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Safety of Tobramycin Inhalation Powder (TIP) vs Tobramycin Solution for Inhalation in Patients With Cystic Fibrosis (EAGER)

Primary Purpose

Cystic Fibrosis

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Tobramycin Inhalation Powder
Tobramycin Solution for Inhalation
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

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

Inclusion Criteria:

  • Confirmed diagnosis of cystic fibrosis
  • Male and female patients at least 6 years of age at the time of screening.
  • Forced expiratory volume in one second (FEV1) at screening must be at least 25% and less than or equal to 75% of normal predicted values for age, sex, and height based on Knudson criteria.
  • Pseudomonas aeruginosa, a type of bacteria, must be present in a sputum/deep-throat cough swab culture (or bronchoalveolar lavage [BAL]) within 6 months prior to screening and in the sputum/ deep-throat cough swab culture at the screening visit.
  • Able to comply with all protocol requirements.
  • Clinically stable in the opinion of the investigator.
  • Use of an effective means of contraception in females of childbearing potential.
  • Provide written informed consent, Health Authority Portability and Accountability Act (HIPAA) authorization (where applicable), and assent (as appropriate) prior to the performance of any study-related procedure.

Exclusion Criteria:

  • History of sputum culture or deep-throat cough swab (or BAL) culture yielding Burkholderia cepacia (B cepacia), a type of bacteria, within 2 years prior to screening and/or sputum culture yielding B cepacia at screening.
  • Coughing up more than 60 cc of blood from the respiratory tract at any time within 30 days prior to study drug administration.
  • Known local or systemic hypersensitivity to aminoglycosides or inhaled antibiotics.
  • Females who are pregnant (positive pregnancy test), lactating, or are planning to become pregnant during the study.
  • History of hearing loss or chronic ringing in the ears deemed clinically significant by the investigator.
  • Use of systemic or inhaled antipseudomonal antibiotics within 28 days prior to study drug administration.
  • Use of loop diuretics within 7 days prior to study drug administration.
  • Use of any investigational treatment within 28 days prior to study drug administration.
  • Initiation of treatment with chronic macrolide therapy, dornase alpha treatment or inhaled corticosteroids within 28 days prior to study drug administration (patients may be taking these therapies at the time of enrollment, but they must have initiated treatment more than 28 days prior to study drug administration).

Other protocol-defined inclusion/exclusion criteria may apply

Sites / Locations

  • Novartis Investigative Site
  • Emory University CF Center
  • Rush University Center
  • University of Louisville
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • University of Rochester
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Penn State College of Medicine
  • Drexel University College of Medicine
  • Children's Hospital of Pittsburgh
  • Novartis Investigative Site
  • University of Virginia Health System
  • West Virginia University Health Sciences Center
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Klinikum der Johann-Wolfgang-Goethe-Universitaet
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Ludwig-Maximilians-Universitaet
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigator Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site
  • Novartis Investigative Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Tobramycin inhalation powder (TIP)

Tobramycin solution for inhalation (TOBI)

Arm Description

Participants received four 28 mg capsules of tobramycin inhalation powder (TIP) delivered with the T-326 inhaler twice daily for 28 days followed by 28 days off therapy (one cycle) for a total of three cycles.

Participants received one 300 mg (in 5 mL) ampoule of tobramycin solution for inhalation (TOBI) delivered with a nebulizer twice daily for 28 days followed by 28 days off therapy (one cycle) for a total of three cycles.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-emergent Adverse Events
An adverse event (AE) is any untoward medical occurrence, including any unfavorable and unintended sign, symptom or disease temporally associated with the use of the study medication that does not necessarily have a causal relationship with study medication. A serious AE (SAE) is an event that results in death, is life-threatening, requires or prolongs inpatient hospitalization, results in persistent or significant disability, is a congenital anomaly or defect, or is a significant medical event that may jeopardize the patient or require intervention to prevent one of the outcomes listed above.

Secondary Outcome Measures

Serum Tobramycin Concentrations
Serum tobramycin concentrations were measured in a subset of participants at Week 1 (start of cycle 1), Week 5 (End of Cycle 1), Week 17 (start of cycle 3) and Week 21 (end of cycle 3). Serum samples were collected at pre-dose and post-dose at specified intervals; one specimen between 0 to 2 hours; two additional specimens between 2 and 5 hours (sample times must have been a minimum of 2 hours apart).
Percentage of Participants With a Decrease From Baseline in Auditory Acuity
Audiology testing was performed only at selected centers. Auditory acuity was measured from 250 to 8000 Hertz using a standard dual-channel audiometer.
Relative Change From Baseline in Percent Predicted Forced Expiratory Volume in One Second (%FEV1)
Forced expiratory volume in one second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation. FEV1 is then converted to a percentage of normal (percent predicted) based on height, weight, and race. FEV1 was measured at Baseline (prior to beginning study treatment) and predose on Day 28 of Cycles 1, 2 and 3 and at the follow-up visit. Relative change = 100 * ((Day 28 of Cycle 3 value - Baseline value)/ Baseline value).
Patient Satisfaction Assessed Using the Treatment Satisfaction Questionnaire for Medication
Patient's self-reported treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM, a validated instrument) which was modified by adding four study-specific questions; the standard fourteen questions of the TSQM were not altered. Responses to nearly all items are rated on a five-point or seven-point rating scale and the items are factored into 4 domains. The TSQM domain scores range from 0 to 100 with higher scores representing higher satisfaction for that domain.
Change From Baseline in Pseudomonas Aeruginosa Sputum Density
Three Pseudomonas aeruginosa biotypes were assessed in patient's sputum; mucoid, dry and small colony variant. Overall density is defined as the sum of all bio-types in Pseudomonas aeruginosa density.
Change From Baseline in Tobramycin Minimum Inhibitory Concentration
The minimum inhibitory concentration (MIC) is the lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism after overnight incubation. The MIC of tobramycin against total Pseudomonas aeruginosa colonization was assessed over the course of the study.
Antipseudomonal Antibiotic Usage During the Study
The average number of days patients required antipseudomonal antibiotics during the course of the study.
Hospitalization Due to Respiratory Events During the Study
The average number of days patients were hospitalized due to respiratory events during the course of the study.

Full Information

First Posted
October 16, 2006
Last Updated
June 19, 2012
Sponsor
Novartis Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00388505
Brief Title
Safety of Tobramycin Inhalation Powder (TIP) vs Tobramycin Solution for Inhalation in Patients With Cystic Fibrosis
Acronym
EAGER
Official Title
A Randomized, Open-label Multicentre Phase 3 Trial to Assess the Safety of Tobramycin Inhalation Powder Compared to Tobramycin Solution for Inhalation in Cystic Fibrosis Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
June 2012
Overall Recruitment Status
Completed
Study Start Date
February 2006 (undefined)
Primary Completion Date
March 2009 (Actual)
Study Completion Date
March 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novartis Pharmaceuticals

4. Oversight

5. Study Description

Brief Summary
This study compares the safety of the tobramycin solution for inhalation with the tobramycin dry powder formulation, used with a simple inhaler

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
517 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Tobramycin inhalation powder (TIP)
Arm Type
Experimental
Arm Description
Participants received four 28 mg capsules of tobramycin inhalation powder (TIP) delivered with the T-326 inhaler twice daily for 28 days followed by 28 days off therapy (one cycle) for a total of three cycles.
Arm Title
Tobramycin solution for inhalation (TOBI)
Arm Type
Active Comparator
Arm Description
Participants received one 300 mg (in 5 mL) ampoule of tobramycin solution for inhalation (TOBI) delivered with a nebulizer twice daily for 28 days followed by 28 days off therapy (one cycle) for a total of three cycles.
Intervention Type
Drug
Intervention Name(s)
Tobramycin Inhalation Powder
Intervention Description
Tobramycin Inhalation Powder (TIP) capsules for inhalation.
Intervention Type
Drug
Intervention Name(s)
Tobramycin Solution for Inhalation
Intervention Description
Tobramycin solution for inhalation (TOBI), supplied as 300 mg/5mL ampoules administered with a nebulizer
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-emergent Adverse Events
Description
An adverse event (AE) is any untoward medical occurrence, including any unfavorable and unintended sign, symptom or disease temporally associated with the use of the study medication that does not necessarily have a causal relationship with study medication. A serious AE (SAE) is an event that results in death, is life-threatening, requires or prolongs inpatient hospitalization, results in persistent or significant disability, is a congenital anomaly or defect, or is a significant medical event that may jeopardize the patient or require intervention to prevent one of the outcomes listed above.
Time Frame
25 weeks
Secondary Outcome Measure Information:
Title
Serum Tobramycin Concentrations
Description
Serum tobramycin concentrations were measured in a subset of participants at Week 1 (start of cycle 1), Week 5 (End of Cycle 1), Week 17 (start of cycle 3) and Week 21 (end of cycle 3). Serum samples were collected at pre-dose and post-dose at specified intervals; one specimen between 0 to 2 hours; two additional specimens between 2 and 5 hours (sample times must have been a minimum of 2 hours apart).
Time Frame
Weeks 1, 5, 17 and 21
Title
Percentage of Participants With a Decrease From Baseline in Auditory Acuity
Description
Audiology testing was performed only at selected centers. Auditory acuity was measured from 250 to 8000 Hertz using a standard dual-channel audiometer.
Time Frame
Baseline and Day 28 of Cycles 1, 2 and 3 (Weeks 5, 13 and 21)
Title
Relative Change From Baseline in Percent Predicted Forced Expiratory Volume in One Second (%FEV1)
Description
Forced expiratory volume in one second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation. FEV1 is then converted to a percentage of normal (percent predicted) based on height, weight, and race. FEV1 was measured at Baseline (prior to beginning study treatment) and predose on Day 28 of Cycles 1, 2 and 3 and at the follow-up visit. Relative change = 100 * ((Day 28 of Cycle 3 value - Baseline value)/ Baseline value).
Time Frame
Baseline and Day 28 of Cycles 1, 2 and 3 (Weeks 5, 13 and 21) and Final Visit (Week 25)
Title
Patient Satisfaction Assessed Using the Treatment Satisfaction Questionnaire for Medication
Description
Patient's self-reported treatment satisfaction was measured using the Treatment Satisfaction Questionnaire for Medication (TSQM, a validated instrument) which was modified by adding four study-specific questions; the standard fourteen questions of the TSQM were not altered. Responses to nearly all items are rated on a five-point or seven-point rating scale and the items are factored into 4 domains. The TSQM domain scores range from 0 to 100 with higher scores representing higher satisfaction for that domain.
Time Frame
Day 28 of Cycles 1, 2 and 3 (Weeks 5, 13 and 21).
Title
Change From Baseline in Pseudomonas Aeruginosa Sputum Density
Description
Three Pseudomonas aeruginosa biotypes were assessed in patient's sputum; mucoid, dry and small colony variant. Overall density is defined as the sum of all bio-types in Pseudomonas aeruginosa density.
Time Frame
Baseline and Day 28 of Cycles 1, 2 and 3 (Weeks 5, 13 and 21) and Final Visit (Week 25).
Title
Change From Baseline in Tobramycin Minimum Inhibitory Concentration
Description
The minimum inhibitory concentration (MIC) is the lowest concentration of an antimicrobial that will inhibit the visible growth of a microorganism after overnight incubation. The MIC of tobramycin against total Pseudomonas aeruginosa colonization was assessed over the course of the study.
Time Frame
Baseline and Day 28 of Cycles 1, 2 and 3 (Weeks 5, 13 and 21) and Final Visit (Week 25)
Title
Antipseudomonal Antibiotic Usage During the Study
Description
The average number of days patients required antipseudomonal antibiotics during the course of the study.
Time Frame
25 Weeks
Title
Hospitalization Due to Respiratory Events During the Study
Description
The average number of days patients were hospitalized due to respiratory events during the course of the study.
Time Frame
25 Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Confirmed diagnosis of cystic fibrosis Male and female patients at least 6 years of age at the time of screening. Forced expiratory volume in one second (FEV1) at screening must be at least 25% and less than or equal to 75% of normal predicted values for age, sex, and height based on Knudson criteria. Pseudomonas aeruginosa, a type of bacteria, must be present in a sputum/deep-throat cough swab culture (or bronchoalveolar lavage [BAL]) within 6 months prior to screening and in the sputum/ deep-throat cough swab culture at the screening visit. Able to comply with all protocol requirements. Clinically stable in the opinion of the investigator. Use of an effective means of contraception in females of childbearing potential. Provide written informed consent, Health Authority Portability and Accountability Act (HIPAA) authorization (where applicable), and assent (as appropriate) prior to the performance of any study-related procedure. Exclusion Criteria: History of sputum culture or deep-throat cough swab (or BAL) culture yielding Burkholderia cepacia (B cepacia), a type of bacteria, within 2 years prior to screening and/or sputum culture yielding B cepacia at screening. Coughing up more than 60 cc of blood from the respiratory tract at any time within 30 days prior to study drug administration. Known local or systemic hypersensitivity to aminoglycosides or inhaled antibiotics. Females who are pregnant (positive pregnancy test), lactating, or are planning to become pregnant during the study. History of hearing loss or chronic ringing in the ears deemed clinically significant by the investigator. Use of systemic or inhaled antipseudomonal antibiotics within 28 days prior to study drug administration. Use of loop diuretics within 7 days prior to study drug administration. Use of any investigational treatment within 28 days prior to study drug administration. Initiation of treatment with chronic macrolide therapy, dornase alpha treatment or inhaled corticosteroids within 28 days prior to study drug administration (patients may be taking these therapies at the time of enrollment, but they must have initiated treatment more than 28 days prior to study drug administration). Other protocol-defined inclusion/exclusion criteria may apply
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Konstan, MD
Organizational Affiliation
University Hospitals Cleveland Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Novartis Investigative Site
City
Hartford
State/Province
Connecticut
ZIP/Postal Code
06102
Country
United States
Facility Name
Emory University CF Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30322
Country
United States
Facility Name
Rush University Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
University of Louisville
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Novartis Investigative Site
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02115
Country
United States
Facility Name
Novartis Investigative Site
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Novartis Investigative Site
City
Livingston
State/Province
New Jersey
ZIP/Postal Code
07039
Country
United States
Facility Name
Novartis Investigative Site
City
Long Branch
State/Province
New Jersey
ZIP/Postal Code
07740
Country
United States
Facility Name
Novartis Investigative Site
City
Morristown
State/Province
New Jersey
ZIP/Postal Code
07967
Country
United States
Facility Name
Novartis Investigative Site
City
Somerset
State/Province
New Jersey
ZIP/Postal Code
08873
Country
United States
Facility Name
Novartis Investigative Site
City
Albany
State/Province
New York
ZIP/Postal Code
12208
Country
United States
Facility Name
Novartis Investigative Site
City
Buffalo
State/Province
New York
ZIP/Postal Code
14222
Country
United States
Facility Name
Novartis Investigative Site
City
New Hyde Park
State/Province
New York
ZIP/Postal Code
11040
Country
United States
Facility Name
Novartis Investigative Site
City
New York City
State/Province
New York
ZIP/Postal Code
10011
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14642
Country
United States
Facility Name
Novartis Investigative Site
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
Novartis Investigative Site
City
Syracuse
State/Province
New York
ZIP/Postal Code
13210
Country
United States
Facility Name
Novartis Investigative Site
City
Valhalla
State/Province
New York
ZIP/Postal Code
10595
Country
United States
Facility Name
Penn State College of Medicine
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Drexel University College of Medicine
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
Facility Name
Children's Hospital of Pittsburgh
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
Novartis Investigative Site
City
Burlington
State/Province
Vermont
ZIP/Postal Code
05401
Country
United States
Facility Name
University of Virginia Health System
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22903
Country
United States
Facility Name
West Virginia University Health Sciences Center
City
Morgantown
State/Province
West Virginia
ZIP/Postal Code
26506
Country
United States
Facility Name
Novartis Investigative Site
City
South Brisbane
Country
Australia
Facility Name
Novartis Investigative Site
City
Calgary
Country
Canada
Facility Name
Novartis Investigative Site
City
Hamilton
Country
Canada
Facility Name
Novartis Investigative Site
City
Ste-Foy
Country
Canada
Facility Name
Novartis Investigative Site
City
Vancouver
Country
Canada
Facility Name
Novartis Investigative Site
City
Santiago
Country
Chile
Facility Name
Novartis Investigative Site
City
Baranquilla
Country
Colombia
Facility Name
Novartis Investigative Site
City
Bogota
Country
Colombia
Facility Name
Novartis Investigative Site
City
Cali
Country
Colombia
Facility Name
Novartis Investigative Site
City
Medellin
Country
Colombia
Facility Name
Novartis Investigative Site
City
Montpellier
Country
France
Facility Name
Novartis Investigative Site
City
Paris
Country
France
Facility Name
Novartis Investigative Site
City
Rouen
Country
France
Facility Name
Novartis Investigative Site
City
Berlin
Country
Germany
Facility Name
Novartis Investigative Site
City
Bochum
Country
Germany
Facility Name
Novartis Investigative Site
City
Bonn
Country
Germany
Facility Name
Novartis Investigative Site
City
Essen
Country
Germany
Facility Name
Klinikum der Johann-Wolfgang-Goethe-Universitaet
City
Frankfurt
ZIP/Postal Code
60596
Country
Germany
Facility Name
Novartis Investigative Site
City
Frankfurt
Country
Germany
Facility Name
Novartis Investigative Site
City
Hamburg
Country
Germany
Facility Name
Novartis Investigative Site
City
Hannover
Country
Germany
Facility Name
Novartis Investigative Site
City
Koeln
Country
Germany
Facility Name
Novartis Investigative Site
City
Muenchen
Country
Germany
Facility Name
Ludwig-Maximilians-Universitaet
City
Munich
ZIP/Postal Code
80337
Country
Germany
Facility Name
Novartis Investigative Site
City
Hungary
Country
Hungary
Facility Name
Novartis Investigative Site
City
Kaposvar
Country
Hungary
Facility Name
Novartis Investigative Site
City
Haifa
Country
Israel
Facility Name
Novartis Investigative Site
City
Jerusalem
Country
Israel
Facility Name
Novartis Investigative Site
City
Petach-Tikva
Country
Israel
Facility Name
Novartis Investigator Site
City
Genoa
Country
Italy
Facility Name
Novartis Investigative Site
City
Palermo
Country
Italy
Facility Name
Novartis Investigative Site
City
Potenza
Country
Italy
Facility Name
Novartis Investigative Site
City
Roma
Country
Italy
Facility Name
Novartis Investigative Site
City
Monterrey Nuevo Leon
Country
Mexico
Facility Name
Novartis Investigative Site
City
Groesbeek
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Rotterdam
Country
Netherlands
Facility Name
Novartis Investigative Site
City
Baracaldo
Country
Spain
Facility Name
Novartis Investigative Site
City
Barcelona
Country
Spain
Facility Name
Novartis Investigative Site
City
Madrid
Country
Spain
Facility Name
Novartis Investigative Site
City
Malaga
Country
Spain
Facility Name
Novartis Investigative Site
City
Sevilla
Country
Spain
Facility Name
Novartis Investigative Site
City
Valencia
Country
Spain
Facility Name
Novartis Investigative Site
City
Belfast
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Birmingham
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Cambridge
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Leeds
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
London
Country
United Kingdom
Facility Name
Novartis Investigative Site
City
Sheffield
Country
United Kingdom

12. IPD Sharing Statement

Links:
URL
http://www.novartisclinicaltrials.com/webapp/etrials/home.do
Description
Related Info

Learn more about this trial

Safety of Tobramycin Inhalation Powder (TIP) vs Tobramycin Solution for Inhalation in Patients With Cystic Fibrosis

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