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The TELO-SCOPE Study: Attenuating Telomere Attrition With Danazol. Is There Scope to Dramatically Improve Health Outcomes for Adults and Children With Pulmonary Fibrosis

Primary Purpose

Pulmonary Fibrosis, Telomere Shortening, Telomere Disease

Status
Recruiting
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
Danazol
Placebo
Sponsored by
The University of Queensland
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Fibrosis

Eligibility Criteria

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

Inclusion Criteria:

  1. Males and females aged >5 years, able to take capsules orally.
  2. Fibrosing interstitial pneumonia (Idiopathic PF, idiopathic non-specific interstitial pneumonia, chronic hypersensitivity pneumonitis, pleuroparenchymal fibroelastosis, unclassifiable interstitial lung disease (ILD)) diagnosed according to the current international guidelines.
  3. Age-adjusted peripheral blood leukocyte telomere length < 10th centile on Flow-FISH.
  4. FVC > 40% predicted.
  5. DLCO > 25% predicted.
  6. If receiving background pirfenidone / nintedanib, stable dose for 28 days prior to screening.
  7. Able to understand and sign a written informed consent form (or legally authorised representative).
  8. Agreement to use a medically approved form of non-hormonal contraception (if of child-bearing potential) (noting that oral contraceptives are advised not to be used concurrently with danazol).

Exclusion Criteria:

  1. Actively or imminently listed for lung transplantation.
  2. Undergone, awaiting, or likely to require bone marrow transplantation within 12 months.
  3. Concurrent enrolment in another study.
  4. Females with a positive pregnancy test at screening or currently breastfeeding.
  5. Pelvic infection.
  6. Past jaundice with oral contraceptives.
  7. Undiagnosed abnormal genital bleeding.
  8. Undiagnosed ovarian/uterine masses
  9. Any history of malignancy likely to result in significant disability or likely to require significant medical or surgical intervention within the next 12 months.
  10. History of androgen-dependent tumour.
  11. Any condition other than PF that, in the opinion of the investigator, is likely to result in the death of the participant within the next 12 months.
  12. History of end-stage liver disease or ALT or AST > 3 times the upper limit of normal.
  13. History of end-stage kidney disease requiring dialysis.
  14. Markedly impaired cardiac function.
  15. Known increased risk of or history of thromboembolism (e.g. Factor V Leiden, Protein C or S deficiency).
  16. Uncontrolled hypertension.
  17. Uncontrolled lipoprotein disorder.
  18. Poorly-controlled diabetes mellitus.
  19. History of marked or persistent androgenic reaction to previous gonadal steroid therapy.
  20. History of epilepsy induced or worsened by previous gonadal steroid therapy.
  21. History of raised intracranial pressure.
  22. Known intolerance to danazol.
  23. Porphyria.
  24. Use of any of the following agents within 28 days before screening: danazol or other androgen therapy, warfarin or other anticoagulant, carbamazepine, phenytoin, investigational therapy, cytotoxic therapy, tacrolimus, cyclosporine.
  25. Professional singer due to potential for voice change.
  26. Competitive athletes.
  27. Prostate specific antigen (PSA) above the upper limit of normal (adult males only).

Sites / Locations

  • John Hunter HospitalRecruiting
  • Sydney Children's Hospital
  • Royal Prince Alfred HospitalRecruiting
  • The Children's Hospital Westmead
  • The Prince Charles HospitalRecruiting
  • Royal Adelaide HospitalRecruiting
  • The AlfredRecruiting
  • The AustinRecruiting
  • Fiona Stanley HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Danazol

Placebo

Arm Description

800mg daily in two divided doses orally for 12 months. In subjects who have difficulty tolerating danazol / placebo, the dose will be reduced by 200mg/day and side effects will be reassessed. If symptoms related to the study drug persist, subsequent 200mg/day dose reductions will be allowed until a tolerated dose is achieved. Background antifibrotic therapy is allowed.

Matching placebo capsules.

Outcomes

Primary Outcome Measures

Change in absolute telomere length from baseline (base pairs)
Telomere length will be measured in absolute terms (base pairs) using the telomere shortest length assay (TeSLA).

Secondary Outcome Measures

Number of participants with treatment-emergent adverse events
Number of Participants With Death or Non-Elective Hospitalisation
Change in telomere length from baseline to 3, 6 and 9 months (base pairs)
Change in forced vital capacity (FVC) at 6 and 12 months
FVC is measured as the volume of air exhaled during spirometry.
Change in diffusing capacity for carbon monoxide at 6 and 12 months
DLCO is a measurement of the of the lung's gas transfer ability.
Change in 6-minute walk distance from baseline
Change in Leicester cough questionnaire (LCQ) from baseline
Change in King's Brief Interstitial Lung Disease Questionnaire (K-BILD) from baseline
Change in Parent cough-specific quality of life (PCSQoL) from baseline

Full Information

First Posted
November 4, 2020
Last Updated
November 2, 2022
Sponsor
The University of Queensland
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1. Study Identification

Unique Protocol Identification Number
NCT04638517
Brief Title
The TELO-SCOPE Study: Attenuating Telomere Attrition With Danazol. Is There Scope to Dramatically Improve Health Outcomes for Adults and Children With Pulmonary Fibrosis
Official Title
The TELO-SCOPE Study: Attenuating Telomere Attrition With Danazol. Is There Scope to Dramatically Improve Health Outcomes for Adults and Children With Pulmonary Fibrosis
Study Type
Interventional

2. Study Status

Record Verification Date
November 2022
Overall Recruitment Status
Recruiting
Study Start Date
September 7, 2021 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
June 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The University of Queensland

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
TELO-SCOPE is a national, multi-centre, double-blind, placebo-controlled, randomised (2:1) trial which will test the hypothesis that, compared to placebo, the addition of danazol to standard of care in pulmonary fibrosis associated with short telomeres is safe and will result in reduced telomere attrition.
Detailed Description
TELO-SCOPE is a national, multi-centre, double-blind, placebo-controlled, randomised trial which will be conducted in subjects aged >5 years with a multi-disciplinary diagnosis of pulmonary fibrosis and with age-adjusted telomere length below the 10th centile in adults; and for children (age < 16 years), a confirmed diagnosis of Dyskeratosis Congenita (DC). Consenting participants who meet all other inclusions and no exclusions will be randomised (n=50, 2:1 (danazol:placebo)) to receive danazol (maximum tolerated dose (up to 800mg daily, two-divided doses) or matched placebo, for 12 months in addition to standard of care background therapy. The primary outcome is change in telomere length at 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Fibrosis, Telomere Shortening, Telomere Disease, Dyskeratosis Congenita

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Danazol
Arm Type
Active Comparator
Arm Description
800mg daily in two divided doses orally for 12 months. In subjects who have difficulty tolerating danazol / placebo, the dose will be reduced by 200mg/day and side effects will be reassessed. If symptoms related to the study drug persist, subsequent 200mg/day dose reductions will be allowed until a tolerated dose is achieved. Background antifibrotic therapy is allowed.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Matching placebo capsules.
Intervention Type
Drug
Intervention Name(s)
Danazol
Intervention Description
Danazol up to 800mg daily in two-divided doses.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo.
Primary Outcome Measure Information:
Title
Change in absolute telomere length from baseline (base pairs)
Description
Telomere length will be measured in absolute terms (base pairs) using the telomere shortest length assay (TeSLA).
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Number of participants with treatment-emergent adverse events
Time Frame
12 months
Title
Number of Participants With Death or Non-Elective Hospitalisation
Time Frame
12 months
Title
Change in telomere length from baseline to 3, 6 and 9 months (base pairs)
Time Frame
3, 6 and 9 months
Title
Change in forced vital capacity (FVC) at 6 and 12 months
Description
FVC is measured as the volume of air exhaled during spirometry.
Time Frame
6 and 12 months
Title
Change in diffusing capacity for carbon monoxide at 6 and 12 months
Description
DLCO is a measurement of the of the lung's gas transfer ability.
Time Frame
6 and 12 months
Title
Change in 6-minute walk distance from baseline
Time Frame
12 months
Title
Change in Leicester cough questionnaire (LCQ) from baseline
Time Frame
12 months
Title
Change in King's Brief Interstitial Lung Disease Questionnaire (K-BILD) from baseline
Time Frame
12 months
Title
Change in Parent cough-specific quality of life (PCSQoL) from baseline
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
5 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females aged >5 years, able to take capsules orally. Fibrosing interstitial pneumonia (Idiopathic PF, idiopathic non-specific interstitial pneumonia, chronic hypersensitivity pneumonitis, pleuroparenchymal fibroelastosis, unclassifiable interstitial lung disease (ILD)) diagnosed according to the current international guidelines. Age-adjusted peripheral blood leukocyte telomere length < 10th centile on Flow-FISH. FVC > 40% predicted. DLCO > 25% predicted. If receiving background pirfenidone / nintedanib, stable dose for 28 days prior to screening. Able to understand and sign a written informed consent form (or legally authorised representative). Agreement to use a medically approved form of non-hormonal contraception (if of child-bearing potential) (noting that oral contraceptives are advised not to be used concurrently with danazol). Exclusion Criteria: Actively or imminently listed for lung transplantation. Undergone, awaiting, or likely to require bone marrow transplantation within 12 months. Concurrent enrolment in another study. Females with a positive pregnancy test at screening or currently breastfeeding. Pelvic infection. Past jaundice with oral contraceptives. Undiagnosed abnormal genital bleeding. Undiagnosed ovarian/uterine masses Any history of malignancy likely to result in significant disability or likely to require significant medical or surgical intervention within the next 12 months. History of androgen-dependent tumour. Any condition other than PF that, in the opinion of the investigator, is likely to result in the death of the participant within the next 12 months. History of end-stage liver disease or ALT or AST > 3 times the upper limit of normal. History of end-stage kidney disease requiring dialysis. Markedly impaired cardiac function. Known increased risk of or history of thromboembolism (e.g. Factor V Leiden, Protein C or S deficiency). Uncontrolled hypertension. Uncontrolled lipoprotein disorder. Poorly-controlled diabetes mellitus. History of marked or persistent androgenic reaction to previous gonadal steroid therapy. History of epilepsy induced or worsened by previous gonadal steroid therapy. History of raised intracranial pressure. Known intolerance to danazol. Porphyria. Use of any of the following agents within 28 days before screening: danazol or other androgen therapy, warfarin or other anticoagulant, carbamazepine, phenytoin, investigational therapy, cytotoxic therapy, tacrolimus, cyclosporine. Professional singer due to potential for voice change. Competitive athletes. Prostate specific antigen (PSA) above the upper limit of normal (adult males only).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Daniel Chambers
Phone
07 3139 4000
Email
daniel.chambers@health.qld.gov.au
Facility Information:
Facility Name
John Hunter Hospital
City
Newcastle
State/Province
New South Wales
ZIP/Postal Code
2305
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Christopher Grainge
Phone
02 4042 1603
Email
Christopher.grainge@health.nsw.gov.au
Facility Name
Sydney Children's Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2031
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Adam Jaffe
Phone
02 9382 5500
Email
a.jaffe@unsw.edu.au
Facility Name
Royal Prince Alfred Hospital
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tamera Corte
Phone
02 9515 6120
Email
tameracorte@me.com
Facility Name
The Children's Hospital Westmead
City
Sydney
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hiran Selvadurai
Phone
02 9845 3395
Email
hiran.selvadurai@health.nsw.gov.au
Facility Name
The Prince Charles Hospital
City
Brisbane
State/Province
Queensland
ZIP/Postal Code
4032
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
John Mackintosh
Phone
07 3139 5695
Email
john.mackintosh@health.qld.gov.au
Facility Name
Royal Adelaide Hospital
City
Adelaide
State/Province
South Australia
ZIP/Postal Code
5000
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Paul Reynolds
Phone
08 7074 2763
Email
paul.reynolds@adelaide.edu.au
Facility Name
The Alfred
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ian Glaspole
Phone
03 9076 2000
Email
iglaspole@lasv.com.au
Facility Name
The Austin
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3084
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Nicole Goh
Email
nicole.goh@austin.org.au
Facility Name
Fiona Stanley Hospital
City
Perth
State/Province
Western Australia
ZIP/Postal Code
6150
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jeremy Wrobel
Phone
08 6152 4029
Email
jeremy.wrobel@health.wa.gov.au

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
De-identified data will be analysed and shared with collaborators with the plan to publish the results.
Citations:
PubMed Identifier
34857525
Citation
Mackintosh JA, Pietsch M, Lutzky V, Enever D, Bancroft S, Apte SH, Tan M, Yerkovich ST, Dickinson JL, Pickett HA, Selvadurai H, Grainge C, Goh NS, Hopkins P, Glaspole I, Reynolds PN, Wrobel J, Jaffe A, Corte TJ, Chambers DC. TELO-SCOPE study: a randomised, double-blind, placebo-controlled, phase 2 trial of danazol for short telomere related pulmonary fibrosis. BMJ Open Respir Res. 2021 Dec;8(1):e001127. doi: 10.1136/bmjresp-2021-001127.
Results Reference
derived

Learn more about this trial

The TELO-SCOPE Study: Attenuating Telomere Attrition With Danazol. Is There Scope to Dramatically Improve Health Outcomes for Adults and Children With Pulmonary Fibrosis

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