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Cystic FibrosisPhase 3AIR-CF4NCT00712166

Safety and Efficacy Study of Aztreonam for Inhalation Solution (AZLI) in Patients With Cystic Fibrosis, Mild Lung Disease, and P. Aeruginosa

A Phase 3 study testing AZLI 75 mg three times daily (TID) in people with Cystic Fibrosis and Lung Infection, run by Gilead Sciences at 40 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study was to evaluate the safety and efficacy of a 28-day course of aztreonam for inhalation solution (AZLI) in patients with cystic fibrosis (CF), mild lung disease (forced expiratory volume in 1 second [FEV1] >75% predicted, and Pseudomonas aeruginosa (PA) infection. Read more about this study

Who is it for?
Ages 6 years and older
What is being tested?
AZLI 75 mg three times daily (TID)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
160 participants
Where
40 sitesin 3 countries
Study dates
May 2008to Aug 2009
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Participants ≥ 6 years of age
  • Documentation of CF diagnosis as evidenced by one or more clinical features consistent with the CF phenotype and one or more of the following criteria:
  • Sweat chloride ≥ 60 mEq/L by quantitative pilocarpine iontophoresis test
  • Two well characterized mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene
  • Abnormal nasal potential difference
  • PA present in expectorated sputum or throat swab culture at Visit 1 OR documented PA in 2 expectorated sputum or throat swab cultures within the 12 months prior to Visit 1 (one of the previous PA positive cultures must have been no more than 3 months prior to Visit 1)
Show all 18Show fewer
  • FEV1 > 75% predicted at Visit 1
  • Participants must have exhibited two or more of the following chronic and/or intermittent CF symptoms, for a minimum of 28 days prior to randomization and with no worsening of symptoms within 7 days prior to randomization:
  • Chest congestion
  • Daily cough
  • Productive cough
  • Wheezing
  • Trouble breathing
  • Nocturnal wakening due to coughing
  • Participants (and parent/guardian as required) had to be able to provide written informed consent/assent prior to any study related procedures
  • Females of childbearing potential had to have a negative urine pregnancy test at Visit 1
  • Ability to perform reproducible pulmonary function tests
  • In the opinion of the Investigator, the participant did not require immediate antipseudomonal antibiotic intervention to treat an impending exacerbation, and the participant's condition was stable enough to enroll in the study

Who cannot join

  • Administration of any investigational drug or device within 28 days prior to Visit 1 or within 6 half-lives of the investigational drug (whichever was longer)
  • Administration of any IV, oral, or inhaled antipseudomonal antibiotic within 28 days prior to Visit 1
  • Known local or systemic hypersensitivity to monobactam antibiotics
  • Inability to tolerate short-acting bronchodilator (BD) use at least TID
  • Changes in or initiation of chronic azithromycin treatment within 28 days prior to Visit 1
  • Changes in or initiation of chronic hypertonic saline treatment within 28 days prior to Visit 1
Show all 16Show fewer
  • Changes in or initiation of dornase alfa within 28 days prior to Visit 1
  • Changes in antimicrobial, BD, or corticosteroid medications within 7 days prior to Visit 1
  • Changes in physiotherapy technique or schedule within 7 days prior to Visit 1
  • History of lung transplantation
  • History of participation (enrollment) in any prior clinical studies with AZLI
  • A chest radiograph at Visit 1 (or within the previous 180 days of Visit 1), with abnormalities indicating a significant acute finding (e.g., lobar infiltrate and atelectasis, pneumothorax, or pleural effusion); a chest radiograph obtained and interpreted between Visits 1 and 2 was also acceptable for determining eligibility
  • Positive urine pregnancy test at Visit 1; all women of childbearing potential were to be tested
  • Females of childbearing potential who were lactating or were not (in the opinion of the investigator) practicing an acceptable method of birth control; female participants who utilized hormonal contraceptives as their birth control method must have used the same method for at least 3 months before study dosing
  • Participant was being assessed at Visit 1 by the investigator for an acute change in respiratory symptoms
  • Any serious or active medical or psychiatric illness, which in the opinion of the investigator, would have interfered with participant treatment, assessment, or compliance with the protocol

Trial locations and contacts

40 sites in 3 countries.

40 sites in 3 countries

United States34 sites
  • Albany Medical College

    Albany, New York

  • University of Michigan Health System

    Ann Arbor, Michigan

  • The Children's Hospital

    Aurora, Colorado

  • Children's Hospital, Boston

    Boston, Massachusetts

  • Tufts Medical Center, Pediatric Pulmonary Clinic

    Boston, Massachusetts

  • The Lung & Cystic Fibrosis Center, University of Buffalo Pediatric Associates, Inc., Women & Children's Hospital of Buffalo

    Buffalo, New York

  • Children's Memorial Hospital

    Chicago, Illinois

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio

  • Nationwide Children's Hospital

    Columbus, Ohio

  • The Children's Hospital of Michigan, Detroit Medical Center

    Detroit, Michigan

  • Connecticut Children's Medical Center

    Hartford, Connecticut

  • Penn State Milton S. Hershey Medical Center

    Hershey, Pennsylvania

  • Baylor College of Medicine

    Houston, Texas

  • Indiana University, Outpatient Clinical Research Facility

    Indianapolis, Indiana

  • James Whitcomb Riley Hospital for Children

    Indianapolis, Indiana

  • Nemours Children's Clinic

    Jacksonville, Florida

  • Children's Lung Specialists

    Las Vegas, Nevada

  • Arkansas Children's Hospital

    Little Rock, Arkansas

  • University of Arkansas for Medical Sciences, Division of Pulmonary and Critical Care Medicine

    Little Rock, Arkansas

  • The Minnesota CF Center, University of Minnesota Medical Center

    Minneapolis, Minnesota

  • Long Island Jewish Medical Center

    New Hyde Park, New York

  • Kaiser Permanente

    Oakland, California

  • Santiago Reyes, MD

    Oklahoma City, Oklahoma

  • Children's Hospital of Orange County

    Orange, California

  • Nemours Children's Clinic

    Orlando, Florida

  • Drexel University College of Medicine, Pulmonary Associates

    Philadelphia, Pennsylvania

  • Penn Presbyterian Medical Center

    Philadelphia, Pennsylvania

  • St. Christopher's Hospital for Children

    Philadelphia, Pennsylvania

  • Phoenix Children's Hospital

    Phoenix, Arizona

  • Primary Children's Medical Center

    Salt Lake City, Utah

  • Children's Hospital and Regional Medical Center

    Seattle, Washington

  • SUNY Upstate Medical University

    Syracuse, New York

  • Toledo Children's Hospital/Toledo Hospital, Cystic Fibrosis Research Center

    Toledo, Ohio

  • University Medical Center

    Tucson, Arizona

Other trials in United States

Australia5 sites
  • The Prince Charles Hospital, Adult Cystic Fibrosis Centre

    Chermside, Queensland

  • Respiratory Medicine, Royal Children's Hospital

    Herston, Queensland

  • Child and Adolescent Health Services, Princess Margaret Hospital

    Perth, Western Australia

  • Department of Respiratory Medicine, The Children's Hospital at Westmead

    Westmead, New South Wales

  • Department of Respiratory Medicine, Westmead Hospital

    Westmead, New South Wales

Other trials in Australia

Canada1 site
  • Centre de Recherche du CHUM

    Montreal, Quebec

Other trials in Canada

About this study

Official title: A Double-Blind, Multicenter, Multinational, Randomized, Placebo-Controlled Trial Evaluating Aztreonam Lysine For Inhalation in Patients With Cystic Fibrosis, Mild Lung Disease, and P. Aeruginosa (AIR-CF4)

The purpose of this study was to evaluate the safety and efficacy of a 28-day course of aztreonam for inhalation solution (AZLI) in patients with cystic fibrosis (CF), mild lung disease (forced expiratory volume in 1 second [FEV1] >75% predicted, and Pseudomonas aeruginosa (PA) infection.

Read the detailed description

CF patients often have lung infections that occur repeatedly or worsen over time. The lung infections are often caused by a bacteria called Pseudomonas aeruginosa (PA). Treatment with antibiotics can stop or slow down the growth of the bacteria. The antibiotics may be given by mouth, intravenously (IV), or by inhalation as a mist. The purpose of this study was to evaluate the safety and efficacy of AZLI, an investigational formulation of the antibiotic aztreonam and administered three times a day using the PARI eFlow® electronic nebulizer, in CF patients with PA and mild lung disease.

In this study, participant eligibility was assessed at a screening visit that occurred up to 14 days prior to the baseline visit (Day 0). Those participants who met eligibility criteria at Day 0 were randomized and began a 28-day course of blinded study treatment (AZLI or placebo TID). Participants returned for clinic visits at Day 14, an end of treatment visit at Day 28, and a follow up visit 14 days after the last dose of the trial drug (Day 42).

Being tested
AZLI 75 mg three times daily (TID), Placebo three times daily (TID)
Keywords
cystic fibrosis, pseudomonas aeruginosa, lung infection, CFQ-R, inhaled antibiotic, aztreonam lysine
Medical subject headings
Cystic Fibrosis, Pseudomonas Infections

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AZLI 75 mg three times daily (TID)Drug

  • Placebo three times daily (TID)Drug

Study groups in NCT00712166
Study groupRoleWhat they receive
Placebo three times daily (TID)Placebo comparatorNot described
Receives: Drug: Placebo three times daily (TID)
AZLI 75 mg three times daily (TID)ExperimentalNot described
Receives: Drug: AZLI 75 mg three times daily (TID)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change From Baseline in Cystic Fibrosis Questionnaire - Revised (CFQ-R) Respiratory Symptoms Scale (RSS) Score at Day 28

    The CFQ-R is a validated patient-reported outcome measuring health-related quality of life for children and adults with CF. The CFQ-R contains both general and CF-specific scales. The CFQ-R was administered at Days 0, 14, 28, and 42. The endpoint was change in respiratory symptoms (e.g., coughing, congestion, wheezing) from Day 0 (baseline), assessed with the CFQ-R RSS (score range: 0-100; higher scores indicating fewer symptoms, higher health-related quality of life, or better functioning). Baseline CFQ-R RSS and age group (<18 vs. >=18 years) were included as covariates in the analysis.

    Measured: Day 0 to Day 28

Secondary outcomes (7)
  1. Change From Baseline in CFQ-R RSS Score at Day 14

    The CFQ-R is a validated patient-reported outcome measuring health-related quality of life for children and adults with CF. The CFQ-R contains both general and CF-specific scales. The CFQ-R was administered at Days 0, 14, 28, and 42. The endpoint was change in respiratory symptoms (e.g., coughing, congestion, wheezing) from Day 0 (baseline), assessed with the CFQ-R RSS (score range: 0-100; higher scores indicating fewer symptoms, higher health-related quality of life, or better functioning). Baseline CFQ-R RSS and age group (<18 vs. >=18 years) were included as covariates in the analysis.

    Measured: Day 0 to Day 14

  2. Change From Baseline in CFQ-R RSS Score at Day 42

    The CFQ-R is a validated patient-reported outcome measuring health-related quality of life for children and adults with CF. The CFQ-R contains both general and CF-specific scales. The CFQ-R was administered at Days 0, 14, 28, and 42. The endpoint was change in respiratory symptoms (e.g., coughing, congestion, wheezing) from Day 0 (baseline), assessed with the CFQ-R RSS (score range: 0-100; higher scores indicating fewer symptoms, higher health-related quality of life, or better functioning). Baseline CFQ-R RSS and age group (<18 vs. >=18 years) were included as covariates in the analysis.

    Measured: Day 0 to Day 42

  3. Change From Baseline in CFQ-R Physical Functioning Domain Score

    The CFQ-R contains both general and CF-specific scales. The CFQ-R was administered at Days 0 (baseline), 14, 28, and 42 (the last study visit). The endpoint was change from baseline in the physical functioning domain (e.g., ability to walk and engage in physical activities) of the CFQ-R at Day 28 (range of scores: 0-100; higher scores indicating fewer symptoms, higher health-related quality of life, or better functioning). Baseline CFQ-R physical functioning domain score and age group (<18 vs. >=18 years) were included as covariates in the analysis.

    Measured: Day 0 to Day 28

  4. Number of Participants Using Additional (Nonprotocol-specified) Antipseudomonal Antibiotics During Study

    The number of participants requiring additional antipseudomonal antibiotics (oral, intravenous [IV], or by inhalation), the time to use of these antibiotics, and the reasons for use was recorded. A binary variable was defined to indicate whether the participants needed any antipseudomonal antibiotics that were non-study drug via the oral, IV, or inhalation route between Day 0 (Baseline Visit) and Day 42 (Visit 5). Fisher's Exact Test was implemented on the intent-to-treat (ITT) and per protocol analysis sets to detect treatment effects on need for additional antipseudomonal antibiotics.

    Measured: Day 0 to Day 42

  5. Number of Participants Hospitalized During Study

    Hospitalization was defined as any hospital admission lasting for more than 1 calendar day that had been recorded as a serious adverse event (SAE) on the electronic case report form (eCRF). Binary variables were defined to indicate whether participants experienced any hospitalization. Number of hospitalizations was summarized by treatment group.

    Measured: Day 0 to Day 42

  6. Change From Baseline in Log10 Pseudomonas Aeruginosa (PA) Colony Forming Units (CFUs) in Sputum at Day 28

    Sputum samples were collected at all study visits for quantitative and qualitative culture for PA. Sputum PA density was quantified by logarithm transformation of the CFU value with base 10. Change from baseline in sputum PA density was calculated as the difference between the log10 CFU values at Day 28 (Visit 4) and the baseline value. Missing data was not imputed. Baseline log10 CFU and age group (<18 vs. >=18 years) were included as covariates in the analysis.

    Measured: Day 0 to Day 28

  7. Relative Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Percent Predicted

    Spirometry was performed according to American Thoracic Society (ATS) guidelines at each visit. Treatment effect on the relative change from baseline in FEV1 percent predicted at Day 28 (Visit 4) was tested by the ANCOVA model using the ITT analysis set. Baseline FEV1 percent predicted and age group (<18 vs. >=18 years) were included as covariates in the analysis.

    Measured: Day 0 to Day 28

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Jul 2008 (estimated)
  2. Study startMay 2008
  3. Primary completionJun 2009
  4. Study completionAug 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
160 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00712166
Sponsor's protocol ID
GS-US-205-0117
Acronym
AIR-CF4
Status last verified
Nov 2010
First submitted
7 Jul 2008
Last updated
20 Dec 2010
Data monitoring committee
Yes

Publications

  • Wainwright CE, Quittner AL, Geller DE, Nakamura C, Wooldridge JL, Gibson RL, Lewis S, Montgomery AB. Aztreonam for inhalation solution (AZLI) in patients with cystic fibrosis, mild lung impairment, and P. aeruginosa. J Cyst Fibros. 2011 Jul;10(4):234-42. doi: 10.1016/j.jcf.2011.02.007. Epub 2011 Mar 26.

    PubMed 21441078

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing AZLI 75 mg three times daily (TID) in people with Cystic Fibrosis and Lung Infection, run by Gilead Sciences at 40 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 18 inclusion and 16 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Dec 2010. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 40 sites in United States, Australia, Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Dec 2010). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change From Baseline in Cystic Fibrosis Questionnaire - Revised (CFQ-R) Respiratory Symptoms Scale (RSS) Score at Day 28 (time frame: Day 0 to Day 28). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00712166, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Dec 2010; AzTrials last refreshed its copy on 26 Oct 2026.

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