- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01719042
Improving Tolerance of Treatment of Pulmonary MAC Infections (ITT-MAC)
Improving Tolerance of Treatment of Pulmonary Mycobacterium Avium Complex Infections
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
As part of this study, investigators will review medical records to be sure that the patient meets the required criteria and is healthy enough to take part in this study.
The study will consist of five separate visits to the Clinical research Center at the University of Florida and each visit will last anywhere from 6-8 hours. Patients will be given a diary of questionnaires where they will record when they take their medication and any side effects they might have. Patients will also have Electrocardiograms (ECGs) to make sure they are healthy enough to be a participant in the study and to measure the effects of their medication on their heart. During this study, patients will continue treatment of their Mycobacterium avium Complex infections. Patients will be observed taking their medication on each of the five separate days. On each of these days patients will have blood drawn at 2 and 6 hours after their drugs are taken in order to measure drug levels in their blood. We will also use this blood to measure levels of proteins and hormones and to make sure the medications are not affecting the patient's heart. The patient will fill out several questionnaires and do a dietary assessment online. Investigators will assess the patient's body make-up using a device called the Bod Pod. The patient will also be assigned to one of two treatment groups: (1) Ondansetron 8mg (Zofran®, GlaxoSmithKline, Research Triangle Park, NC) every morning before breakfast versus (2) a dietary supplement prior to taking daily medication. The patient will be assigned to the first treatment group for a period of two weeks. On the third study visit investigators will switch the patient to the second group.
Although the incidence of tuberculosis has decreased in the United States over the last few decades, the incidence of chronic pulmonary infections with nontuberculous mycobacteria (NTM) appears to be increasing. Unfortunately, a common problem in the management of these infections is the inability of elderly patients to tolerate the currently recommended multidrug regimen of (1) azithromycin or clarithromycin, (2) rifampin or rifabutin, and (3) ethambutol. The most frequent adverse reactions of MAC treatment are gastrointestinal (GI), most commonly associated with the macrolides and rifampin. Although macrolide toxicity is generally dose-related, the role of routine monitoring of drug concentrations and subsequent dose adjustment has not been studied. The role of anti-emetics or dietary supplements to mitigate these symptoms is also not defined.
Study Type
Phase
- Phase 2
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Physician diagnosis of Mycobacterium avium Complex with nodular bronchiectasis
- On daily treatment for Mycobacterium avium Complex consisting of 250mg of Azithromycin, 600mg of Rifampin, and 15mg/kg of Ethambutol
- Experiencing gastrointestinal symptoms due to their multi-drug treatment regimen
- Has access to the internet
Exclusion Criteria:
- Claustrophobia
- Currently smokes cigarettes
- Persons with disseminated Mycobacterium avium Complex infections
- Persons with a known and diagnosed immunosuppressive disorder (i.e. cancer, HIV)
- Persons with physician diagnosed Irritable Bowel Syndrome, Crohn's Disease, or Ulcerative Colitis
- Persons with moderate to severe kidney or liver dysfunction
- Persons who are co-colonized with an NTM aside from Mycobacterium avium Complex
- Persons who initially present with a prolonged QT interval (defined as greater 500 milliseconds) on any baseline ECG
- Previous adverse reaction or allergy to Zofran (Ondansetron)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: CROSSOVER
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
ACTIVE_COMPARATOR: Zofran (8mg)
Participant will take Zofran (8mg) once per day before taking their antibiotic regimen
|
Subject will take 8mg of Zofran before taking antibiotic regimen and will record symptoms in a diary just before taking medication and two hours after taking medication every day for two weeks
Other Names:
|
ACTIVE_COMPARATOR: Ensure
Subject will drink a can of Ensure before taking their antibiotic regimen
|
Subject will drink one cam of Ensure before taking antibiotic regimen and will record symptoms in a diary just before taking medication and two hours after taking medication every day for two weeks
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Gastroparesis Cardinal Symptom Index Score
Time Frame: Change from baseline at the end of nine weeks
|
A survey instrument used to assess the severity of patient-reported gastrointestinal symptoms in clinical trials
|
Change from baseline at the end of nine weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Leptin
Time Frame: Baseline
|
Leptin is a natural hormone produced by your body's fat cells and acts as a signal which tells your brain you are no longer hungry
|
Baseline
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in QTc on Electrocardiogram greater than 500 milliseconds
Time Frame: Change from baseline at the end of nine weeks
|
To determine if the drug-drug interaction of azithromycin and Zofran (ondansetron) causes significant prolongation of the corrected QT (QTc) interval in this population of older female patients
|
Change from baseline at the end of nine weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Kevin P Fennelly, MD, MPH, University of Florida
Study record dates
Study Major Dates
Study Start
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Gram-Positive Bacterial Infections
- Actinomycetales Infections
- Mycobacterium Infections, Nontuberculous
- Mycobacterium Infections
- Mycobacterium avium-intracellulare Infection
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Autonomic Agents
- Peripheral Nervous System Agents
- Antiemetics
- Gastrointestinal Agents
- Dermatologic Agents
- Antipsychotic Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Serotonin Agents
- Serotonin Antagonists
- Anti-Anxiety Agents
- Antipruritics
- Ondansetron
Other Study ID Numbers
- 187-2012
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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