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NCT Number: NCT07148739

Ensuring Access to Optimal Therapy in CF: The ENACT Study

This clinical trial is examining the action and effects of several new drugs in the treatment of cystic fibrosis in children. In addition, several genetic factors are examined. The hope is that the ability to determine prior to treatment those individuals who will or will not respond to existing therapies will avoid needless risk of side effects and the high cost of a potentially ineffective treatment regimen. Understanding the way these drugs work in the body and the best way to study them is critical to expanding the use of these drugs to all patients with cystic fibrosis (CF).

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Key information

Age range

3 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

The University of Alabama at Birmingham, Birmingham, Alabama, United States

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About this study

Understanding variation in genetic response to pharmacological treatments and personalized CFTR modulator response is crucial to the optimization of the use of these novel compounds; expansion to all patients who might benefit from them; and development of predictive biomarkers. In addition, the ability to determine prior to treatment those individuals who will or will not respond to existing therapies will avoid needless risk of side effects and the high cost of a potentially ineffective treatment regimen. Understanding the way these drugs work in the body and the best way to study them and the downstream effects is critical to expanding the use of these drugs to all patients with cystic fibrosis (CF).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • documentation of CF diagnosis per CFF diagnostic criteria and known CFTR genotype
  • age 2 years and older
  • ability to provide written informed consent and/or assent (by subject and/or legal guardian)
  • on a stable dose of triple combination CFTR modulator therapy for at least two weeks prior to Visit 1
  • clinically stable lung disease, defined as no documented acute decrease in FEV1 > 10%, OR use of additional antibiotics (intravenous [IV] or oral [PO]) within 4 weeks prior to screening

Exclusion criteria

  • recent significant unintentional weight loss, as determined by the investigator, in the 4 weeks prior to screening
  • pregnant or breastfeeding female
  • history of alcohol or substance abuse in the 6 months prior to screening
  • participation in a study involving an investigational intervention within 28 days (or 5 half-lives, whichever is longer) prior to screening
  • in the opinion of the Investigator, medical or psychiatric illness, or other conditions that would interfere with participation

Treatment and study plan

Elexacaftor / Ivacaftor / Tezacaftor

Drug

This study will examine different dosing strategies and outcomes for triple combination CFTR modulator therapy using the drug(s) elexacaftor, tezacaftor, and/or ivacaftor in patients with cystic fibrosis.

Other names: Triple Combination CFTR Modulator Therapy, ETI - Elexacaftor/Tezacaftor/Ivacaftor

therapeutic drug monitoring

Other

Participants who consent to the therapeutic drug monitoring study will have their dose adjusted to remain within estimated effective concentrations.

Primary outcomes

  1. Concentration (ng/mL)

    Time frame: One time assessment for observational part of the study, up to 6 times (6 months or more) for the therapeutic drug monitoring pilot and feasibility study.

    Drug concentration of CFTR modulators

Secondary outcomes

  1. Participant Mental and Neuropsychological Health

    Time frame: From enrollment to the end of treatment at 6-12 months.

    Participants will respond to questionnaires about anxiety, depression, suicidal ideation and other indicators of mental and neuropsychological health. Participants will complete assessments and an exam at each study visit.

  2. Investigators will evaluate the feasibility of reducing dose to manage Neuropsychological Side Effects (NPSE).

    Time frame: From enrollment to study conclusion at 6-12 months (after all visits are completed).

    The primary goal will be to assess feasibility to monitor clinical outcomes, patient receptiveness, collection of samples, and concentration interpretation. Assessment of feasibility will include the patient acceptance of dose reduction using an acceptability questionnaire, turnaround for quantitation results by timely return of result, and clinical appropriateness for dose reduction (by monitoring clinical response).

  3. Response to dosing adjustments

    Time frame: From enrollment to study conclusion at 6-12 months, after all visits are completed.

    Outcome includes symptom assessment, spirometry, sweat chloride, weight, and TC quantitation at Visits 2-6. Investigators will monitor patients for 6 visits to assess CF and NP symptom stability under the supervision of the licensed clinical psychologist and TC concentration variability over time. At each visit investigators will re-assess dosing strategy.

Study contacts

Contact information is provided by the study sponsor or research team.

Jennifer S Guimbellot, Medical Degree and License

CONTACT

[email protected]

501-364-5365

Michelle Gillespie

CONTACT

[email protected]

501-364-3377

Sponsors and collaborators

Lead sponsor

Arkansas Children's Hospital Research Institute

Other

Collaborators

  • National Heart, Lung, and Blood Institute (NHLBI)
  • National Institutes of Health (NIH)

Registry information

Official study title

Ensuring Access to Optimal Therapy in Cystic Fibrosis: The ENACT Study

Acronym: ENACT

Important dates

Study start
2025
Primary completion
2030
Study completion
2030
First posted
Aug 29, 2025
Registry last updated
Jun 2, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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