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A Phase 2 IV Gallium Study for Patients With Cystic Fibrosis (IGNITE Study)

Phase 2
Completed
Conditions
Cystic Fibrosis
Interventions
Drug: Normal Saline
Registration Number
NCT02354859
Lead Sponsor
University of Washington
Brief Summary

The purpose of this study is to assess the efficacy of IV gallium to improve pulmonary function as measured by a 5% or greater relative improvement in forced expiratory volume in one second (FEV1) from baseline to Day 28.

Funding Source - FDA OOPD

Detailed Description

This is a phase 2, multi-center, randomized, placebo-controlled trial in adults with CF chronically infected with P. aeruginosa. The study will evaluate the safety and clinical efficacy of a five day infusion of IV gallium nitrate (IV gallium). The purpose of this study is to assess the efficacy of IV gallium to improve pulmonary function as measured by a 5% or greater relative improvement in forced expiratory volume in one second (FEV1) from baseline to Day 28.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
119
Inclusion Criteria
  • Greater than or equal to 18 years of age at Screening

  • Documented chronic colonization with P. aeruginosa defined as dentification in two sputum or oropharyngeal cultures within the year prior to Day 1

  • Documentation of a CF diagnosis as evidenced by one or more clinical features consistent with the CF phenotype and one or more of the following criteria:

    1. sweat chloride ≥ 60 mEq/liter by quantitative pilocarpine iontophoresis test (QPIT)
    2. two well-characterized mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene
    3. Abnormal nasal potential difference (NPD; change in NPD in response to a low chloride solution and isoproteronol of less than -5 mV)
  • FEV1 ≥ 25 % of predicted value at Screening

  • Able to expectorate sputum

  • Serum liver function tests ≤ 2.5 x upper limit of normal at Screening

  • Serum urea nitrogen (BUN) ≤ 1.5 x upper limit of normal at Screening

  • Serum creatinine ≤ 2.0 mg/dl and ≤ 1.5 x upper limit of normal at Screening

  • Hemoglobin ≥ 9 g/dl, platelets ≥ 100,000/mm3, and white blood cells (WBC)

    ≥ 4,500/mm3 at Screening

  • Ionized calcium ≥ lower limit of normal at Screening

  • Written informed consent obtained from subject or subject's legal representative

  • Able to communicate with the Investigator and comply with the requirements of the protocol

  • If female and of childbearing potential, must have a negative pregnancy test on Day 1 prior to receiving study drug

  • If female and of childbearing potential, is willing to use adequate contraception for the duration of the study through Visit 5, as determined by the investigator

  • If male and able to father a child, is willing to use adequate contraception for the duration of the study through Visit 5, as determined by the investigator

  • Clinically stable with no significant changes in health status within 14 days prior to Day 1

Exclusion criteria:

  • Use of inhaled antibiotics within seven days prior to Day 1
  • Unable or unwilling to withhold use of chronic inhaled antibiotics through Day 28
  • Use of intravenous, inhaled, or oral antibiotics for an acute indication within 14 days prior to Day 1
  • Use of bisphosphonates within seven days prior to Day 1
  • History of osteoporosis (defined as the most recent dexa scan with a T-score ≤ -2.5 with the dexa scan performed within the five years prior to Screening)
  • Lactating female
  • Known sensitivity to gallium
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
5 day of infusion of normal salineNormal SalinePlacebo with be dispensed as 1,000 milliliters of 0.9% sodium chloride to match the reconstitution volume of the IV Ga
5 day of infusion of gallium nitrateGallium nitrateGallium nitrate will be infused continuously over 5 days at 200 mg/m2/day. Study drug will be administered via a peripheral IV catheter, a peripherally inserted central catheter (PICC) line, midline catheter, or a chronic indwelling vascular access device () using an ambulatory infusion pump infused over 24 hours for 5 sequential days.
Primary Outcome Measures
NameTimeMethod
Number of Participants With 5% or Greater Relative Change in FEV1 (Liters) From Baseline to Day 28Baseline to Day 28

Difference between treatment groups in the proportion of subjects with 5% or greater relative change in FEV1 (liters) from baseline to Day 28.

Secondary Outcome Measures
NameTimeMethod
Rate of Adverse Events (AEs) and Serious Adverse Events (SAEs)Day 1 to Day 56

Rate is defined as the number of events per participant follow-up week.

Relative Change in FEV1 (Liters) From Baseline to Day 56Day 1 to Day 56

Difference between treatment groups in the relative change in FEV1 (liters) from Baseline to Day 56

Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)Day 1 to Day 56

Incidence is defined as the number and percentage of participants with at least one event over the 56 day follow-up period.

Absolute Change in Respiratory Symptoms, as Measured by the CF Respiratory Symptoms Diary-Chronic Respiratory Infection Symptom Severity Score (CFRSD-CRISS), From Baseline to Day 56Day 1 to Day 56

Difference between treatment groups in the absolute change in respiratory symptoms, as measured by the the CF Respiratory Symptoms Diary-Chronic Respiratory Infection Symptom Severity Score (CFRSD-CRISS), from Baseline to Day 56. The Cystic Fibrosis Respiratory Symptoms Daily Diary asks a participant to state the extent of their 8 respiratory symptoms : difficulty breathing, feverishness, tiredness, chills or sweats, coughing, coughing up mucus, tightness in the chest and wheezing. Each respiratory symptom is assigned a score from 0-4 based on the response, with zero corresponding to the absence of the symptom and four corresponding to symptom being present 'a great deal' or 'extremely'. A summed score (range from 0-24) is calculated for each participant and converted to a final score with a range of 0 to 100, where the lowest scores indicate improvement of symptoms.

Absolute Change in P. Aeruginosa Sputum Density (log10 (CFU)) From Baseline to Day 56Day 1 to Day 56

Difference between treatment groups in the absolute change in P. aeruginosa sputum density (log10 (CFU)) from Baseline to Day 56 based on quantitative cultures.

Trial Locations

Locations (23)

Jackson Memorial Hospital; University of Miami Hospital; University of Miami Hospital and Clinics

🇺🇸

Miami, Florida, United States

AL Adult Birmingham / The Children's Hospital Atlanta

🇺🇸

Birmingham, Alabama, United States

Columbus CC and Peds / Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Pittsburgh Adult, Children's Hospital of Pittsburgh UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

Lexington, KY Adult / University of Kentucky Chandler Medical Center

🇺🇸

Lexington, Kentucky, United States

Minneapolis CC and Adult / University of Minnesota Medical Center, Fairview

🇺🇸

Minneapolis, Minnesota, United States

UC San Diego Medical Center

🇺🇸

La Jolla, California, United States

Shands Hospital

🇺🇸

Gainesville, Florida, United States

Denver Adult / National Jewish Health

🇺🇸

Denver, Colorado, United States

Boston CHB Adult / Boston Children's Hospital (BCH)

🇺🇸

Boston, Massachusetts, United States

Lebanon, NH Dartmouth-Hitchcock CC and Adult / Dartmouth Hitchcock Medical Center

🇺🇸

Lebanon, New Hampshire, United States

Portland, ME Adult

🇺🇸

Portland, Maine, United States

Omaha Adult / The Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

Atlanta Emory Adult / Emory University Hospital

🇺🇸

Atlanta, Georgia, United States

Chicago Northwestern Adult / Northwestern Memorial Hospital

🇺🇸

Chicago, Illinois, United States

Iowa City University of Iowa Adult / University of Iowa Hospitals & Clinics

🇺🇸

Iowa City, Iowa, United States

Baltimore Hopkins Adult / John Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

Cleveland CC and Peds, Hospital of Cleveland

🇺🇸

Cleveland, Ohio, United States

Toledo, OH CC and Peds / The Toledo Hospital; Toledo Children's Hospital

🇺🇸

Toledo, Ohio, United States

Oklahoma City Adult / Presbyterian Hospital at OU Medical Center

🇺🇸

Oklahoma City, Oklahoma, United States

SC CC and Adult Charleston / MUSC

🇺🇸

Charleston, South Carolina, United States

Salt Lake City Adult, Intermountain Cystic Fibrosis Center

🇺🇸

Salt Lake City, Utah, United States

Seattle UW Adult / University of Washington Medical Center

🇺🇸

Seattle, Washington, United States

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