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Study of Ivacaftor in Cystic Fibrosis Subjects Aged 12 Years and Older Homozygous for the F508del-CFTR Mutation

Phase 2
Terminated
Conditions
Cystic Fibrosis
Interventions
Drug: Ivacaftor
Drug: Placebo
Registration Number
NCT00953706
Lead Sponsor
Vertex Pharmaceuticals Incorporated
Brief Summary

The purpose of this study was to evaluate the safety and efficacy of ivacaftor in participants with cystic fibrosis (CF) who were aged 12 years or older and were homozygous for the F508del-CF transmembrane conductance regulator (CFTR) mutation. Ivacaftor is a potent and selective CFTR potentiator of wild-type, G551D, F508del, and R117H forms of human CFTR protein. Potentiators are pharmacological agents that increase the chloride ion transport properties of the channel in the presence of cyclic adenosine monophosphate (AMP)-dependent protein kinase A (PKA) activation.

Detailed Description

This study investigated the effects of ivacaftor in participants with cystic fibrosis (CF) \>=12 years of age with a forced expiratory volume in 1 second (FEV1) \>=40 percent (%) predicted. This study was conducted in 2 parts.

* Part A of this study was a randomized, double-blind, placebo-controlled, parallel-group evaluation of participants with CF who were aged 12 years or older and were homozygous for the F508del-CFTR mutation.

* Part B of this study was an open-label extension of Part A, enrolling participants who completed Part A and met pre-specified endpoint criteria, and explored the safety and efficacy of ivacaftor over long-term treatment in participants with CF aged 12 years or older who were homozygous for the F508del-CFTR mutation.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
140
Inclusion Criteria
  • Confirmed diagnosis of cystic fibrosis (CF) and homozygous for F508del-CFTR mutation
  • Forced expiratory volume in 1 second (FEV1) of at least 40% of predicted normal for age, gender, and height
  • Willing to use at least 2 highly effective birth control methods during the study
  • No clinically significant abnormalities that would have interfered with the study assessments, as judged by the investigator
  • Able to understand and comply with protocol requirements, restrictions, and instructions and likely to complete the study as planned, as judged by the investigator
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Exclusion Criteria
  • History of any illness or condition that might confound the results of the study or pose an additional risk in administering study drug to the subject
  • Acute respiratory infection, pulmonary exacerbation, or changes in therapy for pulmonary disease within 4 weeks of Day 1 of the study
  • History of alcohol, medication or illicit drug abuse within one year prior to Day 1
  • Abnormal liver function >=3 x the upper limit of normal
  • Abnormal renal function at Screening
  • History of solid organ or hematological transplantation
  • Pregnant or breast-feeding (for women)
  • Ongoing participation in another therapeutic clinical study or prior participation in an investigational drug study within 30 days prior to screening
  • Previous participation in a VX-809 study
  • Used inhaled hypertonic saline treatment
  • Concomitant use of any inhibitors or inducers of cytochrome P450 3A4 (CYP3A4)
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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo matched to ivacaftor tablet orally every 12 hours (q12h) for 16 weeks during Part A (double-blind treatment period), followed by ivacaftor 150 mg tablet orally q12h for 96 weeks during Part B (open-label extension period).
PlaceboIvacaftorPlacebo matched to ivacaftor tablet orally every 12 hours (q12h) for 16 weeks during Part A (double-blind treatment period), followed by ivacaftor 150 mg tablet orally q12h for 96 weeks during Part B (open-label extension period).
IvacaftorIvacaftorIvacaftor 150 milligram (mg) tablet orally q12h for 16 weeks during Part A (double-blind treatment period), followed by ivacaftor 150 mg tablet orally q12h for 96 weeks during Part B (open-label extension period).
Primary Outcome Measures
NameTimeMethod
Part A : Absolute Change From Part A Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (ppFEV1) Through Week 16Part A baseline through Week 16

Spirometry (as measured by ppFEV1) is a standardized assessment to evaluate lung function that is the most widely used endpoint in cystic fibrosis studies. FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration. ppFEV1 (predicted for age, gender, and height) was calculated using the Knudson method.

Secondary Outcome Measures
NameTimeMethod
Part A : Absolute Change From Part A Baseline in Sweat Chloride Concentration Through Week 16Part A baseline through Week 16

The sweat chloride (quantitative pilocarpine iontophoresis) test is a standard diagnostic tool for cystic fibrosis (CF), serving as an indicator of cystic fibrosis transmembrane conductance regulator (CFTR) activity.

Part A : Rate of Change From Baseline in Weight Through Week 16Part A baseline through Week 16

As malnutrition is common in participants with cystic fibrosis (CF) because of increased energy expenditures due to lung disease and fat malabsorption, body weight is an important clinical measure of nutritional status.

Part B : Absolute Change From Part A and Part B Baseline in ppFEV1 Through Week 64Change from Part A baseline: Part A Baseline, Week 64; Change from Part B baseline: Part B Baseline (Week 16), Week 64

ppFEV1 is defined in Outcome Measure 1.

Part B : Rate of Change From Part A Baseline in ppFEV1 Through Week 64Part A baseline through Week 64

ppFEV1 is defined in Outcome Measure 1.

Part A : Absolute Change From Part A Baseline in Cystic Fibrosis Questionnaire-Revised (CFQ-R) Respiratory Domain Score Through Week 16Part A baseline through Week 16

The CFQ-R is a validated patient-reported outcome measuring health-related quality of life for participants with cystic fibrosis. Respiratory domain assessed respiratory symptoms (for example, coughing, congestion, wheezing), score range: 0-100; Higher scores indicating fewer symptoms and better health-related quality of life.

Part B : Rate of Change From Part B Baseline in ppFEV1 Through Week 64Part B baseline through Week 64

ppFEV1 is defined in Outcome Measure 1.

Part B : Absolute Change From Part A and Part B Baseline in CFQ-R Respiratory Domain Score Through Week 64Change from Part A baseline: Part A Baseline, Week 64; Change from Part B baseline: Part B Baseline (Week 16), Week 64

The CFQ-R is a validated patient-reported outcome measuring health-related quality of life for participants with cystic fibrosis. Respiratory domain assessed respiratory symptoms (for example, coughing, congestion, wheezing), score range: 0-100; Higher scores indicating fewer symptoms and better health-related quality of life.

Part B : Absolute Change From Part A and Part B Baseline in Sweat Chloride Concentration Through Week 64Change from Part A baseline: Part A Baseline, Week 64; Change from Part B baseline: Part B Baseline (Week 16), Week 64

The sweat chloride (quantitative pilocarpine iontophoresis) test is a standard diagnostic tool for cystic fibrosis (CF), serving as an indicator of cystic fibrosis transmembrane conductance regulator (CFTR) activity.

Part B : Number of Participants With Pulmonary ExacerbationsPart B baseline through Week 64

Pulmonary exacerbation was defined as new, or changed, antibiotic therapy (intravenous, inhaled, or oral) for any 4 or more of the following signs/symptoms: change in sputum; new or increased hemoptysis; increased cough; increased dyspnea; malaise, fatigue, or lethargy; temperature above 38 degrees Celsius; anorexia or weight loss; sinus pain or tenderness; change in sinus discharge; change in physical examination of the chest; decrease in pulmonary function by 10 percent (%); and radiographic changes indicative of pulmonary infection.

Part B : Absolute Change From Part A and Part B Baseline in Weight Through Week 64Change from Part A baseline: Part A Baseline, Week 64; Change from Part B baseline: Part B Baseline (Week 16), Week 64

As malnutrition is common in patients with cystic fibrosis (CF) because of increased energy expenditures due to lung disease and fat malabsorption, body weight is an important clinical measure of nutritional status.

Part B : Number of Pulmonary Exacerbation EventsPart B baseline through Week 64

Pulmonary exacerbation was defined as new, or changed, antibiotic therapy (intravenous, inhaled, or oral) for any 4 or more of the following signs/symptoms: change in sputum; new or increased hemoptysis; increased cough; increased dyspnea; malaise, fatigue, or lethargy; temperature above 38 degrees Celsius; anorexia or weight loss; sinus pain or tenderness; change in sinus discharge; change in physical examination of the chest; decrease in pulmonary function by 10 percent (%); and radiographic changes indicative of pulmonary infection.

Part B : Number of Pulmonary Exacerbation Events Per Participant Per YearPart B baseline through Week 64

Pulmonary exacerbation was defined as new, or changed, antibiotic therapy (intravenous, inhaled, or oral) for any 4 or more of the following signs/symptoms: change in sputum; new or increased hemoptysis; increased cough; increased dyspnea; malaise, fatigue, or lethargy; temperature above 38 degrees Celsius; anorexia or weight loss; sinus pain or tenderness; change in sinus discharge; change in physical examination of the chest; decrease in pulmonary function by 10 percent (%); and radiographic changes indicative of pulmonary infection.

Trial Locations

Locations (34)

Maine Medical Center

🇺🇸

Portland, Maine, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

University of Miami Miller School of Medicine

🇺🇸

Miami, Florida, United States

Riley Hospital for Children

🇺🇸

Indianapolis, Indiana, United States

University of Alabama

🇺🇸

Birmingham, Alabama, United States

Kaiser Permanente Medical Care Program

🇺🇸

Oakland, California, United States

Providence Medical Center

🇺🇸

Anchorage, Alaska, United States

Connecticut Children's Medical Center

🇺🇸

Hartford, Connecticut, United States

Nemours Children's Clinic

🇺🇸

Orlando, Florida, United States

St. Luke's CF clinic

🇺🇸

Boise, Idaho, United States

University of Chicago

🇺🇸

Chicago, Illinois, United States

University of Massachussetts Medical School

🇺🇸

Worcester, Massachusetts, United States

Helen DeVos Children's Hospital; Spectrum Health Hospitals

🇺🇸

Grand Rapids, Michigan, United States

The Children's Mercy Hospital

🇺🇸

Kansas City, Missouri, United States

Dartmouth-Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Monmouth Medical Center

🇺🇸

Long Branch, New Jersey, United States

Morristown Memorial Hospital

🇺🇸

Morristown, New Jersey, United States

New York Medical College

🇺🇸

Hawthorne, New York, United States

The CF Center, Beth Israel Medical Center

🇺🇸

New York City, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Akron Children's Hospital

🇺🇸

Akron, Ohio, United States

Cincinnati Children's Hospital

🇺🇸

Cincinnati, Ohio, United States

University of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

St. Christopher's Hospital for Children

🇺🇸

Philadelphia, Pennsylvania, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

University of Tennessee

🇺🇸

Memphis, Tennessee, United States

Cook Children's Medical Center

🇺🇸

Fort Worth, Texas, United States

Vermont Lung Center at the University of Vermont

🇺🇸

Colchester, Vermont, United States

Medical College of Virginia

🇺🇸

Richmond, Virginia, United States

Univeristy of Utah

🇺🇸

Salt Lake City, Utah, United States

Toldedo Children's Hospital

🇺🇸

Toledo, Ohio, United States

Hershey Medical Center

🇺🇸

Hershey, Pennsylvania, United States

Albany Medical College

🇺🇸

Albany, New York, United States

Women and Children's Hospital of Buffalo

🇺🇸

Buffalo, New York, United States

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