Safety and Efficacy of Sildenafil in Cystic Fibrosis (CF) Lung Disease
The Role of Phosphodiesterase Inhibitors in CF Lung Disease
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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Colorado
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Denver, Colorado, United States, 80206
- National Jewish Health
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Confirmed diagnosis of CF based on the following criteria:
- Positive sweat chloride ≥60mEq/liter (by pilocarpine iontophoresis) and/or
- Genotype with two identifiable mutations consistent with CF, and accompanied by one or more clinical features consistent with the CF phenotype
- Male or female patients ≥ 12 years of age
- FEV1 ≥ 50% predicted (Knudson) 31
- Clinically stable without evidence of acute upper or lower respiratory tract infection or current pulmonary exacerbation within the 14 days prior to the screening visit
- Ability to reproducibly perform spirometry (according to ATS criteria)
- Ability to produce at least 1mL of sputum spontaneously, or be willing to undergo sputum induction
- Ability to understand and sign a written informed consent or assent and comply with the requirements of the study
- Chronic bacterial colonization (3 documented positive cultures in the prior 2 years of which at least one was obtained in the 3 months prior to randomization)
Exclusion Criteria:
- History of hypersensitivity to sildenafil
- Use of an investigational agent within the 4-week period prior to Visit 1 (Day 0)
- Breastfeeding, pregnant, or verbal expression of unwillingness to practice an acceptable birth control method (abstinence, hormonal or barrier methods, partner sterilization or intrauterine device) during participation in the study
- Daily use of systemic corticosteroids and/or NSAIDs within 4 weeks of the study or as needed use within 72 hours prior to the screening visit
- History of significant hepatic (SGOT or SGPT > 3 times the upper limit of normal at screening, documented biliary cirrhosis, or portal hypertension), cardiovascular (history of aortic stenosis, coronary artery disease, pulmonary hypertension with right ventricular systolic pressure >55 mmHg or life-threatening arrhythmia), neurological (history of stroke), hematologic (history of bleeding diathesis), ophthalmologic (history of retinal impairment or non-arteritic ischemic optic neuritis) or renal impairment (creatinine >1.8 mg/dL.)
- Inability to swallow pills
- Previous lung transplantation
- Use of concomitant nitrates, α-blocker, or Ca channel blocker
- Use of concomitant medications known to be potent inhibitors of CYP3A4 (e.g. ketoconazole, itraconazole, ritonavir, clarithromycin, erythromycin, rifampin)
- Presence of a condition or abnormality that in the opinion of the investigator would compromise the safety of the subject or the quality of the data
- Weight less than 40 kg
- History of sputum or throat swab culture yielding Burkholderia cepacia within 2 years of screening
- Resting room air oxygen saturation <93%
- History of migraines
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Pilot study of systemic sildenafil administration to people with cystic fibrosis
This is a study of sildenafil administration to patients with mild to moderate cystic fibrosis (CF).
All subjects will receive oral sildenafil three times per day during the study.
Study endpoints will be measured before the treatment period and at the end of the treatment period to evaluate safety, tolerability, pharmacokinetics in people with CF, and surrogate markers of pulmonary function.
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Sildenafil will be given 20mg po tid for 1 week, and then will be give 40mg po tid for 5 weeks.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in Sputum Elastase Activity
Time Frame: Baseline and 6 weeks
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Exploratory analysis for efficacy of sildenafil on sputum biomarkers of inflammation, including sputum elastase.
This measure will indicate whether sildenafil will increase or decrease sputum elastase activity.
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Baseline and 6 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change in Exhaled Breath Condensate pH
Time Frame: Baseline and 6 weeks
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Endogenous airway acidification can be assessed by measuring pH in exhaled breath condensate, a non-invasive measure of response to therapy.
This measure will indicate whether sildenafil will improve, worsen, or cause no change in exhaled breath condensate pH.
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Baseline and 6 weeks
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Change in Cystic Fibrosis Questionnaire - Revised (CFQ-R) Respiratory Domain, Average Unit Change From Baseline to 6 Weeks is Reported
Time Frame: 6 weeks
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The CFQ-R is designed to measure CF-specific patient-reported health-related quality of life.
It is a validated CF-specific quality of life measure.
The CFQ-R Respiratory domain score (scale 0-100 with higher scores indicating better quality of life).
This measure will indicate whether sildenafil will improve, worsen, or cause no change in the CFQ-R respiratory domain scores from baseline at 6 weeks.
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6 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Jennifer L Taylor-Cousar, MD, National Jewish Health
Publications and helpful links
General Publications
- Poschet JF, Timmins GS, Taylor-Cousar JL, Ornatowski W, Fazio J, Perkett E, Wilson KR, Yu HD, de Jonge HR, Deretic V. Pharmacological modulation of cGMP levels by phosphodiesterase 5 inhibitors as a therapeutic strategy for treatment of respiratory pathology in cystic fibrosis. Am J Physiol Lung Cell Mol Physiol. 2007 Sep;293(3):L712-9. doi: 10.1152/ajplung.00314.2006. Epub 2007 Jun 22.
- Taylor-Cousar JL, Wiley C, Felton LA, St Clair C, Jones M, Curran-Everett D, Poch K, Nichols DP, Solomon GM, Saavedra MT, Accurso FJ, Nick JA. Pharmacokinetics and tolerability of oral sildenafil in adults with cystic fibrosis lung disease. J Cyst Fibros. 2015 Mar;14(2):228-36. doi: 10.1016/j.jcf.2014.10.006. Epub 2014 Nov 13.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Genetic Diseases, Inborn
- Respiratory Tract Diseases
- Digestive System Diseases
- Lung Diseases
- Infant, Newborn, Diseases
- Pancreatic Diseases
- Congenital, Hereditary, and Neonatal Diseases and Abnormalities
- Pathological Conditions, Signs and Symptoms
- Inflammation
- Cystic Fibrosis
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Amides
- Purines
- Sulfonamides
- Sulfones
- Piperazines
- Sildenafil Citrate
Other Study ID Numbers
Other Study ID Numbers
- 851R14-8510M3
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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