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RHB-204 for the Treatment of Pulmonary Mycobacterium Avium Complex Disease

Phase 3
Active, not recruiting
Conditions
Pulmonary Mycobacterium Avium Complex Infection
Bronchiectasis
Lung Diseases
Interventions
Drug: RHB-204
Drug: Placebo
Registration Number
NCT04616924
Lead Sponsor
RedHill Biopharma Limited
Brief Summary

A 2-part multi-center, Phase 3, randomized, double-blind, placebo-controlled, parallel group study to evaluate the efficacy and safety of RHB-204 in adult subjects with underlying nodular bronchiectasis and documented MAC lung infection.

Detailed Description

A 2-part multi-center, Phase 3, randomized, double-blind, placebo-controlled, parallel group study to evaluate the efficacy and safety of RHB-204 in adult subjects with underlying nodular bronchiectasis and documented MAC lung infection.

The co-primary efficacy endpoints at the end of Part 1 evaluate the proportion of patients with sputum culture conversion after 6 months of treatment defined as three consecutive monthly negative sputum cultures at Months 4, 5, and 6 for RHB-204 compared to placebo and the mean change in the Quality of Life Questionnaire - Bronchiectasis (QoL-B) Respiratory Symptoms domain score from baseline to Month 6 for RHB-204 compared to placebo.

At the Month 6 visit (end of Part 1), after all assessments including questionnaires and sputum samples have been collected, subjects will enter Part 2 of the study and receive open-label RHB-204.

In order to comply with current treatment duration guidelines (Nontuberculous Mycobacterial Pulmonary Disease Caused by Mycobacterium avium Complex: Developing Drugs for Treatment - FDA Draft Guidance September 2021) in this protocol subjects will receive active treatment for 12 months after sputum culture conversion. As such, each subject's first negative culture that defines conversion will determine the total duration of their active study drug treatment. The longest duration of active study drug treatment will be 16 months. At the end of study treatment, all subjects will enter a 3-month post-treatment follow-up period (see study design section below for additional details).

To maintain the blind and integrity of the data, an independent team (Sputum Culture Monitors) will inform sites on each subject's treatment duration based on sputum culture conversion. Sputum Culture Monitors will also have access to randomized treatment allocation. All other study related personnel will remain blinded to sputum culture results and treatment allocation (Sponsor, CRO, medical monitors, safety, ECG and sputum laboratories, site personnel as well as participating subjects).

During Part 1, subjects who have completed at least the first 3 months of treatment with study drug, and at the Investigator's discretion, require rescue therapy (alternative anti-NTM treatment) will discontinue study drug (performing an EOT visit) and remain in the study to complete all scheduled study visits and assessments/procedures to Month 6 (performing an EOS visit).

Subjects who complete treatment based on the timeline provided by the Sputum Culture Monitors (EOT visit) and have an ongoing negative sputum culture will be reconsented to enter a follow-up Extension Study, to evaluate sputum culture results at two (2) further time points: 6 months and 12 months following end of treatment (EOT) for each subject in protocol RHB-204-01.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
125
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
RHB-204RHB-204Each capsule contains clarithromycin 158.3mg; rifabutin 40mg; clofazimine 13.3mg.
PlaceboPlaceboMatching placebo will contain riboflavin, a type of B vitamin, which may discolor urine in a similar fashion as RHB-204.
Primary Outcome Measures
NameTimeMethod
Quality of Life Questionnaire - Bronchiectasis (QoL B) Respiratory Symptoms domain score from baseline to Month 6 for RHB-204 compared to placebo6 months

The mean change in the Quality of Life Questionnaire - Bronchiectasis (QoL B) Respiratory Symptoms domain score from baseline to Month 6 for RHB-204 compared to placebo

Sputum culture conversion (SCC)6 months

The proportion of subjects who achieve SCC by Month 6, defined by 3 consecutive monthly negative sputum cultures, without reversion, at Months 4, 5 \& 6 for THB-204 compared to placebo.

Secondary Outcome Measures
NameTimeMethod
Part 1 Secondary efficacy objective - Reduction of fatigue6 months

The mean change in the PROMIS Fatigue SF 8a score from baseline to Month 6 for RHB-204 compared to placebo. The PROMIS Fatigue SF 8a score from baseline to Month 6 for RHB-204 compared to placebo.

Part 1 Secondary efficacy objective - Time to culture conversion6 months

The time to SCC (month of first negative sputum culture) for RHB-204 compared to placebo.

Part 1 Secondary efficacy objective - Improvement in Physical Functioning6 months

The mean change in the Short Form 36 Physical Functioning domain score from baseline to Month 6 for RHB-204 compared to placebo.

Part 2 Secondary efficacy objective - Durable Sputum culture conversion at end of study19 months

The proportion of subjects with SCC by Month 6 who sustain negative sputum cultures at Month 16 and negative sputum culture at Month 19 (3 months off treatment) for RHB-204 compared to placebo (durable responders).

Part 2 Secondary efficacy objective - Durable Sputum culture conversion at end of treatment16 months

Measure the proportion of subjects with SCC by Month 6 who sustain negative sputum cultures at Month 16 for RHB-204 compared to placebo.

QoL B Respiratory Symptoms domain score mean change from baseline to Month 1616 months

The mean change in Quality of Life Questionnaire - Bronchiectasis (QoL-B) Respiratory Symptoms domain scores from baseline to Month 16 for ex-RHB-204 compared to ex-placebo

Part 2 Secondary efficacy objective - Improvement in Quality of Life - Fatigue 16 months16 months

The mean change in the PROMIS Fatigue SF 8a score from baseline to Month 16 for ex-RHB-204 compared to ex-placebo

Part 2 Secondary efficacy objective - Improvement in Quality of Life - Fatigue 19 Months19 months

The mean change in the PROMIS Fatigue SF 8a score from baseline to Month 19 for ex-RHB-204 compared to ex-placebo

Part 2 Secondary efficacy objective - Quality of Life Physical Functioning Symptoms 19 Months19 Months

The mean change in the Short Form 36 Physical Functioning domain score from baseline to Month 19 for ex-RHB-204 compared to ex-placebo

Part 2 Secondary efficacy objective - Quality of Life Physical Functioning Symptoms 16 Months16 months

The mean change in the Short Form 36 Physical Functioning domain score from baseline to Month 16 for ex-RHB-204 compared to ex-placebo

QoL-B Respiratory Symptoms domain scores at Month 1919 Months

The mean change in Quality of Life Questionnaire - Bronchiectasis (QoL-B) Respiratory Symptoms domain scores from baseline to Month 19 for ex-RHB-204 compared to ex-placebo

Trial Locations

Locations (3)

Medical Facility

🇺🇸

Wauwatosa, Wisconsin, United States

Medical Facility 1

🇺🇸

Orlando, Florida, United States

Medical Facility 2

🇺🇸

Orlando, Florida, United States

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