Study of LAU-7b in the Treatment of Cystic Fibrosis in Adults (APPLAUD)
Primary Purpose
Cystic Fibrosis
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
LAU-7b
Placebo oral capsule
Sponsored by
About this trial
This is an interventional treatment trial for Cystic Fibrosis focused on measuring Inflammation, Essential Fatty Acids, Inflammation resolution, Docosahexaenoic acid, Lung function
Eligibility Criteria
Inclusion Criteria:
- Screening FEV1 between 40% and 100% predicted value for age, gender and height, in patients capable of properly performing the test;
- History of pulmonary exacerbation, defined as at least one (1) pulmonary exacerbation in the year prior to Screening which resulted in documented intravenous or Oral antibiotics;
- Patients are eligible independently of their history of pulmonary Pseudomonas aeruginosa (PsA) infection and their PsA status at screening;
- If taking Kalydeco® (ivacaftor), Orkambi® (ivacaftor/lumacaftor), Symdeko® (ivacaftor/tezacaftor) or other commercially available CFTR modulator products, patients must be taking it for a minimum of 3 months prior to screening if naïve to CFTR modulators and 1 month if switched from another CFTR modulator product and deemed to tolerate it;
- No change in CF and allowed systemic chronic therapy for a minimum of 5 weeks prior to randomization, of which 2 weeks minimum are prior to screening;
- Female patients of child bearing potential should be on highly effective contraceptive methods during the study;
- Male patients with spouse or partner of child bearing potential, or pregnant, are eligible if they use an appropriate method of contraception.
Exclusion Criteria:
- Pregnancy: due to the potential teratogenic effects of retinoids, pregnant women are NOT eligible;
- Breast milk feeding by study patient is NOT allowed;
- Clinically abnormal renal function: serum creatinine > 132 μM (1.5 mg/dL);
- Clinically abnormal liver function: Total bilirubin >1.5 x ULN (in the absence of demonstrated Gilbert's syndrome), alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) > 2.5 x ULN;
- Patients with plasma retinol levels below 0.7 µM;
- Presence of nyctalopia or hemeralopia at enrolment, or any other serious retinal, ophthalmological condition;
- Presence of serious dermatological conditions at entry, including inflammatory or xerotic skin pathologies such as psoriasis or ichthyosis;
- Intake of chronic systemic steroids in the month prior to screening and during the study;
- History of acute infections (viral/bacterial/fungal) within 5 weeks prior to randomization, of which 2 weeks minimum are prior to screening, whether or not treated and resolved;
- Presence of infection with Burkholderia cepacia (including all species within the Burkholderia cepacia complex group, and Burkholderia gladioli) in the 12 months prior to screening;
- Patients with a confirmed diagnosis (as per the Cystic Fibrosis Foundation diagnostic criteria) of Allergic BronchoPulmonary Aspergillosis (ABPA) and actively being treated with corticosteroids and/or anti fungal agents.
Sites / Locations
- Long Beach Memorial Medical Center
- Children's Hospital Los Angeles
- UC Davis Medical Center, Division of Pulmonary & Critical Care Medicine
- Children's National Medical Center
- Division of pulmonary, critical care and sleep medicine, University of Florida
- Memorial Healthcare System, Joe DiMaggio Children's Hospital Cystic Fibrosis & Pulmonary Center
- Avanza Medical Research Center
- St-Luke's CF Center of Idaho
- Riley Hospital for Children
- University of Kansas Medical Center
- Maine Medical Center Cystic Fibrosis Research
- University of Michigan Health System
- Wayne State University, Harper University Hospital
- The Minnesota Cystic Fibrosis Center, University of Minnesota
- Washington University Medical School
- Morristown Medical Center, NJ Adult Cystic Fibrosis Center
- Rutgers University Clinical Research Center, RW Johnson University Hospital
- Albany Medical College
- University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital
- Nationwide Children's Hospital
- University of Oklahoma Health Sciences Center
- Cystic Fibrosis Center, Doernbecher Children's Hospital, Oregon Health & Science University
- Children's Hospital of Pittsburgh of UPMC
- Medical University of South Carolina
- University of Utah
- Virginia Commonwealth University
- Medical College of Wisconsin, Div of Pulmonary and Critical Care Medicine
- Respiratory Medicine, John Hunter Hospital
- Department of Respiratory Medicine, Royal Prince Alfred Hospital
- Department of Respiratory and Sleep Medicine, Westmead Hospital
- Mater Misericordiae Ltd
- Monash Lung and Sleep, Monash Health
- The Alfred Hospital
- Institute of Respiratory Health, Harry Perkins Institute
- Pacific Lung Research Institute at St. Paul's Hospital
- The Ottawa Hospital Center for Practice-Changing Research
- Centre d'études cliniques CIUSS SLJ, Hôpital Chicoutimi
- Centre Hospitalier de l'Université de Montréal
- McGill University Health Center
- Centre de recherche de l'institut Universitaire de Cardiologie et de Pneumologie de Québec
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
LAU-7b
Placebo
Arm Description
Active drug fenretinide (as LAU-7b capsules)
Placebo oral capsule (as inactive capsules identical to active arm)
Outcomes
Primary Outcome Measures
Absolute change in percent predicted forced expiratory volume in 1 second (FEV1%)
Standardized, serial FEV1 measurements will be performed during the trial
The safety and tolerability of LAU-7b will be assessed by the incidence of treatment emergent adverse events compared to placebo
This will be assessed through serial assessments and ad-hoc assessments
Secondary Outcome Measures
The proportion of patients achieving normalization of the arachidonic acid, docosahexaenoic acid and their ratio in phospholipids
This will be assessed through serial blood sampling during the trial
The absolute and relative (%) change in FEV1 percent predicted at 3, 7, 11, 15 and 28 weeks into the trial
Standardized, serial FEV1 measurements will be performed during the trial
The time to first protocol-defined pulmonary exacerbation
Reports of pulmonary exacerbation during the trial
The incidence of protocol-defined pulmonary exacerbation
Reports of pulmonary exacerbation during the trial
The time to first change and usage of antibiotic (other than chronic inhaled antibiotics already started prior to trial or oral chronic azithromycin)
Reports of pulmonary exacerbation and their treatment during the trial
The change from baseline of systemic markers of inflammation in blood
This will be assessed through serial blood sampling during the trial
The change from screening of the body weight and calculated Body Mass Index (BMI)
This will be assessed through serial weighing during the trial
The overall change from screening of the Pseudomonas aeruginosa density (colony forming units) in the sputum
This will be assessed through induced sputum on 3 occasions during the trial
The impact (from baseline) on overall health, daily life, perceived well-being and symptoms measured with the Cystic Fibrosis Questionnaire-Revised (CFQ-R)
This will be assessed through administration of the questionnaire at planned times during the trial
Full Information
NCT ID
NCT03265288
First Posted
February 21, 2017
Last Updated
October 3, 2021
Sponsor
Laurent Pharmaceuticals Inc.
Collaborators
Cystic Fibrosis Foundation
1. Study Identification
Unique Protocol Identification Number
NCT03265288
Brief Title
Study of LAU-7b in the Treatment of Cystic Fibrosis in Adults
Acronym
APPLAUD
Official Title
APPLAUD: A Double-Blind, Randomized, Placebo-Controlled, Phase II Study of the Efficacy and Safety of LAU-7b in the Treatment of Cystic Fibrosis in Adults
Study Type
Interventional
2. Study Status
Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
October 10, 2018 (Actual)
Primary Completion Date
September 15, 2021 (Actual)
Study Completion Date
September 15, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Laurent Pharmaceuticals Inc.
Collaborators
Cystic Fibrosis Foundation
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
An International Phase II, double-blind, randomized, placebo-controlled study to evaluate the safety and efficacy of LAU-7b administered once-daily for 6 months for the treatment of CF.
Detailed Description
An International Phase II, double-blind, randomized, placebo-controlled study to evaluate the safety and efficacy of LAU-7b administered once-daily for 6 months for the treatment of CF. All patients will remain on their CF standard-of-care treatments over the trial duration.
The goal for the treatment with LAU-7b in CF is to preserve lung function by reducing the persistent inflammation in the lung and to improve its capacity to defend against resistant bacteria such as Pseudomonas aeruginosa.
The treatment regimen will consist of 6 consecutive "dosing cycles" of 21 days each, spaced by study drug-free periods of 7 days. A total of 136 eligible adult patients with CF will be randomized to receive 300 mg LAU-7b or placebo in a 1:1 ratio. The participation in the study will last about 7 months.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis
Keywords
Inflammation, Essential Fatty Acids, Inflammation resolution, Docosahexaenoic acid, Lung function
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Double-blind, randomized, parallel groups and placebo-controlled trial.
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Patients will be randomly assigned to take either the active drug (fenretinide capsule) or a matching inactive placebo (inactive capsule).
Allocation
Randomized
Enrollment
166 (Actual)
8. Arms, Groups, and Interventions
Arm Title
LAU-7b
Arm Type
Experimental
Arm Description
Active drug fenretinide (as LAU-7b capsules)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo oral capsule (as inactive capsules identical to active arm)
Intervention Type
Drug
Intervention Name(s)
LAU-7b
Other Intervention Name(s)
fenretinide
Intervention Description
LAU-7b will be administered orally once-a-day with the first meal of the day as cycles of 21 days on, 7 days off, for a total of 6 planned cycles.
Intervention Type
Drug
Intervention Name(s)
Placebo oral capsule
Intervention Description
Placebo will be administered orally once-a-day with the first meal of the day as cycles of 21 days on, 7 days off, for a total of 6 planned cycles.
Primary Outcome Measure Information:
Title
Absolute change in percent predicted forced expiratory volume in 1 second (FEV1%)
Description
Standardized, serial FEV1 measurements will be performed during the trial
Time Frame
From baseline to 24 weeks
Title
The safety and tolerability of LAU-7b will be assessed by the incidence of treatment emergent adverse events compared to placebo
Description
This will be assessed through serial assessments and ad-hoc assessments
Time Frame
From Baseline to 28 weeks
Secondary Outcome Measure Information:
Title
The proportion of patients achieving normalization of the arachidonic acid, docosahexaenoic acid and their ratio in phospholipids
Description
This will be assessed through serial blood sampling during the trial
Time Frame
From baseline to 28 weeks
Title
The absolute and relative (%) change in FEV1 percent predicted at 3, 7, 11, 15 and 28 weeks into the trial
Description
Standardized, serial FEV1 measurements will be performed during the trial
Time Frame
From baseline to 3, 7, 11, 15 and 28 weeks into the trial
Title
The time to first protocol-defined pulmonary exacerbation
Description
Reports of pulmonary exacerbation during the trial
Time Frame
From baseline to 28 weeks
Title
The incidence of protocol-defined pulmonary exacerbation
Description
Reports of pulmonary exacerbation during the trial
Time Frame
From baseline to 28 weeks
Title
The time to first change and usage of antibiotic (other than chronic inhaled antibiotics already started prior to trial or oral chronic azithromycin)
Description
Reports of pulmonary exacerbation and their treatment during the trial
Time Frame
From baseline to 28 weeks
Title
The change from baseline of systemic markers of inflammation in blood
Description
This will be assessed through serial blood sampling during the trial
Time Frame
From baseline to 28 weeks
Title
The change from screening of the body weight and calculated Body Mass Index (BMI)
Description
This will be assessed through serial weighing during the trial
Time Frame
From screening to 28 weeks
Title
The overall change from screening of the Pseudomonas aeruginosa density (colony forming units) in the sputum
Description
This will be assessed through induced sputum on 3 occasions during the trial
Time Frame
From screening to Weeks 11 and 24
Title
The impact (from baseline) on overall health, daily life, perceived well-being and symptoms measured with the Cystic Fibrosis Questionnaire-Revised (CFQ-R)
Description
This will be assessed through administration of the questionnaire at planned times during the trial
Time Frame
From baseline to 28 weeks
Other Pre-specified Outcome Measures:
Title
The change in metabolipidomic profile and in markers of oxidative stress in blood
Description
This will be assessed through serial blood sampling during the trial
Time Frame
From baseline to 28 weeks
Title
The change in metabolipidomic profile in blood, the systemic markers of inflammation in blood, the FEV1, the body weight and calculated BMI
Description
Only in patients who experience a pulmonary exacerbation requiring intravenous antibiotics, this will be assessed prior to- and after the intravenous antibiotic course.
Time Frame
From baseline to 28 weeks
Title
The change from baseline of systemic bone formation and resorption biomarkers
Description
This will be assessed through blood sampling on 2 occasions during the trial
Time Frame
Baseline and 24 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Screening FEV1 between 40% and 100% predicted value for age, gender and height, in patients capable of properly performing the test;
History of pulmonary exacerbation, defined as at least one (1) pulmonary exacerbation in the year prior to Screening which resulted in documented intravenous or Oral antibiotics;
Patients are eligible independently of their history of pulmonary Pseudomonas aeruginosa (PsA) infection and their PsA status at screening;
If taking Kalydeco® (ivacaftor), Orkambi® (ivacaftor/lumacaftor), Symdeko® (ivacaftor/tezacaftor) or other commercially available CFTR modulator products, patients must be taking it for a minimum of 3 months prior to screening if naïve to CFTR modulators and 1 month if switched from another CFTR modulator product and deemed to tolerate it;
No change in CF and allowed systemic chronic therapy for a minimum of 5 weeks prior to randomization, of which 2 weeks minimum are prior to screening;
Female patients of child bearing potential should be on highly effective contraceptive methods during the study;
Male patients with spouse or partner of child bearing potential, or pregnant, are eligible if they use an appropriate method of contraception.
Exclusion Criteria:
Pregnancy: due to the potential teratogenic effects of retinoids, pregnant women are NOT eligible;
Breast milk feeding by study patient is NOT allowed;
Clinically abnormal renal function: serum creatinine > 132 μM (1.5 mg/dL);
Clinically abnormal liver function: Total bilirubin >1.5 x ULN (in the absence of demonstrated Gilbert's syndrome), alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) > 2.5 x ULN;
Patients with plasma retinol levels below 0.7 µM;
Presence of nyctalopia or hemeralopia at enrolment, or any other serious retinal, ophthalmological condition;
Presence of serious dermatological conditions at entry, including inflammatory or xerotic skin pathologies such as psoriasis or ichthyosis;
Intake of chronic systemic steroids in the month prior to screening and during the study;
History of acute infections (viral/bacterial/fungal) within 5 weeks prior to randomization, of which 2 weeks minimum are prior to screening, whether or not treated and resolved;
Presence of infection with Burkholderia cepacia (including all species within the Burkholderia cepacia complex group, and Burkholderia gladioli) in the 12 months prior to screening;
Patients with a confirmed diagnosis (as per the Cystic Fibrosis Foundation diagnostic criteria) of Allergic BronchoPulmonary Aspergillosis (ABPA) and actively being treated with corticosteroids and/or anti fungal agents.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Larry C Lands, MD PhD
Organizational Affiliation
McGill Uinversity Health Centre
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Michael W Konstan, MD
Organizational Affiliation
Rainbow Babies and Children's Hospital/ University Hospitals Cleveland Medical Center
Official's Role
Study Chair
Facility Information:
Facility Name
Long Beach Memorial Medical Center
City
Long Beach
State/Province
California
ZIP/Postal Code
90806
Country
United States
Facility Name
Children's Hospital Los Angeles
City
Los Angeles
State/Province
California
ZIP/Postal Code
90227
Country
United States
Facility Name
UC Davis Medical Center, Division of Pulmonary & Critical Care Medicine
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Children's National Medical Center
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Division of pulmonary, critical care and sleep medicine, University of Florida
City
Gainesville
State/Province
Florida
ZIP/Postal Code
32610
Country
United States
Facility Name
Memorial Healthcare System, Joe DiMaggio Children's Hospital Cystic Fibrosis & Pulmonary Center
City
Hollywood
State/Province
Florida
ZIP/Postal Code
33021
Country
United States
Facility Name
Avanza Medical Research Center
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32603
Country
United States
Facility Name
St-Luke's CF Center of Idaho
City
Boise
State/Province
Idaho
ZIP/Postal Code
83712
Country
United States
Facility Name
Riley Hospital for Children
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
University of Kansas Medical Center
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66103
Country
United States
Facility Name
Maine Medical Center Cystic Fibrosis Research
City
Portland
State/Province
Maine
ZIP/Postal Code
04102
Country
United States
Facility Name
University of Michigan Health System
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109
Country
United States
Facility Name
Wayne State University, Harper University Hospital
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48201
Country
United States
Facility Name
The Minnesota Cystic Fibrosis Center, University of Minnesota
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Facility Name
Washington University Medical School
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Morristown Medical Center, NJ Adult Cystic Fibrosis Center
City
Morristown
State/Province
New Jersey
ZIP/Postal Code
07962
Country
United States
Facility Name
Rutgers University Clinical Research Center, RW Johnson University Hospital
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Facility Name
Albany Medical College
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
University Hospitals Cleveland Medical Center, Rainbow Babies and Children's Hospital
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Nationwide Children's Hospital
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43205
Country
United States
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73104
Country
United States
Facility Name
Cystic Fibrosis Center, Doernbecher Children's Hospital, Oregon Health & Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Children's Hospital of Pittsburgh of UPMC
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
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 Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Facility Name
Virginia Commonwealth University
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States
Facility Name
Medical College of Wisconsin, Div of Pulmonary and Critical Care Medicine
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States
Facility Name
Respiratory Medicine, John Hunter Hospital
City
New Lambton Heights
State/Province
New South Wales
ZIP/Postal Code
2305
Country
Australia
Facility Name
Department of Respiratory Medicine, Royal Prince Alfred Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Facility Name
Department of Respiratory and Sleep Medicine, Westmead Hospital
City
Westmead
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Mater Misericordiae Ltd
City
Brisbane
State/Province
Queensland
ZIP/Postal Code
4101
Country
Australia
Facility Name
Monash Lung and Sleep, Monash Health
City
Clayton
State/Province
Victoria
ZIP/Postal Code
3168
Country
Australia
Facility Name
The Alfred Hospital
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia
Facility Name
Institute of Respiratory Health, Harry Perkins Institute
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia
Facility Name
Pacific Lung Research Institute at St. Paul's Hospital
City
Vancouver
State/Province
British Columbia
ZIP/Postal Code
V6Z 1Y6
Country
Canada
Facility Name
The Ottawa Hospital Center for Practice-Changing Research
City
Ottawa
State/Province
Ontario
ZIP/Postal Code
K1H 8L6
Country
Canada
Facility Name
Centre d'études cliniques CIUSS SLJ, Hôpital Chicoutimi
City
Chicoutimi
State/Province
Quebec
ZIP/Postal Code
G7H 5H6
Country
Canada
Facility Name
Centre Hospitalier de l'Université de Montréal
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H2X2P1
Country
Canada
Facility Name
McGill University Health Center
City
Montréal
State/Province
Quebec
ZIP/Postal Code
H4A 3J1
Country
Canada
Facility Name
Centre de recherche de l'institut Universitaire de Cardiologie et de Pneumologie de Québec
City
Québec City
State/Province
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
12. IPD Sharing Statement
Plan to Share IPD
No
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Study of LAU-7b in the Treatment of Cystic Fibrosis in Adults
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