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Prednisone in Cystic Fibrosis Pulmonary Exacerbations (PIPE)

Primary Purpose

Cystic Fibrosis Pulmonary Exacerbation

Status
Recruiting
Phase
Phase 3
Locations
Canada
Study Type
Interventional
Intervention
Prednisone
Placebos
Sponsored by
The Hospital for Sick Children
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cystic Fibrosis Pulmonary Exacerbation

Eligibility Criteria

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

Inclusion Criteria:

  1. Diagnosis of CF by newborn screening or at least one clinical feature of CF, AND either (a) or (b) as follows:
  2. A documented sweat chloride ≥ 60 mEq/L by quantitative pilocarpine iontophoresis
  3. A genotype with two identifiable CF-causing mutations
  4. Age > 6 years old.
  5. Acute pulmonary exacerbation treated with IV antibiotics as previously defined 10% relative drop in FEV1 from baseline at the time of exacerbation
  6. Informed consent by patient or parent/legal guardian
  7. Ability to reproducibly perform pulmonary function testing
  8. Ability to comply with medication use including the ability to take capsules, study visits and study procedures as judged by the site investigator

Exclusion Criteria:

  1. A respiratory tract culture positive for Burkholderia cenocepacia in the 12 months prior to enrollment
  2. A respiratory tract culture positive for Mycobacterium abscessus in the 12 months prior to enrollment
  3. Treatment with IV or oral corticosteroids within 2 weeks of enrollment or from Day 0-Day 7 of the pulmonary exacerbation
  4. Active allergic bronchopulmonary aspergillosis (ABPA) at the time of enrollment as determined by treating physician
  5. Asthma related exacerbation at enrollment as defined by the treating physician based on clinically compatible symptoms (eg. wheeze)
  6. History of avascular necrosis or pathologic bone fracture
  7. Uncontrolled hypertension with end organ damage
  8. Active gastrointestinal bleeding
  9. Status post lung or other organ transplantation
  10. Pregnancy
  11. Lactose intolerance (contained in placebo)
  12. On Lumacaftor-Ivacaftor (Orkambi) at the time of exacerbation
  13. Investigational drug use within 30 days prior to enrollment visit
  14. Physical findings that would compromise the safety of the subject or the quality of the study data as determined by site investigator

Sites / Locations

  • The Governers of The University of Calgary - Alberta Health ServicesRecruiting
  • British Columbia Children's HospitalRecruiting
  • St. Paul's HospitalRecruiting
  • London Health Sciences Centre - Lawson Health Research InstituteRecruiting
  • The Ottawa HospitalRecruiting
  • Unity Health Toronto - St. Michael's HospitalRecruiting
  • SickKidsRecruiting
  • The Centre hospitalier de l'Université de Montréal (CHUM)Recruiting
  • Centre hospitalier universitaire Sainte-JustineRecruiting
  • CHU de Quebec-Universite LavalRecruiting
  • Institut universitaire de cardiologie et de pneumologie de Québec - Université LavalRecruiting
  • University of Saskatchewan - Saskatchewan Health AuthorityRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Placebo

Treatment

Arm Description

Placebo

Prednisone

Outcomes

Primary Outcome Measures

Lung function recovery
The proportion of subjects who achieve >90% of their baseline FEV1 % predicted at day 14 of IV antibiotic treatment for a PEx in each treatment arm.

Secondary Outcome Measures

lung function recovery at follow up visit
The proportion of subjects who achieve >90% of their baseline FEV1 % predicted
change in pulmonary function testing
change in pulmonary function testing
quality of life as measured by CFQ-R questionnaire
quality of life
quality of life as measured by CF Respiratory Symptom Diary
quality of life
length of hospitalization
length of hospitalization
time to subsequent pulmonary exacerbation
time to subsequent pulmonary exacerbation
number of adverse events
number of adverse events
change in sputum inflammatory markers
change in sputum inflammatory markers
change in serum inflammatory markers
change in serum inflammatory markers
Duration of antibiotic treatment
Duration of antibiotic treatment

Full Information

First Posted
February 8, 2017
Last Updated
November 23, 2022
Sponsor
The Hospital for Sick Children
Collaborators
Canadian Cystic Fibrosis Foundation
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1. Study Identification

Unique Protocol Identification Number
NCT03070522
Brief Title
Prednisone in Cystic Fibrosis Pulmonary Exacerbations
Acronym
PIPE
Official Title
Randomized Controlled Trial of Prednisone in Cystic Fibrosis Pulmonary Exacerbations
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
May 1, 2017 (Actual)
Primary Completion Date
May 2023 (Anticipated)
Study Completion Date
May 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
The Hospital for Sick Children
Collaborators
Canadian Cystic Fibrosis Foundation

4. Oversight

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

5. Study Description

Brief Summary
This will be a 5 year randomized, double blind, placebo controlled trial of 7 days of oral prednisone in cystic fibrosis (CF) patients receiving intravenous (IV) antibiotic treatment for a pulmonary exacerbation at the Hospital for Sick Children and other study sub-sites across Canada. The intervention will be oral prednisone 2 mg/kg/day (max 60 mg) divided twice daily for 7 days as an adjunctive therapy for pulmonary exacerbations in CF patients who have not recovered their baseline forced expiratory volume in 1 second (FEV1) after 7 days of IV antibiotic treatment. The primary outcome will be the proportion of subjects who achieve >90% of their baseline FEV1 % predicted at day 14 of IV antibiotic treatment for a pulmonary exacerbation in each treatment arm.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Randomized placebo controlled trial
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
placebo
Allocation
Randomized
Enrollment
84 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Active Comparator
Arm Description
Placebo
Arm Title
Treatment
Arm Type
Active Comparator
Arm Description
Prednisone
Intervention Type
Drug
Intervention Name(s)
Prednisone
Intervention Description
oral prednisone for 7 days during pulmonary exacerbation
Intervention Type
Drug
Intervention Name(s)
Placebos
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Lung function recovery
Description
The proportion of subjects who achieve >90% of their baseline FEV1 % predicted at day 14 of IV antibiotic treatment for a PEx in each treatment arm.
Time Frame
At 14 days of antibiotic therapy
Secondary Outcome Measure Information:
Title
lung function recovery at follow up visit
Description
The proportion of subjects who achieve >90% of their baseline FEV1 % predicted
Time Frame
1 month follow up
Title
change in pulmonary function testing
Description
change in pulmonary function testing
Time Frame
at day 7, 14 and 1 month follow up
Title
quality of life as measured by CFQ-R questionnaire
Description
quality of life
Time Frame
at day 7, 14 and 1 month follow up
Title
quality of life as measured by CF Respiratory Symptom Diary
Description
quality of life
Time Frame
at day 7, 14 and 1 month follow up
Title
length of hospitalization
Description
length of hospitalization
Time Frame
Through study completion, up to 100 weeks
Title
time to subsequent pulmonary exacerbation
Description
time to subsequent pulmonary exacerbation
Time Frame
1 year follow up time
Title
number of adverse events
Description
number of adverse events
Time Frame
At day day 14 of antibiotic therapy and 1 month follow up
Title
change in sputum inflammatory markers
Description
change in sputum inflammatory markers
Time Frame
at day 7, 14 and 1 month follow up
Title
change in serum inflammatory markers
Description
change in serum inflammatory markers
Time Frame
at day 7, 14 and 1 month follow up
Title
Duration of antibiotic treatment
Description
Duration of antibiotic treatment
Time Frame
Through study completion, up to 100 weeks

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of CF by newborn screening or at least one clinical feature of CF, AND either (a) or (b) as follows: A documented sweat chloride ≥ 60 mEq/L by quantitative pilocarpine iontophoresis A genotype with two identifiable CF-causing mutations Age > 6 years old. Acute pulmonary exacerbation treated with IV antibiotics as previously defined 10% relative drop in FEV1 from baseline at the time of exacerbation Informed consent by patient or parent/legal guardian Ability to reproducibly perform pulmonary function testing Ability to comply with medication use including the ability to take capsules, study visits and study procedures as judged by the site investigator Exclusion Criteria: A respiratory tract culture positive for Burkholderia cenocepacia in the 12 months prior to enrollment A respiratory tract culture positive for Mycobacterium abscessus in the 12 months prior to enrollment Treatment with IV or oral corticosteroids within 2 weeks of enrollment or from Day 0-Day 7 of the pulmonary exacerbation Active allergic bronchopulmonary aspergillosis (ABPA) at the time of enrollment as determined by treating physician Asthma related exacerbation at enrollment as defined by the treating physician based on clinically compatible symptoms (eg. wheeze) History of avascular necrosis or pathologic bone fracture Uncontrolled hypertension with end organ damage Active gastrointestinal bleeding Status post lung or other organ transplantation Pregnancy Lactose intolerance (contained in placebo) On Lumacaftor-Ivacaftor (Orkambi) at the time of exacerbation Investigational drug use within 30 days prior to enrollment visit Physical findings that would compromise the safety of the subject or the quality of the study data as determined by site investigator
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Valerie Waters, MD
Phone
416-813-7654
Ext
204541
Email
valerie.waters@sickkids.ca
First Name & Middle Initial & Last Name or Official Title & Degree
Amara Mathews
Email
amara.mathews@sickkids.ca
Facility Information:
Facility Name
The Governers of The University of Calgary - Alberta Health Services
City
Calgary
State/Province
Alberta
ZIP/Postal Code
T2N 4N1
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Clare Smith
Email
Clare.Smith@albertahealthservices.ca
First Name & Middle Initial & Last Name & Degree
Michael Parkins, Dr.
Facility Name
British Columbia Children's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6H 3N1
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rodrigo Sandoval
Email
Rodrigo.Sandoval@bcchr.ca
First Name & Middle Initial & Last Name & Degree
Jonathan Rayment, Dr.
Facility Name
St. Paul's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 1Y6
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ekjot Sangha
Email
esangha@providencehealth.bc.ca
First Name & Middle Initial & Last Name & Degree
Bradley Quon, Dr.
Facility Name
London Health Sciences Centre - Lawson Health Research Institute
City
London
State/Province
Ontario
ZIP/Postal Code
N6C 2R5
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Erin Fleishcer
Email
Erin.Fleischer@lhsc.on.ca
First Name & Middle Initial & Last Name & Degree
April Price, Dr.
Facility Name
The Ottawa Hospital
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Bashour Yazji
Email
byazji@ohri.ca
First Name & Middle Initial & Last Name & Degree
Isabelle Seguin
Email
iseguin@toh.ca
First Name & Middle Initial & Last Name & Degree
Melanie Chin, Dr.
Facility Name
Unity Health Toronto - St. Michael's Hospital
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5B 1W8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kamalprit Chokar
Email
Kamalprit.Chokar@unityhealth.to
First Name & Middle Initial & Last Name & Degree
Elizabeth Tullis, Dr.
Facility Name
SickKids
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G1X8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Valerie Waters
Phone
416-813-7654
Email
valerie.waters@sickkids.ca
First Name & Middle Initial & Last Name & Degree
Amara Mathews
Email
amara.mathews@sickkids.ca
Facility Name
The Centre hospitalier de l'Université de Montréal (CHUM)
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2X A09
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Guillaume Cote-Maurais
Email
guillaume.cote-maurais.chum@ssss.gouv.qc.ca
First Name & Middle Initial & Last Name & Degree
Annick Lavoie, Dr.
Facility Name
Centre hospitalier universitaire Sainte-Justine
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H3T 1C5
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nora Robert
Email
nora.robert.hsj@ssss.gouv.qc.ca
First Name & Middle Initial & Last Name & Degree
Sze Man Tse, Dr.
Facility Name
CHU de Quebec-Universite Laval
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1R 2J6
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gabrielle Desnoyers
Email
gabrielle.desnoyers@crchudequebec.ulaval.ca
First Name & Middle Initial & Last Name & Degree
Patrick Daigneault, Dr.
Facility Name
Institut universitaire de cardiologie et de pneumologie de Québec - Université Laval
City
Quebec City
State/Province
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Andree-Anne Therrien
Email
andree-anne.therrien@criucpq.ulaval.ca
First Name & Middle Initial & Last Name & Degree
Nathalie Vadeboncoeur
Email
nathalie.vadeboncoeur@criucpq.ulaval.ca
First Name & Middle Initial & Last Name & Degree
Lara Bilodeau, Dr.
Facility Name
University of Saskatchewan - Saskatchewan Health Authority
City
Saskatoon
State/Province
Saskatchewan
ZIP/Postal Code
S7N 0W8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dawn Johnson
Email
dawn.johnson@usask.ca
First Name & Middle Initial & Last Name & Degree
Julian Tam, Dr.

12. IPD Sharing Statement

Plan to Share IPD
No

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Prednisone in Cystic Fibrosis Pulmonary Exacerbations

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