- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02968212
Clofazimine in the Treatment of Pulmonary Mycobacterium Avium Complex (MAC)
March 25, 2024 updated by: Kevin Winthrop, Oregon Health and Science University
Phase 2 Study of Clofazimine for the Treatment of Pulmonary Mycobacterium Avium Disease
The purpose of this study is to evaluate the clinical effectiveness and safety of clofazimine when used to treat Mycobacteria avium complex (MAC) lung disease.
Funding Source - FDA OOPD
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Clofazimine is an orphan antibiotic drug that is no longer available through pharmacies in the United States.
It is approved for the treatment of Mycobacterium leprae (leprosy) infections.
Clofazimine has been used for many years off-label against other Mycobacterium, including Mycobacteria avium complex (MAC) lung disease, an increasingly prevalent infection in older Americans.
The U.S. Food and Drug Administration currently oversees clofazimine use to treat MAC lung disease through a special investigational drug access program.
However, to date, there is little understanding of the benefits and risks of clofazimine when used to treat MAC lung disease.
Accordingly, the investigators have developed a randomized, placebo-controlled clinical trial to assess the clinical efficacy and safety of clofazimine.
To be eligible, participants must have MAC lung disease, positive sputum cultures for MAC, and not currently taking antibiotics for MAC.
Eligible participants (102 total enrolled) will be randomly given either clofazimine or placebo for 6 months, and followed closely by their treating physician.
The percentage of participants who become culture negative in each group will be compared, as it is suspected that participants treated with clofazimine will be more likely to become culture negative.
The safety of clofazimine will be measured as well as other potential benefits of the therapy including changes in lung function and quality of life.
Study Type
Interventional
Enrollment (Estimated)
102
Phase
- Phase 2
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Naomi DeBacker
- Phone Number: 503-346-3435
- Email: debacken@ohsu.edu
Study Contact Backup
- Name: Daniel Bouchat
- Phone Number: 503-494-2568
- Email: johdanie@ohsu.edu
Study Locations
-
-
Colorado
-
Denver, Colorado, United States, 80206
- Completed
- National Jewish Health
-
-
District of Columbia
-
Washington, District of Columbia, United States, 20007
- Withdrawn
- Georgetown University
-
-
Florida
-
Tampa, Florida, United States, 33620
- Recruiting
- University of South Florida
-
Contact:
- Tatyana Harris, MBA-MHA, DHA
- Phone Number: 813-250-2392
- Email: trharris1@usf.edu
-
Principal Investigator:
- W. Dwight Miller, MD, MS
-
-
Illinois
-
Chicago, Illinois, United States, 60637
- Completed
- University of Chicago
-
-
Louisiana
-
Baton Rouge, Louisiana, United States, 70803
- Recruiting
- Louisiana State University
-
Principal Investigator:
- Judd Shellito, MD
-
Contact:
- Olivia Rohert
- Phone Number: 504-568-2248
- Email: orohre@lsuhsc.edu
-
-
Maryland
-
Bethesda, Maryland, United States, 20814
- Active, not recruiting
- National Heart, Lung and Blood Institute
-
-
Oregon
-
Portland, Oregon, United States, 97239
- Recruiting
- Oregon Health & Science University
-
Contact:
- Gina Megson, MPH
- Phone Number: (503) 494-2565
- Email: megson@ohsu.edu
-
Contact:
- Naomi DeBacker
- Phone Number: 503-346-3435
- Email: debacken@ohsu.edu
-
Principal Investigator:
- Kevin L Winthrop, MD, MPH
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19140
- Withdrawn
- Temple University Hospital
-
-
Texas
-
Tyler, Texas, United States, 75708
- Recruiting
- University of Texas Health Science Center
-
Principal Investigator:
- Pamela J McShane, MD
-
Contact:
- Alexis Hester, MA
- Phone Number: 903-877-7860
- Email: alexis.hester@uttyler.edu
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- At least 2 positive MAC sputum cultures in the last 12 months with at least one obtained within 12 weeks prior to randomization
- Meet ATS/IDSA 2007 pulmonary disease criteria
- Adult males and females age 18 or over
- Ability to provide informed consent for the use of study drug
Exclusion Criteria:
- Any patient who is unwilling or unable to provide consent or to comply with this protocol
- Cavitary NTM disease
- Patients who are currently taking or within the prior 12 weeks received any of the following: bedaquiline, or any component of ATS/IDSA multi-drug recommended therapy (macrolide, ethambutol, rifampin) for MAC
- Current usage of inhaled amikacin, tobramycin, or gentamicin
- In the judgment of the investigator, the patient is not a candidate for observation (e.g. severe symptoms, extensive disease burden) but rather should be treated with standard multi-drug therapy
- Prior use of clofazimine that has resulted in an allergy to clofazimine or a severe adverse reaction
- Current usage of medications associated with QT prolongation (see Appendix C for full list of prohibited concomitant medications)
- Corrected QT (QTc) interval on electrocardiogram (ECG) > 470 ms for females or 450 ms for males, calculated using Fridericia's formula60,61
- Advanced lung disease (FEV<30%)
- HIV
- Active pulmonary tuberculosis requiring treatment at screening
- Active pulmonary malignancy or chemotherapy or radiation within 1 year of screening
- Use of chronic systemic corticosteroids at doses of 15 mg/day for more than 12 weeks
- Prior lung or other solid organ transplant
- Pregnancy, or breastfeeding that will continue during treatment
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: clofazimine
Participants receive lamprene
|
All participants in the experimental/treatment arm on this protocol will take a loading dose of 200 mg daily in soft capsule form of clofazimine for 16 weeks, dropping to 100 mg daily for the next 8 weeks.
Other Names:
|
Placebo Comparator: sugar pill
Participants receive placebo
|
All participants in the placebo arm on this protocol will take placebo in soft capsule form daily dropping to a smaller dose after 16 weeks to mirror the treatment arm dosing.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from Baseline sputum culture at 24 weeks
Time Frame: Sputum examined for culture change from Baseline at 24 weeks
|
sputum will be processed for acid fast bacilli stain/acid fast bacterial culture.
A semi-quantitative assessment will be made by colony count for patients.
|
Sputum examined for culture change from Baseline at 24 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change from Baseline 6 Minute Walk Test at 24 weeks
Time Frame: 6 Minute Walk Test results examined for change from Baseline at 24 weeks
|
Walking distance achieved in 6 minutes is assessed
|
6 Minute Walk Test results examined for change from Baseline at 24 weeks
|
Change from Baseline PROMIS Fatigue 7a short form questionnaire at 24 weeks
Time Frame: PROMIS Fatigue 7a short form results examined for change from Baseline at 24 weeks
|
Self-administered questionnaire assessing a range of self-reported symptoms over the past seven days, from mild subjective feelings of tiredness to an overwhelming, debilitating, and sustained sense of exhaustion that likely decreases one's ability to execute daily activities and function normally in family or social roles.
Fatigue is divided into the experience of fatigue (frequency, duration, and intensity) and the impact of fatigue on physical, mental, and social activities.
|
PROMIS Fatigue 7a short form results examined for change from Baseline at 24 weeks
|
Change from Baseline Quality of Life-Bronchiectasis (QOL-B) with NTM module at 24 weeks
Time Frame: QOL-B results examined for change from Baseline at 24 weeks
|
Self-administered questionnaire measuring 8 separate domains: Physical Functioning, Role Functioning, Vitality, Emotional Functioning, Social Functioning, Treatment Burden, Health Perceptions, and Respiratory Symptoms.
|
QOL-B results examined for change from Baseline at 24 weeks
|
Change from Baseline CT scan at 24 weeks
Time Frame: CT scan examined for change from Baseline at 24 weeks
|
CT scans will be computationally evaluated using custom software to provide volumetric assessment of NTM-associated abnormalities.
|
CT scan examined for change from Baseline at 24 weeks
|
Change from Baseline semi-quantitative sputum acid fast smear culture at 24 weeks
Time Frame: semi-quantitative sputum acid fast smear culture examined for change from Baseline at 24 weeks
|
sputum will be processed for acid fast bacilli stain/acid fast bacterial culture.
A semi-quantitative assessment will be made by colony count for patients.
|
semi-quantitative sputum acid fast smear culture examined for change from Baseline at 24 weeks
|
Change from Baseline Spirometry at 24 weeks
Time Frame: Spirometry with FEV1/FVC ratio examined for change from Baseline at 24 weeks
|
Mean change in pulmonary function parameters as measured by %predicted FEV1 and FVC
|
Spirometry with FEV1/FVC ratio examined for change from Baseline at 24 weeks
|
Change from Baseline Erythrocyte Sedimentation Rate at 24 weeks
Time Frame: Erythrocyte Sedimentation Rate examined for change from Baseline at 24 weeks
|
Detecting change in Inflammatory markers
|
Erythrocyte Sedimentation Rate examined for change from Baseline at 24 weeks
|
Change from Baseline C-Reactive Protein levels at 24 weeks
Time Frame: C-Reactive Protein levels examined for change from Baseline at 24 weeks
|
Detecting change in Inflammatory markers
|
C-Reactive Protein levels examined for change from Baseline at 24 weeks
|
Number of Adverse Events
Time Frame: Number of Patient-reported and Investigator-reported Adverse Events at 24 weeks
|
Comparison of experienced adverse events between the two study groups
|
Number of Patient-reported and Investigator-reported Adverse Events at 24 weeks
|
Change from Baseline QT interval at 24 weeks
Time Frame: QT interval examined for change from Baseline at 24 weeks
|
A 12-lead ECG will be conducted, and the QT interval calculated using Fridericia's formula: QTC = QT / RR 1/3
|
QT interval examined for change from Baseline at 24 weeks
|
Change from Baseline blood serum chemistry at week 24
Time Frame: blood serum chemistry examined for change from Baseline at 24 weeks
|
Detecting changes in liver ALT and AST levels
|
blood serum chemistry examined for change from Baseline at 24 weeks
|
Change from Baseline complete blood count at week 24
Time Frame: complete blood count examined for change from Baseline at 24 weeks
|
Detecting changes in complete blood count
|
complete blood count examined for change from Baseline at 24 weeks
|
Change from Baseline Minimal Inhibitory Concentration of MAC isolates in vitro at week 24
Time Frame: Minimal Inhibitory Concentration of MAC isolates in vitro examined for change from Baseline at 24 weeks
|
Detecting change in MAC isolates sensitivity to clofazimine
|
Minimal Inhibitory Concentration of MAC isolates in vitro examined for change from Baseline at 24 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Kevin Winthrop, MD, Oregon Health and Science University
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
April 11, 2017
Primary Completion (Estimated)
December 1, 2024
Study Completion (Estimated)
April 1, 2025
Study Registration Dates
First Submitted
November 10, 2016
First Submitted That Met QC Criteria
November 16, 2016
First Posted (Estimated)
November 18, 2016
Study Record Updates
Last Update Posted (Actual)
March 27, 2024
Last Update Submitted That Met QC Criteria
March 25, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Keywords
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
- Anti-Infective Agents
- Anti-Inflammatory Agents
- Anti-Bacterial Agents
- Leprostatic Agents
- Clofazimine
Other Study ID Numbers
- FD-R-5401
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
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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