of daily dosing ]
Exploratory evaluation of durability of clinical benefit [ Time Frame: 28 days of daily dosing ]


Enrollment:	46
Study Start Date:	January 2008
Study Completion Date:	June 2009
Primary Completion Date:	June 2009 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Active Comparator: A Arikace at 560 mg	Drug: Arikace™ Subjects will be randomly assigned to study drug dose of of Arikace™ or placebo in accordance with a code provided by the Sponsor/CRO. Randomization will be made in a 2:1 allocation between Arikace™ and placebo. They will be blinded whether they receive Arikace™ or Placebo Study subjects will receive Arikace™ or placebo on Days 1 through Day 28. Drug is administered once a day via a nebulizer.
Placebo Comparator: B Matching placebo	Drug: Placebo Subjects will be randomly assigned to study drug dose of of Arikace™ or placebo in accordance with a code provided by the Sponsor/CRO. Randomization will be made in a 2:1 allocation between Arikace™ and placebo. They will be blinded whether they receive Arikace™ or Placebo Study subjects will receive Arikace™ or placebo on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

Arms

Assigned Interventions

Active Comparator: A

Arikace at 560 mg

Drug: Arikace™

Subjects will be randomly assigned to study drug dose of of Arikace™ or placebo in accordance with a code provided by the Sponsor/CRO. Randomization will be made in a 2:1 allocation between Arikace™ and placebo. They will be blinded whether they receive Arikace™ or Placebo Study subjects will receive Arikace™ or placebo on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

Placebo Comparator: B

Matching placebo

Drug: Placebo

Subjects will be randomly assigned to study drug dose of of Arikace™ or placebo in accordance with a code provided by the Sponsor/CRO. Randomization will be made in a 2:1 allocation between Arikace™ and placebo. They will be blinded whether they receive Arikace™ or Placebo Study subjects will receive Arikace™ or placebo on Days 1 through Day 28. Drug is administered once a day via a nebulizer.

Detailed Description:

Cystic fibrosis (CF) is a gentic disease resulting from mutations in a 230 kb gene on chromosome 7 known as the cystic fibrosis transmembrane conductance regulator (CFTR). Study subjects with CF manifest pathological changes in a variety or organs that express CFTR. The lungs are frequently affected, the sequelae being chronic infections and airway inflammation. The principal goal of both treatment of subjects with CF is to slow the chronic deterioration of lung function.

Study subjects will be randomized to receive either study drug or placebo (1.5% NaCl) by inhalation via a PARI eFlow nebulizer. Each subject will complete 28 days of daily dosing. All study patients will be followed for safety, pharmacokinetics, clinical and microbiologic activity for 56 days post completion of study treatment. The total study period will be up to 84 days, with screening visit occurring within the preceding 14 days prior to study day 1. Patients will be clinically evaluated during the first 48 hours post first study dose and weekly for the 28 day treatment period and during the follow up visits at study days 35, 42, 49, 56, 70 and 85 days to determine safety and tolerability, pharmacokinetics (PK) and clinical and microbiologic activity.

Clinical laboratory parameters, audiology testing, clinical adverse events and pulmonary function will be evaluated for all study subjects in order to determine the qualitative and quantitative safety and tolerability of Arikace™ compared to placebo. Serum, urine and sputum specimens will be collected at periodic intervals to assess PK. Additionally, sputum samples will be collected to determine changes in bacterial density. Pulmonary function testing and CFQ-R measurements will be assessed at selected time points throughout the study. An exploratory evaluation of a Cystic Fibrosis Symptom Diary (CFSD) will also be implemented.

Eligibility


Ages Eligible for Study:	6 Years and older (Child, Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Male or female study subjects must be adults (≥ 6 years of age)
Confirmed diagnosis of CF
History of chronic infection with P.aeruginosa
FEV1 ≥40% of predicted at Screening
Ability to comply with study medication use, study visits and procedures
Ability to produce 0.5 grams of sputum

Exclusion Criteria:

Administration of any investigational drug within 8 weeks to Study Day 1
Emergency room visit or hospitalization for CF or respiratory-related illness within 4 weeks prior to screening
History of alcohol, medication or illicit drug abuse within 1 yr. to screening
History of lung transplantation
Female of childbearing potential who are not practicing an acceptable method of birth control or who are lactating
Positive Pregnancy test
Use of any anti-pseudomonal antibiotics within 28 days prior to Study Day 1
Initiation of chronic therapy within 28 days prior to Study Day 1
History of sputum or throat swab culture yielding Burkholderia cepacia within 2 years prior to screening
History of mycobacterial and/or Aspergillus infection requiring treatment within 2 years prior to screening
History of biliary cirrhosis with portal hypertension, or splenomegaly

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: NCT00558844

Show 19 Study Locations

Sponsors and Collaborators

Insmed Incorporated

Investigators


Study Director:	Gina Eagle, MD	Insmed Incorporated

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Clancy JP, Dupont L, Konstan MW, Billings J, Fustik S, Goss CH, Lymp J, Minic P, Quittner AL, Rubenstein RC, Young KR, Saiman L, Burns JL, Govan JR, Ramsey B, Gupta R; Arikace Study Group.. Phase II studies of nebulised Arikace in CF patients with Pseudomonas aeruginosa infection. Thorax. 2013 Sep;68(9):818-25. doi: 10.1136/thoraxjnl-2012-202230. Epub 2013 Jun 8.


Responsible Party:	Insmed Incorporated
ClinicalTrials.gov Identifier:	NCT00558844 History of Changes
Other Study ID Numbers:	TR02-106
Study First Received:	November 13, 2007
Last Updated:	October 6, 2016

Keywords provided by Insmed Incorporated:


Cystic Fibrosis Respiratory Infections Pulmonary Cystic Fibrosis CFTR

Additional relevant MeSH terms:


Fibrosis Cystic Fibrosis Pathologic Processes Pancreatic Diseases Digestive System Diseases Lung Diseases	Respiratory Tract Diseases Genetic Diseases, Inborn Infant, Newborn, Diseases Amikacin Anti-Bacterial Agents Anti-Infective Agents

ClinicalTrials.gov processed this record on May 23, 2017