Study of Ivacaftor in Cystic Fibrosis Subjects Aged 12 Years and Older With the G551D Mutation (STRIVE)

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ClinicalTrials.gov Identifier: NCT00909532

Recruitment Status : Completed

First Posted : May 28, 2009

Results First Posted : August 21, 2012

Last Update Posted : January 18, 2013

Sponsor:

Collaborator:

Cystic Fibrosis Foundation

Information provided by (Responsible Party):

Vertex Pharmaceuticals Incorporated

Study Description

Brief Summary:

The purpose of this study was to evaluate the efficacy and safety of ivacaftor in subjects with cystic fibrosis aged 12 years and older who have the G551D mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Ivacaftor is a potent and selective CFTR potentiator of wild-type, G551D, F508del, and R117H forms of human CFTR protein. Potentiators are pharmacological agents that increase the chloride ion transport properties of the channel in the presence of cyclic AMP-dependent protein kinase A (PKA) activation.

Condition or disease	Intervention/treatment	Phase
Cystic Fibrosis	Drug: Ivacaftor Drug: Placebo	Phase 3

Detailed Description:

This was a phase 3 study in subjects with cystic fibrosis (CF) age 12 years and older who have a G551D-CFTR mutation and percent predicted forced expiratory volumn in 1 second (FEV1) between 40% and 90%.

Based on in vitro studies and pharmacologic, pharmacokinetic (PK), and safety profiles, ivacaftor was selected for clinical development as a possible treatment for patients with CF. Patients with the G551D mutation were the targeted population for this study because ivacaftor is a potentiator of the gating function of the CFTR protein, and the most prevalent mutation with a gating defect in CF is the G551D mutation.

This study was designed to further evaluate the efficacy of ivacaftor in subjects with CF who have a G551D-CFTR gene mutation and to evaluate safety in this population over a longer period than previously studied.

Study Design

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Study Type :	Interventional (Clinical Trial)
Actual Enrollment :	167 participants
Allocation:	Randomized
Intervention Model:	Parallel Assignment
Masking:	Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose:	Treatment
Official Title:	A Phase 3, Randomized, Double-Blind, Placebo-Controlled, Parallel Group Study to Evaluate the Efficacy and Safety of VX-770 in Subjects With Cystic Fibrosis and the G551D Mutation
Study Start Date :	June 2009
Actual Primary Completion Date :	July 2010
Actual Study Completion Date :	November 2012

Resource links provided by the National Library of Medicine

MedlinePlus Genetics related topics: Cystic fibrosis

MedlinePlus related topics: Cystic Fibrosis

Drug Information available for: Ivacaftor

Genetic and Rare Diseases Information Center resources: Cystic Fibrosis

U.S. FDA Resources

Arms and Interventions

Arm	Intervention/treatment
Placebo Comparator: Placebo Subjects who received placebo every 12 hours (q12h) for up to 48 weeks.	Drug: Placebo Tablet given orally q12h for up to 48 weeks
Experimental: 150 mg Ivacaftor q12h Subjects who received 150 mg of ivacaftor q12h for up to 48 weeks.	Drug: Ivacaftor 150-mg tablets given orally q12h for up to 48 weeks Other Name: VX-770

Outcome Measures

Primary Outcome Measures :

Absolute Mean Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through Week 24 [ Time Frame: baseline through 24 weeks ]
Spirometry (as measured by FEV1) is a standardized assessment to evaluate lung function that is the most widely used endpoint in cystic fibrosis studies.

Secondary Outcome Measures :

Absolute Mean Change From Baseline in Percent Predicted FEV1 Through Week 48 [ Time Frame: baseline through 48 weeks ]
Spirometry (as measured by FEV1) is a standardized assessment to evaluate lung function that is the most widely used endpoint in cystic fibrosis studies.
Absolute Change From Baseline in Cystic Fibrosis Questionnaire-Revised (CFQ-R) Score Through Week 24 and Week 48 (Respiratory Domain Score, Pooled) [ Time Frame: baseline through 24 weeks and 48 weeks ]
The CFQ-R is a health-related quality of life measure for subjects with cystic fibrosis. Each domain is scored from 0 (worst) to 100 (best). A difference of at least 4 points in the respiratory domain score of the CFQ-R is considered a minimal clinically important difference (MCID).
Absolute Change From Baseline in Sweat Chloride Concentration Through Week 24 and Week 48 [ Time Frame: baseline through 24 weeks and 48 weeks ]
The sweat chloride (quantitative pilocarpine iontophoresis) test is a standard diagnostic tool for cystic fibrosis (CF), serving as an indicator of cystic fibrosis transmembrane conductance regulator (CFTR) activity.
Time-to-first Pulmonary Exacerbation Through Week 24 and Week 48 [ Time Frame: baseline through 24 weeks and 48 weeks ]
Pulmonary exacerbation was defined as a change in antibiotic therapy (intravenous, inhaled, or oral) for any 4 or more of signs/symptoms such as change in sputum; new or increased hemoptysis; increased cough or dyspnea; malaise, fatigue, or lethargy; temperature above 38 degrees C; anorexia or weight loss; sinus pain/tenderness and discharge; change in physical examination of the chest; decreased pulmonary function by 10%; and radiographic changes indicative of pulmonary infection.
Absolute Change From Baseline in Weight at Week 24 and Week 48 [ Time Frame: baseline to 24 weeks and 48 weeks ]
As malnutrition is common in patients with cystic fibrosis (CF) because of increased energy expenditures due to lung disease and fat malabsorption, body weight is an important clinical measure of nutritional status.

Eligibility Criteria

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Ages Eligible for Study:	12 Years and older (Child, Adult, Older Adult)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Confirmed diagnosis of cystic fibrosis (CF) and G551D mutation in at least 1 allele
Forced expiratory volume in 1 second (FEV1) of 40% to 90% (inclusive) of predicted normal for age, gender, and height at Screening.
No clinically significant abnormalities that would have interfered with the study assessments, as judged by the investigator
Willing to use highly effective birth control methods during the study

Exclusion Criteria:

History of any illness or condition that might confound the results of the study or pose an additional risk in administering study drug to the subject
Acute respiratory infection, pulmonary exacerbation, or changes in therapy for pulmonary disease within 4 weeks of Day 1 of the study
History of alcohol, medication or illicit drug abuse within one year prior to Day 1
Abnormal liver function ≥ 3x the upper limit of normal
Abnormal renal function at Screening
History of solid organ or hematological transplantation
Pregnant, planning a pregnancy, breast-feeding, or unwilling to follow contraception requirements
Ongoing participation in another therapeutic clinical study or prior participation in an investigational drug study within 30 days prior to Screening
Use of inhaled hypertonic saline treatment
Concomitant use of any inhibitors or inducers of cytochrome P450 3A4 (CYP 3A4)

Contacts and Locations

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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): NCT00909532

Locations

Show 65 study locations

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United States, Alabama
University of Alabama
Birmingham, Alabama, United States, 35233-1711
United States, California
Kaiser Permanente Medical Care Program
Oakland, California, United States, 94611
Cystic Fibrosis Research Office, Stanford University
Palo Alto, California, United States, 94304
Rady Children's Hospital
San Diego, California, United States, 92123-5070
United States, Colorado
National Jewish Medical and Research Center
Denver, Colorado, United States, 80206
United States, Georgia
Emory Cystic Fibrosis Center
Atlanta, Georgia, United States, 30322
United States, Idaho
St. Luke's CF Clinic
Boise, Idaho, United States, 83712
United States, Illinois
Children's Memorial Hospital
Chicago, Illinois, United States, 60614
United States, Indiana
Indiana University
Indianapolis, Indiana, United States, 46202
United States, Iowa
University of Iowa
Iowa City, Iowa, United States, 52242
United States, Maryland
Johns Hopkins University
Baltimore, Maryland, United States, 21205
United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Children's Hospital Boston
Boston, Massachusetts, United States, 02115
United States, Michigan
University of Michigan
Ann Arbor, Michigan, United States, 48109
United States, Minnesota
Pulmonary, Allergy & Critical Care Medicine, University of Minnesota
Minneapolis, Minnesota, United States, 55455
United States, Missouri
The Children's Mercy Hospital
Kansas City, Missouri, United States, 64108
Washington University
St. Louis, Missouri, United States, 63110
United States, Nebraska
Adult Pulmonary/ CF, University of Nebraska Medical Center
Omaha, Nebraska, United States, 68198-5300
United States, New Jersey
Monmouth Medical Center
Long Branch, New Jersey, United States, 07740
United States, New York
Women and Children's Hospital of Buffalo
Buffalo, New York, United States, 14222
Long Island Jewish Medical Center
New Hyde Park, New York, United States, 11042
SUNY Upstate Medical University
Syracuse, New York, United States, 13210
United States, North Carolina
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States, 27599
United States, Ohio
Cincinnati Children's Hospital Medical Center
Cincinnati, Ohio, United States, 45229
Pediatric & Pulmonary Division, Rainbow Babies/Case Western
Cleveland, Ohio, United States, 44106
Nationwide Children's Hospital
Columbus, Ohio, United States, 43205
Toledo Children's Hospital
Toledo, Ohio, United States, 43606
United States, Oregon
Oregon Health & Sciences University
Portland, Oregon, United States, 97239-3098
United States, Pennsylvania
Hershey Medical Center
Hershey, Pennsylvania, United States, 17033
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States, 19104
Children's Hospital of Pittsburgh of UPMC
Pittsburgh, Pennsylvania, United States, 15224
United States, Tennessee
East Tennessee Children's Hospital
Knoxville, Tennessee, United States, 37916
Vanderbilt University Medical Center
Nashville, Tennessee, United States, 37232-5735
United States, Utah
University of Utah
Salt Lake City, Utah, United States, 84132
United States, Virginia
University of Virginia
Charlottesville, Virginia, United States, 22908
United States, Washington
Seattle Children's Hospital
Seattle, Washington, United States, 98105
Division of Pulmonary and CCM, University of Washington
Seattle, Washington, United States, 98195-6522
United States, West Virginia
West Virginia University
Morgantown, West Virginia, United States, 26506
United States, Wisconsin
Medical College of Wisconsin
Milwaukee, Wisconsin, United States, 53226
Australia, New South Wales
The Children's Hospital Westmead
Westmead, New South Wales, Australia, 2145
Australia, Queensland
The Prince Charles Hospital
Chermside, Queensland, Australia, 4032
Royal Children's Hospital Brisbane
Herston, Queensland, Australia, 4026
Mater Adult Hospital
South Brisbane, Queensland, Australia, 4101
Australia, Victoria
Royal Children's Hospital Melbourne
Parkville, Victoria, Australia, 3052
Australia, Western Australia
Lung Institute of Western Australia
Nedlands, Western Australia, Australia, 6009
Princess Margaret Hospital for Children
Subiaco, Western Australia, Australia, 6008
Canada, Nova Scotia
Queen Elizabeth II Health Sciences Centre
Halifax, Nova Scotia, Canada, B3H 3A7
Canada, Ontario
St. Michael's Hospital
Toronto, Ontario, Canada, M5B 1W8
CF Center, Hospital for Sick Children
Toronto, Ontario, Canada, M5G 1X8
Canada, Quebec
Montreal Children's Hospital - MUHC
Montreal, Quebec, Canada, H3H 1P3
Czech Republic
FN Motol
Prague, Czech Republic, 15006
France
Hopital Cochin
Paris, France, 75014
Hopital Necker
Paris, France, 75015
Centre de Perharidy
Roscoff, France, 29684
Germany
Kinder- und Jugendklinik Universitätsklinikum Erlangen
Erlangen, Germany, 91054
Mukoviszidose-Zentrum am Klinikum der Friedrich-Schiller-Universität Jena, Klinik für Kinder- und Jugendmedizin
Jena, Germany, 07740
Klinikum der LMU München, Dr. von Haunersches Kinderspital (CHA)
Munich, Germany, 80337
Universitäts-Kinderklinik Würzburg
Wurzburg, Germany, 97080
Ireland
Cork University Hospital
Cork, Ireland
Our Lady's Children's Hospital
Dublin, Ireland, 12
The National Children's Hospital
Dublin, Ireland, 24
St. Vincent's University Hospital
Dublin, Ireland, 4
Beaumont Hospital
Dublin, Ireland, 9
United Kingdom
Belfast City Hospital
Belfast, Northern Ireland, United Kingdom, BT9 7AB
Imperial College London
London, United Kingdom, SW3 6LR

Sponsors and Collaborators

Vertex Pharmaceuticals Incorporated

Cystic Fibrosis Foundation

Investigators

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Principal Investigator:	Bonnie W. Ramsey, MD	Children's Hospital and Regional Medical Center, Seattle, Washington, USA
Principal Investigator:	Stuart Elborn, MD	Respiratory Medicine Group, Queen's University of Belfast, Belfast, Northern Ireland, UK

More Information

Additional Information:

Genetics Home Reference This link exits the ClinicalTrials.gov site

Medline Plus This link exits the ClinicalTrials.gov site

U.S. FDA Resources This link exits the ClinicalTrials.gov site

Publications:

Ramsey BW, Davies J, McElvaney NG, Tullis E, Bell SC, Dřevínek P, Griese M, McKone EF, Wainwright CE, Konstan MW, Moss R, Ratjen F, Sermet-Gaudelus I, Rowe SM, Dong Q, Rodriguez S, Yen K, Ordoñez C, Elborn JS; VX08-770-102 Study Group. A CFTR potentiator in patients with cystic fibrosis and the G551D mutation. N Engl J Med. 2011 Nov 3;365(18):1663-72. doi: 10.1056/NEJMoa1105185.

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

Flume PA, Wainwright CE, Elizabeth Tullis D, Rodriguez S, Niknian M, Higgins M, Davies JC, Wagener JS. Recovery of lung function following a pulmonary exacerbation in patients with cystic fibrosis and the G551D-CFTR mutation treated with ivacaftor. J Cyst Fibros. 2018 Jan;17(1):83-88. doi: 10.1016/j.jcf.2017.06.002. Epub 2017 Jun 24.

Solem CT, Vera-Llonch M, Liu S, Botteman M, Castiglione B. Impact of pulmonary exacerbations and lung function on generic health-related quality of life in patients with cystic fibrosis. Health Qual Life Outcomes. 2016 Apr 21;14:63. doi: 10.1186/s12955-016-0465-z.

Quittner A, Suthoff E, Rendas-Baum R, Bayliss MS, Sermet-Gaudelus I, Castiglione B, Vera-Llonch M. Effect of ivacaftor treatment in patients with cystic fibrosis and the G551D-CFTR mutation: patient-reported outcomes in the STRIVE randomized, controlled trial. Health Qual Life Outcomes. 2015 Jul 2;13:93. doi: 10.1186/s12955-015-0293-6.

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Responsible Party:	Vertex Pharmaceuticals Incorporated
ClinicalTrials.gov Identifier:	NCT00909532
Other Study ID Numbers:	VX08-770-102
First Posted:	May 28, 2009 Key Record Dates
Results First Posted:	August 21, 2012
Last Update Posted:	January 18, 2013
Last Verified:	January 2013

Keywords provided by Vertex Pharmaceuticals Incorporated:


Fibrosis Pancreatic Diseases Lung Diseases Respiratory Tract Diseases	Genetic Diseases, Inborn Infant, Newborn, Diseases Pathologic Processes

Additional relevant MeSH terms:

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Cystic Fibrosis Fibrosis Pathologic Processes Pancreatic Diseases Digestive System Diseases Lung Diseases Respiratory Tract Diseases	Genetic Diseases, Inborn Infant, Newborn, Diseases Ivacaftor Chloride Channel Agonists Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action

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