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Completed

NCT Number: NCT01180634

MP-376 (Aeroquin™, Levofloxacin for Inhalation) in Patients With Cystic Fibrosis

Patients with cystic fibrosis (CF) suffer from chronic infections of the lower respiratory tract that can be caused by one or multiple bacteria, including Pseudomonas aeruginosa, which has been particularly problematic to eradicate and been implicated as the major cause of morbidity and mortality in CF patients. Aerosol delivery of antibiotics directly to the lung increases the local concentrations of antibiotic at the site of infection resulting in improved antimicrobial effects compared to systemic administration. Decreased efficacy, intolerance and high treatment burden with currently available therapies indicate a need for additional therapies. MP-376 (Aeroquin™) is a novel formulation of the fluoroquinolone levofloxacin that has been optimized for aerosol delivery. Preclinical and clinical studies conducted to date show that aerosol doses of MP-376 are safe and well tolerated, exert an antimicrobial effect, improve lung function and reduce the need for other anti-pseudomonal antibiotics. High concentrations of levofloxacin in the lung delivered as MP-376 are active against CF pathogens including those with high minimum inhibitory concentration (MIC) levels to aminoglycosides such as tobramycin (TOBI®) and other inhaled antimicrobial agents. Inhaled MP-376 can be delivered rapidly and efficiently using a customized PARI investigational configuration of the eFlow® nebulizer system.

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Key information

Age range

12 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

John Hunter Hospital, New South Wales, Australia

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About this study

This trial will be a double-blind, placebo-controlled study to evaluate the efficacy and safety of levofloxacin administered as MP-376 given for 28 days by the aerosol route to CF patients.

Study with completed results acquired from Horizon in 2024.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

(selected):

  • >/= 12 years of age
  • Confirmed Diagnosis of Cystic Fibrosis
  • Positive sputum culture for P. aeruginosa at screening and within the past 12 months
  • Patients are able to elicit an FEV1 >/= 25% but </= 85% of predicted value at screening
  • Have received at least 3 courses of inhaled antimicrobials over the preceding 12 months
  • Clinically stable with no changes in health status within the last 28 days
  • Able to reproducibly produce sputum and perform spirometry

Exclusion criteria

(selected):

  • Use of any nebulized or systemic antibiotics within 28 days prior to baseline
  • History of hypersensitivity to fluoroquinolones or intolerance with aerosol medication
  • Evidence of respiratory infections within 14 days prior to dosing
  • CrCl < 20ml/min or < 20ml/min/1.73 m2 at Screening

Treatment and study plan

Aeroquin

Drug

Inhalation Solution

Other names: MP-376, Levofloxacin Inhalation solution 240 mg

Placebo

Drug

Inhalation Solution

Primary outcomes

  1. Time to an Exacerbation

    Time frame: Baseline to end of study (up to 59 days)

    The start of the exacerbation was determined by the earliest date at which a participant concurrently met at least 4 of the 12 modified Fuchs symptoms/signs; discontinued from the study early; died; or received an antipseudomonal agent for an event that did not meet modified Fuchs criteria but was determined to be an exacerbation by the Blinded Exacerbation.

    Fuchs symptoms/signs;

    • Change in sputum
    • New or increased hemoptysis
    • Increased cough
    • Increased dyspnea
    • Malaise, fatigue or lethargy
    • Temperature above 38oC
    • Anorexia or weight loss
    • Sinus pain or tenderness
    • Change in sinus discharge
    • Change in physical examination of the chest
    • Decrease in pulmonary function by 10 percent or more from a previously recorded value
    • Radiographic changes indicative of pulmonary infection

    Median and 95%Ci were estimated using Kaplan Meier estimates.

Secondary outcomes

  1. Absolute Change in Percent Predicted Forced Expiratory Volume in One Second (FEV1)

    Time frame: Baseline, day 28

    FEV1 was the volume of air exhaled in first second of a forced expiration as measured by spirometer. Least squares (LS) mean and standard error are determined from a repeated measures model with terms for treatment, visit, treatment*visit, region (US, non-US), age (12-18 years, >18 years), and baseline FEV1 (<55%, >=55%).

  2. Change From Baseline in Pseudomonas Aeruginosa Sputum Density

    Time frame: Baseline, Day 28

    Pseudomonas aeruginosa density was measured as log10 colony-forming units [CFU] per gram sputum. LSMean and standard are determined from a repeated measures model with terms for treatment, visit, treatment*visit, region (US, non-US), age (12-18 years, >18 years), baseline FEV1 (<55%, >=55%), and baseline organism log density.

  3. Change From Baseline in the Respiratory Domain of the Cystic Fibrosis Questionnaire Revised (CFQ-R)

    Time frame: Baseline, Day 28

    The Cystic Fibrosis Questionnaire (CFQ-R) is a disease-specific instrument that measures health-related quality of life (HRQOL) for adolescents and adults with cystic fibrosis (CF). Respiratory domain assessed respiratory symptoms, score range: 0-100; higher scores indicating fewer symptoms and better health-related quality of life. LSMean and standard error were determined from a repeated measures model with terms for treatment, visit, treatment*visit, region (US, non-US), age (12 to 18 years, > 18 years), Baseline FEV1 (<55%, ≥ 55%), and Baseline value.

  4. Relative Change From Baseline in Percent Predicted FEV1

    Time frame: Baseline, Day 28

    FEV1 was the volume of air exhaled in first second of a forced expiration as measured by spirometer. Least squares (LS) mean and standard error are determined from a repeated measures model with terms for treatment, visit, treatment*visit, region (US, non-US), age (12-18 years, >18 years), and baseline FEV1 (<55%, >=55%).

  5. Time to Administration of Other Systemic and/or Inhaled Antipseudomonal Antimicrobials

    Time frame: Baseline to end of study (up to 59 days)

    Participants who had at least one of four worsening respiratory symptoms (increased cough, increased sputum/chest congestion, decreased exercise tolerance, decreased appetite) at the time of administration of the anti-pseudomonal antimicrobial agent were included in the analysis. Median and 95% CI are estimated using Kaplan Meier estimates.

  6. Time to First Hospitalization

    Time frame: Baseline to end of study (up to 59 days)

    Median and 95%CI was estimated using Kaplan Meier estimates.

  7. Number of Participants With Treatment Emergent Adverse Events

    Time frame: From start of study until end of study (Up to 59 days)

    An AE was defined as any unfavorable or unintended sign, symptom, or disease temporally associated with the use of a Study Drug, whether or not considered related to the Study Drug.

    An AE could potentially be a new disease, any untoward event, or an exacerbation of a pre-existing condition. AEs included, but were not limited to:

    • Any symptom not previously reported by the patient (medical history)
    • An exacerbation of a pre-existing illness
    • An increase in frequency or intensity of a pre-existing episodic event or condition
    • A condition first detected or diagnosed after Study Drug administration even though the condition may have been present before the start of the study
    • Overdose of Study Drug

Sponsors and collaborators

Lead sponsor

Amgen

Industry

Collaborators

  • Forest Laboratories

Registry information

Official study title

A Phase 3, Multi-Center, Multinational, Randomized, Double-Blind, Placebo-Controlled Study To Evaluate The Efficacy And Safety Of MP-376 (Levofloxacin Inhalation Solution; Aeroquin™) In Stable Cystic Fibrosis Patients

Important dates

Study start
2010
Primary completion
2012
Study completion
2012
First posted
Aug 12, 2010
Registry last updated
Dec 18, 2024

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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