Reduction of Exposure, Inflammation, and Oxidative Stress Following at Least 2 Years of Switching to THS Use Compared to Cigarette Smoking
Primary Purpose
Inflammation, Oxidative Stress, Smoking
Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
THS use
Cigarette smoking
Smoking abstinence
Sponsored by
About this trial
This is an interventional other trial for Inflammation
Eligibility Criteria
Inclusion Criteria:
- Subject is able to understand the information provided in the main ICF and has signed the main ICF.
- Subject is 30-60 years old.
- Subject is healthy based on ECG, spirometry, vital signs, physical examination, medical history and Investigator's assessment.
Cigarette smokers:
- Has smoked ≥ 10 cigarettes/day on average (no brand restriction) over the past 2 years prior to screening.
- Has smoked ≥ 10 cigarettes/day on average (no brand restriction) for at least 10 years.
- Has not used other tobacco and nicotine products apart from cigarettes on a daily basis over the past 2 years prior to screening.
- Smoking status will be verified by urinary cotinine test (≥ 200 ng/mL) and CO breath test (≥ 10 ppm (1)).
THS users:
- Has used ≥ 10 HeatSticks/day on average over the past 2 years prior to screening.
- Has smoked ≥ 10 cigarettes/day on average (no brand restriction) for at least 8 years prior to switching to THS.
- Has smoked < 30 cigarettes/month and used other tobacco products or e-cigarettes < daily over the past 2 years prior to screening.
- Product use will be verified by urinary cotinine test (≥ 200 ng/mL) and CO breath test (< 10 ppm).
Former cigarette smokers:
- Has not smoked cigarettes or used any tobacco or nicotine-containing products on a daily basis over the past 2 years prior to screening.
- Has smoked ≥ 10 cigarettes/day on average (no brand restriction) for at least 8 years prior to stopping smoking.
- Smoking status will be verified by urinary cotinine test (< 100 ng/mL) and CO breath test (< 10 ppm).
Exclusion Criteria:
- As per the judgment of the Investigator, the subject cannot participate in the study for any reason (e.g., medical, psychiatric and/or social reason). The Investigator should specifically evaluate the subject's eligibility considering COVID-19 risk factors and local situation.
- The subject is legally incompetent or physically/mentally incapable of giving consent (e.g., emergency situation, under guardianship, in a social or sanitary establishment, prisoner or involuntarily incarcerated).
- The subject has/had clinically relevant diseases (including but not limited to gastrointestinal, renal, hepatic, neurological, hematological, endocrine, oncological, urological, immunological, pulmonary, and cardiovascular disease) or conditions that in the opinion of the investigator would jeopardize the safety of the subject or affect the validity of the study results.
- The subject has abnormal findings on physical examination, ECG, vital signs, spirometry or in the medical history, deemed clinically significant by investigators.
- The subject has/had within 30 days prior to screening a body temperature >37.5°C or an acute illness (e.g., upper-respiratory-tract infection, viral infection, etc.…) or the subject is confirmed or suspected active COVID-19 infection (based on the signs and symptoms observed at the time of assessment) at screening.
- The subject has used any prescribed or over-the-counter systemic medication with an impact on WBC or 8-epi-PGF2α within 5 half-lives of the medication prior to enrollment in the study (please refer to Appendix B).
- Subject has high blood pressure (hypertension), defined as > 139 mmHg systolic and/or > 89 mmHg diastolic or is currently treated with medication controlling high blood pressure.
- The subject has (FEV1/FVC) < 0.7 and FEV1 < 80% predicted value at post-bronchodilator (BD) spirometry.
- The subject has (FEV1/FVC) < 0.75 (pre-BD) and reversibility in FEV1 (that is both > 12% and > 200 mL from pre- to post-BD values).
- The subject has a history of allergic reactions to salbutamol.
- The subject has a body mass index (BMI) < 18.5 or ≥ 30 kg/m2.
- The subject has positive alcohol and/or drug screening test results.
- The subject has donated or received whole blood or blood products within 3 months prior to V1.
- The subject has been previously screened for this study.
- The subject is a current or former employee of the tobacco or e-cigarettes industry or of their first-degree relatives (parent, sibling, and child).
- The subject is an employee of the investigational site or any other parties involved in the study or of their first-degree relatives (parent, sibling, and child).
- The subject has participated in a clinical study within 3 months prior to V1.
- For women only: the subject is pregnant (does have a positive pregnancy test) or breast-feeding.
Sites / Locations
- Clintrial s.r.o.Recruiting
- Vestra Clinics s.r.o.Recruiting
- emovis GmbHRecruiting
- Sibamed GmbH & Co.KGRecruiting
- Centrum für Diagnostik und Gesundheit, Klinische Forschung und EntwicklungRecruiting
- Praxis Reinfeld MitteRecruiting
- Hautarzt Stuttgart - Hautarztpraxis Leitz & KollegenRecruiting
- National and Kapodistrian University of Athens, Medical school, Attikon Hospital, 2nd Cardiology DepartmentRecruiting
- Hakata ClinicRecruiting
- Nishikumamoto HospitalRecruiting
- Sumida HospitalRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
Cigarette
THS
SA
Arm Description
Current cigarette smokers
THS users with a minimum of 2 years of THS use
Former cigarette smokers with minimum of 2 years of smoking abstinence
Outcomes
Primary Outcome Measures
Carboxyhemoglobin (COHb) in blood
Carboxyhemoglobin (COHb) is assayed from whole blood. Expressed as % of saturation of hemoglobin. Geometric Mean values are provided as descriptive statistics.
Total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (total NNAL) in urine
Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat). Geometric Mean values are provided as descriptive statistics.
White Blood Cell total count (WBC) in blood
Total count in blood (GI/L). Mean values are provided as descriptive statistics.
8-epi-Prostaglandin-F2α (8-epi-PGF2α) in urine
Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat). Geometric Mean values are provided as descriptive statistics.
Secondary Outcome Measures
High-Density Lipoprotein Cholesterol (HDL-C)
Concentrations (mg/dL) measured in serum. Mean values are provided as descriptive statistics.
soluble Intercellular Adhesion Molecule-1 (sICAM-1)
Concentrations (ng/mL) measured in serum. Geometric Mean values are provided as descriptive statistics.
11-dehydrothromboxane B2 (11-DTX-B2)
Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat). Geometric Mean values are provided as descriptive statistics.
Augmentation Index (AIx)
The augmentation index (AIx) is a measure of systemic arterial stiffness, and is defined as the ratio of augmentation (Δ P) to central pulse pressure and expressed as percent. AIx = (ΔP/PP) x 100, where P = pressure and PP = Pulse Pressure.
Forced Expiratory Volume in 1 second (FEV1) %predicted, post-bronchodilator (post-BD)
FEV1 post-bronchodilator and expressed as percentage predicted (FEV1 %pred). Mean values are provided as descriptive statistics.
Full Information
NCT ID
NCT05385055
First Posted
May 17, 2022
Last Updated
December 13, 2022
Sponsor
Philip Morris Products S.A.
1. Study Identification
Unique Protocol Identification Number
NCT05385055
Brief Title
Reduction of Exposure, Inflammation, and Oxidative Stress Following at Least 2 Years of Switching to THS Use Compared to Cigarette Smoking
Official Title
A Cross-sectional, Multi-regional Study to Demonstrate Reduction in Exposure to Key Toxicants, Oxidative Stress, and Inflammation Following at Least 2 Years of Tobacco Heating System (THS) Use Compared to Cigarette Smoking
Study Type
Interventional
2. Study Status
Record Verification Date
July 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 13, 2022 (Actual)
Primary Completion Date
October 2023 (Anticipated)
Study Completion Date
February 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Philip Morris Products S.A.
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 is a cross-sectional 3-group study with subjects enrolled and matched by region (Asia, Europe), age, sex, and average daily product consumption over the last 2 years as self-reported. The study will be conducted as a multi-center and multi-regional study, to demonstrate beneficial effects of switching from cigarettes to THS.
Detailed Description
The purpose of this study is primarily to demonstrate beneficial effects of switching from cigarette smoking to THS use for at least 2 years compared to cigarette smoking in a real-life condition on both inflammation and oxidative stress status as a proxy for further long-term harm in healthy subjects, using the well-established and fit-to-purpose measures of WBC and 8-epi-PGF2α, respectively, as indicators of the status of these pathways.
The study aims also at demonstrating additional benefits on other mechanistic pathways along with inflammation and oxidative stress by the means of additional biomarkers of potential harm (BoPH) and to assess association with functional benefits that are expected to be responsive to the extent of exposure to harmful and potentially harmful constituents (HPHCs).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Inflammation, Oxidative Stress, Smoking, Smoking Abstinence
7. Study Design
Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Masking Description
Subjects and Investigators will be unblinded to the subject's group. However, there will be a limited degree of blinding in the data review and data analysis process. In particular, sponsor and contract research organization (CRO) personnel will be blinded to the endpoints tested in the primary objective.
Allocation
Non-Randomized
Enrollment
960 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Cigarette
Arm Type
Active Comparator
Arm Description
Current cigarette smokers
Arm Title
THS
Arm Type
Active Comparator
Arm Description
THS users with a minimum of 2 years of THS use
Arm Title
SA
Arm Type
Active Comparator
Arm Description
Former cigarette smokers with minimum of 2 years of smoking abstinence
Intervention Type
Other
Intervention Name(s)
THS use
Intervention Description
Subjects (current THS users) will continue using THS in real-life setting
Intervention Type
Other
Intervention Name(s)
Cigarette smoking
Intervention Description
Subjects (current cigarette smokers) will continue smoking cigarettes in real-life setting
Intervention Type
Other
Intervention Name(s)
Smoking abstinence
Intervention Description
Subjects (former cigarette smokers) will continue smoking abstinence (confirmed by cotinine test, with a threshold of < 100 ng/mL)
Primary Outcome Measure Information:
Title
Carboxyhemoglobin (COHb) in blood
Description
Carboxyhemoglobin (COHb) is assayed from whole blood. Expressed as % of saturation of hemoglobin. Geometric Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Title
Total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (total NNAL) in urine
Description
Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat). Geometric Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Title
White Blood Cell total count (WBC) in blood
Description
Total count in blood (GI/L). Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Title
8-epi-Prostaglandin-F2α (8-epi-PGF2α) in urine
Description
Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat). Geometric Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Secondary Outcome Measure Information:
Title
High-Density Lipoprotein Cholesterol (HDL-C)
Description
Concentrations (mg/dL) measured in serum. Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Title
soluble Intercellular Adhesion Molecule-1 (sICAM-1)
Description
Concentrations (ng/mL) measured in serum. Geometric Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Title
11-dehydrothromboxane B2 (11-DTX-B2)
Description
Concentrations measured in urine and expressed as concentration adjusted for creatinine (pg/mg creat). Geometric Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
Title
Augmentation Index (AIx)
Description
The augmentation index (AIx) is a measure of systemic arterial stiffness, and is defined as the ratio of augmentation (Δ P) to central pulse pressure and expressed as percent. AIx = (ΔP/PP) x 100, where P = pressure and PP = Pulse Pressure.
Time Frame
Measured when subject visits study site on day 1.
Title
Forced Expiratory Volume in 1 second (FEV1) %predicted, post-bronchodilator (post-BD)
Description
FEV1 post-bronchodilator and expressed as percentage predicted (FEV1 %pred). Mean values are provided as descriptive statistics.
Time Frame
Measured when subject visits study site on day 1.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
30 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Subject is able to understand the information provided in the main ICF and has signed the main ICF.
Subject is 30-60 years old.
Subject is healthy based on ECG, spirometry, vital signs, physical examination, medical history and Investigator's assessment.
Cigarette smokers:
Has smoked ≥ 10 cigarettes/day on average (no brand restriction) over the past 2 years prior to screening.
Has smoked ≥ 10 cigarettes/day on average (no brand restriction) for at least 10 years.
Has not used other tobacco and nicotine products apart from cigarettes on a daily basis over the past 2 years prior to screening.
Smoking status will be verified by urinary cotinine test (≥ 200 ng/mL) and CO breath test (≥ 10 ppm (1)).
THS users:
Has used ≥ 10 HeatSticks/day on average over the past 2 years prior to screening.
Has smoked ≥ 10 cigarettes/day on average (no brand restriction) for at least 8 years prior to switching to THS.
Has smoked < 30 cigarettes/month and used other tobacco products or e-cigarettes < daily over the past 2 years prior to screening.
Product use will be verified by urinary cotinine test (≥ 200 ng/mL) and CO breath test (< 10 ppm).
Former cigarette smokers:
Has not smoked cigarettes or used any tobacco or nicotine-containing products on a daily basis over the past 2 years prior to screening.
Has smoked ≥ 10 cigarettes/day on average (no brand restriction) for at least 8 years prior to stopping smoking.
Smoking status will be verified by urinary cotinine test (< 100 ng/mL) and CO breath test (< 10 ppm).
Exclusion Criteria:
As per the judgment of the Investigator, the subject cannot participate in the study for any reason (e.g., medical, psychiatric and/or social reason). The Investigator should specifically evaluate the subject's eligibility considering COVID-19 risk factors and local situation.
The subject is legally incompetent or physically/mentally incapable of giving consent (e.g., emergency situation, under guardianship, in a social or sanitary establishment, prisoner or involuntarily incarcerated).
The subject has/had clinically relevant diseases (including but not limited to gastrointestinal, renal, hepatic, neurological, hematological, endocrine, oncological, urological, immunological, pulmonary, and cardiovascular disease) or conditions that in the opinion of the investigator would jeopardize the safety of the subject or affect the validity of the study results.
The subject has abnormal findings on physical examination, ECG, vital signs, spirometry or in the medical history, deemed clinically significant by investigators.
The subject has/had within 30 days prior to screening a body temperature >37.5°C or an acute illness (e.g., upper-respiratory-tract infection, viral infection, etc.…) or the subject is confirmed or suspected active COVID-19 infection (based on the signs and symptoms observed at the time of assessment) at screening.
The subject has used any prescribed or over-the-counter systemic medication with an impact on WBC or 8-epi-PGF2α within 5 half-lives of the medication prior to enrollment in the study (please refer to Appendix B).
Subject has high blood pressure (hypertension), defined as > 139 mmHg systolic and/or > 89 mmHg diastolic or is currently treated with medication controlling high blood pressure.
The subject has (FEV1/FVC) < 0.7 and FEV1 < 80% predicted value at post-bronchodilator (BD) spirometry.
The subject has (FEV1/FVC) < 0.75 (pre-BD) and reversibility in FEV1 (that is both > 12% and > 200 mL from pre- to post-BD values).
The subject has a history of allergic reactions to salbutamol.
The subject has a body mass index (BMI) < 18.5 or ≥ 30 kg/m2.
The subject has positive alcohol and/or drug screening test results.
The subject has donated or received whole blood or blood products within 3 months prior to V1.
The subject has been previously screened for this study.
The subject is a current or former employee of the tobacco or e-cigarettes industry or of their first-degree relatives (parent, sibling, and child).
The subject is an employee of the investigational site or any other parties involved in the study or of their first-degree relatives (parent, sibling, and child).
The subject has participated in a clinical study within 3 months prior to V1.
For women only: the subject is pregnant (does have a positive pregnancy test) or breast-feeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Christelle Haziza, PhD
Phone
+41 58 242 11 11
Email
Christelle.Haziza@pmi.com
First Name & Middle Initial & Last Name or Official Title & Degree
S. Michael Ansari
Phone
+41 58 242 11 11
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christelle Haziza, PhD
Organizational Affiliation
Philip Morris Products S.A.
Official's Role
Study Chair
Facility Information:
Facility Name
Clintrial s.r.o.
City
Praha
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
Email
r.gregar@clintrial.cz
First Name & Middle Initial & Last Name & Degree
Roman Gregar, MD
Facility Name
Vestra Clinics s.r.o.
City
Rychnov nad Kněžnou
Country
Czechia
Individual Site Status
Recruiting
Facility Contact:
Email
pazdera@vestraclinics.org
First Name & Middle Initial & Last Name & Degree
Ladislav Pazdera, MD
Facility Name
emovis GmbH
City
Berlin
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
Email
Luci.Magimaiseelan@emovis.de
First Name & Middle Initial & Last Name & Degree
Luci Magimaiseelan, MD
Facility Name
Sibamed GmbH & Co.KG
City
Leipzig
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
Email
helena@sigal-sms.de
First Name & Middle Initial & Last Name & Degree
Helena Sigal, MD
Facility Name
Centrum für Diagnostik und Gesundheit, Klinische Forschung und Entwicklung
City
München
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
Email
manfred.hartard@sigal-sms.de
First Name & Middle Initial & Last Name & Degree
Manfred Hartard, MD
Facility Name
Praxis Reinfeld Mitte
City
Reinfeld
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
Email
joachim.weimer@sigal-sms.de
First Name & Middle Initial & Last Name & Degree
Joachim Weimer, MD
Facility Name
Hautarzt Stuttgart - Hautarztpraxis Leitz & Kollegen
City
Stuttgart
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
Email
Nicolas.leitz@sigal-sms.de
First Name & Middle Initial & Last Name & Degree
Nicolas Leitz, MD
Facility Name
National and Kapodistrian University of Athens, Medical school, Attikon Hospital, 2nd Cardiology Department
City
Athens
Country
Greece
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
John Parissis, MD
Facility Name
Hakata Clinic
City
Fukuoka
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
Email
Takashi-eto@lta-med.com
First Name & Middle Initial & Last Name & Degree
Takashi Etou, MD
Facility Name
Nishikumamoto Hospital
City
Minami
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
Email
takanori-tanaka@lta-med.com
First Name & Middle Initial & Last Name & Degree
Takanori Tanaka, MD
Facility Name
Sumida Hospital
City
Tokyo
Country
Japan
Individual Site Status
Recruiting
Facility Contact:
Email
takuma-yonemura@lta-med.com
First Name & Middle Initial & Last Name & Degree
Takuma Yonemura, MD
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Reduction of Exposure, Inflammation, and Oxidative Stress Following at Least 2 Years of Switching to THS Use Compared to Cigarette Smoking
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