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Completed

NCT Number: NCT04016571

Parameters to Assess Response to Intra-Venous Antibiotic Treatment for Pulmonary Exacerbations in Cystic Fibrosis

Cystic fibrosis (CF) is a multisystem disease characterized by viscid secretions in multiple organ systems. Lung infection and damage account for most of the disease burden. Acute changes in respiratory signs and symptoms termed Pulmonary Exacerbations require treatment with intravenous antibiotics and hospital admission. These episodes cause substantial disruption to people's lives and impact on lung function, quality of life and lifespan. Current treatment regimes require improvement but further study is needed to identify who might benefit from a different approach.

This observational study aims to assess if multi-dimensional measurements taken during treatment correspond with later treatment response. This may allow us to personalise treatment more effectively in the future and to better understand how individuals respond to treatment.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

Belfast Regional Adult CF Centre

Belfast, BT9 7AE, United Kingdom

About this study

Pulmonary Exacerbations in CF require treatment with intravenous (IV) antibiotics and hospital admission for between 10-21 days. These episodes cause substantial disruption to people's lives and impact on lung function, quality of life and lifespan.Robust evidence to support current treatment approaches is lacking with awareness that current regimes could be optimised.

As yet there is no model for predicting how patients with CF will respond to IV antibiotic treatment- other than clinical judgement and lung function response.This is due to lack of robust measures to identify clinical response at the time of treatment and safely predict later clinical outcomes. The heterogeneity of the 21st Century CF population means a multi-dimensional composite measure is needed. This study has therefore been designed to provide an overall picture of people's response including clinical, biochemical and patient related outcome measures. Using multi-dimensional assessment we hope the measures assessed in this study will give a better picture of how people feel and how they respond to treatment.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Patients attending the adult service with a confirmed diagnosis of CF by sweat test or genotype
  • Able to provide written informed consent
  • Able to understand and comply with protocol requirements and instructions
  • Confirmed Pulmonary Exacerbation requiring treatment with intravenous antibiotics using defined criteria (Physician and patient agreed need for admission for intravenous antibiotic treatment)

Exclusion criteria

  • Previous recipient of a lung or other solid organ transplant
  • Inability to complete questionnaires
  • Current enrolment in other investigational medicinal product randomised trial
  • Admission for reasons other than pulmonary exacerbation of CF

Treatment and study plan

Primary outcomes

  1. Forced Expiratory Volume in 1 second (FEV1)

    Time frame: Change in lung function between baseline and day 0, Day 5 and Day 14 of treatment

    Lung function Measure

Secondary outcomes

  1. Treatment Failure defined by need for further IV antibiotic treatment within 30 days

    Time frame: Need for a further course of IV antibiotics within 30 days of treatment completion

    The number of participants requiring a further course of IV antibiotics within 30 days

  2. Change in Respiratory Symptoms

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in Respiratory Symptoms assessed by CF-Respiratory Symptom Diary

  3. Physical activity levels (step count, distance walked, Lightly active minutes, Moderate velocity physical activity (MVPA) and Exercise)

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in Physical Activity Levels measured by consumable wearable device

  4. Sleep parameters measured by consumable wearable device

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in time in bed, time asleep and time awake/restless (mins)

  5. Change in serum inflammatory marker (C-Reactive Protein)

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in serum inflammatory marker (CRP)

  6. Change in sputum inflammatory markers

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in sputum (Interleukins, Tumour Necrosis Factor-Alpha, Calprotectin and Human Mobility Growth Box Protein -1) inflammatory markers (measured in pg/ml)

  7. Change in microbiological growth measured by culture

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in microbiological growth measured by culture

  8. Change in microbiological community composition measured by microbiota analysis

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in microbiological relative abundance, dominance, evenness, diversity and richness

  9. Change in 24 hour sputum volume

    Time frame: Change between Day 0, day 5 and day 14 of treatment

    Change in 24 hour sputum volume (mls)

  10. Time to next exacerbation

    Time frame: Time to next course of intravenous antibiotics within 12 month follow up period (study end)

    Time to next exacerbation

Sponsors and collaborators

Lead sponsor

Belfast Health and Social Care Trust

Other

Collaborators

  • Queen's University, Belfast

Registry information

Acronym: PRIVATE

Important dates

Study start
2016
Primary completion
2018
Study completion
2019
First posted
Jul 11, 2019
Registry last updated
Aug 5, 2020

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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