A Study of OligoG in Cystic Fibrosis Subjects With Burkholderia Spp. Infection (SMR-2591)
Primary Purpose
Cystic Fibrosis, Burkholderia Infection
Status
Completed
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Alginate oligosaccharide
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Cystic Fibrosis focused on measuring alginate oligosaccharide, cystic fibrosis, Burkholderia, aztreonam
Eligibility Criteria
Inclusion Criteria:
Male or female with a confirmed diagnosis of cystic fibrosis defined by:
- Clinical features consistent with the diagnosis of CF; AND
- Sweat chloride ≥60 mmol/L by pilocarpine iontophoresis; OR
- Genotypic confirmation of CFTR mutation
- Aged 18 years or older
- Ability to provide sputum samples for microbiological evaluation throughout the study either spontaneously or induced.
- Chronic colonization with Burkholderia spp. defined as at least two positive microbiological cultures in expectorated sputum within the last 12 months from Visit 1.
- Use of inhaled aztreonam three times daily in a 4 weeks on/off cycle treatment regimen or a continuous intake regimen for at least 4 weeks before screening visit. For on/off cycles, screening visit should take place in the off phase. Randomization visit should take place the first day "on" to harmonize the aztreonam inhalation period with the IMP intake period.
- Willingness to stop treatment with other inhaled antibiotics.
- At Screening no clinical or laboratory findings suggestive of significant pulmonary illness, other than CF, which in the opinion of the investigator would preclude participation in the study.
- FEV1 greater than 25% of the predicted normal value following adjustment for age, gender, and height according to the Global Lung Initiative
- Female subjects of child bearing potential and male subjects participating in the study who are sexually active must use acceptable contraception. Female subjects documented as being of non-child-bearing potential are exempt from the contraceptive requirements.
- Provision of written informed consent.
Exclusion Criteria:
- Changes in underlying therapy within the 14 days prior to Day 0. Subjects must be willing to remain on the same underlying stable therapy regimens for the duration of the study until the final follow-up visit at Day 98.
- Changes in physiotherapy technique or schedule within 14 days prior to Day 0.
- Prohibited medications within 7 days prior to Day 0. Concomitant administration of inhaled mannitol or hypertonic saline within 7 days prior to Day 0.
- Concomitant use of inhaled antibiotics other than aztreonam.
- Pulmonary exacerbation within 28 days of Screening.
- Lactose intolerance/milk allergy.
- On-going acute illness. Subjects must not have needed an outpatient visit, hospitalization or required any change in therapy for other pulmonary disease between Screening and Day 0.
- History of, or planned organ transplantation.
- Active allergic bronchopulmonary aspergillosis (ABPA) in the last 12 months prior to Screening, defined as having received treatment for ABPA.
- Inability or unwillingness to provide sputum samples for microbiological evaluation throughout the study either spontaneously or induced by means of using inhaled hypertonic saline.
- Clinically significant abnormal findings on haematology or clinical chemistry. In addition, any value ≥ 3 x the upper limit of normal will exclude the subject from participating in the study.
- Subjects unable to perform pulmonary function tests according to the ATS/ERS criteria.
- Pregnant or breast-feeding women. A negative urine pregnancy test must be demonstrated in females of child-bearing potential at Screening.
- Subjects who have participated in any interventional clinical trial within the 28 days prior to Day 0.
- Subjects with documented or suspected, clinically significant, alcohol or drug abuse, as determined by the Investigator.
- Current malignant disease (with the exception of basal cell carcinoma; BCC).
- Any serious or active medical or psychiatric illness, which in the opinion of the Investigator, would interfere with subject treatment, assessment, or compliance with the protocol.
- Patients not willing/able to follow the study instructions.
- Resistance to aztreonam, or intolerance to aztreonam or any of its excipients.
Sites / Locations
- Pneumologische Praxis Pasing
- Charité Universitätsmedizin Berlin
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Placebo Comparator
Arm Label
Alginate oligosaccharide
Placebo
Arm Description
Inhalation of a dry powder OligoG in the first treatment period, and placebo in the second period
Inhalation of placebo dry powder in the first treatment period, and OligoG in the second period
Outcomes
Primary Outcome Measures
Changes in Burkholderia spp. density in expectorated sputum and/or induced sputum.
Secondary Outcome Measures
Clinical safety as measured by vital signs
Measurement of vital signs
Clinical safety as measured by ECG
Measurement of ECG
Clinical safety as measured by blood oxygen saturation
Measurement of blood oxygen saturation
Clinical safety as measured by FEV1 (Forced Expiratory Volume in 1 second)
Measurement of pulmonary function tests
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02453789
Brief Title
A Study of OligoG in Cystic Fibrosis Subjects With Burkholderia Spp. Infection
Acronym
SMR-2591
Official Title
A Randomized Double-blind, Placebo-controlled Cross-over Study of Inhaled Alginate Oligosaccharide (OligoG) for 28 Days in Subjects With Cystic Fibrosis Using Aztreonam Due to Chronic Colonization With Burkholderia Spp.
Study Type
Interventional
2. Study Status
Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
February 2015 (undefined)
Primary Completion Date
March 2017 (Actual)
Study Completion Date
December 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AlgiPharma AS
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of the study is to assess the efficacy of Alginate oligosaccharide (OligoG) dry powder for inhalation in cystic fibrosis (CF) patients with a Burkholderia spp. infection.
Detailed Description
Primary objective:
To explore the efficacy of inhaled OligoG in reducing the microbial burden of Burkholderia spp. as measured in expectorated sputum samples.
Secondary objectives:
To explore the effect of inhaled OligoG on various efficacy variables such as lung function, Quality-of-Life, rheology and other microbiological outcome measures.
To evaluate the safety, tolerability and subject compliance with treatment The study will also evaluate the effect of inhaled OligoG on various efficacy variables such as lung function, Quality-of-Life, rheology and other microbiological outcome measures, and evaluate the safety and patient compliance with treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis, Burkholderia Infection
Keywords
alginate oligosaccharide, cystic fibrosis, Burkholderia, aztreonam
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
15 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Alginate oligosaccharide
Arm Type
Active Comparator
Arm Description
Inhalation of a dry powder OligoG in the first treatment period, and placebo in the second period
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Inhalation of placebo dry powder in the first treatment period, and OligoG in the second period
Intervention Type
Drug
Intervention Name(s)
Alginate oligosaccharide
Other Intervention Name(s)
OligoG
Intervention Description
Inhalation of dry powder for inhalation (DPI)
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Changes in Burkholderia spp. density in expectorated sputum and/or induced sputum.
Time Frame
28 days, i.e. at start and end of treatment
Secondary Outcome Measure Information:
Title
Clinical safety as measured by vital signs
Description
Measurement of vital signs
Time Frame
Time Frame: Screening, day 0, 14, 28, 56, 70, 84 and follow up at day 112
Title
Clinical safety as measured by ECG
Description
Measurement of ECG
Time Frame
Time Frame: Screening, day 0, 14, 28, 56, 70, 84 and follow upat day 112
Title
Clinical safety as measured by blood oxygen saturation
Description
Measurement of blood oxygen saturation
Time Frame
Time Frame: Screening, day 0, 14, 28, 56, 70, 84 and follow upat day 112
Title
Clinical safety as measured by FEV1 (Forced Expiratory Volume in 1 second)
Description
Measurement of pulmonary function tests
Time Frame
Time Frame: Screening, day 0, 14, 28, 56, 70, 84 and follow up at day 112
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female with a confirmed diagnosis of cystic fibrosis defined by:
Clinical features consistent with the diagnosis of CF; AND
Sweat chloride ≥60 mmol/L by pilocarpine iontophoresis; OR
Genotypic confirmation of CFTR mutation
Aged 18 years or older
Ability to provide sputum samples for microbiological evaluation throughout the study either spontaneously or induced.
Chronic colonization with Burkholderia spp. defined as at least two positive microbiological cultures in expectorated sputum within the last 12 months from Visit 1.
Use of inhaled aztreonam three times daily in a 4 weeks on/off cycle treatment regimen or a continuous intake regimen for at least 4 weeks before screening visit. For on/off cycles, screening visit should take place in the off phase. Randomization visit should take place the first day "on" to harmonize the aztreonam inhalation period with the IMP intake period.
Willingness to stop treatment with other inhaled antibiotics.
At Screening no clinical or laboratory findings suggestive of significant pulmonary illness, other than CF, which in the opinion of the investigator would preclude participation in the study.
FEV1 greater than 25% of the predicted normal value following adjustment for age, gender, and height according to the Global Lung Initiative
Female subjects of child bearing potential and male subjects participating in the study who are sexually active must use acceptable contraception. Female subjects documented as being of non-child-bearing potential are exempt from the contraceptive requirements.
Provision of written informed consent.
Exclusion Criteria:
Changes in underlying therapy within the 14 days prior to Day 0. Subjects must be willing to remain on the same underlying stable therapy regimens for the duration of the study until the final follow-up visit at Day 98.
Changes in physiotherapy technique or schedule within 14 days prior to Day 0.
Prohibited medications within 7 days prior to Day 0. Concomitant administration of inhaled mannitol or hypertonic saline within 7 days prior to Day 0.
Concomitant use of inhaled antibiotics other than aztreonam.
Pulmonary exacerbation within 28 days of Screening.
Lactose intolerance/milk allergy.
On-going acute illness. Subjects must not have needed an outpatient visit, hospitalization or required any change in therapy for other pulmonary disease between Screening and Day 0.
History of, or planned organ transplantation.
Active allergic bronchopulmonary aspergillosis (ABPA) in the last 12 months prior to Screening, defined as having received treatment for ABPA.
Inability or unwillingness to provide sputum samples for microbiological evaluation throughout the study either spontaneously or induced by means of using inhaled hypertonic saline.
Clinically significant abnormal findings on haematology or clinical chemistry. In addition, any value ≥ 3 x the upper limit of normal will exclude the subject from participating in the study.
Subjects unable to perform pulmonary function tests according to the ATS/ERS criteria.
Pregnant or breast-feeding women. A negative urine pregnancy test must be demonstrated in females of child-bearing potential at Screening.
Subjects who have participated in any interventional clinical trial within the 28 days prior to Day 0.
Subjects with documented or suspected, clinically significant, alcohol or drug abuse, as determined by the Investigator.
Current malignant disease (with the exception of basal cell carcinoma; BCC).
Any serious or active medical or psychiatric illness, which in the opinion of the Investigator, would interfere with subject treatment, assessment, or compliance with the protocol.
Patients not willing/able to follow the study instructions.
Resistance to aztreonam, or intolerance to aztreonam or any of its excipients.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Rainald Fischer, MD, PD
Organizational Affiliation
Pneumologische Praxis Pasing
Official's Role
Principal Investigator
Facility Information:
Facility Name
Pneumologische Praxis Pasing
City
Münich
State/Province
Münich-Pasing
ZIP/Postal Code
81241
Country
Germany
Facility Name
Charité Universitätsmedizin Berlin
City
Berlin
ZIP/Postal Code
13353
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
35086790
Citation
Fischer R, Schwarz C, Weiser R, Mahenthiralingam E, Smerud K, Meland N, Flaten H, Rye PD. Evaluating the alginate oligosaccharide (OligoG) as a therapy for Burkholderia cepacia complex cystic fibrosis lung infection. J Cyst Fibros. 2022 Sep;21(5):821-829. doi: 10.1016/j.jcf.2022.01.003. Epub 2022 Jan 24.
Results Reference
derived
PubMed Identifier
32671834
Citation
Hurley MN, Smith S, Forrester DL, Smyth AR. Antibiotic adjuvant therapy for pulmonary infection in cystic fibrosis. Cochrane Database Syst Rev. 2020 Jul 16;7(7):CD008037. doi: 10.1002/14651858.CD008037.pub4.
Results Reference
derived
Learn more about this trial
A Study of OligoG in Cystic Fibrosis Subjects With Burkholderia Spp. Infection
We'll reach out to this number within 24 hrs