- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04204252
Evaluate Efficacy and Safety of "Kamada-AAT for Inhalation" in Patients With AATD (InnovAATe)
April 30, 2023 updated by: Kamada, Ltd.
A Prospective Phase III Multi-center, Placebo Controlled, Double Blind Study to Evaluate the Efficacy and Safety of "Kamada-AAT for Inhalation" 80 mg Per Day in Adult Patients With Congenital Alpha-1 Antitrypsin Deficiency With Moderate and Severe Airflow Limitation (40% ≤ FEV1 ≤ 80% of Predicted; FEV1/SVC ≤ 70%)
The current study population will consist of adult patients with congenital alpha-1 antitrypsin (AAT) deficiency who have moderate or severe airflow limitation (forced expiratory volume in 1 second 40% ≤ [FEV1] ≤ 80% of predicted) and FEV1/slow vital capacity [SVC] ≤ 70% and who have not experienced two or more moderate or one or more severe exacerbations of COPD during the past year.
A total of 220 patients will be recruited, and after 4 weeks practice inhaling saline with the nebulizer, will be randomized 1:1 to inhale either 80 mg/day "Kamada-AAT for Inhalation" or a placebo with identical appearance.
Patients will be treated for 104 weeks and then followed up for a further 26 weeks.
Over this time there will be 13 visits to the clinical site and in addition the patients will be required to fill out a daily e-diary.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Individuals with a genetic deficiency of alpha-1-antitrypsin (AATD) are at a significantly increased risk (80-100%) of developing emphysema.
This study is designed to administer a solution of AAT by nebulizer so that patients can inhale the drug instead of requiring infusions as in current treatment.
A significant advantage of inhalation is that the AAT is directly transferred to the lungs, which is the site most in need of the protein.
Previous results show that in addition to the added convenience, three times higher concentrations of AAT can be achieved in the lungs by inhalation than by intravenous infusions.
To date, more than 220 patients have completed Inhalation studies for several indications.
Study Type
Interventional
Enrollment (Anticipated)
220
Phase
- Phase 3
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
-
-
-
Leuven, Belgium
- Recruiting
- University Hospital (UZ) Leuven
-
Contact:
- Wim Janssens
- Phone Number: 003216341966
- Email: wim.janssens@uzleuven.be
-
Contact:
- Ella Demesmaeker
- Phone Number: 003216341966
- Email: ella.demesmaeker@uzleuven.be
-
-
-
-
-
Tampere, Finland
- Recruiting
- Tays Central Hospital
-
Contact:
- Seppo Saarelainen
- Phone Number: 00358444722863
- Email: Seppo.Saarelainen@pshp.fi
-
Contact:
- Minttu Kopra
- Phone Number: 00358444722863
- Email: minttu.kopra@pirha.fi
-
-
-
-
-
Dublin, Ireland
- Recruiting
- Beaumont Hospital
-
Contact:
- Gerry McElvaney
- Phone Number: 0035318093763
- Email: gmcelvaney@rcsi.ie
-
Contact:
- Ann M. Collins
- Phone Number: 0035318093864
- Email: annmcollins@rcsi.ie
-
-
-
-
-
Nijmegen, Netherlands
- Recruiting
- Canisius Wilhelmina Hospital (CWZ)
-
Contact:
- Rob Janssen
- Phone Number: 0031243658755
- Email: rob.janssen@cwz.nl
-
Contact:
- Britt Hulsen
- Phone Number: 0031243657944
- Email: res.long@cwz.nl
-
-
ZA
-
Leiden, ZA, Netherlands, 2333
- Recruiting
- Leiden University Medical Center (LUMC)
-
Contact:
- Prof. Jan Stolk, MD PhD
- Phone Number: +31 71 526 5731
- Email: research-longziekten@lumc.nl
-
-
-
-
-
Malmö, Sweden
- Recruiting
- Skåne University Hospital
-
Contact:
- Hanan Tanash
- Phone Number: 0046040332180
- Email: hanan.tanash@med.lu.se
-
Contact:
- Louise Qvist
- Phone Number: 0046040337574
- Email: louise.qvist@med.lu.se
-
-
-
-
-
Birmingham, United Kingdom
- Recruiting
- University Hospitals Birmingham NHS Foundation Trust
-
Contact:
- Alice Turner
- Phone Number: 004401213713885
- Email: alice.turner2@uhb.nhs.uk
-
Contact:
- Anita Pye
- Phone Number: 00441213713886
- Email: Anita.Pye@uhb.nhs.uk
-
-
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 to 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria
- Diagnosis of severe AAT deficiency, i.e. patients with either Pi(ZZ), Pi(Z/Null), or Pi(Null/Null) genotypes confirmed by genotype blood test documented prior to screening.
- Serum AAT levels ≤ 11 µM at screening.
- Lung disease with clinical evidence of airflow limitation (post bronchodilator FEV1/SVC ≤ 70%) at screening.
- 40% ≤ FEV1 ≤ 80% of predicted post-bronchodilator at screening.
- Patients who are either naïve or washed out of any AAT treatment for at least 8 weeks prior to randomization.
- Age between 18 to 65 years inclusive at screening.
- Able to read and sign informed consent and willing to participate in the study.
- Males or non-pregnant, non-lactating females whose screening pregnancy test is negative, who are using contraceptive methods deemed reliable by the investigator, who are post-menopausal, or are surgically sterilized.
- High compliance during run in defined as study medication use and e-Diary compliance for at least 20 out of the 28 days of run in.
Exclusion Criteria
- Immunoglobulin A (IgA) absolute deficiency defined as serum IgA levels < 0.05 g/L at screening.
- History of life-threatening transfusion reaction(s), allergy, anaphylactic reaction, or systemic response to human plasma-derived products.
- Two or more moderate or any severe exacerbation(s) within the year prior to the baseline visit.
- A moderate exacerbation within 6 weeks prior to the baseline.
- Use of oral or parenteral glucocorticoids in doses above 10 mg of prednisone daily or equivalent generics (substance and dose).
- Clinically significant inter-current illnesses (except for respiratory or liver disease secondary to AAT deficiency), including: cardiac, hepatic, renal, endocrine, neurological, hematological, neoplastic, immunological, skeletal, or other. Patients might be included after consultation with the treating physician and the sponsor if, in the opinion of the Investigator, their condition will not interfere with the safety, compliance or other aspects of this study.
- Hospitalization for any cause 6 weeks prior to screening.
- History of lung or liver transplant.
- On any thoracic or hepatic surgery waiting list.
- Any lung surgery within the past two years (including bronchoscopic lung volume reduction).
- Any smoking within the year prior to screening.
- Evidence of alcohol abuse or history of alcohol abuse, or use of illegal drugs and/or abuse of legally prescribed drugs in the last 5 years prior to screening.
- Acute or chronic hepatitis (hepatitis A, hepatitis B, hepatitis C), or positive human immunodeficiency virus (HIV) serology.
- Signs of significant abnormalities in serum hematology, serum chemistry, serum inflammatory / immunogenic markers and urinalysis per investigator judgment, taking into considerations the potential effects of the AAT deficiency.
- Signs of significant abnormalities in ECG per investigator judgment at screening.
- Presence of psychiatric/ mental disorder or any other medical disorder that might impair the patient's ability to give informed consent or to comply with the requirements of the study protocol. If, in the opinion of the Investigator, the condition will not interfere with the compliance or other aspects of this study, the patient might be included after consultation with the treating physician and the sponsor.
- Participation in another clinical trial involving investigational medication or interventional treatment within 30 days and/or last dose 5 half-lives prior to screening visit.
- Inability to attend scheduled clinic visits and/or comply with study protocol.
- Any other factor that, in the opinion of the investigator, would prevent the patient from complying with the requirements of the protocol.
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: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Inhaled AAT
Daily inhalation of 80 mg/day "Kamada-AAT for Inhalation" for 104 weeks
|
Kamada's alpha 1-antitrypsin product given by inhalation using the eFlow® electronic nebulizer manufactured by PARI Pharma GmbH
Other Names:
|
Placebo Comparator: Placebo
Daily inhalation of a solution of NaCl in phosphate buffer solution with 0.01% TWEEN-80
|
Preparation of NaCl in phosphate buffer solution with 0.01% TWEEN-80
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
FEV1 post bronchodilator
Time Frame: 104 weeks
|
Change from baseline in post bronchodilator FEV1 at 104 weeks
|
104 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
CT densitometry whole-lung 15th percentile lung density (PD15) at total lung capacity (TLC).
Time Frame: 104 weeks
|
Change from baseline over 104 weeks of treatment in CT densitometry whole-lung 15th percentile lung density (PD15) at total lung capacity (TLC).
|
104 weeks
|
FEV1 % of predicted
Time Frame: 104 weeks
|
Change from baseline over 104 weeks of treatment in FEV1 % of predicted
|
104 weeks
|
FEV1/FVC %
Time Frame: 104 weeks
|
Change from baseline over 104 weeks of treatment in FEV1/FVC %
|
104 weeks
|
Exacerbations
Time Frame: 104 weeks
|
Annual rate of exacerbations by severity and duration
|
104 weeks
|
6 minute walk test
Time Frame: 104 weeks
|
Change from Baseline in the distance walked in six minutes
|
104 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
TEAEs
Time Frame: 130 weeks
|
Rate and severity of adverse events during treatment emergent adverse events (TEAEs), adverse events of special interest (AESIs) and serious adverse events (SAEs) during treatment and follow-up period [Safety Outcome]
|
130 weeks
|
PiM
Time Frame: 130 weeks
|
Plasma M-type AAT specific (PiM) levels evaluated as function of exposure time, antibody response (positive vs. negative), and antibody titers
|
130 weeks
|
ADA/nADA
Time Frame: 130 weeks
|
Rate and titers of binding and neutralizing AAT antibodies (ADA/nADA) in plasma [Safety Outcome]
|
130 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Jan Stolk, Prof, LUMC
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)
November 25, 2019
Primary Completion (Anticipated)
March 1, 2027
Study Completion (Anticipated)
September 1, 2027
Study Registration Dates
First Submitted
December 17, 2019
First Submitted That Met QC Criteria
December 17, 2019
First Posted (Actual)
December 18, 2019
Study Record Updates
Last Update Posted (Actual)
May 3, 2023
Last Update Submitted That Met QC Criteria
April 30, 2023
Last Verified
April 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- Respiratory Tract Diseases
- Lung Diseases
- Liver Diseases
- Genetic Diseases, Inborn
- Subcutaneous Emphysema
- Emphysema
- 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) 008
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.
Clinical Trials on Alpha 1-Antitrypsin Deficiency
-
University of FloridaAlpha-1 FoundationEnrolling by invitation
-
Thomayer University HospitalMasaryk UniversityRecruiting
-
Grifols Therapeutics LLCCompletedAlpha₁-Antitrypsin DeficiencyUnited States
-
Michael Campos, MDCSL BehringCompletedAlpha 1 Antitrypsin DeficiencyUnited States
-
University of PittsburghNational Heart, Lung, and Blood Institute (NHLBI)CompletedAlpha 1 Antitrypsin Deficiency | AATDUnited States
-
Washington University School of MedicineNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); N... and other collaboratorsTerminatedLiver Cirrhosis | Alpha-1-antitrypsin DeficiencyUnited States
-
Alnylam PharmaceuticalsTerminatedZZ Type Alpha-1 Antitrypsin Deficiency Liver DiseaseUnited Kingdom
-
Hospices Civils de LyonCompletedChildren With a Deficiency of Alpha-1 AntitrypsinFrance
-
Heidelberg UniversityTerminatedHereditary Emphysema (Alpha 1-antitrypsin Deficiency)Germany
-
Grifols Therapeutics LLCCompletedEmphysema | Alpha 1-antitrypsin Deficiency (AATD)United States
Clinical Trials on Alpha 1-Antitrypsin
-
Kamada, Ltd.CompletedType 1 Diabetes MellitusIsrael
-
Rabin Medical CenterUnknownLung Transplantation | Bronchiolitis Obliterable Syndrome
-
Kamada, Ltd.CompletedNew Onset Type-1 DiabetesIsrael
-
University of Colorado, DenverOmni Bio Pharmaceutical, Inc.CompletedDiabetes | Type 1 DiabetesUnited States
-
Impatients N.V. trading as myTomorrowsKamada, Ltd.No longer availableAlpha 1-Antitrypsin Deficiency | Graft Vs Host Disease | Graft-versus-host-disease | Acute-graft-versus-host Disease | Steroid Refractory Acute Graft Versus Host Disease | Alpha-1 Proteinase Inhibitor | Alpha-1 Protease Inhibitor Deficiency | Acute Graft-Versus-Host Reaction Following Bone Marrow...
-
CSL BehringRecruitingAcute-graft-versus-host DiseaseUnited States, Korea, Republic of, Spain, Australia, Germany, Italy, Turkey, Japan
-
Michael Campos, MDCSL BehringCompletedAlpha 1 Antitrypsin DeficiencyUnited States
-
National Institute of Allergy and Infectious Diseases...Juvenile Diabetes Research Foundation; Immune Tolerance Network (ITN)WithdrawnDiabetes Mellitus, Type 1United States
-
University of FloridaRecruitingAlpha-1 Antitrypsin DeficiencyUnited States
-
Grifols Therapeutics LLCCompletedAlpha 1-Antitrypsin DeficiencyUnited States, United Kingdom