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Preventie van ototoxiciteit bij NTM-patiënten behandeld met IV Amikacin

28 september 2026 bijgewerkt door: Kevin Winthrop

Fase 2-studie naar de werkzaamheid en veiligheid van ORC-13661 voor de preventie van door geneesmiddelen veroorzaakt gehoorverlies bij patiënten die intraveneuze amikacine krijgen voor de behandeling van niet-tuberculeuze mycobacteriumziekte

The goal of this clinical trial is to test the effectiveness of the study drug, ORC-13361, in preventing hearing loss in patients with NTM infection who are undergoing treatment with IV amikacin therapy. The main question this study aims to answer is:

  • Is ORC-13661 effective for preventing or lessening hearing loss induced by amikacin treatment?
  • Is ORC-13661 effective for preventing or lessening other measures of hearing impairment?

Participants will be asked to take a study drug while they are being treated with IV amikacin. Participants will take study drug for 90 days or until the end of their amikacin treatment, whichever comes first. During this time, researchers will gather clinical data on the participants' health.

Researchers will compare three groups - two groups taking different doses of the study drug and one group taking a placebo drug - to see if dose of drug has any effect on preventing hearing loss. A placebo is a look-alike substance that contains no active drug.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Nontuberculous mycobacteria (NTM) are environmental bacteria that can cause chronic, debilitating pulmonary disease, primarily affecting those over age 60. In more severe cases of NTM infection, patients are given a therapy with parenteral aminoglycoside antibiotics (AGs), to achieve control or cure. Amikacin is the most commonly used aminoglycoside for treatment in this setting, however it is limited by in its use by its tendency to cause ototoxicity including hearing loss and/or vestibular dysfunction. Ototoxicity refers to substances (i.e. medications) which are damaging to the inner ear sensory cells and may result in functional hearing loss and other negative effects.

This main goal of this study is to test the effectiveness of the study drug, ORC-13661, a small molecule compound being developed as an adjunct therapy to be administered during AG use in order to prevent associated ototoxicity. This study is a randomized, double-blind, placebo-controlled, multicenter, dose-ranging clinical trial to compare the effects and safety of ORC-13661 in preventing or mitigating hearing in patients taking amikacin.

105 participants will be enrolled across 5 enrolling sites over the course of the study. Participants will be randomized in equal numbers between three different study arms: high-dose ORC-13661, low-dose ORC-13661, and placebo. Participants will take study drug for 90 days from the start of their amikacin treatment or until their amikacin treatment ends, whichever comes first.

The primary outcome of this study is prevention or mitigation of amikacin-induced ototoxicity. Secondary outcomes include changes in speech perception, auditory and balance effects, and quality of hearing.

Studietype

Ingrijpend

Inschrijving (Geschat)

105

Fase

  • Fase 2

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

  • Verenigde Staten
    • California
      • San Francisco, California, Verenigde Staten, 94143
        • Werving
        • University of California, San Francisco
        • Onderonderzoeker:
          • Shoshana Zha, MD, PhD
        • Hoofdonderzoeker:
          • Catherine DeVoe, MD
        • Contact:
    • Colorado
      • Denver, Colorado, Verenigde Staten, 80206
    • Maryland
      • Baltimore, Maryland, Verenigde Staten, 21224
        • Werving
        • Johns Hopkins University
        • Contact:
        • Hoofdonderzoeker:
          • Elisa Ignatius, MD, MSc
        • Contact:
    • Minnesota
      • Rochester, Minnesota, Verenigde Staten, 55905
        • Ingetrokken
        • Mayo Clinic
    • New York
      • Manhasset, New York, Verenigde Staten, 11030
        • Werving
        • Northwell Health
        • Hoofdonderzoeker:
          • Lisa Hayes, MD
        • Onderonderzoeker:
          • Marcia Epstein, MD
        • Contact:
        • Contact:
    • Oregon
      • Portland, Oregon, Verenigde Staten, 97239
        • Werving
        • Oregon Health & Science University
        • Hoofdonderzoeker:
          • Kevin Winthrop, MD, MPH
        • Contact:
        • Contact:
    • South Carolina
      • Charleston, South Carolina, Verenigde Staten, 29425
        • Werving
        • Medical University of South Carolina
        • Hoofdonderzoeker:
          • Patrick Flume, MD
        • Contact:
        • Contact:
    • Texas
      • Tyler, Texas, Verenigde Staten, 75708
        • Werving
        • University of Texas Health Science Center
        • Contact:
        • Hoofdonderzoeker:
          • Devanshi Mehta, MD

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar tot 80 jaar (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  1. Providing informed consent, documented by signing and dating the currently valid informed consent form.
  2. Considered by the Investigator to have unimpaired consent capacity, without reliance on a legally authorized representative.
  3. Stated willingness and ability to comply with study procedures and availability for the duration of the study.
  4. Aged > 18 and < 80.
  5. NTM infection meeting current Pulmonary NTM guidelines from the American Thoracic Society and the Infectious Diseases Society of America (ATS/IDSA) for systemic (IV) aminoglycoside therapy.
  6. Anticipated duration of IV amikacin treatment of at least 30 days at time of study entry.
  7. Statement of ability to take oral medication and adhere to the daily dosing regimen.
  8. For females of reproductive potential: If they are of childbearing potential, they must agree in writing to practice an effective double barrier method of contraception from the signing of the informed consent form until 1 month following discontinuation of study drug treatment or agree to practice true abstinence, when this is consistent with the preferred and usual lifestyle of the subject.
  9. For males of reproductive potential: Agree to practice effective barrier contraception from the signing of the informed consent form until 3 months (one spermatogenesis cycle) following the last dose of study drug or agree to practice true abstinence.

Exclusion Criteria:

  1. Received a systemic aminoglycoside antibiotic within 6 months prior to planned first dose of amikacin.
  2. ECG at Screening or prior to randomization (mean of triplicate values) with QT interval corrected using Fridericia's formula (QTcF interval) ≥ 450 msec.
  3. ECG at Screening or prior to randomization with abnormalities that, in the Investigator's judgment, might predispose patient to clinically significant arrhythmia.
  4. Patients taking strong CYP3A4 inducers such as rifampin and rifabutin in the 7 days prior to randomization or have the need for ongoing treatment with concomitant oral or intravenous therapy with strong CYP3A4 inducers during the study. If an additional antibiotic is needed, then azithromycin will be used.
  5. Patients taking strong CYP3A4 inhibitors such as clarithromycin in the 7 days prior to randomization or the need for ongoing treatment with concomitant oral or intravenous therapy with strong CYP3A4 inhibitors during the study. If an additional antibiotic is needed, then azithromycin will be used.
  6. Patients taking clofazimine or bedaquiline AND who also have congestive heart failure, significant ventricular arrhythmia, uncorrected hypokalemia, or ECG (single at Screening, mean of triplicate prior to randomization) showing QRS > 120 msec or heart rate < 50 bpm.
  7. Patients with amikacin exposure within the 6 months prior to randomization.
  8. Patients with known amikacin resistance (MIC >64)
  9. Progressive liver disease (Child-Pugh B or C) which would affect or invalidate interpretation of change from the baseline liver function tests over the course of the study.
  10. Signs of disturbed integrity of the tympanic membrane, determined by otoscopy or tympanometry, including chronic perforation or middle ear or ear canal inflammation or effusion.
  11. History of congenital hearing loss, otological surgery (excluding myringotomy tubes or simple tympanoplasty healed and currently intact), sudden hearing loss, or Meniere's disease.
  12. Bilateral profound hearing loss (>90 Decibels [dB] HL) at all test frequencies.
  13. Conductive hearing loss evidenced by average air-bone-gaps >15 dB HL for 0.25-4.0 kilohertz (kHz)
  14. History of active malignancy, either untreated or under active treatment.
  15. History of risk factors for Torsades des Pointes (e.g., heart failure, hypokalemia, family history of Long QT Syndrome).
  16. Venous access not adequate for performance of study procedures.
  17. Presence of any circumstance, condition, ECG or laboratory finding that, based on investigator judgment, would interfere with study procedures or assessments or present to the patient an unreasonable risk from participation in this study.
  18. Current or anticipated use of excluded concomitant medications as specified in Section 6.5.
  19. Pregnant or lactating.
  20. Female of childbearing potential who does not have a negative serum pregnancy test and does not agree in writing to using a double barrier method of contraception.
  21. Female relying on menopausal status for contraception who does not have Follicle-Stimulating Hormone (FSH) level consistent with that condition and who does not agree in writing to using a double barrier method of contraception.
  22. Currently under correctional supervision (imprisoned, on probation or parole).

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verviervoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: High Dose ORC-13661

This arm is a daily treatment regimen of study drug (ORC-13661) with a loading dose of 150mg followed by a daily dose of 30mg. Treatment regimen will run concurrently with treatment with IV amikacin. Study drug treatment will continue until treatment with IV amikacin ends or 90 days, whichever is earlier.
Geneesmiddel: ORC-13661

High-dose intervention (30mg daily)

Geneesmiddel: ORC-13661

Low-dose intervention (12mg daily)
Experimenteel: Low Dose ORC-13661

This arm is a daily treatment regimen of study drug (ORC-13661) with a loading dose of 60mg capsules followed by a daily dose of 12mg capsules. Treatment regimen will run concurrently with treatment with IV amikacin. Study drug treatment will continue until treatment with IV amikacin ends or 90 days, whichever is earlier.
Geneesmiddel: ORC-13661

High-dose intervention (30mg daily)

Geneesmiddel: ORC-13661

Low-dose intervention (12mg daily)
Placebo-vergelijker: Placebo

This arm is a daily treatment regimen of a placebo with a loading dose and a daily dose of placebo capsules to match the treatment arms. Placebo regimen will run concurrently with treatment with IV amikacin. Placebo regimen will continue until treatment with IV amikacin ends or 90 days, whichever is earlier.
Geneesmiddel: Placebo

Placebo intervention

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Mitigation or Prevention of Ototoxicity
Tijdsspanne: Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.

Outcome is measured by changes from baseline using the American Speech-Language-Hearing Association (ASHA) shift criterion in patients with NTM disease undergoing treatment with IV amikacin therapy
Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Mitigation or Prevention of hearing impairment with regards to speech perceptions
Tijdsspanne: Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.

Outcome is measured by changes to patient's speech perceptions using the High Frequency Digits-in-Noise (HF-DIN) test
Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.
Mitigation or Prevention of hearing impairment with regards to perceived auditory and balance effects
Tijdsspanne: Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.

Outcome is measured by changes to patient's tinnitus using the Modified-Tinnitus Ototoxicity Monitoring Interview (TOMI)
Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.
Mitigation or Prevention of hearing impairment with regards to speech, spatial and quality of hearing
Tijdsspanne: Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.

Outcome is measured by changes to patient's Speech, Spatial and Quality of Hearing Scale (SSQ12)
Baseline to 28 (±5) days after study treatment discontinuation or 28 days after 90 days of study treatment, whichever comes first.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Kevin Winthrop

Medewerkers

Medical University of South Carolina
Johns Hopkins University
Mayo Clinic
Northwell Health
University of Washington
University of California, San Francisco
National Institute on Deafness and Other Communication Disorders (NIDCD)
National Center for Advancing Translational Sciences (NCATS)
The University of Texas Health Science Center at Tyler
National Jewish Health
Oricula Therapeutics

Onderzoekers

  • Hoofdonderzoeker: Kevin L Winthrop, MD, MPH, Oregon Health and Science University
  • Hoofdonderzoeker: Edwin Rubel, PhD, Oricula Therapeutics

Publicaties en nuttige links

De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.

Algemene publicaties

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

2 juni 2025

Primaire voltooiing (Geschat)

29 februari 2028

Studie voltooiing (Geschat)

29 februari 2028

Studieregistratiedata

Eerst ingediend

7 februari 2023

Eerst ingediend dat voldeed aan de QC-criteria

7 februari 2023

Eerst geplaatst (Werkelijk)

15 februari 2023

Updates van studierecords

Laatste update geplaatst (Werkelijk)

1 oktober 2026

Laatste update ingediend die voldeed aan QC-criteria

28 september 2026

Laatst geverifieerd

1 september 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • SOUNDS Trial
  • U01DC020175 (Subsidie/contract van de Amerikaanse NIH)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

NEE

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Ja

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

product vervaardigd in en geëxporteerd uit de V.S.

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .

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