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Safety and Tolerability Study of Pirfenidone in Combination With Nintedanib in Participants With Idiopathic Pulmonary Fibrosis (IPF)

Primary Purpose

Idiopathic Pulmonary Fibrosis

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Nintedanib
Pirfenidone
Sponsored by
Hoffmann-La Roche
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Idiopathic Pulmonary Fibrosis

Eligibility Criteria

40 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Participants who are on pirfenidone for at least 16 weeks and on a stable dose (defined as 1602-2403 mg/day) for at least 28 days at the start of Screening; the dose must be expected to remain in that range throughout the study
  • Documented diagnosis of IPF, per the Investigator per using the criteria of the 2011 American Thoracic Society / European Respiratory Society / Japanese Respiratory Society / Latin American Thoracic Association guidelines
  • Participants with percent predicted forced vital capacity (FVC) more than or equal to (>=) 50 percent (%) and percent predicted carbon monoxide diffusing capacity (DLco) >=30% at Screening
  • For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use two adequate methods of contraception, including at least one method with a failure rate of less than (<) 1% per year, during the treatment period and for at least 3 months after the final Follow-up Visit
  • For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures and agreement to refrain from donating sperm during the treatment period and for at least 4 months after the final Follow-up Visit

Exclusion Criteria:

  • Participants with clinical evidence of active infection
  • Participant with any new or ongoing moderate or severe adverse reaction considered by the Investigator to be related to pirfenidone, or an pirfenidone treatment interruption in the 28 days before the start of Screening
  • Any condition that is likely to result in death in the 12 months after the start of Screening
  • Lung transplantation anticipated or any planned significant surgical intervention
  • Known hypersensitivity to the active substance or any excipient of either pirfenidone or nintedanib
  • Mild (Child Pugh A), moderate (Child Pugh B), or severe (Child Pugh C) hepatic and/or severe renal impairment
  • History of gastrointestinal (GI) tract perforation, unstable or deteriorating cardiac or pulmonary disease (other than IPF), long QT syndrome, alcohol or substance abuse in the 2 years before the start of screening, use of any tobacco product in the 12 weeks before the start of screening
  • Bleeding risk
  • Use of Cytochrome P450 (CYP) 1A2 (CYP1A2) inhibitors (for example, fluvoxamine, enoxacin) and/or use of inhibitors of P-glycoprotein (for example, ketoconazole, erythromycin) or CYP3A4 (for example, ketoconazole, erythromycin) or their inducers (for example, rifampicin, carbamazepine, phenytoin, St John's wort) in the 28 days before the start of Screening
  • Pregnancy or lactation
  • Hypersensitivity to peanuts and/or soy
  • Use of pirfenidone and/or nintedanib in a clinical study protocol in the 28 days before the start of screening

Sites / Locations

  • David Geffen School of Medicine at UCLA;Division of Pulmonary & Critical Care/ Department of Medic
  • Stanford University School of Medicine ; Pulmonary/Critical Care Medicine
  • Sarasota Memorial Hospital
  • Beth Israel Deaconess Medical Center
  • University of Michigan Health System
  • Cardio-Pulmonary Associates of St. Luke's Hospital
  • Creighton University
  • Atlantic Respiratory Institute
  • Mount Sinai School of Medicine
  • Columbia University Medical Center
  • Pulmonix LLC
  • UC Health Clinical Trials Office
  • John A. Butler, M.D. - Oregon Pulmonary Associates
  • Medical University of South Carolina (MUSC); MUSC Pulmonary
  • Vanderbilt University Medical Center
  • Inova Health Care Services; Advanced Lung Disease Transplant Program
  • South Health Campus/Alberta Health Services/ University of Calgary
  • University Health Network
  • Gentofte Hospital, Lungemedicinsk Afdeling
  • Hopital Avicenne; Pneumologie
  • Hopital Louis Pradel; Pneumologie
  • Hopital de Pontchaillou; Service de Pneumologie
  • Fachkrankenhaus Coswig GmbH Zentrum f.Pneumologie Beatmungsmedizin Thorax-u.Gefäßchirurgie
  • Ruhrlandklinik Lungenzentrum der UNI Essen Abt.Pneumologie-Allergologie
  • Klinikum Fulda gAG; Universitätsmedizin Marburg, Campus Fulda
  • ASST DI MONZA; U O Clinica Pneumologica
  • A.O. Universitaria San Luigi Gonzaga di Orbassano; Malattie Apparato Respiratorio (MAR2)
  • Azienda Ospedaliero Universitaria Pisana; U.O. Pneumologia
  • A.O. Univ. Senese Policlinico S. Maria alle Scotte; UOC Malattie Resepiratorie e Trapianto Polmonare
  • Antonius Ziekenhuis; Dept of Lung Diseases
  • Erasmus MC; Afdeling Longziekten
  • Hospital Universitari de Bellvitge ; Servicio de Neumologia
  • Hospital del Henares; Medicina Interna. Unidad de Neumología
  • Hospital Universitario de Canarias; Servicio de Neumologia
  • Complejo Asistencial Universitario de Leon; Pneumology
  • Hospital Universitario La Princesa; Servicio de Neumologia
  • Hospital Universitario Virgen del Rocio; Servicio de Neumologia
  • Hospital General Universitario De Valencia; Servicio de Neumologia

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pirfenidone+Nintedanib

Arm Description

Participants with IPF will receive pirfenidone at 1602-2403 milligrams per day (mg/day) dose and nintedanib at the 200-300 mg/day dose up to 24 weeks.

Outcomes

Primary Outcome Measures

Percentage of Participants Who Complete 24 Weeks of Combination Treatment on Pirfenidone at a Dose of 1602-2403 mg/Day and Nintedanib at a Dose of 200-300 mg/Day

Secondary Outcome Measures

Percentage of Participants With Adverse Events and Serious Adverse Events
An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Percentage of Participants Who Discontinue Pirfenidone, Nintedanib, or Both Study Treatments Because of Adverse Events Before the Week 24 Visit
Total Number of Participant Days of Combination Treatment With Pirfenidone and Nintedanib
Total Number of Days From the Initiation of Combination Treatment to Discontinuation of Pirfenidone, Nintedanib, or Both Study Treatments

Full Information

First Posted
November 4, 2015
Last Updated
May 16, 2018
Sponsor
Hoffmann-La Roche
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1. Study Identification

Unique Protocol Identification Number
NCT02598193
Brief Title
Safety and Tolerability Study of Pirfenidone in Combination With Nintedanib in Participants With Idiopathic Pulmonary Fibrosis (IPF)
Official Title
An Exploratory Multicenter, Open-Label, Single Arm Study of the Safety and Tolerability of Pirfenidone (Esbriet®) in Combination With Nintedanib (Ofev®) in Patients With Idiopathic Pulmonary Fibrosis
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
January 14, 2016 (Actual)
Primary Completion Date
May 16, 2017 (Actual)
Study Completion Date
May 16, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This clinical study will evaluate the safety and tolerability of combination treatment of nintedanib and pirfenidone in participants with IPF. Eligible participants must have received pirfenidone for at least 16 weeks on a stable dose. Nintedanib will be added on Day 1 of the study as a combination treatment for IPF for 24 weeks.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
89 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pirfenidone+Nintedanib
Arm Type
Experimental
Arm Description
Participants with IPF will receive pirfenidone at 1602-2403 milligrams per day (mg/day) dose and nintedanib at the 200-300 mg/day dose up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Nintedanib
Other Intervention Name(s)
Ofev
Intervention Description
Participants with IPF will receive nintedanib at the 200-300 mg/day dose up to 24 weeks.
Intervention Type
Drug
Intervention Name(s)
Pirfenidone
Other Intervention Name(s)
Esbriet
Intervention Description
Participants with IPF will receive pirfenidone at 1602-2403 mg/day dose up to 24 weeks.
Primary Outcome Measure Information:
Title
Percentage of Participants Who Complete 24 Weeks of Combination Treatment on Pirfenidone at a Dose of 1602-2403 mg/Day and Nintedanib at a Dose of 200-300 mg/Day
Time Frame
Week 24
Secondary Outcome Measure Information:
Title
Percentage of Participants With Adverse Events and Serious Adverse Events
Description
An adverse event is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An adverse event can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a pharmaceutical product, whether or not considered related to the pharmaceutical product. Preexisting conditions which worsen during a study are also considered as adverse events.
Time Frame
Baseline up to Week 28
Title
Percentage of Participants Who Discontinue Pirfenidone, Nintedanib, or Both Study Treatments Because of Adverse Events Before the Week 24 Visit
Time Frame
Baseline up to Week 24
Title
Total Number of Participant Days of Combination Treatment With Pirfenidone and Nintedanib
Time Frame
Baseline up to Week 24
Title
Total Number of Days From the Initiation of Combination Treatment to Discontinuation of Pirfenidone, Nintedanib, or Both Study Treatments
Time Frame
Baseline up to Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Participants who are on pirfenidone for at least 16 weeks and on a stable dose (defined as 1602-2403 mg/day) for at least 28 days at the start of Screening; the dose must be expected to remain in that range throughout the study Documented diagnosis of IPF, per the Investigator per using the criteria of the 2011 American Thoracic Society / European Respiratory Society / Japanese Respiratory Society / Latin American Thoracic Association guidelines Participants with percent predicted forced vital capacity (FVC) more than or equal to (>=) 50 percent (%) and percent predicted carbon monoxide diffusing capacity (DLco) >=30% at Screening For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use two adequate methods of contraception, including at least one method with a failure rate of less than (<) 1% per year, during the treatment period and for at least 3 months after the final Follow-up Visit For men: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive measures and agreement to refrain from donating sperm during the treatment period and for at least 4 months after the final Follow-up Visit Exclusion Criteria: Participants with clinical evidence of active infection Participant with any new or ongoing moderate or severe adverse reaction considered by the Investigator to be related to pirfenidone, or an pirfenidone treatment interruption in the 28 days before the start of Screening Any condition that is likely to result in death in the 12 months after the start of Screening Lung transplantation anticipated or any planned significant surgical intervention Known hypersensitivity to the active substance or any excipient of either pirfenidone or nintedanib Mild (Child Pugh A), moderate (Child Pugh B), or severe (Child Pugh C) hepatic and/or severe renal impairment History of gastrointestinal (GI) tract perforation, unstable or deteriorating cardiac or pulmonary disease (other than IPF), long QT syndrome, alcohol or substance abuse in the 2 years before the start of screening, use of any tobacco product in the 12 weeks before the start of screening Bleeding risk Use of Cytochrome P450 (CYP) 1A2 (CYP1A2) inhibitors (for example, fluvoxamine, enoxacin) and/or use of inhibitors of P-glycoprotein (for example, ketoconazole, erythromycin) or CYP3A4 (for example, ketoconazole, erythromycin) or their inducers (for example, rifampicin, carbamazepine, phenytoin, St John's wort) in the 28 days before the start of Screening Pregnancy or lactation Hypersensitivity to peanuts and/or soy Use of pirfenidone and/or nintedanib in a clinical study protocol in the 28 days before the start of screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
Facility Information:
Facility Name
David Geffen School of Medicine at UCLA;Division of Pulmonary & Critical Care/ Department of Medic
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095-1690
Country
United States
Facility Name
Stanford University School of Medicine ; Pulmonary/Critical Care Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Sarasota Memorial Hospital
City
Sarasota
State/Province
Florida
ZIP/Postal Code
34239
Country
United States
Facility Name
Beth Israel Deaconess Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
University of Michigan Health System
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-0666
Country
United States
Facility Name
Cardio-Pulmonary Associates of St. Luke's Hospital
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63017
Country
United States
Facility Name
Creighton University
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68131
Country
United States
Facility Name
Atlantic Respiratory Institute
City
Summit
State/Province
New Jersey
ZIP/Postal Code
07901
Country
United States
Facility Name
Mount Sinai School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Facility Name
Pulmonix LLC
City
Greensboro
State/Province
North Carolina
ZIP/Postal Code
27403
Country
United States
Facility Name
UC Health Clinical Trials Office
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
Facility Name
John A. Butler, M.D. - Oregon Pulmonary Associates
City
Portland
State/Province
Oregon
ZIP/Postal Code
97225
Country
United States
Facility Name
Medical University of South Carolina (MUSC); MUSC Pulmonary
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Vanderbilt University Medical Center
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37232
Country
United States
Facility Name
Inova Health Care Services; Advanced Lung Disease Transplant Program
City
Falls Church
State/Province
Virginia
ZIP/Postal Code
22042
Country
United States
Facility Name
South Health Campus/Alberta Health Services/ University of Calgary
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T3M 1M4
Country
Canada
Facility Name
University Health Network
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2N2
Country
Canada
Facility Name
Gentofte Hospital, Lungemedicinsk Afdeling
City
Hellerup
ZIP/Postal Code
2900
Country
Denmark
Facility Name
Hopital Avicenne; Pneumologie
City
Bobigny
ZIP/Postal Code
93000
Country
France
Facility Name
Hopital Louis Pradel; Pneumologie
City
Bron
ZIP/Postal Code
69677
Country
France
Facility Name
Hopital de Pontchaillou; Service de Pneumologie
City
Rennes
ZIP/Postal Code
35033
Country
France
Facility Name
Fachkrankenhaus Coswig GmbH Zentrum f.Pneumologie Beatmungsmedizin Thorax-u.Gefäßchirurgie
City
Coswig
ZIP/Postal Code
01640
Country
Germany
Facility Name
Ruhrlandklinik Lungenzentrum der UNI Essen Abt.Pneumologie-Allergologie
City
Essen
ZIP/Postal Code
45239
Country
Germany
Facility Name
Klinikum Fulda gAG; Universitätsmedizin Marburg, Campus Fulda
City
Fulda
ZIP/Postal Code
36043
Country
Germany
Facility Name
ASST DI MONZA; U O Clinica Pneumologica
City
Monza
State/Province
Lombardia
ZIP/Postal Code
20900
Country
Italy
Facility Name
A.O. Universitaria San Luigi Gonzaga di Orbassano; Malattie Apparato Respiratorio (MAR2)
City
Orbassano
State/Province
Piemonte
ZIP/Postal Code
10043
Country
Italy
Facility Name
Azienda Ospedaliero Universitaria Pisana; U.O. Pneumologia
City
Pisa
State/Province
Toscana
ZIP/Postal Code
56124
Country
Italy
Facility Name
A.O. Univ. Senese Policlinico S. Maria alle Scotte; UOC Malattie Resepiratorie e Trapianto Polmonare
City
Siena
State/Province
Toscana
ZIP/Postal Code
53100
Country
Italy
Facility Name
Antonius Ziekenhuis; Dept of Lung Diseases
City
Nieuwegein
ZIP/Postal Code
3435 CM
Country
Netherlands
Facility Name
Erasmus MC; Afdeling Longziekten
City
Rotterdam
ZIP/Postal Code
3000 CA
Country
Netherlands
Facility Name
Hospital Universitari de Bellvitge ; Servicio de Neumologia
City
Hospitalet de Llobregat
State/Province
Barcelona
ZIP/Postal Code
08097
Country
Spain
Facility Name
Hospital del Henares; Medicina Interna. Unidad de Neumología
City
Coslada (Madrid)
State/Province
Madrid
ZIP/Postal Code
28822
Country
Spain
Facility Name
Hospital Universitario de Canarias; Servicio de Neumologia
City
La Laguna
State/Province
Tenerife
ZIP/Postal Code
38320
Country
Spain
Facility Name
Complejo Asistencial Universitario de Leon; Pneumology
City
Leon
ZIP/Postal Code
24071
Country
Spain
Facility Name
Hospital Universitario La Princesa; Servicio de Neumologia
City
Madrid
ZIP/Postal Code
28006
Country
Spain
Facility Name
Hospital Universitario Virgen del Rocio; Servicio de Neumologia
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Facility Name
Hospital General Universitario De Valencia; Servicio de Neumologia
City
Valencia
ZIP/Postal Code
46014
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
29946005
Citation
Flaherty KR, Fell CD, Huggins JT, Nunes H, Sussman R, Valenzuela C, Petzinger U, Stauffer JL, Gilberg F, Bengus M, Wijsenbeek M. Safety of nintedanib added to pirfenidone treatment for idiopathic pulmonary fibrosis. Eur Respir J. 2018 Aug 2;52(2):1800230. doi: 10.1183/13993003.00230-2018. Print 2018 Aug. Erratum In: Eur Respir J. 2018 Oct 4;52(4):
Results Reference
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Safety and Tolerability Study of Pirfenidone in Combination With Nintedanib in Participants With Idiopathic Pulmonary Fibrosis (IPF)

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