- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03473340
Studying the Treatment Effect of Pirfenidone in Chronic Lung Allograft Dysfunction (STOP-CLAD)
July 23, 2022 updated by: Vibha Lama, University of Michigan
A Phase Two Randomized, Double-blinded, Placebo-controlled Study Combining Physiological, Radiographic, and Biological Biomarkers to Study the Anti-fibrotic Effect of Pirfenidone in CLAD Post Lung-transplantation
Greater than 50% of lung transplant recipients show signs of chronic lung allograft dysfunction (CLAD) by 5 years post-transplantation.Therapies to prevent or slow CLAD are lacking.
Anti-fibrotic therapies may offer an avenue to prevent progression of CLAD and prolong allograft survival.
This study investigates if Pirfenidone therapy will stabilize lung function decline and slow progression of Functional small airways disease (fSAD) in lung transplant recipients with CLAD.
Study Overview
Status
Terminated
Intervention / Treatment
Detailed Description
The study aimed to enroll lung transplant recipients with an established diagnosis of CLAD.
The patients were randomized to receive an anti-fibrotic drug Pirfenidone or Placebo pills for 6 month period.
High-resolution CT scan of the chest was utilized to measure the primary endpoint of change in functional small airway disease (fSAD).
Pulmonary function testing and spirometry were utilized to measure the secondary endpoint of change in FEV1 and FVC.
Study Type
Interventional
Enrollment (Actual)
24
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 Locations
-
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Michigan
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Ann Arbor, Michigan, United States, 48109
- The University of Michigan
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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
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Lung transplant recipients 18 years of age or older
- Greater than 6 months after single or bilateral lung transplantation
- Baseline FEV1 and FVC values (mean of two highest value measured 3 weeks apart) > 50% predicted (to assure viable graft)
- Diagnosis of CLAD (two consecutive spirometric values of FEV1 alone or both FEV1 and FVC < 80% of baseline)
Exclusion Criteria
- Acute Rejection (AR) diagnosis by biopsy in the 28 days prior to enrollment
- Treatment with pulse steroids, Anti-thymocyte Globulin (ATG), extracorporeal photopheresis (ECP), plasmapheresis, or Immunoglobulin therapy aimed at CLAD within the 28 days prior to enrollment
- If the subject is receiving chronic Azithromycin therapy, the dose must be stable for the 28 days prior to enrollment
- Presence of active pulmonary infection at the time of enrollment as determined by an investigator in consultation with the treating pulmonologist
- Diagnosis of bronchial stenosis either a) requiring stenting, or b) thought to be responsible for the spirometric decline by principal investigator
- Abnormal liver function tests (aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 2 x upper limit of normal (ULN), Alkaline phosphatase > 2.5 x ULN, total bilirubin > ULN) or known cirrhosis (>2 times upper limit of normal of AST/ALT/AP)
- Total white blood cell (WBC) < 3.0 K/uL
- Moderate to Severe Renal insufficiency (CrCl <15 mL/min calculated by the Cockcroft-Gault equation)
- Use of any medication known to cause significant interactions with pirfenidone (strong CYP1A2 inhibitors such as Fluvoxamine or Enoxacin or inducers)
- Pregnancy or lactation. Women of child-bearing potential will have a pregnancy test at enrollment and must agree to maintain highly effective contraception with two methods of birth control from the date of consent through the end of the study.
- Tobacco use within 6 months
- History of alcohol abuse in the past 1 year as determined by the treating pulmonologist
- Any condition other than CLAD that will likely result in death in the next 1 year
- Any condition in the judgement of the principal investigator that would preclude participation in this study
- EKG with QTc interval > 500 msec at screening
- Listed for repeat lung transplantation
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: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Pirfenidone Capsule
Method of Administration: Oral (capsule) Dosing:
|
Dosing: Days 1 through 7, 267 mg three times daily; Days 8 through 14, 534 mg three times daily; Days 15 through end of treatment (24 weeks), 801 mg three times daily duration: 24 weeks
Other Names:
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Placebo Comparator: Placebo Capsule
Method of Administration: Oral (capsule) Dosing:
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Dosing:
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Percent of Functional Small Airways Disease (fSAD) as Measured by Parametric Response Mapping
Time Frame: Baseline, 24 weeks
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Evaluate if pirfenidone compared to placebo will stabilize progression of fSAD by comparison of inspiratory and expiratory high resolution computed tomography (HRCT) images through co-registration to provide quantitative measures of fSAD.
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Baseline, 24 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Forced Expiratory Volume 1 Over 24 Weeks (FEV1)
Time Frame: Baseline, 24 weeks
|
Measured by spirometry
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Baseline, 24 weeks
|
Change in Forced Vital Capacity (FVC) Over 24 Weeks
Time Frame: Baseline, 24 weeks
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Measured by spirometry
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Baseline, 24 weeks
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Number of Adverse Events Related to Study Treatment
Time Frame: 28 weeks
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Safety of pirfenidone will be measured by adverse events determined to be related to the study drug through review of medical history, physical exam and laboratory findings.
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28 weeks
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Number of Subjects With Treatment Intolerance
Time Frame: 24 weeks
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Subjects permanently discontinuing study medication before 24 weeks
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24 weeks
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Vibha Lama, MD, University of Michigan
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 27, 2018
Primary Completion (Actual)
July 23, 2021
Study Completion (Actual)
August 20, 2021
Study Registration Dates
First Submitted
March 14, 2018
First Submitted That Met QC Criteria
March 14, 2018
First Posted (Actual)
March 22, 2018
Study Record Updates
Last Update Posted (Actual)
August 17, 2022
Last Update Submitted That Met QC Criteria
July 23, 2022
Last Verified
July 1, 2022
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- HUM00131610
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
product manufactured in and exported from the U.S.
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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