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Study to Evaluate ARINA-1 in the Prevention of Bronchiolitis Obliterans Progression in Participants With Bilateral Lung Transplant

Primary Purpose

Pre-Bronchiolitis Obliterans Syndrome

Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
ARINA-1
Standard of care only
Sponsored by
Renovion, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pre-Bronchiolitis Obliterans Syndrome

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Bilateral lung transplant >12 months from the time of Visit 1 / Randomization Age 18-75 years old at the time of consent Routinely followed at enrolling site Willing and able to comply with visit schedule and at-home requirements 10-24% decrease in FEV1 from the post-transplant baseline within the last 12 months. Capable of giving informed consent On a stable maintenance regimen of azithromycin for >4 weeks prior to the Screening Visit On a stable 3-agent immunosuppression regimen that includes a steroid, a calcineurin inhibitor (CNI), and cell cycle inhibitor (e.g., mycophenolate, azathioprine) >4 weeks prior to Screening If a woman of childbearing potential (WOCBP), must agree to use a reliable method of birth control for the entire duration of the study. Exclusion Criteria: Positive urine pregnancy test at screening and baseline visit Diagnosis of active congestive heart failure or symptomatic coronary artery disease > grade 3 based on the New York Heart Association Functional Classification (NYHA) criteria Restrictive allograft syndrome (RAS) defined by radiographic interstitial or alveolar opacities on chest X-ray or CT scan that are consistent with RAS Have advanced BOS, defined by >24% decrease in FEV1 in post-transplant baseline A diagnosis of probable antibody-mediated rejection (AMR) <12 months prior to the baseline visit Donor-specific antibodies (DSA) identified <6 months prior to the baseline visit. *The presence of DSA >6 months from the baseline visit is acceptable for enrollment into the study. Unresolved diffuse alveolar damage Receiving mechanical ventilation Chronic kidney disease stage IV or higher, including on dialysis Initiating a new maintenance therapy or changing immunosuppression maintenance therapy (e.g., changing tacrolimus to cyclosporine) <14 days prior to the baseline visit. Currently using an mTOR inhibitor or azathioprine Initiating or changing antibiotic (including azithromycin), antiviral, or antifungal therapy <14 days prior to the baseline visit. Use of alemtuzumab <6 months prior to the baseline visit Use of anti-thymocyte therapies (e.g., anti-thymocyte globulin) or photopheresis <90 days prior to the Screening Visit. Prior use of Trikafta (elexacaftor, ivacaftor, and tezacaftor is allowed as long as the participant has been on stable dose for >90 days prior to the Screening Visit. Initiating a multivitamin or other supplement (inhaled, oral, or IV) containing vitamin C, glutathione, or N-acetylcysteine <90 days prior to the baseline visit Significant unstable comorbidities, in the opinion of the site investigator Allery or previous adverse reaction to azithromycin A diagnosis of dynamic collapse / tracheobrochomalacia <90 days of the baseline visit. Subjects currently participating in, or who have participated in an interventional (drug or device) clinical study <30 days of the baseline visit. Have been diagnosed with ARAD within 6 weeks of the Screening Visit. Have used belatacept <6 months prior to Clinic Visit 1 Have had bronchial stents or cryotherapy within 12 months of the Screening Visit

Sites / Locations

  • Dignity Health - St. Joseph's Hospital and Medical Center
  • University of California Log Angeles School of MedicineRecruiting
  • University of California San Diego HealthRecruiting
  • Adventist Health
  • University of South FloridaRecruiting
  • University of Iowa HospitalRecruiting
  • Johns Hopkins HospitalRecruiting
  • University of Minnesota Medical SchoolRecruiting
  • Washington University School of MedicineRecruiting
  • Columbia University Irving Medical CenterRecruiting
  • Cleveland ClinicRecruiting
  • The Ohio State University Wexner Medical CenterRecruiting
  • Medical University of South CarolinaRecruiting
  • University of Texas Southwestern Medical CenterRecruiting
  • Baylor Scott and White Research Institute
  • Houston Methodist HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

ARINA-1 plus standard of care

Standard of care only

Arm Description

ARINA-1 (88 mg/mL ascorbic acid, ASC; 150 mg/mL reduced glutathione, GSH); fixed dose, 4 mL solution inhaled twice daily via nebulization plus standard 3-therapy immunosuppression regimen and azithromycin

Standard 3-therapy immunosuppression regimen and azithromycin

Outcomes

Primary Outcome Measures

Percentage change from baseline in FEV1 (%ΔFEV1)
Week 24 (mL) - Baseline (mL) = ΔFEV1 (mL) ΔFEV1 (mL) / Baseline (mL) x 100 = %ΔFEV1

Secondary Outcome Measures

Percentage change from baseline of Forced Expiratory Volume in one second (FEV1)
Week 48 (mL) - Baseline (mL) = ΔFEV1 (mL) ΔFEV1 (mL) / Baseline (mL) x 100 = %ΔFEV1
Percentage change from baseline of Forced Vital Capacity (FVC)
Percentage change from baseline of FVC
Percentage change from baseline of FEF25-75%
Percentage change from baseline of FEF25-75%
Number of participants in each arm with augmented immunosuppression
number
Number of participants in each arm with augmented immunosuppression
Time to initiation of augmented immunosuppression
Length of time to when participant requires a change in their immunosuppression regimen
Change from baseline in Saint George's Respiratory Questionnaire total score
quality of life questionnaire, total score of 0 to 100, higher score = more limitations
Change from baseline in Saint George's Respiratory Questionnaire total score
quality of life questionnaire, total score of 0 to 100, higher score = more limitations

Full Information

First Posted
December 8, 2022
Last Updated
September 20, 2023
Sponsor
Renovion, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05654922
Brief Title
Study to Evaluate ARINA-1 in the Prevention of Bronchiolitis Obliterans Progression in Participants With Bilateral Lung Transplant
Official Title
A Phase 3, Open-label, Randomized, Standard of Care-controlled, Parallel Study Arm Study to Demonstrate Efficacy and Safety of ARINA-1 in the Prevention of Bronchiolitis Obliterans Syndrome (BOS) Progression in Participants With a Bilateral Lung Transplant
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 10, 2023 (Actual)
Primary Completion Date
January 2024 (Anticipated)
Study Completion Date
July 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Renovion, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The goal of this clinical trial is to compare ARINA-1 plus Standard of Care vs Standard of Care alone. The main question it aims to answer are: Evaluate the effectiveness of ARINA-1 in preventing bronchiolitis obliterans syndrome (BOS) progression in participants with a bilateral lung transplant To evaluate the effectiveness of ARINA-1 on improving quality of life decline and preventing or delaying the use of augmented immunosuppression in participants with pre-BOS relative to SOC. Participants will have clinic visits at screening, randomization (day 1) and weeks 4, 12, 18, and 24. After week 24, participants will have clinic visits at weeks 32, 40, and 48. Participants will also have a telehealth visit on day 2 and phone calls to assess adverse events (AEs), serious adverse events (SAEs), and review patient education will occur during weeks 5, 8, 36, and 44.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pre-Bronchiolitis Obliterans Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Masking Description
For individuals performing spirometry, every attempt will be made to keep them masked to treatment.
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ARINA-1 plus standard of care
Arm Type
Experimental
Arm Description
ARINA-1 (88 mg/mL ascorbic acid, ASC; 150 mg/mL reduced glutathione, GSH); fixed dose, 4 mL solution inhaled twice daily via nebulization plus standard 3-therapy immunosuppression regimen and azithromycin
Arm Title
Standard of care only
Arm Type
Other
Arm Description
Standard 3-therapy immunosuppression regimen and azithromycin
Intervention Type
Drug
Intervention Name(s)
ARINA-1
Intervention Description
ARINA-1 (88 mg/mL ascorbic acid, ASC; 150 mg/mL reduced glutathione, GSH)
Intervention Type
Other
Intervention Name(s)
Standard of care only
Intervention Description
Standard 3-therapy immunosuppression regimen and azithromycin
Primary Outcome Measure Information:
Title
Percentage change from baseline in FEV1 (%ΔFEV1)
Description
Week 24 (mL) - Baseline (mL) = ΔFEV1 (mL) ΔFEV1 (mL) / Baseline (mL) x 100 = %ΔFEV1
Time Frame
24 weeks
Secondary Outcome Measure Information:
Title
Percentage change from baseline of Forced Expiratory Volume in one second (FEV1)
Description
Week 48 (mL) - Baseline (mL) = ΔFEV1 (mL) ΔFEV1 (mL) / Baseline (mL) x 100 = %ΔFEV1
Time Frame
48 weeks
Title
Percentage change from baseline of Forced Vital Capacity (FVC)
Time Frame
24 weeks
Title
Percentage change from baseline of FVC
Time Frame
48 weeks
Title
Percentage change from baseline of FEF25-75%
Time Frame
24 weeks
Title
Percentage change from baseline of FEF25-75%
Time Frame
48 weeks
Title
Number of participants in each arm with augmented immunosuppression
Description
number
Time Frame
24 weeks
Title
Number of participants in each arm with augmented immunosuppression
Time Frame
48 weeks
Title
Time to initiation of augmented immunosuppression
Description
Length of time to when participant requires a change in their immunosuppression regimen
Time Frame
over the duration of the 48 week trial
Title
Change from baseline in Saint George's Respiratory Questionnaire total score
Description
quality of life questionnaire, total score of 0 to 100, higher score = more limitations
Time Frame
24 weeks
Title
Change from baseline in Saint George's Respiratory Questionnaire total score
Description
quality of life questionnaire, total score of 0 to 100, higher score = more limitations
Time Frame
48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Bilateral lung transplant >12 months from the time of Visit 1 / Randomization Age 18-75 years old at the time of consent Routinely followed at enrolling site Willing and able to comply with visit schedule and at-home requirements 10-24% decrease in FEV1 from the post-transplant baseline within the last 12 months. Capable of giving informed consent On a stable maintenance regimen of azithromycin for >4 weeks prior to the Screening Visit On a stable 3-agent immunosuppression regimen that includes a steroid, a calcineurin inhibitor (CNI), and cell cycle inhibitor (e.g., mycophenolate, azathioprine) >4 weeks prior to Screening If a woman of childbearing potential (WOCBP), must agree to use a reliable method of birth control for the entire duration of the study. Exclusion Criteria: Positive urine pregnancy test at screening and baseline visit Diagnosis of active congestive heart failure or symptomatic coronary artery disease > grade 3 based on the New York Heart Association Functional Classification (NYHA) criteria Restrictive allograft syndrome (RAS) defined by radiographic interstitial or alveolar opacities on chest X-ray or CT scan that are consistent with RAS Have advanced BOS, defined by >24% decrease in FEV1 in post-transplant baseline A diagnosis of probable antibody-mediated rejection (AMR) <12 months prior to the baseline visit Donor-specific antibodies (DSA) identified <6 months prior to the baseline visit. *The presence of DSA >6 months from the baseline visit is acceptable for enrollment into the study. Unresolved diffuse alveolar damage Receiving mechanical ventilation Chronic kidney disease stage IV or higher, including on dialysis Initiating a new maintenance therapy or changing immunosuppression maintenance therapy (e.g., changing tacrolimus to cyclosporine) <14 days prior to the baseline visit. Currently using an mTOR inhibitor or azathioprine Initiating or changing antibiotic (including azithromycin), antiviral, or antifungal therapy <14 days prior to the baseline visit. Use of alemtuzumab <6 months prior to the baseline visit Use of anti-thymocyte therapies (e.g., anti-thymocyte globulin) or photopheresis <90 days prior to the Screening Visit. Prior use of Trikafta (elexacaftor, ivacaftor, and tezacaftor is allowed as long as the participant has been on stable dose for >90 days prior to the Screening Visit. Initiating a multivitamin or other supplement (inhaled, oral, or IV) containing vitamin C, glutathione, or N-acetylcysteine <90 days prior to the baseline visit Significant unstable comorbidities, in the opinion of the site investigator Allery or previous adverse reaction to azithromycin A diagnosis of dynamic collapse / tracheobrochomalacia <90 days of the baseline visit. Subjects currently participating in, or who have participated in an interventional (drug or device) clinical study <30 days of the baseline visit. Have been diagnosed with ARAD within 6 weeks of the Screening Visit. Have used belatacept <6 months prior to Clinic Visit 1 Have had bronchial stents or cryotherapy within 12 months of the Screening Visit
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Carolyn Durham, PhD
Phone
919-240-7034
Email
info@renovion.com
First Name & Middle Initial & Last Name or Official Title & Degree
Will Anderson
Phone
919-240-7034
Email
info@renovion.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ramsey Hachem, MD
Organizational Affiliation
Barnes-Jewish Hospital / Washington University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dignity Health - St. Joseph's Hospital and Medical Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85013
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brian Mutoff
First Name & Middle Initial & Last Name & Degree
Rajat Walia, MD
Facility Name
University of California Log Angeles School of Medicine
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Lopez
Phone
310-794-8595
Email
PLopez@mednet.ucla.edu
First Name & Middle Initial & Last Name & Degree
Sam Weigt, MD
Facility Name
University of California San Diego Health
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Amber Martineau
Phone
619-471-0817
Email
ajm002@health.ucsd.edu
First Name & Middle Initial & Last Name & Degree
Jiao Zhang, MD, PhD
Phone
619-471-0802
Email
jiz161@health.ucsd.edu
First Name & Middle Initial & Last Name & Degree
Kamyar Afsher, MD
Facility Name
Adventist Health
City
Orlando
State/Province
Florida
ZIP/Postal Code
32803
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
June Kim, MD
Email
june.kim.md@adventhealth.com
First Name & Middle Initial & Last Name & Degree
646 385 0044
First Name & Middle Initial & Last Name & Degree
June Kim, MD
Facility Name
University of South Florida
City
Tampa
State/Province
Florida
ZIP/Postal Code
33606
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michelle Beck
Email
mbeck@tgh.org
First Name & Middle Initial & Last Name & Degree
Muhammed Qureshi, MD
Facility Name
University of Iowa Hospital
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mary Teresi
Phone
319-384-7546
Email
mary-teresi@uiowa.edu
First Name & Middle Initial & Last Name & Degree
Tahuanty Pena, MD
Facility Name
Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joby Mathew
Phone
410-550-6458
Email
jmathe27@jhmi.edu
First Name & Middle Initial & Last Name & Degree
Christian Merlo, MD
Facility Name
University of Minnesota Medical School
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55455
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mary Bailey
Phone
612-626-2743
Email
mpbailey@umn.edu
First Name & Middle Initial & Last Name & Degree
Sarah Kiel, MD
Facility Name
Washington University School of Medicine
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brigitte Mittler
Phone
314-747-1931
Email
b.mittler@wustl.edu
First Name & Middle Initial & Last Name & Degree
Ramsay Hachem, MD
Facility Name
Columbia University Irving Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Leo Suarez
Phone
646-528-9006
Email
ls955@cumc.columbia.edu
First Name & Middle Initial & Last Name & Degree
Selim Arcasoy, MD
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rijuta Singh, MD
Phone
216-894-3826
Email
singhr13@ccf.org
First Name & Middle Initial & Last Name & Degree
Marie Budev, MD
Facility Name
The Ohio State University Wexner Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43221
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brent Oleksak
Phone
614-366-2775
Email
Brent.Oleksak@osumc.edu
First Name & Middle Initial & Last Name & Degree
Justin Rosenheck, MD
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29452
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sara Garcia, MS
Phone
843-792-5885
Email
garcisar@musc.edu
First Name & Middle Initial & Last Name & Degree
Tim Whelan, MD
Facility Name
University of Texas Southwestern Medical Center
City
Dallas
State/Province
Texas
ZIP/Postal Code
45390
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rama Diallo
Email
Ramatoulaye.Diallo@utsouthwestern.edu
First Name & Middle Initial & Last Name & Degree
Alan Jacob
Email
Alan.Jacob@utsouthwestern.edu
First Name & Middle Initial & Last Name & Degree
Vaidehi Kaza, MD
Facility Name
Baylor Scott and White Research Institute
City
Dallas
State/Province
Texas
ZIP/Postal Code
75246
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kristen Paasch
Phone
214-865-4994
Email
Kristen.Paasch@BSWHealth.org
First Name & Middle Initial & Last Name & Degree
Felicia Padilla
Phone
214-820-1771
Email
felicia.padilla@bswhealth.org
First Name & Middle Initial & Last Name & Degree
Todd Grazia, MD
Facility Name
Houston Methodist Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mohanad Alhalboos, MD
Phone
713-441-6285
Email
malhalboos@houstonmethodist.org
First Name & Middle Initial & Last Name & Degree
Doris Onyekwere, MD
Phone
346-238-4586
Email
donyekwere@houstonmethodist.org
First Name & Middle Initial & Last Name & Degree
Howard Huang, MD

12. IPD Sharing Statement

Learn more about this trial

Study to Evaluate ARINA-1 in the Prevention of Bronchiolitis Obliterans Progression in Participants With Bilateral Lung Transplant

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