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Efficacy/Safety of HA Inhalation Solution for Hereditary Emphysema in Patients With Alpha-1 Antitrypsin Deficiency

Primary Purpose

Emphysema, Alpha 1-Antitrypsin Deficiency

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Hyaluronic Acid Inhalation Solution
Placebo Inhalation Solution
Sponsored by
Gerard Turino
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Emphysema focused on measuring Emphysema, COPD, Alpha-1 Antitrypsin Deficiency

Eligibility Criteria

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

Inclusion Criteria:

  1. Able and willing to provide written informed consent and comply with study requirements
  2. Men or women aged 18 through 80 years at the time of consent
  3. Diagnosis of emphysema at screening consistent with National Institutes of Health guidelines 19 GOLD COPD classification stages I, II or III
  4. Evidence of emphysema on radiographic imaging.
  5. A ratio of pre-bronchodilator FEV1 to forced vital capacity (FVC) of ≤ 80% at screening
  6. FEV1 ≥ 30% and ≤ 79% (post-bronchodilator) of predicted normal at screening
  7. Clinical laboratory tests (complete blood count, serum chemistry, and urinalysis) within normal limits or clinically acceptable to the PI and sponsor at screening
  8. Women of childbearing potential and men who are sexually active must agree to use an adequate method of contraception (oral contraceptives, depot progesterone, condom plus spermicidal, or IUD) during the study and for 1 month after the final dose of study drug.
  9. Evidence of alpha-1 antitrypsin deficiency (AATD) with any genotype except PiMZ deficiency. Individuals with PiMZ deficiency are not allowed in the study.
  10. Patients must have stopped using Intravenous alpha-1 antitrypsin protein (AAT) augmentation therapy at least 3 months before entering study.

Exclusion Criteria:

  1. Subjects with measured DLCO of ≤ 35%, or unable to perform a reproducible DLCO
  2. Subjects unable to perform 3 reproducible spirometry tests after 8 attempts
  3. Upper or lower respiratory tract infection within 2 weeks prior to screening and baseline (day1)
  4. Presence of clinically relevant abnormality on chest x-ray (other than evidence of emphysema) within the previous 12 months
  5. Use of supplemental oxygen therapy
  6. Requirement for ventilator support within the last year
  7. Exacerbation requiring treatment with systemic corticosteroids within the last 3 months
  8. History of lung transplant or liver transplant.
  9. Presence of clinically relevant abnormality on electrocardiogram (ECG)
  10. Any medical condition that, in the investigator's judgment, would compromise study participation or the evaluation of the study drug
  11. Women who are pregnant or breastfeeding
  12. Receipt of an investigational drug within 30 days prior to screening
  13. Patients who are current smokers or have smoked within the last 3 months -

Sites / Locations

  • University of Miami Hospital
  • Pulmonary Health Physicians, PC
  • Medical University of South Carolina
  • University of Texas Health Science Center
  • Medical College of Wisconsin / Froedtert Hospital
  • Inspiration Research Limited

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Hyaluronic Acid inhalation solution

Placebo Inhalation Solution

Arm Description

3mL of 0.03% Hyaluronic Acid inhalation solution BID for 28 days

3mL matching placebo inhalation solution BID for 28 days

Outcomes

Primary Outcome Measures

Measurement of sputum, plasma and urine concentrations of desmosine and isodesmosine
measurement of biomarkers
Assessment of pulmonary function tests
measurement of pulmonary function

Secondary Outcome Measures

Assessment of St. George Respiratory Questionnaire
measurement of patient abilities

Full Information

First Posted
April 5, 2017
Last Updated
April 17, 2020
Sponsor
Gerard Turino
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1. Study Identification

Unique Protocol Identification Number
NCT03114020
Brief Title
Efficacy/Safety of HA Inhalation Solution for Hereditary Emphysema in Patients With Alpha-1 Antitrypsin Deficiency
Official Title
Phase 2 Randomized Parallel-Group Double-Blind Placebo-Controlled Multiple-Dose Proof-of-Concept Study to Evaluate the Efficacy/Safety of Hyaluronic Acid Inhalation Solution for Treatment of Emphysema
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
March 22, 2017 (Actual)
Primary Completion Date
November 12, 2019 (Actual)
Study Completion Date
November 12, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Gerard Turino

4. Oversight

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

5. Study Description

Brief Summary
The purpose of the study is to evaluate the safety and efficacy of administering repeated doses of Hyaluronic Acid Inhalation Solution to subjects with Emphysema that have Alpha-1-Antitrypsin deficiency
Detailed Description
The study primarily aims to establish desmosine and isodesmosine concentrations in plasma, sputum and urine measured as markers of elastin degradation systemically in the lung and also markers of inflammation and fibrinogen. Assessment of vital signs, lab tests, carbon monoxide diffusing capacity, oxygen saturation, pulmonary function tests, ECGs, physical exams and adverse events.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Emphysema, Alpha 1-Antitrypsin Deficiency
Keywords
Emphysema, COPD, Alpha-1 Antitrypsin Deficiency

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Masking Description
treatment has blinded labeling
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Hyaluronic Acid inhalation solution
Arm Type
Experimental
Arm Description
3mL of 0.03% Hyaluronic Acid inhalation solution BID for 28 days
Arm Title
Placebo Inhalation Solution
Arm Type
Placebo Comparator
Arm Description
3mL matching placebo inhalation solution BID for 28 days
Intervention Type
Drug
Intervention Name(s)
Hyaluronic Acid Inhalation Solution
Other Intervention Name(s)
active inhalation solution
Intervention Description
twice a day 3 mL of 0.03% Hyaluronic Acid Inhalation Solution
Intervention Type
Drug
Intervention Name(s)
Placebo Inhalation Solution
Intervention Description
Twice a day 3 ml of placebo inhalation solution
Primary Outcome Measure Information:
Title
Measurement of sputum, plasma and urine concentrations of desmosine and isodesmosine
Description
measurement of biomarkers
Time Frame
28 days
Title
Assessment of pulmonary function tests
Description
measurement of pulmonary function
Time Frame
28 days
Secondary Outcome Measure Information:
Title
Assessment of St. George Respiratory Questionnaire
Description
measurement of patient abilities
Time Frame
28 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to provide written informed consent and comply with study requirements Men or women aged 18 through 80 years at the time of consent Diagnosis of emphysema at screening consistent with National Institutes of Health guidelines 19 GOLD COPD classification stages I, II or III Evidence of emphysema on radiographic imaging. A ratio of pre-bronchodilator FEV1 to forced vital capacity (FVC) of ≤ 80% at screening FEV1 ≥ 30% and ≤ 79% (post-bronchodilator) of predicted normal at screening Clinical laboratory tests (complete blood count, serum chemistry, and urinalysis) within normal limits or clinically acceptable to the PI and sponsor at screening Women of childbearing potential and men who are sexually active must agree to use an adequate method of contraception (oral contraceptives, depot progesterone, condom plus spermicidal, or IUD) during the study and for 1 month after the final dose of study drug. Evidence of alpha-1 antitrypsin deficiency (AATD) with any genotype except PiMZ deficiency. Individuals with PiMZ deficiency are not allowed in the study. Patients must have stopped using Intravenous alpha-1 antitrypsin protein (AAT) augmentation therapy at least 3 months before entering study. Exclusion Criteria: Subjects with measured DLCO of ≤ 35%, or unable to perform a reproducible DLCO Subjects unable to perform 3 reproducible spirometry tests after 8 attempts Upper or lower respiratory tract infection within 2 weeks prior to screening and baseline (day1) Presence of clinically relevant abnormality on chest x-ray (other than evidence of emphysema) within the previous 12 months Use of supplemental oxygen therapy Requirement for ventilator support within the last year Exacerbation requiring treatment with systemic corticosteroids within the last 3 months History of lung transplant or liver transplant. Presence of clinically relevant abnormality on electrocardiogram (ECG) Any medical condition that, in the investigator's judgment, would compromise study participation or the evaluation of the study drug Women who are pregnant or breastfeeding Receipt of an investigational drug within 30 days prior to screening Patients who are current smokers or have smoked within the last 3 months -
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerard M Turino, MD
Organizational Affiliation
Mount Sinai St Lukes
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Miami Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
Facility Name
Pulmonary Health Physicians, PC
City
Fayetteville
State/Province
New York
ZIP/Postal Code
13066
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
University of Texas Health Science Center
City
Tyler
State/Province
Texas
ZIP/Postal Code
75708
Country
United States
Facility Name
Medical College of Wisconsin / Froedtert Hospital
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Inspiration Research Limited
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5T 3A9
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

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Efficacy/Safety of HA Inhalation Solution for Hereditary Emphysema in Patients With Alpha-1 Antitrypsin Deficiency

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