The Effect of PC945 on Aspergillus or Candida Lung Infections in Patients With Asthma or Chronic Respiratory Diseases
Primary Purpose
Asthma, Respiratory Candidiasis, Respiratory Aspergillosis
Status
Terminated
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
PC945
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Asthma
Eligibility Criteria
Inclusion Criteria:
- Subject must be male or female, aged 18 years (inclusive) or older (at the time of consent).
- Each subject must sign an informed consent form (ICF) indicating that he or she understands the purpose and requirements of the study and is willing to participate.
Subject's diagnosis of moderate to severe asthma (GINA Step 3 or 4) made by a respiratory physician and treated with an inhaled steroid or other chronic respiratory disease.
For subjects with asthma, the diagnosis of asthma must be supported either by:
i. Historical evidence of:
- 1. Increased airway hyper-responsiveness (methacholine PC20 <8 mg/ml).
- or
- 2. Airflow obstruction (FEV1/FVC ratio of less than 70%) and short-term variations in FEV1 (>12%).
- or
- ii. Bronchodilator reversibility ≥12% or ≥200 mL improvement in FEV1 post bronchodilator after administration of a short-acting beta agonist at screening.
OR
- Subjects with other chronic respiratory disease (such as COPD or bronchiectasis) susceptible to fungal bronchitis.
- Subject must have a positive sputum fungal culture with one or more colonies of A. fumigatus complex / A. niger complex or 200 or more colonies of yeast measured using a modified standard approach on one occasion obtained within the 28-day screening period.
- Subject must be able to produce a spontaneous sputum sample.
Exclusion Criteria:
- Subjects who have received more than 2 weeks of intravenous (IV), oral or inhaled antifungal therapy within 6 months prior to Visit 3 or any antifungal therapy (IV, oral or inhaled) within 2 months of Visit 3.
- Subjects taking medication that could significantly increase the risks of AEs with triazoles.
- Subjects who are receiving antiretroviral protease inhibitors.
- Clinical or laboratory evidence of bacterial bronchitis at the point of screening.
- Subjects who have used an experimental medical device or received an experimental drug within 3 months or within a period less than five times the experimental drug's half-life, whichever is longer, before the first dose of the study drug is scheduled.
- Clinically significant screening abnormalities (including, but not limited to, vital signs, ECG, laboratory tests, physical examination and spirometry) that, in the Investigator's opinion, exclude the subject from participation in the study.
- Positive test at screening for hepatitis B virus infection, or antibodies to hepatitis C virus.
- If female, the subject is pregnant (e.g. has a positive serum β human chorionic gonadotropin at screening or a positive urinary pregnancy test pre-dose on Day 1), lactating or breast feeding.
- Subject is an employee or a first-degree relative of anyone employed by Pulmocide, a participating clinical trial site, or any contract research organisation involved in the study.
- Any other reason that the Investigator considers makes the subject unsuitable to participate.
Sites / Locations
- Glenfield Hospital
- Royal Liverpool University Hospital
- Royal Brompton Hospital
- Northwest Lung Research Centre
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
PC945
Placebo
Arm Description
PC945 5mg once-daily, nebulized
Placebo, nebulized
Outcomes
Primary Outcome Measures
Presence or absence of Aspergillus fumigatus (A. fumigatus) complex / Aspergillus niger (A. niger) complex colonies on sputum culture
This is a binary endpoint
Reduction in the numbed of colonies of Candida species (spp) on sputum culture
Substantial reduction in colony forming unit (CFU) count by at least 50%
Secondary Outcome Measures
Predicted post bronchodilator forced expiratory volume in 1 second (FEV1) values
Forced vital capacity (FVC) values
The number of sputum A. fumigatus complex / A. niger complex CFUs in fungal culture
Sputum A. fumigatus measured by quantitative polymerase chain reaction (qPCR)
Spontaneous sputum weight (24-hour collection)
The number of sputum Candida spp. CFUs in fungal culture
C. albicans measured by qPCR in sputum
The concentration of A. fumigatus-specific immunoglobulin G (IgG) as measured in serum
Serum Total immunoglobulin E (IgE) levels
A. fumigatus-specific IgE levels
Change in Asthma control questionnaire - 6 item [ACQ6] (Total score) in asthma patients only
Change in Asthma Quality of Life Questionnaire - Juniper [AQLQ-J] (Total score) in asthma patients only
Change in St George's Respiratory Questionnaire [SGRQ] (Total score)
Change in Leicester Cough Questionnaire (Total score)
Breathlessness visual analogue scale rating, change over time
Symptom severity rated from "Best ever" to "Worst possible"
Correlation between A. fumigatus measured by qPCR and clinical response
Correlation between Candida albicans measured by qPCR and clinical response
Area undertake curve from time 0 to 2h post dose (AUC(0-2))
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
Last quantifiable plasma concentration (Ct)
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
maximum observed concentration (Cmax)
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
concentration at the end of the dosage interval (Ctrough)
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
Adverse events (AEs) incidence (safety and tolerability)
Twelve-lead electrocardiogram (ECG) (Safety parameter)
including QT interval corrected for Bazetts formula, QT interval, QRS Interval, PR Interval and ventricular rate).
Proportion of participants who meet the markedly abnormal criteria for vital signs assessment at lease once post dose
Proportion of participants who meet the markedly abnormal criteria for safety laboratory assessment at lease once post dose
Change in peak expiratory flow rate [PEFR]
Antibiotic use
Sputum characteristics - consistency and presence of blood (fresh morning sputum samples)
Sputum colour (fresh morning sputum samples)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03745196
Brief Title
The Effect of PC945 on Aspergillus or Candida Lung Infections in Patients With Asthma or Chronic Respiratory Diseases
Official Title
A Double-blind, Placebo-controlled Study to Assess the Effects of Inhaled PC945 in the Treatment of Culture-positive Aspergillus or Candida Fungal Bronchitis in Subjects With Moderate to Severe Asthma or Other Chronic Respiratory Diseases.
Study Type
Interventional
2. Study Status
Record Verification Date
June 2020
Overall Recruitment Status
Terminated
Why Stopped
The study is being terminated early as a result of the coronavirus (COVID-19) outbreak.
Study Start Date
November 15, 2018 (Actual)
Primary Completion Date
June 1, 2020 (Actual)
Study Completion Date
June 1, 2020 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pulmocide Ltd
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study tests the effects of an experimental drug PC945 in people with asthma or other chronic respiratory diseases whose lungs are infected by Aspergillus fungi and Candida yeasts.
PC945 may be useful in treating patients infected with Aspergillus as, unlike the usual treatments, it is inhaled into the lung and has been designed to stay there and treat the infection. Participants will continue to receive their usual treatment for their chronic respiratory disease. Half of the participants will receive PC945 and half will receive a placebo. The amount of fungus and yeast in the patients' phlegm will be measured over the course of the study. The study will take place at multiple sites in UK and will include approximately 46 participants. The maximum study duration will be about 16 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma, Respiratory Candidiasis, Respiratory Aspergillosis, COPD, Bronchiectasis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
This is a double-blind study.
Allocation
Randomized
Enrollment
13 (Actual)
8. Arms, Groups, and Interventions
Arm Title
PC945
Arm Type
Experimental
Arm Description
PC945 5mg once-daily, nebulized
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo, nebulized
Intervention Type
Drug
Intervention Name(s)
PC945
Intervention Description
Study drug under investigation
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo control
Primary Outcome Measure Information:
Title
Presence or absence of Aspergillus fumigatus (A. fumigatus) complex / Aspergillus niger (A. niger) complex colonies on sputum culture
Description
This is a binary endpoint
Time Frame
Baseline to Day 32-35
Title
Reduction in the numbed of colonies of Candida species (spp) on sputum culture
Description
Substantial reduction in colony forming unit (CFU) count by at least 50%
Time Frame
Baseline to Day 32-35
Secondary Outcome Measure Information:
Title
Predicted post bronchodilator forced expiratory volume in 1 second (FEV1) values
Time Frame
Baseline to Day 84
Title
Forced vital capacity (FVC) values
Time Frame
Baseline to Day 84
Title
The number of sputum A. fumigatus complex / A. niger complex CFUs in fungal culture
Time Frame
Baseline to Day 84
Title
Sputum A. fumigatus measured by quantitative polymerase chain reaction (qPCR)
Time Frame
Baseline to Day 84
Title
Spontaneous sputum weight (24-hour collection)
Time Frame
Baseline to Day 84
Title
The number of sputum Candida spp. CFUs in fungal culture
Time Frame
Baseline to Day 84
Title
C. albicans measured by qPCR in sputum
Time Frame
Baseline to Day 84
Title
The concentration of A. fumigatus-specific immunoglobulin G (IgG) as measured in serum
Time Frame
Baseline to Day 84
Title
Serum Total immunoglobulin E (IgE) levels
Time Frame
Baseline to Day 84
Title
A. fumigatus-specific IgE levels
Time Frame
Baseline to Day 84
Title
Change in Asthma control questionnaire - 6 item [ACQ6] (Total score) in asthma patients only
Time Frame
Baseline to Day 84
Title
Change in Asthma Quality of Life Questionnaire - Juniper [AQLQ-J] (Total score) in asthma patients only
Time Frame
Baseline to Day 84
Title
Change in St George's Respiratory Questionnaire [SGRQ] (Total score)
Time Frame
Baseline to Day 84
Title
Change in Leicester Cough Questionnaire (Total score)
Time Frame
Baseline to Day 84
Title
Breathlessness visual analogue scale rating, change over time
Description
Symptom severity rated from "Best ever" to "Worst possible"
Time Frame
Baseline to Day 84
Title
Correlation between A. fumigatus measured by qPCR and clinical response
Time Frame
Baseline to Day 84
Title
Correlation between Candida albicans measured by qPCR and clinical response
Time Frame
Baseline to Day 84
Title
Area undertake curve from time 0 to 2h post dose (AUC(0-2))
Description
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
Time Frame
Baseline to Day 84
Title
Last quantifiable plasma concentration (Ct)
Description
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
Time Frame
Baseline to Day 84
Title
maximum observed concentration (Cmax)
Description
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
Time Frame
Baseline to Day 84
Title
concentration at the end of the dosage interval (Ctrough)
Description
Derived pharmacokinetic parameters for PC945 and the potential circulating metabolite(s), if detectable
Time Frame
Baseline to Day 84
Title
Adverse events (AEs) incidence (safety and tolerability)
Time Frame
Baseline to Day 84
Title
Twelve-lead electrocardiogram (ECG) (Safety parameter)
Description
including QT interval corrected for Bazetts formula, QT interval, QRS Interval, PR Interval and ventricular rate).
Time Frame
Baseline to Day 84
Title
Proportion of participants who meet the markedly abnormal criteria for vital signs assessment at lease once post dose
Time Frame
Baseline to Day 84
Title
Proportion of participants who meet the markedly abnormal criteria for safety laboratory assessment at lease once post dose
Time Frame
Baseline to Day 84
Title
Change in peak expiratory flow rate [PEFR]
Time Frame
Baseline to Day 84
Title
Antibiotic use
Time Frame
Baseline to Day 84
Title
Sputum characteristics - consistency and presence of blood (fresh morning sputum samples)
Time Frame
Baseline to Day 84
Title
Sputum colour (fresh morning sputum samples)
Time Frame
Baseline to Day 84
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subject must be male or female, aged 18 years (inclusive) or older (at the time of consent).
Each subject must sign an informed consent form (ICF) indicating that he or she understands the purpose and requirements of the study and is willing to participate.
Subject's diagnosis of moderate to severe asthma (GINA Step 3 or 4) made by a respiratory physician and treated with an inhaled steroid or other chronic respiratory disease.
For subjects with asthma, the diagnosis of asthma must be supported either by:
i. Historical evidence of:
1. Increased airway hyper-responsiveness (methacholine PC20 <8 mg/ml).
or
2. Airflow obstruction (FEV1/FVC ratio of less than 70%) and short-term variations in FEV1 (>12%).
or
ii. Bronchodilator reversibility ≥12% or ≥200 mL improvement in FEV1 post bronchodilator after administration of a short-acting beta agonist at screening.
OR
Subjects with other chronic respiratory disease (such as COPD or bronchiectasis) susceptible to fungal bronchitis.
Subject must have a positive sputum fungal culture with one or more colonies of A. fumigatus complex / A. niger complex or 200 or more colonies of yeast measured using a modified standard approach on one occasion obtained within the 28-day screening period.
Subject must be able to produce a spontaneous sputum sample.
Exclusion Criteria:
Subjects who have received more than 2 weeks of intravenous (IV), oral or inhaled antifungal therapy within 6 months prior to Visit 3 or any antifungal therapy (IV, oral or inhaled) within 2 months of Visit 3.
Subjects taking medication that could significantly increase the risks of AEs with triazoles.
Subjects who are receiving antiretroviral protease inhibitors.
Clinical or laboratory evidence of bacterial bronchitis at the point of screening.
Subjects who have used an experimental medical device or received an experimental drug within 3 months or within a period less than five times the experimental drug's half-life, whichever is longer, before the first dose of the study drug is scheduled.
Clinically significant screening abnormalities (including, but not limited to, vital signs, ECG, laboratory tests, physical examination and spirometry) that, in the Investigator's opinion, exclude the subject from participation in the study.
Positive test at screening for hepatitis B virus infection, or antibodies to hepatitis C virus.
If female, the subject is pregnant (e.g. has a positive serum β human chorionic gonadotropin at screening or a positive urinary pregnancy test pre-dose on Day 1), lactating or breast feeding.
Subject is an employee or a first-degree relative of anyone employed by Pulmocide, a participating clinical trial site, or any contract research organisation involved in the study.
Any other reason that the Investigator considers makes the subject unsuitable to participate.
Facility Information:
Facility Name
Glenfield Hospital
City
Leicester
ZIP/Postal Code
LE3 9QP
Country
United Kingdom
Facility Name
Royal Liverpool University Hospital
City
Liverpool
ZIP/Postal Code
L7 8XP
Country
United Kingdom
Facility Name
Royal Brompton Hospital
City
London
ZIP/Postal Code
SW3 6NP
Country
United Kingdom
Facility Name
Northwest Lung Research Centre
City
Manchester
ZIP/Postal Code
M23 9LT
Country
United Kingdom
12. IPD Sharing Statement
Learn more about this trial
The Effect of PC945 on Aspergillus or Candida Lung Infections in Patients With Asthma or Chronic Respiratory Diseases
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