Inhaled Mannitol as a Mucoactive Therapy for Bronchiectasis
Primary Purpose
Bronchiectasis
Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Inhaled mannitol
Matched control
Sponsored by
About this trial
This is an interventional treatment trial for Bronchiectasis focused on measuring randomized clinical trial, mannitol, mucoactive
Eligibility Criteria
Inclusion Criteria
- Have given written informed consent to participate in this study in accordance with local regulations
- Have documented evidence of confirmed diagnosis of (non-cystic fibrosis) bronchiectasis by computed tomography (CT), High resolution computed tomography (HRCT) or bronchogram
- Be aged 18 - 85 years inclusive, male and female
- Have FEV1 (Forced expiratory volume in one second) ≥ 40% and ≤85% predicted* and ≥1.0L (*according to NHANES III predicted tables) measured at Visit 0A (V0A)
- Clinician documented history of at least 2 pulmonary exacerbations, each requiring antibiotic therapy, in the last 12 months prior to Visit 0A (V0A) and a total of at least 4 in the last 2 years prior to Visit 0A
- Have a total SGRQ (St George's respiratory questionnaire) score of ≥30 at Visit 0B (V0B)
- Have a production of ≥10g of sputum at Visit 0B Have reported chronic sputum production of ≥1 tablespoon (15mL) per day on the majority of days in the 3 months prior to Visit 0A
- Be able to perform all the techniques necessary to measure lung function
- Have FEV1 ≥40% predicted* and ≥1.0L (*according to NHANES III 1999 predicted tables) measured at V0B (Baseline result prior to MTT (Mannitol Tolerance Test) administration)
Exclusion Criteria
- Be investigators, site personnel directly affiliated with this study, or their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biologically or legally adopted.
- Have bronchiectasis as a consequence of cystic fibrosis or focal endobronchial lesion or otherwise curable causes (e.g. foreign body aspiration)
- Be considered "terminally ill" or listed for transplantation
- Be using hypertonic saline in the 14 days prior to commencing Visit 0B or thereafter at any time during the study
- Have previously used inhaled mannitol (Bronchitol) for more than a day
- Have had a significant episode of hemoptysis (>60 mL) in the previous 6 months
- Have had rescue antibiotics in the 4 weeks prior to V0B (chronic background antibiotic therapy accepted)
- Have smoked within the last 3 months and must not smoke during their participation in the study
- Have had a myocardial infarction in the three months prior to Visit 0A
- Have had a cerebral vascular accident in the three months prior to Visit 0A
- Have had major ocular surgery in the three months prior to Visit 0A
- Have had major abdominal, chest or brain surgery in the three months prior to Visit 0A
- Have a known cerebral, aortic or abdominal aneurysm
- Have actively treated Mycobacterium tuberculosis
- Have actively treated or unstable nontuberculous mycobacterial (NTM)infection or be under consideration for NTM treatment in the next 12 months
- Have unstable Allergic bronchopulmonary aspergillosis (ABPA) requiring steroid therapy (≤5mg dose oral steroids in stable ABPA accepted)
- Have end stage interstitial lung disease
- Have active malignancy including melanoma (other skin carcinomas exempted). Remissions from any malignancy ≥2 years also exempted
- Be breast feeding or pregnant, or plan to become pregnant while in the study
- Be using an unreliable form of contraception (female subjects at risk of pregnancy only)
- Be participating in another investigational drug study, parallel to, or within 4 weeks of Visit 0A
- Have a known intolerance to mannitol or β2-agonists
- Have uncontrolled hypertension - e.g. for adults: systolic blood pressure (BP) > 190 and or diastolic BP > 100
- Subject has a condition or is in a situation which in the Investigator's opinion may put the subject at significant risk, may confound results or may interfere significantly with the patient's participation in the study
- Have previously been screen failed for the study (exceptions - see section 3.3.2 Eligibility Criteria - Rescreening)
Sites / Locations
- National Jewish Medical and Research Center
- University of Connecticut Health Center, Pulmonary Division
- Georgetown University Medical Center
- University of Miami
- Florida Pulmonary Research
- The University of Chicago Hospitals
- Chest Medicine Clinical Services, LLC
- Allergy and Critical Care Medicine Pulmonary Clinical Research Unit
- Saint Luke's Hospital
- Pulmonary and Allergy Associates
- Winthrop University Hospital
- Research Associates of New York
- University of North Carolina
- The Oregon Clinic, PC/Pulmonary Division
- University of Pennsylvania Medical Center
- Temple University Hospital
- South Carolina Pharmaceutical Research
- Alamo Clinical Research Associates
- Pulmonary Associates of Richmond, Inc
- Instituto Argentino de Investigación Neurológica
- Centro Privado de Medicina Respiratoria
- Hospital Zonal Especializado en Agudos y Cronicos "Dr Antonio A. Cetrangolo
- Centro Respiratorio Quilmes
- Hospital Privado - Centro Medico de Cordoba
- Insares
- Clinica del Torax
- Instituto Cardiovascular de Rosario
- Sanatorio Parque
- Investigaciones en Patologias Respiratorias
- Hospital Interzonal General de Agudos "Dr Jose Penna"
- Corporacion medica de General San Martin
- Atención Integral en Reumatología (AIR)
- Centro Médico Dra. De Salvo
- Woolcock Institute of Medical Research
- St George Hospital
- The Prince Charles Hospital
- Royal Adelaide Hospital
- Repatriation General Hospital
- The Queen Elizabeth Hospital
- St Vincent's Hospital
- Western Hospital
- The Rooms of Dr C Steinfort
- Royal Melbourne Hospital
- ULB Hopital Erasme - Department of Pneumology
- Cliniques Universitaires St. Luc (UCL) - Department of Pulmonology
- UZ Leuven (University Hospital Leuven) - Depatment of Pulmonary Medicine
- Pontificia Universidad Catolica de Chile
- Universidad de Chile
- Hospital Regional de Talca
- IKF Pneumologie GmbH and Co KG
- Medizinische Hochschule Hannover Klinik für Pneumologie
- Lungen und Bronchialheikunde
- Pneumologisch Studienzentrum
- Medisch Centrum Alkmaar - Department of Pulmonary Medicine
- Medisch Centrum Leeuwarden (MCL) - Department of Pulmonology
- Atrium MC -Department of Pulmonary Diseases
- Green Lane Clinical Centre
- Middlemore Hospital
- Waikato Hospital
- West Wales General Hospital
- Royal Derby Hospital
- Royal Devon and Exeter Hospital
- Torbay Hospital
- Castle Hill Hospital
- Glenfield Hospital
- Nottingham City Hospital
- Churchill Hospital
- Royal Shrewsbury Hospital
- Sheffield Northern General Hospital
- Stafford Hospital
- Ashford & St Peters Hospital
- University Hospital of North Tees
- Llandough Hospital
- Birmingam Queen Elizabeth Hospital
- Wolverhampton New Cross Hospital
- Aberdeen Royal Infirmary
- Belfast City Hospital
- University Hospital Aintree
- Royal Brompton Hospital
- Freeman Hospital
- North Tyneside General Hospital
- Southampton General Hospital
- Wrexham Maelor Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Mannitol
Control
Arm Description
Inhaled mannitol 400mg
Matched control - inhaled mannitol 50mg
Outcomes
Primary Outcome Measures
Rate of Graded Pulmonary Exacerbations
A graded pulmonary exacerbation was defined as a worsening in signs and symptoms requiring a change in treatment (Center for Drug Evaluation and Research (CDER), 2007). Grade I was required 3 main signs and symptoms, Grade II 2 main signs and symptoms and Grade III 1 main and one or more minor signs and symptoms. Main signs and symptoms were increased cough, sputum volume or sputum purulence. Minor were upper respiratory tract infection, fever, increased wheezing, increased dyspnea, increase in respiratory rate, increase in cardiac frequency of >20%, and increased malaise, fatigue or lethargy. Rate is defined as the number of all GPE events observed in one treatment year
Secondary Outcome Measures
Quality of Life as Measured by the St. Georges Respiratory Questionnaire (SGRQ) Total Score
The SGRQ was collected at baseline, week 6, week 16, week 28, week 40 and week 52. Change in total score was calculated from baseline. Total scores are a weighted sum across all questions. Scores are expressed as a percentage of overall impairment where 100 represents worst possible health status and 0 indicates best possible health status. Higher scores indicate lower quality of life. Outcome data table gives the raw mean total score at each visit.
Antibiotic Use Prescribed for Treated Pulmonary Exacerbations
Rate of antibiotic treated graded pulmonary exacerbations, using the same definition of a graded pulmonary exacerbation as the primary endpoint. A graded pulmonary exacerbation was considered to be anti-biotic treated if use of oral, IV or inhaled antibiotic use was recorded related to the GPE event.
Time to First Graded Exacerbation
Time to first graded exacerbation is defined as the duration (in months) from the randomisation date to the start of the first reported graded PE during the on-treatment period. Patients without reported graded PE event will be censored at the last participation.
Duration of Graded Exacerbations
Duration of graded exacerbations is defined as the number of days with graded PE within one treatment year. Mean days estimated via negative binomial model with treatment, region and baseline pulmonary exacerbation rate as predictors, with log of follow-up time as the offset variable
Sputum Volume
24 hour sputum weight, measured at baseline, week 6, week 16, week 28, week 40, week 52
Daytime Sleepiness Scores
Epworth Sleepiness Scale (ESS) score was calculated as the sum of scores for each of eight individual questions, such that a total score of zero represents no daytime sleepiness, and a total score of 24 represents the maximum degree of daytime sleepiness. Measured at baseline, 6 weeks, 16 weeks, 28 weeks, 40 weeks, 52 weeks
Lung Function - Change in FEV1 (Forced Expiratory Volume in One Second)
Lung Function - Change in FVC (Forced Vital Capacity)
Lung Function - Change in FEV1/FVC
FEV1 expressed as a ratio of FVC. Endpoint is expressed as a percentage ie FEV1/FVC*100
Lung Function - Change in FEF25-75 (Forced Expiratory Flow Rate Averaged Over 25th -75th Percentile of FVC)
Safety Profile - Sputum Microbiology
sputum microbiology assessed as the presence of abnormal flora in sputum sample taken at any post baseline visit
Safety Profile - Clinical Chemistry
Clinical chemistry was assessed as clinically significant abnormal liver function test and clinically significant abnormal urea/electrolyte test at any point post baseline.
Safety Profile - Hematology
hematology assessed as clinically significant abnormal FBC (Full Blood count) at any point post baseline.
• (Exploratory) Number of Hospitalizations Due to Pulmonary Exacerbations
Mean rate of hospitalisations (number/year) summarised and analysed to take account of differing follow-up times.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00669331
Brief Title
Inhaled Mannitol as a Mucoactive Therapy for Bronchiectasis
Official Title
: A Phase III Multicenter, Randomized, Parallel Group, Controlled, Double Blind Study to Investigate the Safety and Efficacy of Inhaled Mannitol Over 12 Months in the Treatment of Bronchiectasis.
Study Type
Interventional
2. Study Status
Record Verification Date
March 2016
Overall Recruitment Status
Completed
Study Start Date
November 2009 (undefined)
Primary Completion Date
January 2014 (Actual)
Study Completion Date
January 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pharmaxis
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
No gold standard therapy exists for clearing mucus from the airways of patients with bronchiectasis. While rhDNase has a proven place in the treatment of cystic fibrosis (CF), it failed to improve Forced expiratory volume in one second (FEV1) in a short-term non-CF bronchiectasis study and has been shown to be detrimental after 6 months therapy in non CF bronchiectasis, moreover it has no proven effect on mucociliary clearance. Hypertonic saline has been shown to have a comparable mode of action to inhaled mannitol, but has yet to be examined as a long term treatment option in bronchiectasis.
The purpose of this study is to examine the efficacy and safety of 52 weeks treatment with inhaled mannitol in subjects with non-cystic fibrosis bronchiectasis. Previous studies with inhaled mannitol have demonstrated improvement in mucociliary clearance; mucus rehydration; improvement in quality of life and respiratory symptoms in patients with bronchiectasis and pulmonary function in cystic fibrosis. The results of this current study in combination with a recently completed 3 month study seek to confirm these early findings and to extend the evidence to support its use as a mucoactive therapy in subjects with bronchiectasis.
We hypothesize that mannitol will improve the overall health and hygiene of the lung through regular and effective clearing of the mucus load. As a consequence of the reduction in mucus load and inflammatory process, the frequency of bronchiectasis related pulmonary exacerbations and the need for exacerbation related antibiotic treatment should fall. Days in hospital and community health care costs are expected to change in line with improvements in respiratory health.
Finally, we plan to demonstrate that inhaled mannitol is safe and well tolerated over a 52 week period. We will test these hypotheses using 400 mg mannitol twice daily (BD) against control.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bronchiectasis
Keywords
randomized clinical trial, mannitol, mucoactive
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
485 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Mannitol
Arm Type
Experimental
Arm Description
Inhaled mannitol 400mg
Arm Title
Control
Arm Type
Placebo Comparator
Arm Description
Matched control - inhaled mannitol 50mg
Intervention Type
Drug
Intervention Name(s)
Inhaled mannitol
Intervention Description
400mg dose of Mannitol BD (twice a day) for 52 weeks
Intervention Type
Drug
Intervention Name(s)
Matched control
Intervention Description
50mg dose of Mannitol BD (twice a day) for 52 weeks
Primary Outcome Measure Information:
Title
Rate of Graded Pulmonary Exacerbations
Description
A graded pulmonary exacerbation was defined as a worsening in signs and symptoms requiring a change in treatment (Center for Drug Evaluation and Research (CDER), 2007). Grade I was required 3 main signs and symptoms, Grade II 2 main signs and symptoms and Grade III 1 main and one or more minor signs and symptoms. Main signs and symptoms were increased cough, sputum volume or sputum purulence. Minor were upper respiratory tract infection, fever, increased wheezing, increased dyspnea, increase in respiratory rate, increase in cardiac frequency of >20%, and increased malaise, fatigue or lethargy. Rate is defined as the number of all GPE events observed in one treatment year
Time Frame
52 weeks
Secondary Outcome Measure Information:
Title
Quality of Life as Measured by the St. Georges Respiratory Questionnaire (SGRQ) Total Score
Description
The SGRQ was collected at baseline, week 6, week 16, week 28, week 40 and week 52. Change in total score was calculated from baseline. Total scores are a weighted sum across all questions. Scores are expressed as a percentage of overall impairment where 100 represents worst possible health status and 0 indicates best possible health status. Higher scores indicate lower quality of life. Outcome data table gives the raw mean total score at each visit.
Time Frame
52 weeks
Title
Antibiotic Use Prescribed for Treated Pulmonary Exacerbations
Description
Rate of antibiotic treated graded pulmonary exacerbations, using the same definition of a graded pulmonary exacerbation as the primary endpoint. A graded pulmonary exacerbation was considered to be anti-biotic treated if use of oral, IV or inhaled antibiotic use was recorded related to the GPE event.
Time Frame
52 weeks
Title
Time to First Graded Exacerbation
Description
Time to first graded exacerbation is defined as the duration (in months) from the randomisation date to the start of the first reported graded PE during the on-treatment period. Patients without reported graded PE event will be censored at the last participation.
Time Frame
52 weeks
Title
Duration of Graded Exacerbations
Description
Duration of graded exacerbations is defined as the number of days with graded PE within one treatment year. Mean days estimated via negative binomial model with treatment, region and baseline pulmonary exacerbation rate as predictors, with log of follow-up time as the offset variable
Time Frame
52 weeks
Title
Sputum Volume
Description
24 hour sputum weight, measured at baseline, week 6, week 16, week 28, week 40, week 52
Time Frame
52 weeks
Title
Daytime Sleepiness Scores
Description
Epworth Sleepiness Scale (ESS) score was calculated as the sum of scores for each of eight individual questions, such that a total score of zero represents no daytime sleepiness, and a total score of 24 represents the maximum degree of daytime sleepiness. Measured at baseline, 6 weeks, 16 weeks, 28 weeks, 40 weeks, 52 weeks
Time Frame
52 weeks
Title
Lung Function - Change in FEV1 (Forced Expiratory Volume in One Second)
Time Frame
52 weeks
Title
Lung Function - Change in FVC (Forced Vital Capacity)
Time Frame
52 weeks
Title
Lung Function - Change in FEV1/FVC
Description
FEV1 expressed as a ratio of FVC. Endpoint is expressed as a percentage ie FEV1/FVC*100
Time Frame
52 weeks
Title
Lung Function - Change in FEF25-75 (Forced Expiratory Flow Rate Averaged Over 25th -75th Percentile of FVC)
Time Frame
52 weeks
Title
Safety Profile - Sputum Microbiology
Description
sputum microbiology assessed as the presence of abnormal flora in sputum sample taken at any post baseline visit
Time Frame
52 weeks
Title
Safety Profile - Clinical Chemistry
Description
Clinical chemistry was assessed as clinically significant abnormal liver function test and clinically significant abnormal urea/electrolyte test at any point post baseline.
Time Frame
52 weeks
Title
Safety Profile - Hematology
Description
hematology assessed as clinically significant abnormal FBC (Full Blood count) at any point post baseline.
Time Frame
52 weeks
Title
• (Exploratory) Number of Hospitalizations Due to Pulmonary Exacerbations
Description
Mean rate of hospitalisations (number/year) summarised and analysed to take account of differing follow-up times.
Time Frame
52 weeks
Other Pre-specified Outcome Measures:
Title
Health Related Costs of Treating Patients With Bronchiectasis
Description
In the presence of a significant primary endpoint, these data were intended to be derived using the trial data together with external information (Note as the primary objective of this study did not reach statistical significance, health related costs were not assessed)
Time Frame
52 weeks
Title
Health Status and Utility Scores
Description
In the presence of a significant primary endpoint, these data were intended to be derived from the trial data and external information (Note as the primary objective of this study did not reach statistical significance, differences in health status and utility scores were not assessed)
Time Frame
52 weeks
Title
Health Related Quality of Life (HRQL) and Quality Adjusted Life Years (QALYs) by Treatment Group Using Utility Scores From the Health Utilities Index Questionnaire
Description
In the presence of a significant primary endpoint, these data were intended to be derived using the trial data and external information (Note as the primary objective of this study did not reach statistical significance, HRQL and QALYs were not collected).
Time Frame
52 weeks
Title
Cost Effectiveness of Treating Patients With Bronchiectasis With Inhaled Mannitol
Description
In the presence of a significant primary endpoint, these data were intended to be derived using the trial data and external information (Note as the primary objective of this study did not reach statistical significance, cost effectiveness was not collected).
Time Frame
52 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria
Have given written informed consent to participate in this study in accordance with local regulations
Have documented evidence of confirmed diagnosis of (non-cystic fibrosis) bronchiectasis by computed tomography (CT), High resolution computed tomography (HRCT) or bronchogram
Be aged 18 - 85 years inclusive, male and female
Have FEV1 (Forced expiratory volume in one second) ≥ 40% and ≤85% predicted* and ≥1.0L (*according to NHANES III predicted tables) measured at Visit 0A (V0A)
Clinician documented history of at least 2 pulmonary exacerbations, each requiring antibiotic therapy, in the last 12 months prior to Visit 0A (V0A) and a total of at least 4 in the last 2 years prior to Visit 0A
Have a total SGRQ (St George's respiratory questionnaire) score of ≥30 at Visit 0B (V0B)
Have a production of ≥10g of sputum at Visit 0B Have reported chronic sputum production of ≥1 tablespoon (15mL) per day on the majority of days in the 3 months prior to Visit 0A
Be able to perform all the techniques necessary to measure lung function
Have FEV1 ≥40% predicted* and ≥1.0L (*according to NHANES III 1999 predicted tables) measured at V0B (Baseline result prior to MTT (Mannitol Tolerance Test) administration)
Exclusion Criteria
Be investigators, site personnel directly affiliated with this study, or their immediate families. Immediate family is defined as a spouse, parent, child or sibling, whether biologically or legally adopted.
Have bronchiectasis as a consequence of cystic fibrosis or focal endobronchial lesion or otherwise curable causes (e.g. foreign body aspiration)
Be considered "terminally ill" or listed for transplantation
Be using hypertonic saline in the 14 days prior to commencing Visit 0B or thereafter at any time during the study
Have previously used inhaled mannitol (Bronchitol) for more than a day
Have had a significant episode of hemoptysis (>60 mL) in the previous 6 months
Have had rescue antibiotics in the 4 weeks prior to V0B (chronic background antibiotic therapy accepted)
Have smoked within the last 3 months and must not smoke during their participation in the study
Have had a myocardial infarction in the three months prior to Visit 0A
Have had a cerebral vascular accident in the three months prior to Visit 0A
Have had major ocular surgery in the three months prior to Visit 0A
Have had major abdominal, chest or brain surgery in the three months prior to Visit 0A
Have a known cerebral, aortic or abdominal aneurysm
Have actively treated Mycobacterium tuberculosis
Have actively treated or unstable nontuberculous mycobacterial (NTM)infection or be under consideration for NTM treatment in the next 12 months
Have unstable Allergic bronchopulmonary aspergillosis (ABPA) requiring steroid therapy (≤5mg dose oral steroids in stable ABPA accepted)
Have end stage interstitial lung disease
Have active malignancy including melanoma (other skin carcinomas exempted). Remissions from any malignancy ≥2 years also exempted
Be breast feeding or pregnant, or plan to become pregnant while in the study
Be using an unreliable form of contraception (female subjects at risk of pregnancy only)
Be participating in another investigational drug study, parallel to, or within 4 weeks of Visit 0A
Have a known intolerance to mannitol or β2-agonists
Have uncontrolled hypertension - e.g. for adults: systolic blood pressure (BP) > 190 and or diastolic BP > 100
Subject has a condition or is in a situation which in the Investigator's opinion may put the subject at significant risk, may confound results or may interfere significantly with the patient's participation in the study
Have previously been screen failed for the study (exceptions - see section 3.3.2 Eligibility Criteria - Rescreening)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Diana Bilton, MD
Organizational Affiliation
Brompton Hospital London UK
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Greg Tino, MD
Organizational Affiliation
University of Pennsylvania Medical Centre, Philadelphia
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Alan Barker, MD
Organizational Affiliation
Oregon Health Sciences University, Portland Oregon
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Jewish Medical and Research Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80206
Country
United States
Facility Name
University of Connecticut Health Center, Pulmonary Division
City
Farmington
State/Province
Connecticut
ZIP/Postal Code
06030-1321
Country
United States
Facility Name
Georgetown University Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20007
Country
United States
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Florida Pulmonary Research
City
Winter Park
State/Province
Florida
ZIP/Postal Code
32789
Country
United States
Facility Name
The University of Chicago Hospitals
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60637
Country
United States
Facility Name
Chest Medicine Clinical Services, LLC
City
Skokie
State/Province
Illinois
ZIP/Postal Code
60076
Country
United States
Facility Name
Allergy and Critical Care Medicine Pulmonary Clinical Research Unit
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
Saint Luke's Hospital
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63017
Country
United States
Facility Name
Pulmonary and Allergy Associates
City
Summit
State/Province
New Jersey
ZIP/Postal Code
07901
Country
United States
Facility Name
Winthrop University Hospital
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Research Associates of New York
City
New York
State/Province
New York
ZIP/Postal Code
10028
Country
United States
Facility Name
University of North Carolina
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27514
Country
United States
Facility Name
The Oregon Clinic, PC/Pulmonary Division
City
Portland
State/Province
Oregon
ZIP/Postal Code
97220
Country
United States
Facility Name
University of Pennsylvania Medical Center
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Temple University Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19140
Country
United States
Facility Name
South Carolina Pharmaceutical Research
City
Spartanburg
State/Province
South Carolina
ZIP/Postal Code
29303
Country
United States
Facility Name
Alamo Clinical Research Associates
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78212
Country
United States
Facility Name
Pulmonary Associates of Richmond, Inc
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23225
Country
United States
Facility Name
Instituto Argentino de Investigación Neurológica
City
Ciudad Autónoma de Buenos Aires
State/Province
Ciudad Autónoma de Buenos Aires,
ZIP/Postal Code
C1015ABR
Country
Argentina
Facility Name
Centro Privado de Medicina Respiratoria
City
Entre Rios
State/Province
Paraná Entre Ríos
ZIP/Postal Code
E3100BHK
Country
Argentina
Facility Name
Hospital Zonal Especializado en Agudos y Cronicos "Dr Antonio A. Cetrangolo
City
Florida Partido de Vicente López
State/Province
Provincia de Buenos Aires
ZIP/Postal Code
B1602DOH
Country
Argentina
Facility Name
Centro Respiratorio Quilmes
City
Quilmes
State/Province
Provincia de Buenos Aires
ZIP/Postal Code
B1878FNR
Country
Argentina
Facility Name
Hospital Privado - Centro Medico de Cordoba
City
Cordoba
State/Province
Provincia de Cordoba
ZIP/Postal Code
X5016KEH
Country
Argentina
Facility Name
Insares
City
Mendoza
State/Province
Provincia de Mendoza
ZIP/Postal Code
M5500CCG
Country
Argentina
Facility Name
Clinica del Torax
City
Rosario
State/Province
Provincia de Santa Fe
ZIP/Postal Code
S2000DBS
Country
Argentina
Facility Name
Instituto Cardiovascular de Rosario
City
Rosario
State/Province
Provincia de Santa Fe
ZIP/Postal Code
S2000DSR
Country
Argentina
Facility Name
Sanatorio Parque
City
Rosario
State/Province
Provincia de Santa Fe
ZIP/Postal Code
S2000KZD
Country
Argentina
Facility Name
Investigaciones en Patologias Respiratorias
City
San Miguel de Tucumán
State/Province
Provincia de Tucumán
ZIP/Postal Code
T4000IAR
Country
Argentina
Facility Name
Hospital Interzonal General de Agudos "Dr Jose Penna"
City
Bahia Bianca
State/Province
Provinica de Buenos Aires
ZIP/Postal Code
B8001DDU
Country
Argentina
Facility Name
Corporacion medica de General San Martin
City
Mathew 4071
State/Province
San Martin Provincia de Buenos Aires
ZIP/Postal Code
B1650CSQ
Country
Argentina
Facility Name
Atención Integral en Reumatología (AIR)
City
Buenos Aires
ZIP/Postal Code
CP1426
Country
Argentina
Facility Name
Centro Médico Dra. De Salvo
City
Ciudad Autonoma de Buenos Aires
ZIP/Postal Code
CP1426ABO
Country
Argentina
Facility Name
Woolcock Institute of Medical Research
City
Glebe
State/Province
New South Wales
ZIP/Postal Code
2037
Country
Australia
Facility Name
St George Hospital
City
Kogarah
State/Province
New South Wales
ZIP/Postal Code
2217
Country
Australia
Facility Name
The Prince Charles Hospital
City
Chermside
State/Province
Queensland
ZIP/Postal Code
4032
Country
Australia
Facility Name
Royal Adelaide Hospital
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Facility Name
Repatriation General Hospital
City
Daws Park
State/Province
South Australia
ZIP/Postal Code
5041
Country
Australia
Facility Name
The Queen Elizabeth Hospital
City
Woodville
State/Province
South Australia
ZIP/Postal Code
5011
Country
Australia
Facility Name
St Vincent's Hospital
City
Fitzroy
State/Province
Victoria
ZIP/Postal Code
3065
Country
Australia
Facility Name
Western Hospital
City
Footscray
State/Province
Victoria
ZIP/Postal Code
3011
Country
Australia
Facility Name
The Rooms of Dr C Steinfort
City
Geelong
State/Province
Victoria
ZIP/Postal Code
3220
Country
Australia
Facility Name
Royal Melbourne Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3050
Country
Australia
Facility Name
ULB Hopital Erasme - Department of Pneumology
City
Brussels
ZIP/Postal Code
B-1070
Country
Belgium
Facility Name
Cliniques Universitaires St. Luc (UCL) - Department of Pulmonology
City
Brussels
ZIP/Postal Code
B-1200
Country
Belgium
Facility Name
UZ Leuven (University Hospital Leuven) - Depatment of Pulmonary Medicine
City
Leuven
ZIP/Postal Code
B-3000
Country
Belgium
Facility Name
Pontificia Universidad Catolica de Chile
City
Santiago de Chile
State/Province
Santiago
Country
Chile
Facility Name
Universidad de Chile
City
Santiago de Chile
State/Province
Santiago
Country
Chile
Facility Name
Hospital Regional de Talca
City
Talca
ZIP/Postal Code
1990
Country
Chile
Facility Name
IKF Pneumologie GmbH and Co KG
City
Frankfurt
State/Province
Hessen
ZIP/Postal Code
60596
Country
Germany
Facility Name
Medizinische Hochschule Hannover Klinik für Pneumologie
City
Hannover
State/Province
Niedersachsen
ZIP/Postal Code
30625
Country
Germany
Facility Name
Lungen und Bronchialheikunde
City
Bonn
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
53123
Country
Germany
Facility Name
Pneumologisch Studienzentrum
City
Leipzig
State/Province
Sachsen
ZIP/Postal Code
4357
Country
Germany
Facility Name
Medisch Centrum Alkmaar - Department of Pulmonary Medicine
City
Alkmaar
State/Province
Alkmaar AM
ZIP/Postal Code
1800
Country
Netherlands
Facility Name
Medisch Centrum Leeuwarden (MCL) - Department of Pulmonology
City
Leeuwarden
State/Province
Leeuwarden AD
ZIP/Postal Code
8934
Country
Netherlands
Facility Name
Atrium MC -Department of Pulmonary Diseases
City
Heerlen
ZIP/Postal Code
6419
Country
Netherlands
Facility Name
Green Lane Clinical Centre
City
Greenlane
State/Province
Auckland
ZIP/Postal Code
1051
Country
New Zealand
Facility Name
Middlemore Hospital
City
Auckland
ZIP/Postal Code
1640
Country
New Zealand
Facility Name
Waikato Hospital
City
Hamilton
ZIP/Postal Code
3240
Country
New Zealand
Facility Name
West Wales General Hospital
City
Carmarthen
State/Province
Carmarthenshire
ZIP/Postal Code
SA31 2AF
Country
United Kingdom
Facility Name
Royal Derby Hospital
City
Derby
State/Province
Derbyshire
ZIP/Postal Code
DE22 3NE
Country
United Kingdom
Facility Name
Royal Devon and Exeter Hospital
City
Exeter
State/Province
Devon
ZIP/Postal Code
EX2 5DW
Country
United Kingdom
Facility Name
Torbay Hospital
City
Torquay
State/Province
Devon
ZIP/Postal Code
TQ2 7AA
Country
United Kingdom
Facility Name
Castle Hill Hospital
City
Cottingham
State/Province
East Yorkshire
ZIP/Postal Code
HU16 5JQ
Country
United Kingdom
Facility Name
Glenfield Hospital
City
Leicester
State/Province
Leicestershire
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Facility Name
Nottingham City Hospital
City
Nottingham
State/Province
Nottinghamshire
ZIP/Postal Code
NG5 1PB
Country
United Kingdom
Facility Name
Churchill Hospital
City
Headington
State/Province
Oxfordshire
ZIP/Postal Code
OX3 7LJ
Country
United Kingdom
Facility Name
Royal Shrewsbury Hospital
City
Shrewsbury
State/Province
Shropshire
ZIP/Postal Code
SY3 8XQ
Country
United Kingdom
Facility Name
Sheffield Northern General Hospital
City
Sheffield
State/Province
South Yorkshire
ZIP/Postal Code
S5 7AU
Country
United Kingdom
Facility Name
Stafford Hospital
City
Stafford
State/Province
Staffordshire
ZIP/Postal Code
ST16 3SA
Country
United Kingdom
Facility Name
Ashford & St Peters Hospital
City
Chertsey
State/Province
Surrey
ZIP/Postal Code
KT16 0PZ
Country
United Kingdom
Facility Name
University Hospital of North Tees
City
Stockton
State/Province
Teeside
ZIP/Postal Code
TS19 8PE
Country
United Kingdom
Facility Name
Llandough Hospital
City
Cardiff
State/Province
Vale of Glamorgan
ZIP/Postal Code
CF64 2XX
Country
United Kingdom
Facility Name
Birmingam Queen Elizabeth Hospital
City
Birmingham
State/Province
West Midlands
ZIP/Postal Code
B15 2TH
Country
United Kingdom
Facility Name
Wolverhampton New Cross Hospital
City
Wolverhampton
State/Province
West Midlands
ZIP/Postal Code
WV10 0QP
Country
United Kingdom
Facility Name
Aberdeen Royal Infirmary
City
Aberdeen
ZIP/Postal Code
AB25 22N
Country
United Kingdom
Facility Name
Belfast City Hospital
City
Belfast
ZIP/Postal Code
BT9 7AB
Country
United Kingdom
Facility Name
University Hospital Aintree
City
Liverpool
ZIP/Postal Code
L9 7AL
Country
United Kingdom
Facility Name
Royal Brompton Hospital
City
London
ZIP/Postal Code
SW3 6NP
Country
United Kingdom
Facility Name
Freeman Hospital
City
Newcastle-upon-Tyne
ZIP/Postal Code
NE7 7DN
Country
United Kingdom
Facility Name
North Tyneside General Hospital
City
North Shields
ZIP/Postal Code
NE29 8NH
Country
United Kingdom
Facility Name
Southampton General Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Facility Name
Wrexham Maelor Hospital
City
Wrexham
ZIP/Postal Code
LL13 7TD
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
10351929
Citation
Daviskas E, Anderson SD, Eberl S, Chan HK, Bautovich G. Inhalation of dry powder mannitol improves clearance of mucus in patients with bronchiectasis. Am J Respir Crit Care Med. 1999 Jun;159(6):1843-8. doi: 10.1164/ajrccm.159.6.9809074.
Results Reference
background
PubMed Identifier
18057051
Citation
Daviskas E, Anderson SD, Eberl S, Young IH. Effect of increasing doses of mannitol on mucus clearance in patients with bronchiectasis. Eur Respir J. 2008 Apr;31(4):765-72. doi: 10.1183/09031936.00119707. Epub 2007 Dec 5.
Results Reference
background
PubMed Identifier
17875056
Citation
Daviskas E, Anderson SD, Young IH. Inhaled mannitol changes the sputum properties in asthmatics with mucus hypersecretion. Respirology. 2007 Sep;12(5):683-91. doi: 10.1111/j.1440-1843.2007.01107.x.
Results Reference
background
PubMed Identifier
16551221
Citation
Daviskas E, Anderson SD. Hyperosmolar agents and clearance of mucus in the diseased airway. J Aerosol Med. 2006 Spring;19(1):100-9. doi: 10.1089/jam.2006.19.100.
Results Reference
background
PubMed Identifier
15691238
Citation
Daviskas E, Anderson SD, Gomes K, Briffa P, Cochrane B, Chan HK, Young IH, Rubin BK. Inhaled mannitol for the treatment of mucociliary dysfunction in patients with bronchiectasis: effect on lung function, health status and sputum. Respirology. 2005 Jan;10(1):46-56. doi: 10.1111/j.1440-1843.2005.00659.x.
Results Reference
background
PubMed Identifier
12396422
Citation
Daviskas E, Robinson M, Anderson SD, Bye PT. Osmotic stimuli increase clearance of mucus in patients with mucociliary dysfunction. J Aerosol Med. 2002 Fall;15(3):331-41. doi: 10.1089/089426802760292681.
Results Reference
background
PubMed Identifier
11171717
Citation
Daviskas E, Anderson SD, Eberl S, Chan HK, Young IH. The 24-h effect of mannitol on the clearance of mucus in patients with bronchiectasis. Chest. 2001 Feb;119(2):414-21. doi: 10.1378/chest.119.2.414.
Results Reference
background
PubMed Identifier
25246664
Citation
Bilton D, Tino G, Barker AF, Chambers DC, De Soyza A, Dupont LJ, O'Dochartaigh C, van Haren EH, Vidal LO, Welte T, Fox HG, Wu J, Charlton B; B-305 Study Investigators. Inhaled mannitol for non-cystic fibrosis bronchiectasis: a randomised, controlled trial. Thorax. 2014 Dec;69(12):1073-9. doi: 10.1136/thoraxjnl-2014-205587. Epub 2014 Sep 21.
Results Reference
derived
Learn more about this trial
Inhaled Mannitol as a Mucoactive Therapy for Bronchiectasis
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