Safety & Pharmacokinetics Study of Inhaled Laninamivir Octanoate TwinCaps® Dry Powder Inhaler in Children With Influenza (FROSTY)

Randomised, Parallel Dose, Phase 1/2 Safety and Pharmacokinetics Study of Inhaled Laninamivir Octanoate TwinCaps® Dry Powder Inhaler in Children With Naturally Acquired Influenza A or B

This Phase 1/2 protocol is designed to collect safety, tolerability and pharmacokinetic data of two doses of Laninamivir Octanoate in children and adolescents. The protocol will also explore virology and efficacy endpoints.

Study Overview

• Status: Terminated
• Conditions: Influenza
• Intervention / Treatment: Drug: Placebo; Drug: 20 mg laninamivir octanoate; Drug: 40 mg laninamivir octanoate

Detailed Description

Approximately 48 subjects aged 5-17 years inclusive will be randomised into the study.

Subjects with recent onset of presumptive influenza will have influenza A or B infection confirm by Rapid Antigen Test.

The study will be conducted on an outpatient basis. The dose is administered in a single session in the clinic on Day 1. The subject will return to the clinic for assessments and follow up.

• Study Type: Interventional
• Enrollment (Actual): 15
• Phase: Phase 2; Phase 1

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Phoenix, Arizona, United States, 85032
      • Precision Trials LLC
  • Arkansas
    • Little Rock, Arkansas, United States, 72202
      • Arkansas Children's Hospital
  • California
    • Bellflower, California, United States, 90706
      • SoCal Clinical Research Med Group
    • Canoga Park, California, United States, 91306
      • Sherif Khamis MD Inc
    • Lakewood, California, United States, 90712
      • Advanced Medical Research
    • Madera, California, United States, 93637
      • Madera Family Medical Group
  • Connecticut
    • Hartford, Connecticut, United States, 06106
      • Connecticut Children's Medical Center
  • Florida
    • Hialeah, Florida, United States, 33012
      • A.G.A Clinical Trials
  • Indiana
    • Lafayette, Indiana, United States, 47905
      • Lafayette Clinical Research Group
  • Iowa
    • Iowa City, Iowa, United States, 52242
      • University of Iowa Hospitals and Clinics
  • Louisiana
    • Shreveport, Louisiana, United States, 71103
      • Louisiana State University Health Sciences Center
  • Mississippi
    • Carriere, Mississippi, United States, 39426
      • Dr Haidar's Clinic
  • Missouri
    • Bridgeton, Missouri, United States, 63044
      • DePaul Health Center
  • North Carolina
    • Boone, North Carolina, United States, 28607
      • Blue Ridge Pediatric and Adolescent Medicine Group
  • Ohio
    • Dayton, Ohio, United States, 45404
      • Dayton Children's Hospital
    • Toledo, Ohio, United States, 43606
      • The University of Toledo Medical Center
  • Oklahoma
    • Oklahoma, Oklahoma, United States, 73112
      • Dr Santiago Reyes
  • Oregon
    • Gresham, Oregon, United States, 97030
      • Cyn3rgy Research
  • South Dakota
    • Sioux Falls, South Dakota, United States, 57117
      • Sanford Research University of South Dakota
  • Texas
    • Houston, Texas, United States, 77055
      • West Houston Clinical Research Service
    • Houston, Texas, United States, 77052
      • Avant Research Assoc.
  • Utah
    • Salt Lake City, Utah, United States, 84109
      • Foothill Family Clinic
    • Salt Lake City, Utah, United States, 84121
      • First Med
    • Salt Lake City, Utah, United States, 84121
      • Foothill Family Clinic South
    • South Jordan, Utah, United States, 84095
      • CopperView Medical Center
    • St. George, Utah, United States, 84790
      • Dixie Pediatrics
  • Washington
    • Spokane, Washington, United States, 99202
      • Rockwood Clinic
    • Spokane, Washington, United States, 99218
      • Rockwood North Clinic

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 17 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects' parent/legally acceptable representative/guardian must give written informed consent to participate in the study and must understand the nature of the study and must be willing to comply with all protocol requirements. Subjects over 12 must provide assent to participate in the study and potential subjects below this age should provide assent if deemed appropriate to the maturity level of the subject or if required according to local guidance/regulations.
• Males or females aged between 5 and 17 years inclusive, who weigh at least 15 kg at screening.
• Confirmed influenza infection based on positive rapid antigen test (RAT) for Influenza A or B.

• Fever, defined as either:

  1. Otic temperature ≥38.0° C (100.4°F) at the screening visit, OR,
  2. A history of fever within the 24 hours prior to the screening visit and has administered antipyretic(s) in the 6 hours prior to the screening visit.

• Presence on the Screening questionnaire of, at least two, of the following influenza symptoms:

  1. Non-productive Cough, of at least moderate severity,
  2. Sore throat, of at least moderate severity,
  3. Nasal congestion/runny nose, of at least moderate severity,
  4. Headache, of at least moderate severity,
  5. Muscle aches and pain, of at least moderate severity,
  6. Feeling feverish, of at least moderate severity,
  7. Low energy, tired, fatigue, of at least moderate severity;

• Onset of illness no more than 40 hours before randomization, defined as:

  1. time when the temperature was first measured as elevated ≥38.0°C (oral or otic) OR
  2. time when the subject first experienced at least one influenza symptom (non-productive cough, sore throat or nasal congestion/runny nose, headache, muscle aches and pain, feeling feverish, or low energy/tired/fatigue)
• In the Investigator's opinion able to complete the required inhalations of the investigational medicinal product.

Exclusion Criteria:

• Use of antiviral treatment for influenza (e.g., zanamivir, oseltamivir, peramivir, rimantadine, or amantadine) within 14 days prior to screening
• Received influenza virus vaccine in the previous 3 weeks.
• History or presence of clinically significant pulmonary disease (e.g., chronic obstructive pulmonary disease, cystic fibrosis, or bronchiectasis)
• Current asthma requiring treatment, or history of asthma requiring treatment in the last 5 years, or episode of wheezing in the 12 months prior to randomization.
• History of congestive heart failure with symptoms consistent with New York Heart Association Class III or IV functional status.
• Presence of an immune compromised status due to chronic illness, organ transplantation or use of daily systemic immunosuppressants
• Presence of clinically significant signs of acute respiratory distress during screening.
• Current use of inhaled medications (nasal or oral) or anticipated use of inhaled medications (nasal or oral) at any time during the study.
• Current or a history of acute or chronic renal impairment/disease
• Currently hospitalized or any planned hospitalizations within 1 month following the last dose of IMP.
• Current clinical evidence of otitis, bronchitis, sinusitis, or pneumonia or active bacterial infection at any body site
• Severe infection within 30 days prior to screening which required parenteral antibiotic use or hospitalization.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Triple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 20mg Laninamivir Octanoate; Dry Powder plus placebo	Drug: Placebo; Other Names: Lactose; Drug: 20 mg laninamivir octanoate; Other Names: CS-8958
Experimental: 40mg Laninamivir Octanoate; Dry Powder	Drug: 40 mg laninamivir octanoate; Other Names: CS-8958

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate the safety and tolerability of laninamivir octanoate following administration of the dose by inhalation in children with influenza A or B infection	Safety data will be presented according to dose group and age strata. All safety data will be summarized with descriptive statistics, and include assessment of SAEs, AEs, Clinically Significant changes in routine labs, O2 Saturation, ECG, Vitals, Con Meds, Physical Exam findings.	Subjects are assessed at clinic visits and followed up to 28-days post dose.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate the pharmacokinetic (PK) profiles of the prodrug, laninamivir octanoate, and its active metabolite, laninamivir, following administration of a single dose (20 or 40 mg)	Pharmacokinetic parameters will be calculated and summarized, PK concentration data will add to population models.	Samples are collected at clinic visits over 5 days.

Collaborators and Investigators

• Sponsor: Biota Scientific Management Pty Ltd
• Collaborators: Department of Health and Human Services
• Investigators: Study Director: Jolanta Airey, Dr, Biota Scientific Management Pty Ltd

Study record dates

Study Major Dates

• Study Start: November 1, 2013
• Primary Completion (Actual): April 1, 2014
• Study Completion (Actual): May 1, 2014

Study Registration Dates

• First Submitted: November 24, 2013
• First Submitted That Met QC Criteria: December 12, 2013
• First Posted (Estimate): December 18, 2013

Study Record Updates

• Last Update Posted (Estimate): April 22, 2016
• Last Update Submitted That Met QC Criteria: March 22, 2016
• Last Verified: March 1, 2016

More Information

Terms related to this study

• Keywords: pediatric; Influenza treatment; laninamivir
• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Orthomyxoviridae Infections; Influenza, Human; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Antiviral Agents; Enzyme Inhibitors; Zanamivir; Laninamivir
• Other Study ID Numbers: BTA51-350-203; U1111-1150-7392 (Other Identifier: WHO)