- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04530383
Effects of Metformin on Airway Ion Channel Dysfunction in Cystic Fibrosis-related Diabetes
May 8, 2023 updated by: Matthias Salathe, MD, University of Kansas Medical Center
A Randomized, Double-blind, Crossover Clinical Trial of Metformin in Those With CFRD on CFTR Modulator Therapy to Improve Ion Channel Function
The purpose of this study is to assess the efficacy of metformin to improve airway ion channel function in those with CF-related diabetes (CFRD)
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
Up to 30 patients with CFRD on highly effective CFTR modulator therapy who meet criteria and agree to participation in the study will be placed on metformin 500mg twice daily (low) and 1000mg twice daily (normal) in a randomized order (simple randomization).
There will be a dose-escalation with each dosing regimen starting with 500mg twice daily for a week, followed by 500mg in the AM and 1000mg in the PM for another week and finally followed by 1000mg twice daily until the end of normal dose cycle (in those in the normal dose portion of the crossover trial).
A matching placebo pill will be utilized so participants do not know which dosing regimen, low or normal, they are on during each 14-week period.
Participants will continue each dosing regimen of metformin for 14 weeks with a washout period of 2 weeks between dose changes.
To minimize risk of B12 deficiency, a known side effect of long-term metformin use, we will also provide a supplement of 1000 µg oral cyanocobalamin daily for the duration of the trial.
Study Type
Interventional
Enrollment (Anticipated)
36
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: Matthias A Salathe, M.D.
- Phone Number: 9135886000
- Email: msalathe@kumc.edu
Study Contact Backup
- Name: Carolina Aguiar
- Phone Number: 9139459295
- Email: caguiar@kumc.edu
Study Locations
-
-
Kansas
-
Kansas City, Kansas, United States, 66160
- Recruiting
- University of Kansas Medical Center
-
Contact:
- Matthias A Salathe, M.D.
- Phone Number: 913-588-6000
- Email: msalathe@kumc.edu
-
Contact:
- Carolina Aguiar
- Phone Number: 9139459295
-
Sub-Investigator:
- Charles D Bengtson, M.D.
-
Sub-Investigator:
- Andreas Schmid, M.D.
-
-
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
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion criteria:
- Age >18 years with a prior diagnosis of CF.
- Use of ivacaftor or elexacaftor/tezacaftor/ivacaftor for 30 days prior to day 0
3. Diagnosis of CFRD with evidence of continued glucose intolerance at least 6 months after starting elexacaftor/tezacaftor/ivacaftor will be based upon one of the following:
- Insulin use
- Hemoglobin A1C >6.5%
- Fasting glucose >126 mg/dl
- Non-fasting glucose >200 mg/dl (random or as part of a 2-hr OGTT)
Exclusion criteria:
- Prior lung or liver transplant
- Use of supplemental oxygen
- BMI <18
- CF pulmonary exacerbation requiring hospitalization or intravenous antibiotics in the preceding 30 days
- Systemic corticosteroid or regular non-steroidal anti-inflammatory use in the preceding 30 days
- Cardiac, renal (creatinine clearance <45 mL/minute), neurologic, psychiatric, endocrine or neoplastic diseases that are judged to interfere with participation in the study
- Alanine aminotransferase, aspartate aminotransferase or alkaline phosphatase >1.5X the upper limit of normal; bilirubin >3 mg/dL
- Taking medications that interact with metformin.
- Vitamin B12 deficiency
- Pregnancy or lactation
- Inability or unwillingness to comply with an approved contraceptive method during the study period (females of childbearing age)
- Use of medications known to be strong CYP inducers or moderate to strong CYP inhibitors
- In the opinion of the investigator any severe or acute or chronic condition or laboratory abnormality that may increase the risk associated with trial participation or make the subject inappropriate for enrollment
- Participation in another interventional trial that, in the opinion of the investigator, has the potential to affect the primary outcome
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: Crossover Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Metformin dose regimen A
Participants with CFRD on elexacaftor/tezacaftor/ivacaftor who meet criteria and agree to participation in the study will be placed on metformin 500 mg twice daily on study week 0 after undergoing study procedures through week 14.
They will then undergo a two week washout period.
For the second half of the study metformin will be resumed and, if tolerated, dose will be increased by 500mg on weeks 17 and 18 to a final dose of 1000 mg twice daily through end of study (week 30).
|
500-1000 mg twice daily
Other Names:
|
Experimental: Metformin dose regimen B
Participants with CFRD on elexacaftor/tezacaftor/ivafactor who meet criteria and agree to participation in the study will be placed on metformin 500 mg twice daily on study week 0 after undergoing study procedures.
If tolerated, dose will be increased by 500mg on weeks 1 and 2 to a final dose of 1000 mg twice daily through week 14.They will then undergo a two week washout period.
For the second half of the study metformin will be resumed at a dose of 500 mg twice daily through the end of study (week 30).
|
500-1000 mg twice daily
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in BK channel gene expression
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Levels of LRRC26 (big potassium channel regulatory subunit) mRNA will be measured by polymerase chain reaction from nasal cells acquired via brushing
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in CFTR function, as measured by nasal potential difference testing
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Nasal potential difference testing measures direct CFTR current in the nasal epithelium, with greater current indicating greater CFTR function
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in BK function, as measured by nasal potential difference testing
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Nasal potential difference testing measures direct BK current in the nasal epithelium, with greater current indicating greater BK function
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in receptor for receptor for advanced glycation end products (RAGE) gene expression
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Levels of RAGE mRNA will be measured by polymerase chain reaction from nasal cells acquired via brushing
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in advanced glycation end products (AGE)
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Plasma levels of AGE, receptor for AGE (RAGE), soluble RAGE and S100A12 will be quantified by ELISA
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in sweat chloride
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Measured as a secondary marker of CFTR function, with lower levels indicating greater CFTR function
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in lung function
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Measured by percent predicted forced expiatory volume in one second captured on spirometry (FEV1)
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in Quality of Life (CFQ-R)
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Measured by Patient Reported Outcome measurement tool called CFQ-R (validated)
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Change in airway inflammatory markers
Time Frame: Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Inflammatory markers (interleukin-1beta, interleukin-6, interleukin-8, transforming growth factor beta1, tissue necrosis factor-alpha, matrix metalloproteinase-9 and cyclooxygenase-2) collected from nasal fluid will be measured by enzyme linked immunosorbent assay (ELISA)
|
Baseline through week 14 and week 16 through week 30 of metformin treatment
|
Safety of metformin
Time Frame: Baseline through week 30 of metformin treatment
|
Number of adverse events during study period
|
Baseline through week 30 of metformin treatment
|
Pharmacokinetics of metformin
Time Frame: Week 14 and week 30 of metformin treatment
|
Plasma levels of metformin will be quantified by liquid chromatography-mass spectrometry
|
Week 14 and week 30 of metformin treatment
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Matthias A Salathe, M.D., Professor
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)
February 14, 2022
Primary Completion (Anticipated)
May 1, 2025
Study Completion (Anticipated)
October 1, 2025
Study Registration Dates
First Submitted
August 24, 2020
First Submitted That Met QC Criteria
August 24, 2020
First Posted (Actual)
August 28, 2020
Study Record Updates
Last Update Posted (Actual)
May 10, 2023
Last Update Submitted That Met QC Criteria
May 8, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY00146063
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.
Clinical Trials on Cystic Fibrosis
-
Hospital de Clinicas de Porto AlegreUnknownCystic Fibrosis | Cystic Fibrosis Pulmonary Exacerbation | Cystic Fibrosis in Children | Cystic Fibrosis With ExacerbationBrazil
-
University of Colorado, DenverCystic Fibrosis FoundationTerminatedCystic Fibrosis-related Diabetes | Cystic Fibrosis Pulmonary Exacerbation | Cystic Fibrosis in ChildrenUnited States
-
Royal College of Surgeons, IrelandThe Hospital for Sick Children; Imperial College London; Erasmus Medical Center; University College Dublin and other collaboratorsActive, not recruitingCystic Fibrosis | Adherence, Medication | Cystic Fibrosis Gastrointestinal Disease | Cystic Fibrosis in Children | Cystic Fibrosis Liver DiseaseUnited Kingdom, Ireland
-
Herlev and Gentofte HospitalCopenhagen University Hospital, DenmarkActive, not recruitingMyocardial Infarction | Heart Diseases | Heart Failure | Stroke | Cystic Fibrosis | Heart Failure, Diastolic | Heart Failure, Systolic | Left Ventricular Dysfunction | Cystic Fibrosis-related Diabetes | Cystic Fibrosis Gastrointestinal Disease | Cystic Fibrosis of Pancreas | Cystic Fibrosis, Pulmonary | Cystic...Denmark
-
The Hospital for Sick ChildrenCanadian Cystic Fibrosis FoundationActive, not recruitingCystic Fibrosis | Cystic Fibrosis Gastrointestinal Disease | Cystic Fibrosis in ChildrenCanada
-
Arrowhead PharmaceuticalsTerminatedCystic Fibrosis, PulmonaryAustralia, New Zealand
-
AzurRx SASCompletedCystic Fibrosis | Cystic Fibrosis Gastrointestinal Disease | Cystic Fibrosis of PancreasTurkey, Hungary
-
Dartmouth-Hitchcock Medical CenterTrustees of Dartmouth CollegeWithdrawnCystic Fibrosis-related Diabetes | Cystic Fibrosis Liver Disease | CF - Cystic FibrosisUnited States
-
University Hospital, BordeauxCompleted
-
University of PortsmouthUniversity Hospital Southampton NHS Foundation Trust; Loughborough University; Queen Alexandra HospitalTerminated
Clinical Trials on Metformin Hydrochloride
-
Haisco Pharmaceutical Group Co., Ltd.The Fourth Hospital of Hebei Medical UniversityRecruitingDiabetic Neuropathies | Diabetic Neuropathy PeripheralChina
-
University of UtahNational Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)Recruiting
-
University of ArizonaNational Cancer Institute (NCI)RecruitingOral Leukoplakia | ErythroplakiaUnited States, Canada
-
National Cancer Institute (NCI)RecruitingLung CarcinomaUnited States, Canada
-
GlaxoSmithKlineCompleted
-
UConn HealthCompletedAging | Vaccine Response Impaired | Age-Related ImmunodeficiencyUnited States
-
Johns Hopkins UniversityBaylor College of Medicine; National Heart, Lung, and Blood Institute (NHLBI); Temple UniversityNot yet recruitingAsthma | Overweight and Obesity | Asthma Chronic
-
RenJi HospitalCompleted
-
Laboratorios Silanes S.A. de C.V.Completed
-
Bing HeActive, not recruitingPolycystic Ovary SyndromeChina