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Efficacy and Safety Study of Inhaled Glutathione in Cystic Fibrosis Patients

Primary Purpose

Cystic Fibrosis

Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
reduced glutathione sodium salt
0.9% normal saline (control)
Sponsored by
Mukoviszidose Institut gGmbH
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cystic Fibrosis

Eligibility Criteria

8 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Male or female patient, 8 years (pediatric 8 - 17 years inclusive; adult 18 years)
  • Confirmed diagnosis of CF (positive sweat chloride, 60 mEq/liter by pilocarpine iontophoresis and/or a genotype with two identifiable mutations consistent with CF accompanied by one or more clinical features with the CF phenotype)
  • Patient is able to perform acceptable spirometric maneuvers according to ATS standards
  • FEV1 > 40% predicted and < 90% predicted
  • The patient is clinically stable fulfilling the following:

No evidence of acute upper or lower respiratory tract infection within 4 weeks of screening.

No pulmonary exacerbation requiring an use of i.v./oral/inhaled antibiotics, or oral corticosteroids within 4 weeks of screening.

FEV1 at Visit 2 is within a range of ± 10% of FEV1 from the Visit 1. (If FEV1 at V2 is not within that range, V2 may be re-scheduled once within 7 days)

  • Concomitant or chronic medication is planned to be continued unchanged for the entire study duration
  • The patient or the patient's legally acceptable representative is able to give informed consent in accordance with ICH and GCP guidelines and local legislation
  • Patient is able to comply with the study visit schedule and willing and able to complete the assessments specified in the protocol.

Exclusion Criteria:

  • History of allergy/hypersensitivity (including medication allergy) that is deemed relevant to the trial by the investigator. "Relevance" in this context refers to any increased risk of hypersensitivity reaction to trial medication. (Specific concerns currently identified with respect to the use of inhaled glutathione in allergic patients per se are not existing)
  • Concomitant inhaled thiol-containing medications (e.g., inhaled N-acetylcysteine).

Such medication had to be finished at least 2 weeks before the screening visit. Oral N-acetylcysteine may be continued.

  • New oral or inhaled thiol-containing medications (e.g., inhaled or oral N-acetylcysteine) throughout the study period.
  • Patient with a known relevant substance abuse, including alcohol or drug abuse.
  • Pregnant or lactating woman or female patient of child bearing potential who is sexually active and not using a medically approved form of contraception such as oral or injectable contraceptives, intrauterine devices, double-barrier method, contraceptive patch, male partner sterilization or condoms.
  • Patient with a documented persistent colonization with B. cepacia (defined as more than one positive culture within the past year).
  • Start of a new concomitant or chronic medication for CF within 4 weeks of screening.
  • Existing cycling medication regimen without completion of at least 3 cycles prior to the screening visit or the drug cycles of other therapies are not in accordance with the 4-week time-schedule for the single visits of this study
  • Clinically relevant diseases or medical conditions other than CF or CF-related conditions that, in the opinion of the investigator, would compromise the safety of the patient or the quality of the data. This includes, but is not limited to, significant hematological, hepatic,renal, cardiovascular, and neurological diseases (diabetic patients may participate if their disease is under good control prior to screening).
  • Participation in another study with an investigational drug within one month or 6 halflives(whichever is greater) preceding the screening visit.
  • The patient is an employee of the investigator or the institution with direct involvement in the trial or other trials under the direction of the investigator or their members.

Sites / Locations

  • Charité Campus Virchow Klinikum,Klinik für Pädiatrie
  • Universitätskinderklinink
  • Uniklinik Köln Mukoviszidose Zentrum
  • Ruhrlandklinink
  • CF-Ambulanz/ Universitätsklinikum Essen
  • CF-Ambulanz Frankfurt
  • Universitätsklinikum Freiburg
  • Gemeinschaftspraxis CF Ambulanz
  • Med. Hochschule Hannover
  • MHH Kinderklinik CF-Ambulanz
  • Universitätsklinik
  • CF-Amulanz/ Dr.von Haunersches Kinderspital
  • Klinikum Innenstadt, Medizinische Klinik / Pneumologie
  • Clemenshospital GmbH,Akademisches Lehrkrankenhaus der Westfälischen Wildhelms-Universität Münster

Outcomes

Primary Outcome Measures

Differences between inhaled glutathione and inhaled normal saline with respect to the area under the curve of FEV1 % predicted (forced expiratory volume in 1 second) within the period from baseline to week 24 (V5, EOT)

Secondary Outcome Measures

Treatment changes with respect to the variables:Spirometry,Peak flow,quality-of-life,Weight/ height,Percentage of neutrophils/other cell types (induced sputum),Induced sputum levels of glutathione/ inflammatory mediators,Pulmonary exacerbation

Full Information

First Posted
July 24, 2007
Last Updated
July 6, 2012
Sponsor
Mukoviszidose Institut gGmbH
Collaborators
Cystic Fibrosis Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT00506688
Brief Title
Efficacy and Safety Study of Inhaled Glutathione in Cystic Fibrosis Patients
Official Title
Randomized, Placebo-controlled, Double-blinded Study to Investigate the Efficacy and Safety of a 24-week Inhalation Treatment With Glutathione in Cystic Fibrosis Patients
Study Type
Interventional

2. Study Status

Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
July 2007 (undefined)
Primary Completion Date
May 2010 (Actual)
Study Completion Date
May 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mukoviszidose Institut gGmbH
Collaborators
Cystic Fibrosis Foundation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The majority of cystic fibrosis (CF) patients die from a progressive pulmonary disease.Airway inflammation plays a major role for the pathogenesis of CF lung disease, and ultimately leads to lung destruction. The release of oxidants during the inflammation process leads to a chronic imbalance of oxidants and antioxidants and may be a central component leading to irreversible lung damage in CF patients. The antioxidant glutathione, which is a naturally occurring tripeptide, is depleted in the extracellular epithelial lining fluid of the CF lung. The elevation of reduced level to normal and also the augmentation of glutathione concentrations above the normal level, as observed in smokers and during defence of Pseudomonas infection, may be desirable to avoid lung damage. Data from pilot studies in humans and animals have indicated that the glutathione concentrations in epithelial lining fluid can be elevated by aerosol application. The main objective of this trial is to evaluate the effect of a 24-week treatment with inhaled glutathione compared with control inhalations (normal saline) on pulmonary function in adult and pediatric CF patients. Secondary objectives are to determine the effects of inhaled glutathione on inflammatory variables, glutathione levels and free elastase in induced sputum and to evaluate the safety and tolerability of the 24-week treatment with inhaled GSH. There is considerable hope within the CF community that the addition of anti-oxidative therapy to an already comprehensive program for treating the lungs will decrease morbidity and improve the quality of life for patients with CF.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
153 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
reduced glutathione sodium salt
Other Intervention Name(s)
TAD 600
Intervention Description
646 mg GSH-Na powder per vial to prepare a 4ml solution, twice daily for 24 weeks.
Intervention Type
Drug
Intervention Name(s)
0.9% normal saline (control)
Intervention Description
4 ml of a 0.9% normal saline solution (9mg/ml NaCl), twice daily for 24 weeks.
Primary Outcome Measure Information:
Title
Differences between inhaled glutathione and inhaled normal saline with respect to the area under the curve of FEV1 % predicted (forced expiratory volume in 1 second) within the period from baseline to week 24 (V5, EOT)
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Treatment changes with respect to the variables:Spirometry,Peak flow,quality-of-life,Weight/ height,Percentage of neutrophils/other cell types (induced sputum),Induced sputum levels of glutathione/ inflammatory mediators,Pulmonary exacerbation
Time Frame
0,4, 12, 24 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
8 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female patient, 8 years (pediatric 8 - 17 years inclusive; adult 18 years) Confirmed diagnosis of CF (positive sweat chloride, 60 mEq/liter by pilocarpine iontophoresis and/or a genotype with two identifiable mutations consistent with CF accompanied by one or more clinical features with the CF phenotype) Patient is able to perform acceptable spirometric maneuvers according to ATS standards FEV1 > 40% predicted and < 90% predicted The patient is clinically stable fulfilling the following: No evidence of acute upper or lower respiratory tract infection within 4 weeks of screening. No pulmonary exacerbation requiring an use of i.v./oral/inhaled antibiotics, or oral corticosteroids within 4 weeks of screening. FEV1 at Visit 2 is within a range of ± 10% of FEV1 from the Visit 1. (If FEV1 at V2 is not within that range, V2 may be re-scheduled once within 7 days) Concomitant or chronic medication is planned to be continued unchanged for the entire study duration The patient or the patient's legally acceptable representative is able to give informed consent in accordance with ICH and GCP guidelines and local legislation Patient is able to comply with the study visit schedule and willing and able to complete the assessments specified in the protocol. Exclusion Criteria: History of allergy/hypersensitivity (including medication allergy) that is deemed relevant to the trial by the investigator. "Relevance" in this context refers to any increased risk of hypersensitivity reaction to trial medication. (Specific concerns currently identified with respect to the use of inhaled glutathione in allergic patients per se are not existing) Concomitant inhaled thiol-containing medications (e.g., inhaled N-acetylcysteine). Such medication had to be finished at least 2 weeks before the screening visit. Oral N-acetylcysteine may be continued. New oral or inhaled thiol-containing medications (e.g., inhaled or oral N-acetylcysteine) throughout the study period. Patient with a known relevant substance abuse, including alcohol or drug abuse. Pregnant or lactating woman or female patient of child bearing potential who is sexually active and not using a medically approved form of contraception such as oral or injectable contraceptives, intrauterine devices, double-barrier method, contraceptive patch, male partner sterilization or condoms. Patient with a documented persistent colonization with B. cepacia (defined as more than one positive culture within the past year). Start of a new concomitant or chronic medication for CF within 4 weeks of screening. Existing cycling medication regimen without completion of at least 3 cycles prior to the screening visit or the drug cycles of other therapies are not in accordance with the 4-week time-schedule for the single visits of this study Clinically relevant diseases or medical conditions other than CF or CF-related conditions that, in the opinion of the investigator, would compromise the safety of the patient or the quality of the data. This includes, but is not limited to, significant hematological, hepatic,renal, cardiovascular, and neurological diseases (diabetic patients may participate if their disease is under good control prior to screening). Participation in another study with an investigational drug within one month or 6 halflives(whichever is greater) preceding the screening visit. The patient is an employee of the investigator or the institution with direct involvement in the trial or other trials under the direction of the investigator or their members.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matthias Griese, Prof.
Organizational Affiliation
Dr. von Haunersches Kinderspital (University of Munich, Germany)
Official's Role
Principal Investigator
Facility Information:
Facility Name
Charité Campus Virchow Klinikum,Klinik für Pädiatrie
City
Berlin
ZIP/Postal Code
13353
Country
Germany
Facility Name
Universitätskinderklinink
City
Bochum
ZIP/Postal Code
44791
Country
Germany
Facility Name
Uniklinik Köln Mukoviszidose Zentrum
City
Cologne
ZIP/Postal Code
D-50924
Country
Germany
Facility Name
Ruhrlandklinink
City
Essen
ZIP/Postal Code
45239
Country
Germany
Facility Name
CF-Ambulanz/ Universitätsklinikum Essen
City
Essen
ZIP/Postal Code
D-45128
Country
Germany
Facility Name
CF-Ambulanz Frankfurt
City
Frankfurt
ZIP/Postal Code
D-60590
Country
Germany
Facility Name
Universitätsklinikum Freiburg
City
Freiburg
ZIP/Postal Code
79104
Country
Germany
Facility Name
Gemeinschaftspraxis CF Ambulanz
City
Hamburg
ZIP/Postal Code
22763
Country
Germany
Facility Name
Med. Hochschule Hannover
City
Hannover
ZIP/Postal Code
30625
Country
Germany
Facility Name
MHH Kinderklinik CF-Ambulanz
City
Hannover
ZIP/Postal Code
D-30625
Country
Germany
Facility Name
Universitätsklinik
City
Leipzig
ZIP/Postal Code
04109
Country
Germany
Facility Name
CF-Amulanz/ Dr.von Haunersches Kinderspital
City
Munich
ZIP/Postal Code
D-80337
Country
Germany
Facility Name
Klinikum Innenstadt, Medizinische Klinik / Pneumologie
City
München
ZIP/Postal Code
80336
Country
Germany
Facility Name
Clemenshospital GmbH,Akademisches Lehrkrankenhaus der Westfälischen Wildhelms-Universität Münster
City
Münster
ZIP/Postal Code
48153
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
23631796
Citation
Griese M, Kappler M, Eismann C, Ballmann M, Junge S, Rietschel E, van Koningsbruggen-Rietschel S, Staab D, Rolinck-Werninghaus C, Mellies U, Kohnlein T, Wagner T, Konig S, Teschler H, Heuer HE, Kopp M, Heyder S, Hammermann J, Kuster P, Honer M, Mansmann U, Beck-Speier I, Hartl D, Fuchs C; Glutathione Study Group; Hector A. Inhalation treatment with glutathione in patients with cystic fibrosis. A randomized clinical trial. Am J Respir Crit Care Med. 2013 Jul 1;188(1):83-9. doi: 10.1164/rccm.201303-0427OC.
Results Reference
derived

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Efficacy and Safety Study of Inhaled Glutathione in Cystic Fibrosis Patients

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