Study Evaluating Fosfomycin/Tobramycin for Inhalation in Cystic Fibrosis Patients With Pseudomonas Aeruginosa Lung Infection

Condition(s) targeted: Cystic Fibrosis

Intervention: FTI, AZLI (Drug); Placebo, AZLI (Drug)

Phase: Phase 2

Status: Recruiting

Sponsored by: Gilead Sciences

Official(s) and/or principal investigator(s):
Bruce Trapnell, MD, Principal Investigator, Affiliation: Children's Hospital Medical Center, Cincinnati

Overall contact:
Crystal Green, Email: FTIforCF@gilead.com

The purpose of this study is to evaluate the safety and efficacy of 2 dose combinations of fosfomycin/tobramycin for inhalation (FTI), following a 28-day course of Aztreonam for Inhalation (AZLI) in patients with cystic fibrosis and Pseudomonas aeruginosa lung infection.

Official title: A Phase 2, Double-Blind, Multicenter, Randomized, Placebo-Controlled Trial Evaluating Fosfomycin/Tobramycin for Inhalation in Patients With Cystic Fibrosis and Pseudomonas Aeruginosa

Study design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Safety/Efficacy Study

Primary outcome: Relative change in lung function from baseline at Day 28.

Detailed description: Gilead is developing a broad spectrum combination antibiotic (FTI) consisting of fosfomycin (an antibiotic with activity against gram-positive and gram-negative bacteria) and tobramycin (an aminoglycoside antibiotic with potent gram-negative activity) for treatment of patients with CF. FTI offers a potential option for treatment of CF lung infections. It is important to note that the concentration of tobramycin in FTI is lower than that of the approved dose of inhaled tobramycin alone, thereby demonstrating the potential of FTI to minimize long-term toxicity from repeated exposure to aminoglycosides like tobramycin. This study will evaluate the safety and efficacy of 2 dose combinations of fosfomycin/tobramycin for inhalation (FTI), following a 28-day course of Aztreonam for Inhalation (AZLI) in patients with cystic fibrosis and Pseudomonas aeruginosa lung infection.

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Males or females aged 18 years and older

- Patients with CF as diagnosed by one of the following:

- Documented sweat chloride greater than or equal to 60 mEq/L by quantitative

pilocarpine iontophoresis test, OR

- Documented sweat sodium greater than or equal to 60 mmol/L, OR

- Abnormal nasal potential difference, OR

- Two well-characterized genetic mutations in the CF transmembrane conductance

regulator (CFTR) gene, AND

- Accompanying symptoms characteristic of CF

- Documented presence of PA in an expectorated sputum or throat swab culture at Visit 1

OR documented PA in 2 expectorated sputum or throat swab cultures within 12 months prior to Visit 1; one of the previous PA-positive cultures must be within 3 months prior to Visit 1

- Patients must be able to provide written informed consent prior to any study related

procedures

- FEV1 greater than or equal to 25% and less than or equal to 75% predicted at Visit 1

- Ability to perform reproducible pulmonary function tests

- Chest radiograph at Visit 1 without significant acute findings (e. g., infiltrates

[lobar or diffuse interstitial], pleural effusion, pneumothorax); or chest radiograph, CT, or MRI obtained within the 90 days prior to Visit 1 without acute findings or significant intercurrent illness; chronic, stable findings (e. g., chronic scarring or atelectasis) are allowed.

Exclusion Criteria:

- Current use of oral corticosteroids in doses exceeding the equivalent of 10 mg

prednisone a day or 20 mg prednisone every other day

- History of sputum or throat swab culture yielding B. cepacia in the previous 2 years

- Current requirement for daily continuous oxygen supplementation or requirement for

more than 2 L/minute at night

- Administration of any investigational drug or device within 28 days of Visit 1 or

within 6 half-lives of the investigational drug (whichever is longer)

- Known local or systemic hypersensitivity to monobactam antibiotics

- Known allergies/intolerance to tobramycin or other aminoglycosides

- Known allergies/intolerance to fosfomycin

- Inability to tolerate inhalation of a short acting beta2 agonist

- Changes in or initiation of chronic azithromycin treatment within 14 days prior to

Visit 1

- Administration of antipseudomonal antibiotics by inhalation, IV, or oral routes

within the 14 days prior to Visit 1

- Changes in antimicrobial, bronchodilator (BD), corticosteroid, hypertonic saline, or

dornase alfa medications within 7 days prior to Visit 1

- Changes in physiotherapy technique or schedule within 7 days prior to Visit 1

- History of lung transplantation

- Abnormal renal or hepatic function or serum chemistry at Visit 1, defined as:

- AST, ALT > 3 times upper limit of normal range (ULN)

- Creatinine > 1. 5 times ULN

- Positive pregnancy test at Visit 1; all women of childbearing potential will be

tested

- Female patients of childbearing potential who are lactating or are not (in the

opinion of the investigator) practicing an acceptable method of birth control; female patients who utilize hormonal contraceptives as a birth control method must have used the same method for at least 3 months before study dosing

- Any serious or active medical or psychiatric illness, which in the opinion of the

investigator, would interfere with patient treatment, assessment, or compliance with the protocol

Crystal Green, Email: FTIforCF@gilead.com

Anchorage, Alaska 99508, United States; Active, not recruiting

Tucson, Arizona 85724, United States; Active, not recruiting

Phoenix, Arizona 85016, United States; Active, not recruiting

Little Rock, Arkansas 72205, United States; Active, not recruiting

Palo Alto, California 94304, United States; Active, not recruiting

Denver, Colorado 80206, United States; Active, not recruiting

New Haven, Connecticut 06520, United States; Active, not recruiting

Hartford, Connecticut 06102, United States; Active, not recruiting

Washington, District of Columbia 20010, United States; Active, not recruiting

Orlando, Florida 32803, United States; Active, not recruiting

Tampa, Florida 33606, United States; Active, not recruiting

Glenview, Illinois 60025, United States; Active, not recruiting

Chicago, Illinois 60614, United States; Active, not recruiting

Boston, Massachusetts 02114, United States; Active, not recruiting

Boston, Massachusetts 02115, United States; Active, not recruiting

Detroit, Michigan 48201, United States; Active, not recruiting

Ann Arbor, Michigan 48109, United States; Active, not recruiting

Las Vegas, Nevada 89107, United States; Active, not recruiting

Albany, New York 12208, United States; Active, not recruiting

New Hyde Park, New York 11040, United States; Active, not recruiting

Syracuse, New York 13210, United States; Active, not recruiting

New York, New York 10032, United States; Recruiting

Buffalo, New York 14222, United States; Active, not recruiting

Chapel Hill, North Carolina 27599, United States; Active, not recruiting

Cincinnati, Ohio 45229, United States; Active, not recruiting

Columbus, Ohio 43205, United States; Active, not recruiting

Cleveland, Ohio 44106, United States; Active, not recruiting

Oklahoma City, Oklahoma 73112, United States; Active, not recruiting

Philadelphia, Pennsylvania 19102, United States; Active, not recruiting

Hershey, Pennsylvania 17033, United States; Active, not recruiting

Charleston, South Carolina 29425, United States; Active, not recruiting

Houston, Texas 77030, United States; Active, not recruiting

San Antonio, Texas 78212, United States; Active, not recruiting

Richmond, Virginia 23298, United States; Active, not recruiting

Portsmouth, Virginia 23708, United States; Active, not recruiting

Tacoma, Washington 98405, United States; Active, not recruiting

Starting date: November 2008
Ending date: March 2010
Last updated: October 7, 2009