Phase II Study of the Safety and Efficacy of Inhaled Alpha-1 Antitrypsin (AAT ) in Cystic Fibrosis Patients

Double-Blind, Randomized, Placebo-Controlled, Phase II Study of the Safety and Efficacy of Inhaled Alpha-1 Antitrypsin (AAT ) in Cystic Fibrosis Patients

Cystic Fibrosis (CF) is an inherited disorder in which mucus-secreting glands in the lungs produce considerable quantity of thick, sticky secretions that clog the airways, promote bacterial growth and lead to chronic obstruction, inflammation and destruction of the airways.

The purpose of this study is to collect data about the resolution of the chronic inflammatory state in addition to assure the safety of the therapy in CF patients.

Study Overview

• Status: Completed
• Conditions: Cystic Fibrosis
• Intervention / Treatment: Drug: Aerosolized, human, plasma-derived Alpha-1 Antitrypsin

Detailed Description

In CF patients the unregulated inflammatory response overwhelms the normal protease (elastase)/antiprotease (AAT) balance, leading to the accumulation of elastase in the lung, destruction of the lung architecture, severe pulmonary dysfunction, and ultimately death.

Administration of AAT is to address the elastase/antiprotease imbalance in order to prevent destruction of the lung tissue and reduce the inflammatory dysregulation that causes pulmonary dysfunction.

• Study Type: Interventional
• Enrollment (Actual): 21
• Phase: Phase 2

Contacts and Locations

Study Locations

• Israel
  • Jerusalem, Israel, 91240
    • Hadassah Hebrew University, Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years and older (ADULT, OLDER_ADULT, CHILD)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Diagnosis of CF by clinical symptoms and positive sweat test or disease inducing mutation.
• Age >5 yrs
• Proven ability to perform reproducible PFTs
• FEV1 >25% predicted
• Steady disease state for 3 months and no decrease in lung function exceeding 10% during that period
• Colonization
• Stable concomitant therapy >2 weeks prior to visit 1 and during the study
• Non-tobacco user of any kind
• Ability for sputum induction
• Written informed consent

Exclusion Criteria:

• Severe CF with an FEV1 of <25% predicted
• History of lung transplant
• Active allergic bronchopulmonary aspergillosis (ABPA)
• Treatment with additional antibiotics (beyond standard CF treatment) for a period of 14 days before study entry (routine antibiotics permitted)
• Treatment with additional oral and/or IV steroids (beyond standard CF treatment) for a period of 14 days before study entry (screening day)
• Known hypersensitivity to plasma products
• IgA deficiency
• Uncontrolled hypertension
• Lung surgery in the previous two years
• Being on any thoracic surgery waiting list
• Severe concomitant disease
• Hospitalization within 1 month before study entry, not due to an airway disease
• Severe liver cirrhosis with ascites
• Hypersplenism
• Grade III/IV oesophageal varices
• Active pulmonary exacerbation within the 4 weeks prior to screening
• History of significant hemoptysis within the previous year
• Use of tobacco products or recreational drugs
• Pregnancy or breastfeeding
• 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.
• Being a female of child-bearing age without adequate contraception
• Participation in research study within 1 month

Study Plan

How is the study designed?

Design Details

• Primary Purpose: TREATMENT
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: QUADRUPLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
EXPERIMENTAL: 80 mg/kg AAT inhaled	Drug: Aerosolized, human, plasma-derived Alpha-1 Antitrypsin
PLACEBO_COMPARATOR: Placebo inhaled	Drug: Aerosolized, human, plasma-derived Alpha-1 Antitrypsin

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Safety and airway inflammation	days 1,7,14,21,28,35,42,49,56,63

Secondary Outcome Measures

Outcome Measure	Time Frame
Sputum microbiology, pulmonary function and serum CRP	days 1,7,14,21,28,35,42,49,56,63

Collaborators and Investigators

• Sponsor: Kamada, Ltd.
• Investigators: Principal Investigator: Eitan Kerem, MD, Hadassah Hebrew University, Medical Center, Mt. Scopus, Jerusalem

Study record dates

Study Major Dates

• Study Start: September 1, 2007
• Primary Completion (ACTUAL): July 1, 2008
• Study Completion (ACTUAL): July 1, 2008

Study Registration Dates

• First Submitted: July 11, 2007
• First Submitted That Met QC Criteria: July 11, 2007
• First Posted (ESTIMATE): July 12, 2007

Study Record Updates

• Last Update Posted (ESTIMATE): June 9, 2016
• Last Update Submitted That Met QC Criteria: June 8, 2016
• Last Verified: April 1, 2016

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Respiratory Tract Diseases; Lung Diseases; Infant, Newborn, Diseases; Liver Diseases; Genetic Diseases, Inborn; Pancreatic Diseases; Subcutaneous Emphysema; Emphysema; Fibrosis; Cystic Fibrosis; Alpha 1-Antitrypsin Deficiency; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Protease Inhibitors; Serine Proteinase Inhibitors; Trypsin Inhibitors; Alpha 1-Antitrypsin; Protein C Inhibitor
• Other Study ID Numbers: Kamada-AAT (inhaled)-003

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO