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A Two-Part Multicenter Prospective Longitudinal Study of CFTR-dependent Disease Profiling in Cystic Fibrosis (PROSPECT) (PROSPECT)

12. maj 2020 opdateret af: Steven M Rowe, University of Alabama at Birmingham
identify and validate biomarkers that might reflect partial restoration of CFTR function and can be used to monitor disease progression, and ii) evaluate the mechanistic effects of CFTR modulators and other relevant therapies in individuals with CF

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Cystic fibrosis (CF) is a genetic disorder caused by mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Over 1,900 mutations, categorized into five genotypic or functional classes are implicated in causing CF. Severity of disease varies widely in CF based on CFTR-dependent and independent factors. Progressive obstructive lung disease is the main determinant of morbidity and mortality in CF; therefore it is critical to identify biomarker profiles that reflect and predict this phenotypic variability, and understand their relationship to residual CFTR activity. Emerging CFTR modulator therapies that directly target defective CFTR are being evaluated in pivotal clinical trials and may become available in the next few years. It is not known how partial restoration of CFTR function might impact CF disease progression and disease-related biomarkers. Thus there is urgent need to i) identify and validate biomarkers that might reflect partial restoration of CFTR function and can be used to monitor disease progression, and ii) evaluate the mechanistic effects of CFTR modulators and other relevant therapies in individuals with CF

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

452

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Forenede Stater
    • Alabama
      • Birmingham, Alabama, Forenede Stater, 35233
        • University of Alabama at Birmingham
    • California
      • Los Angeles, California, Forenede Stater, 90027
        • Childrens Hospital Los Angeles
      • Palo Alto, California, Forenede Stater, 94394
        • Lucile S. Packard Children's Hospital
    • Colorado
      • Aurora, Colorado, Forenede Stater, 80045
        • The Children's Hospital Colarado
      • Denver, Colorado, Forenede Stater, 80206
        • National Jewish Health
    • Illinois
      • Chicago, Illinois, Forenede Stater, 60611-2605
        • Ann & Robert H. Lurie Children's Hospital of Chicago
    • Indiana
      • Indianapolis, Indiana, Forenede Stater
        • Indianapolis University Hospital; James Whitcomb Riley Hospital for Children
    • Kansas
      • Kansas City, Kansas, Forenede Stater, 66160
        • The University of Kansas Hospital
    • Maryland
      • Baltimore, Maryland, Forenede Stater, 21287
        • John Hopkins University
    • Massachusetts
      • Boston, Massachusetts, Forenede Stater, 02114
        • Massachusetts General Hospital
      • Boston, Massachusetts, Forenede Stater, 02115
        • Children's Hospital Boston
    • Michigan
      • Detroit, Michigan, Forenede Stater, 48201
        • Children's Hospital of Michigan
      • Grand Rapids, Michigan, Forenede Stater, 49503
        • Devon Children's Hospital at Spectrum Health
    • Minnesota
      • Minneapolis, Minnesota, Forenede Stater, 55455
        • University of Minnesota
    • Missouri
      • Kansas City, Missouri, Forenede Stater, 64108
        • Children's Mercy Hospital
      • Saint Louis, Missouri, Forenede Stater, 63104
        • Cardinal Glennon Children's Medical Center
      • Saint Louis, Missouri, Forenede Stater
        • St. Louis Children's Hospital
    • New Hampshire
      • Lebanon, New Hampshire, Forenede Stater
        • Dartmouth Hitchcock Medical Center
    • New York
      • Buffalo, New York, Forenede Stater, 14222
        • Women and Children's Hospital of Buffalo
      • New York, New York, Forenede Stater, 10032
        • Columbia University Medical Center
      • Valhalla, New York, Forenede Stater, 10595
        • Maria Fareri Children's Hospital; Westchester Medical Center
    • North Carolina
      • Chapel Hill, North Carolina, Forenede Stater, 27599
        • University of North Carolina at Chapel Hill
    • Ohio
      • Akron, Ohio, Forenede Stater, 44308
        • Akron Children's Hospital
      • Cincinnati, Ohio, Forenede Stater, 45229
        • Cincinnati Children's Hospital Medical Center
      • Cleveland, Ohio, Forenede Stater, 44106
        • University Hospital of Cleveland
      • Columbus, Ohio, Forenede Stater
        • Nation Wide Childrens Hospital
    • Oregon
      • Portland, Oregon, Forenede Stater, 97239
        • Oregon Health & Sciences University
    • Pennsylvania
      • Hershey, Pennsylvania, Forenede Stater, 17033
        • Hershey Medical Center; Penn State Children's Hospital
      • Philadelphia, Pennsylvania, Forenede Stater
        • Children's Hospital of Philadelphia
      • Pittsburgh, Pennsylvania, Forenede Stater, 15213
        • Children's Hospital of Pittsburgh of UPMC
    • South Carolina
      • Charleston, South Carolina, Forenede Stater, 29403
        • Medical University of South Carolina
    • Tennessee
      • Nashville, Tennessee, Forenede Stater, 37232-9500
        • The Children's Hospital at Vanderbilt
    • Texas
      • Houston, Texas, Forenede Stater, 77030
        • Baylor College of Medicine/Texas Children's Hospital
    • Utah
      • Salt Lake City, Utah, Forenede Stater, 84132
        • Primary Children's Hospital
    • Washington
      • Seattle, Washington, Forenede Stater, 98195
        • University of Washington Medical Center
      • Seattle, Washington, Forenede Stater, 98145-9807
        • Seattle Children's Hospital
    • Wisconsin
      • Milwaukee, Wisconsin, Forenede Stater, 53226
        • Froedtert Hospital
      • Milwaukee, Wisconsin, Forenede Stater, 55455
        • Children's Hospital of Wisconsin

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

12 år og ældre (Barn, Voksen, Ældre voksen)

Tager imod sunde frivillige

Ja

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Part A N = 260 (210 CF, 50 non-CF controls)

  • Cohort 1: 50 non-CF control subjects ≥ 12 years of age, with at least 15 subjects 12 - 21 yrs of age
  • Cohort 2: 50 Partial CFTR Function CF subjects with at least one class IV/V CFTR mutation, ≥ 12 years of age
  • Cohort 3 160 Absent CFTR Function CF subjects with two class I/II mutations ≥ 12 years of age

Part B

Up to 250 CF subjects who are homozygous for F508del mutation and who are prescribed ivacaftor/lumacafor for clinical care will be allowed to enroll. This will include :

  • Cohort 3 subjects homozygous for F508del mutation from Part A who are prescribed ivacaftor/lumacaftor will be invited to participate in Part B (up to 100 potential subjects).
  • Up to 150 additional CF subjects homozygous for F508del mutation ≥ 12 years of age who did not participate in Part A but are otherwise eligible for participation in Part B.

Beskrivelse

Inclusion Criteria Part A COHORT 1:

  • 1. Written informed consent (and assent when applicable) obtained from subject or subject's legal representative.

    2. Be willing and able to adhere to the study visit schedule and other protocol requirements 3. Male or female ≥ 12 years of age at Visit 1. 4. Have a body mass index (BMI) of:

    • For subjects ≥ 18 years of age: ≤ 30 kg/m2

    • For subjects 12 - 17 years of age: ≤ 95th percentile 5. Be a non-smoker for ≥ 1 year at screening and have ≤ 10 pack-year history of smoking.

      6. To participate in the optional DNA banking component of this study, subject must have signed the informed consent indicating willingness to participate in the genomic component of the study. Refusal to give consent for this component does not exclude a subject from participation in the study.

Inclusion Cohorts 2-3

  1. Written informed consent (and assent when applicable) obtained from subject or subject's legal representative.
  2. Male or female ≥ 12 years of age at Visit 1.

  3. Documentation of a CF diagnosis as evidenced by one or more clinical features consistent with the CF phenotype and the following criteria: Cohort 2: (Partial Function CFTR CF)

    • Two mutations in the CFTR gene:

      • At least one allele must be a Class IV or V mutation
      • The second allele can be within any CFTR mutation class.
    • Pancreatic sufficient (based on the absence of daily PERT use)
    • At least one historic sweat chloride ≥60 mEq/L by quantitative pilocarpine iontophoresis test (QPIT) OR sweat chloride results ≥ 40, but < 60mEQ/L upon permission of the PROSPECT Investigator-Sponsors.

    Cohort 3: (Absent Function CF)

    • Two class I or II CFTR mutations

  4. Enrolled in the Cystic Fibrosis Foundation Patient Registry. Patients may enroll in the Registry at Visit 1 if not previously enrolled.
  5. Clinically stable with no significant changes in health status within 2 weeks prior to Visit 1.
  6. Be a non-smoker for ≥ 1 year at screening and have ≤ 10 pack-year history of smoking.
  7. To participate in the optional DNA banking component of this study, subject must have signed the informed consent indicating willingness to participate in the genomic component of the study. Refusal to give consent for this component does not exclude a subject from participation in the study

Part B Inclusion

  1. Written informed consent (and assent when applicable) obtained from subject or subject's legal representative.
  2. Physician decision to treat with ivacaftor/lumacaftor.
  3. Completion of at least Visit 1 and Visit 2 of Part A

Exclusion Criteria PART A COHORT 1

  1. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
  2. A history of any clinically significant medical illness or medical disorder that requires ongoing systemic medical therapy, including (but not limited to) cardiovascular disease, neuromuscular disease, hematological disease including bleeding disorders, chronic respiratory disease (including persistent asthma), hepatic or gastrointestinal (GI) disease, neurological disease, neoplastic disease, renal diseases, or endocrine disorders including diabetes.
  3. Acute illness requiring any new prescription or over-the-counter treatment within 14 days prior to Visit 1.
  4. Major or traumatic surgery within 12 weeks prior to Visit 1.
  5. For females of child-bearing potential: a positive pregnancy test at Visit 1.
  6. Initiation of any new chronic therapy within 28 days prior to Visit 1.
  7. Use of an investigational agent within 28 days prior to Visit 1.

Exclusion Part A COHORTS 2-3

  1. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
  2. Initiation of newly prescribed antibiotics [oral, intravenous (IV), and/or inhaled] for acute respiratory symptoms within 2 weeks of Visit 1.
  3. Major or traumatic surgery within 12 weeks prior to Visit 1.
  4. For females of child-bearing potential: a positive pregnancy test at Visit 1.
  5. Initiation of any new chronic therapy (e.g., ibuprofen Pulmozyme®, hypertonic saline, azithromycin, TOBI®, Cayston®) within 4 weeks prior to Visit 1.
  6. Use of an investigational agent within 28 days prior to Visit 1.
  7. Use of oral corticosteroids in doses exceeding 10 mg prednisone/day or 20 mg prednisone/every other day (subjects on oral steroids will be on stable doses for > 12 weeks prior to visit 1).
  8. Active treatment for nontuberculous mycobacterial (NTM) infection, consisting of ≥ two antibiotics (oral, IV, and/or inhaled).
  9. Use of CFTR modulator therapy such as ivacaftor (Kalydeco®) within 28 days prior to Visit 1.
  10. History of lung or liver transplantation, or listing for organ transplantation.

Exclusion PART B

  1. Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
  2. Initiation of newly prescribed antibiotics [oral, intravenous (IV), and/or inhaled] for acute respiratory symptoms within 2 weeks of Visit 4.
  3. Initiation of any new chronic therapy (e.g., ibuprofen, Pulmozyme®, hypertonic saline, azithromycin, TOBI®, Cayston®) within 4 weeks prior to Visit 4.
  4. Use of an investigational agent within 28 days prior to Visit 4.
  5. Use of oral corticosteroids in doses exceeding 10 mg prednisone/day or 20 mg prednisone/every other day (subjects on oral steroids will be on stable doses for > 12 weeks prior to Visit 4).
  6. Active treatment for nontuberculous mycobacterial (NTM) infection, consisting of ≥ two antibiotics (oral, IV, and/or inhaled).
  7. Use of CFTR modulator therapy such as ivacaftor (Kalydeco®) within 28 days prior to Visit 4.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Part A
  • Cohort 1: Healthy Controls
  • Cohort 2: Partial CFTR function CF (class IV/V)
  • Cohort 3: Absent CFTR function CF (Class I/II)
Andet: Observationel
Part B
CF patients who are homozygous for the F508del
Andet: Observationel

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sweat Chloride by Cohort (Part A Only)
Tidsramme: For cohort 1, sweat chloride at Day 0 is time frame. For cohorts 2-3, sweat chloride averaged across all 3 visits at days 0, 14 and 90 is time frame.

This is the primary endpoint for Part A per the PROSPECT protocol. Mean sweat chloride was not reported for Part B, as it is not a relevant statistic.

For cohort 1, sweat chloride is from day 0 only. For cohorts 2-3, sweat chloride was averaged from days 0, 14, 90 via a random intercept longitudinal model.
For cohort 1, sweat chloride at Day 0 is time frame. For cohorts 2-3, sweat chloride averaged across all 3 visits at days 0, 14 and 90 is time frame.
6 Month Change in FEV1 Percent Predicted (Part B Only)
Tidsramme: Baseline and 6 months
This is the primary endpoint for Part B per the PROSPECT protocol. Change in FEV1 Percent Predicted is only relevant for Part B as it captures changes in lung function post-initiation of Ivacaftor/Lumacaftor.
Baseline and 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Alabama at Birmingham

Samarbejdspartnere

Cystic Fibrosis Foundation

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. marts 2015

Primær færdiggørelse (Faktiske)

25. april 2018

Studieafslutning (Faktiske)

27. juli 2018

Datoer for studieregistrering

Først indsendt

22. maj 2015

Først indsendt, der opfyldte QC-kriterier

19. juni 2015

Først opslået (Skøn)

22. juni 2015

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

20. maj 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. maj 2020

Sidst verificeret

1. maj 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • PROSPECT

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

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