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A Phase 2b Randomised, Placebo Controlled Study of OligoG in Patients With Cystic Fibrosis

Primary Purpose

Cystic Fibrosis

Status
Unknown status
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
OligoG DPI
Sponsored by
AlgiPharma AS
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cystic Fibrosis focused on measuring cystic fibrosis

Eligibility Criteria

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

Inclusion Criteria:

  • Genotypic confirmation of CFTR mutation or clinical diagnosis of Cystic Fibrosis (CF) confirmed by a sweat chloride value ≥60 mmol/L by quantitative pilocarpine iontophoresis.
  • Age 18 years or older.
  • Male or female patients with any ethnicity.
  • FEV1 at screening in the range of ≥40% and 90% of the predicted normal for age, sex, and height, according to the GLI equation (Eur Respir J. Dec 2012; 40(6): 1324-1343).
  • History of Pseudomonas aeruginosa (PA) infection with at least one positive microbiological PA testing during the last 12 months before the Screening Visit.
  • History of antibiotic treatment due to PA infection (not for eradication therapy) during the last 12 months
  • Concomitant treatment with inhaled tobramycin, colistin, or aztreonam (either cycled or continuous) for at least 3 months at screening to treat PA infection. In case of cycled antibiotic treatment, the treatment should start with an active cycle at the day of randomisation (+/- 2 day) (together with the IMP intake). If taking tobramycin cycled with another antibiotic, IMP should start on the active cycle of tobramycin.
  • Stable CF disease as judged by the investigator.
  • Willing to remain on a stable CF medication regimen (standard of care; SOC) during the study.
  • Women of child-bearing potential must have a negative urine pregnancy test at the Screening and Randomisation Visit.
  • Male and female patients must use acceptable contraceptive methods for the duration of the study. Male and female patients without child-bearing potential (i.e. who are infertile, surgically sterile or post-menopausal) are exempted from the contraceptive requirements. For the purpose of this study acceptable contraception is defined as one or a combination of the following:

    • oral, injected, transdermal or implanted hormonal methods of contraception; placement of an intrauterine device (IUD) or intrauterine system (IUS); barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository.
  • Capable of inhaling dry powder.
  • Willing to sign informed consent
  • Willing and able to follow the study procedures.

Exclusion Criteria:

  • Use of hypertonic saline more than 2 times a day. If hypertonic saline is used, OligoG inhalation should be taken at least 15 minutes after completion of hypertonic saline therapy.
  • Use of CFTR modulator therapies.
  • Clinically significant abnormal findings of haematology or clinical chemistry;

    • Elevated gamma GT (GGT), ALT, or AST > 3x the upper normal limit of normal (ULN)
    • Bilirubin >2x ULN
    • Abnormal renal function, with a creatinine clearance calculated <50ml/min
    • Haemoglobin <10g/dL
  • History of any comorbidity that, in the opinion of the investigator, might distort the results of the study or cause an additional risk in administering study drug to the patient.
  • Pulmonary exacerbation within 28 days prior to randomisation.
  • Change in CF therapy within 28 days before randomisation (first dose of IMP).
  • Pregnant or breastfeeding females.
  • History of allergic reactions to the ingredients of the IMP according to Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, including lactose and milk protein.
  • Patients unable to perform pulmonary function tests according to the ATS/ERS criteria.
  • Uncontrolled or unstable chronic diseases (e.g. congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations) that would limit the compliance with study requirements in the opinion of the investigator.
  • Any acute illness in the last 14 days
  • History of, or planned organ transplantation.
  • Lung infection with organisms associated with a more rapid decline in pulmonary status (including, but not limited to Burkholderia cenocepacia, Burkholderia dolosa, and Mycobacterium abscessus). For subjects who have had a history of a positive culture, the following criteria will be used to determine whether the subject is free of infection with such organisms:-

    • The subject has not had a respiratory tract culture positive for these organisms within the 12 months before the date of informed consent, and
    • The subject has had at least 2 respiratory tract cultures negative for such organisms within the 12 months before the date of informed consent, with the first and last of these separated by at least 3 months, and the most recent one within the 6 months before the date of informed consent.
  • Active allergic bronchopulmonary aspergillosis (ABPA) in the last 12 months prior to the Screening Visit, that has received pharmacological treatment for ABPA.
  • Requirement for continuous (24 hour/day) oxygen supplementation.
  • Patients currently receiving any other investigational treatment, or who have participated in a clinical study within 4 weeks (28 days) prior to the screening visit.
  • Current malignant disease (with the exception of basal cell carcinoma and cervical neoplasia).
  • Any medical or psychological condition, other than CF, which in the opinion of the investigator exposes the patient to an unacceptably high risk.
  • Patients with documented or suspected, clinically significant, alcohol or drug abuse as per Investigator's discretion.

Sites / Locations

  • John Hunter Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

OligoG DPI

Placebo DPI

Arm Description

Active DPI containing the oligosaccharide OligoG and excipients

Placebo DPI containing lactose and excipients

Outcomes

Primary Outcome Measures

FEV1 percent predicted
Absolute change in percent Forced Expiratory Volume in one second,

Secondary Outcome Measures

Pulmonary exacerbation rate
rate of pulmonary exacerbations

Full Information

First Posted
January 29, 2019
Last Updated
May 25, 2020
Sponsor
AlgiPharma AS
Collaborators
AlgiPharma Australia Pty. Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT03822455
Brief Title
A Phase 2b Randomised, Placebo Controlled Study of OligoG in Patients With Cystic Fibrosis
Official Title
A Phase 2b Randomised, Double-blind, Parallel-group Study of Alginate Oligosaccharide (OligoG) Dry Powder Inhalation in Addition to Standard of Care Compared to Placebo in Addition to Standard of Care in Patients With Cystic Fibrosis (CF)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2020
Overall Recruitment Status
Unknown status
Study Start Date
May 16, 2019 (Actual)
Primary Completion Date
March 11, 2020 (Actual)
Study Completion Date
July 10, 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AlgiPharma AS
Collaborators
AlgiPharma Australia Pty. 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
A double-blind, randomised study of OligoG DPI compared to placebo DPI, both on top of standard-of-care, to assess safety, efficacy and tolerability. Adult patients with Cystic Fibrosis will be included in the study.
Detailed Description
The alginate oligosaccharide OligoG CF-5/20 dry powder for inhalation (OligoG DPI) represents a novel therapeutic approach for patients with cystic fibrosis (CF). OligoG has been shown to release stagnant mucus, modulate sputum rheology and disrupt the biofilm formation often typically observed in CF. These properties will in turn facilitate mucus clearance and promote effectiveness of antibiotic therapy against the chronic pulmonary infections characteristic of CF. Patients with CF (age 18 years or older) will be eligible to participate in this study. The design will be a randomised, blinded, placebo-controlled pilot study for proof of concept that OligoG DPI can improve lung function in adult CF patients. Study medication will be given twice daily for twelve weeks on top of standard of care (SOC). Thirty-three patients will be included, out of which twenty-two shall receive OligoG, and eleven shall receive placebo. After all patients have completed the 12 week double blind treatment period, all patients will be offered open-label OligoG twice daily, in addition to standard of care, for 12 months. The primary endpoint will be absolute change i percent predicted FEV1 Exploratory parameters will include sputum microbiology.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis
Keywords
cystic fibrosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Randomised, double blind, placebo controlled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Patients will be randomised to receive OligoG or placebo DPI. The investigational medicinal products will have identical appearance
Allocation
Randomized
Enrollment
20 (Actual)

8. Arms, Groups, and Interventions

Arm Title
OligoG DPI
Arm Type
Active Comparator
Arm Description
Active DPI containing the oligosaccharide OligoG and excipients
Arm Title
Placebo DPI
Arm Type
Placebo Comparator
Arm Description
Placebo DPI containing lactose and excipients
Intervention Type
Drug
Intervention Name(s)
OligoG DPI
Intervention Description
OligoG Dry Powder for Inhalation
Primary Outcome Measure Information:
Title
FEV1 percent predicted
Description
Absolute change in percent Forced Expiratory Volume in one second,
Time Frame
Baseline compared to 12 weeks
Secondary Outcome Measure Information:
Title
Pulmonary exacerbation rate
Description
rate of pulmonary exacerbations
Time Frame
6 months before treatment, 6 months after treatment,

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Genotypic confirmation of CFTR mutation or clinical diagnosis of Cystic Fibrosis (CF) confirmed by a sweat chloride value ≥60 mmol/L by quantitative pilocarpine iontophoresis. Age 18 years or older. Male or female patients with any ethnicity. FEV1 at screening in the range of ≥40% and 90% of the predicted normal for age, sex, and height, according to the GLI equation (Eur Respir J. Dec 2012; 40(6): 1324-1343). History of Pseudomonas aeruginosa (PA) infection with at least one positive microbiological PA testing during the last 12 months before the Screening Visit. History of antibiotic treatment due to PA infection (not for eradication therapy) during the last 12 months Concomitant treatment with inhaled tobramycin, colistin, or aztreonam (either cycled or continuous) for at least 3 months at screening to treat PA infection. In case of cycled antibiotic treatment, the treatment should start with an active cycle at the day of randomisation (+/- 2 day) (together with the IMP intake). If taking tobramycin cycled with another antibiotic, IMP should start on the active cycle of tobramycin. Stable CF disease as judged by the investigator. Willing to remain on a stable CF medication regimen (standard of care; SOC) during the study. Women of child-bearing potential must have a negative urine pregnancy test at the Screening and Randomisation Visit. Male and female patients must use acceptable contraceptive methods for the duration of the study. Male and female patients without child-bearing potential (i.e. who are infertile, surgically sterile or post-menopausal) are exempted from the contraceptive requirements. For the purpose of this study acceptable contraception is defined as one or a combination of the following: oral, injected, transdermal or implanted hormonal methods of contraception; placement of an intrauterine device (IUD) or intrauterine system (IUS); barrier methods of contraception: condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository. Capable of inhaling dry powder. Willing to sign informed consent Willing and able to follow the study procedures. Exclusion Criteria: Use of hypertonic saline more than 2 times a day. If hypertonic saline is used, OligoG inhalation should be taken at least 15 minutes after completion of hypertonic saline therapy. Use of CFTR modulator therapies. Clinically significant abnormal findings of haematology or clinical chemistry; Elevated gamma GT (GGT), ALT, or AST > 3x the upper normal limit of normal (ULN) Bilirubin >2x ULN Abnormal renal function, with a creatinine clearance calculated <50ml/min Haemoglobin <10g/dL History of any comorbidity that, in the opinion of the investigator, might distort the results of the study or cause an additional risk in administering study drug to the patient. Pulmonary exacerbation within 28 days prior to randomisation. Change in CF therapy within 28 days before randomisation (first dose of IMP). Pregnant or breastfeeding females. History of allergic reactions to the ingredients of the IMP according to Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, including lactose and milk protein. Patients unable to perform pulmonary function tests according to the ATS/ERS criteria. Uncontrolled or unstable chronic diseases (e.g. congestive heart failure, cardiac arrhythmia, or psychiatric illness/social situations) that would limit the compliance with study requirements in the opinion of the investigator. Any acute illness in the last 14 days History of, or planned organ transplantation. Lung infection with organisms associated with a more rapid decline in pulmonary status (including, but not limited to Burkholderia cenocepacia, Burkholderia dolosa, and Mycobacterium abscessus). For subjects who have had a history of a positive culture, the following criteria will be used to determine whether the subject is free of infection with such organisms:- The subject has not had a respiratory tract culture positive for these organisms within the 12 months before the date of informed consent, and The subject has had at least 2 respiratory tract cultures negative for such organisms within the 12 months before the date of informed consent, with the first and last of these separated by at least 3 months, and the most recent one within the 6 months before the date of informed consent. Active allergic bronchopulmonary aspergillosis (ABPA) in the last 12 months prior to the Screening Visit, that has received pharmacological treatment for ABPA. Requirement for continuous (24 hour/day) oxygen supplementation. Patients currently receiving any other investigational treatment, or who have participated in a clinical study within 4 weeks (28 days) prior to the screening visit. Current malignant disease (with the exception of basal cell carcinoma and cervical neoplasia). Any medical or psychological condition, other than CF, which in the opinion of the investigator exposes the patient to an unacceptably high risk. Patients with documented or suspected, clinically significant, alcohol or drug abuse as per Investigator's discretion.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Wark
Organizational Affiliation
John Hunter Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
John Hunter Hospital
City
Newcastle
State/Province
New South Wales
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase 2b Randomised, Placebo Controlled Study of OligoG in Patients With Cystic Fibrosis

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