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Cystic FibrosisPhase 2AquADEKs-2NCT01859390

Effects of an Antioxidant-Enriched Multivitamin Supplement on Inflammation and Oxidative Stress in Cystic Fibrosis

A Phase 2 study testing AquADEKs-2 in people with Cystic Fibrosis, run by University of Colorado, Denver at 15 sites in United States.

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 will be to evaluate the effects of a modified formulation of AquADEKs (AquADEKs-2) on markers of inflammation, antioxidant levels and oxidative stress. Cystic Fibrosis (CF) is a disease that affects the organs in the body such as the lungs. Read more about this study

Who is it for?
Ages 10 years and older
Conditions the study is for
Cystic Fibrosis
What is being tested?
AquADEKs-2
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
73 participants
Where
15 sitesUnited States
Study dates
Jun 2013to Jul 2016
Phase
Phase 2
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 10 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Male or female ≥10 years of age
  • Documentation of a Cystic Fibrosis (CF) diagnosis as evidenced by 1 or more clinical features consistent with the CF phenotype and 1 or more of the following criteria:
  • Sweat chloride equal to or greater than 60 milliequivalent (mEq/L) by quantitative pilocarpine iontophoresis test (QPIT)
  • 2 well-characterized mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene
  • Pancreatic insufficiency documented by having a spot fecal elastase-1 (FE-1) ≤ 100μg/g in a stool sample done either historically or at the screening visit
  • Clinically stable with no significant changes in health status within 2 weeks prior to randomization
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  • Forced expiratory volume over one second (FEV1) ≥ 40 and ≤ 100% of predicted for age based on the Wang (males < 18 years,females < 16 years) or Hankinson (males ≥ 18 years, females ≥ 16 years) standardized equations at the screening visit
  • Weight ≥ 30 kg at the screening visit
  • Able to perform repeatable, consistent efforts in pulmonary function testing
  • Able to tolerate sputum induction with 3% hypertonic saline and to expectorate with induction
  • Written informed consent (and assent when applicable) obtained from subject or subject's legal representative
  • Ability to swallow softgel capsules

Who cannot join

  • Subjects being treated with ivacaftor (Kalydeco™)
  • Liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), or gamma-glutamyl transferase (GGT) > 3 times the upper limits of normal at the screening visit
  • Use of antibiotics (oral, iv, and/or inhaled) for acute respiratory symptoms within 2 weeks prior to randomization
  • Active treatment for allergic bronchopulmonary aspergillosis (ABPA)
  • Current use of oral corticosteroids in doses exceeding the equivalent of 10 mg prednisone/day or 20 mg prednisone every other day
  • Active treatment for nontuberculous mycobacterial (NTM) infection
Show all 22Show fewer
  • Initiation of any new chronic therapy (e.g., ibuprofen, Pulmozyme®, hypertonic saline,azithromycin,Tobramycin Inhalation solution (TOBI®), Cayston® within 8 weeks prior to randomization
  • Unwilling to discontinue current oral vitamin and antioxidant supplementation (e.g.,AquADEKs®, another source of β-carotene, vitamin A, vitamin E or tocopherols,vitamins D or K, n-acetylcysteine, glutathione, CoQ10, other over-the-counter antioxidant) for the duration of the study
  • Use of vitamins (other than control vitamin) or antioxidants within 4 weeks prior to randomization
  • Daily use of > 2 cans of Boost or Pulmocare dietary supplement formulas
  • Known hypersensitivity to oral AquADEKs®
  • For women of child bearing potential:
  • positive pregnancy test at Visit 1 or at Visit 2, or
  • lactating or
  • unwilling to practice a medically acceptable form of contraception (acceptable forms of contraception: abstinence, hormonal birth control, intrauterine device, or barrier method plus a spermicidal agent)
  • Subject unlikely to complete the study as determined by the Investigator
  • Any condition that the Investigator believes would interfere with the intent of this study or would make participation not in the best interest of the subject
  • Use of investigational therapies within 4 weeks prior to randomization
  • Current tobacco smoker
  • Current use of anticoagulant medications
  • Severe malnutrition based either on having a BMI less than the 5th percentile for subjects < 18 years of age or a body mass index (BMI) less than 18 kg/m2 for subjects > 18 years of age.
  • Subjects with poorly controlled CF-related diabetes on active insulin therapy, defined as having a Glycosylated Hemoglobin (HgbA1c) ≥ 7.5% at the most recent historic evaluation of HgbA1c

Trial locations and contacts

15 sites in 1 country.

15 sites in 1 country

United States15 sites
  • Children's Hospital Colorado

    Aurora, Colorado, 80045

  • Women and Children's Hospital of Buffalo

    Buffalo, New York, 14222

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Rainbow Babies and Children's Hospital

    Cleveland, Ohio, 44106

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • The University of Texas Southwestern Medical Center at Dallas

    Dallas, Texas, 75390

  • Children's Hospital of Michigan

    Detroit, Michigan, 48201

  • Penn State Milton S. Hershey Medical Center

    Hershey, Pennsylvania, 17033

  • University of Wisconsin Hospital Center

    Madison, Wisconsin, 53792

  • Children's Hospital of Wisconsin

    Milwaukee, Wisconsin, 53226

  • University of Minnesota Children's Hospital

    Minneapolis, Minnesota, 55455

  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37232-5735

  • The Nemours Children's Clinic

    Orlando, Florida, 32806

  • Children's Hospital of Pittsburgh of UPMC

    Pittsburgh, Pennsylvania, 15224

  • University Medical Center

    Tucson, Arizona, 85724

Other trials in United States

About this study

Official title: A Multi-Center, Randomized, Controlled, Double-Blind Study of the Effects of an Antioxidant-Enriched Multivitamin Supplement on Inflammation and Oxidative Stress in Cystic Fibrosis Patients

The purpose of this study will be to evaluate the effects of a modified formulation of AquADEKs (AquADEKs-2) on markers of inflammation, antioxidant levels and oxidative stress.

Cystic Fibrosis (CF) is a disease that affects the organs in the body such as the lungs. Some of the damage to the lungs of CF patients may be caused by something called oxidant/antioxidant imbalance and oxidative stress.

Read more

Oxidation in the body is kind of what happens to an apple when it turns brown after being cut. And, just as a squeeze of lemon juice stops the oxidation of an apple, antioxidants can stop the rusting (or damage) inside our bodies by unstable oxygen molecules called free radicals. Free radicals can help fight off bacteria and viruses but too many of them do damage instead. Our bodies need antioxidants to keep things in balance so we have the right amount of free radicals.

Many CF patients also have trouble digesting food and absorbing nutrients like vitamins. Many of the vitamins we rely on are antioxidants, like vitamins A, D, E, K and beta-carotene. In some people with CF, even though they take multivitamins and pancreatic enzymes, they still have low amounts of antioxidants. The investigators are looking to see if taking more vitamins and antioxidants will help CF patients.

AquADEKs-2 is an investigational new drug (a drug that has not received approval by the Food and Drug Administration [FDA]). This research study is being done with the AquADEKs-2 compared to a control multivitamin. The study drug, AquADEKs-2 contains standard amounts of fat-soluble vitamins (A, D, E, K) that are contained in typical CF multivitamin supplements plus several antioxidants including beta-carotene, mixed tocopherols (different forms of vitamin E), coenzyme Q10 (CoQ10), mixed carotenoids (lutein, lycopene and zeaxanthin), and the minerals zinc and selenium. The control multivitamin contains standard amounts of vitamins A, B, D, E, and K without additional antioxidant supplementation.

Conditions
Cystic Fibrosis
Being tested
AquADEKs-2, control multivitamin
Keywords
Antioxidants, Vitamins, Inflammation, Oxidative stress
Medical subject headings
Cystic Fibrosis, Inflammation

What participants receive

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

  • AquADEKs-2Drug

    Also called Antioxidant-enriched multivitamin supplement

    AquADEKs-2 contains standard amounts of fat-soluble vitamins (A, D, E, K) that are contained in typical CF multivitamin supplements plus several antioxidants including beta-carotene, mixed tocopherols (different forms of vitamin E), coenzyme Q10 (CoQ10), mixed carotenoids (lutein, lycopene and zeaxanthin), and the minerals zinc and selenium.

  • control multivitaminDietary supplement

    The control multivitamin contains standard (standard for CF multivitamin supplements) amounts of vitamins A, B, D, E, and K without added antioxidants.

Study groups in NCT01859390
Study groupRoleWhat they receive
AquADEKs-2ExperimentalTwo control multivitamin softgel capsules will be taken orally on a once daily basis with pancreatic enzymes and a glass of milk or fat-containing meal for 4 weeks for the screening run in period. For those subjects randomized to the AquADEKs-2 arm, two AquADEKs-2 softgel capsules will be taken orally on a once daily basis with pancreatic enzymes and a glass of milk or fat-containing meal for 16 weeks.
Receives: Drug: AquADEKs-2; Dietary Supplement: control multivitamin
Control multivitaminActive comparatorTwo control multivitamin softgel capsules will be taken orally on a once daily basis with pancreatic enzymes and a glass of milk or fat-containing meal for 4 weeks for the screening run in period for all participants and for 16 weeks for those randomized to this comparative therapy.
Receives: Dietary Supplement: control multivitamin

What is being measured

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

  1. Change in Sputum Myeloperoxidase (MPO) Level

    The primary outcome is the difference in 16 week mean change in log10 sputum myeloperoxidase levels between the AquADEKs-2 arm and the Control Multivitamin arm.

    Measured: Baseline (Visit 2) to Week 16 (Visit 4)

Secondary outcomes (8)
  1. Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Incidence is defined as the number and percentage of participants with at least one event over the 18 week follow-up period.

    Measured: 18 weeks follow up

  2. Rate of Adverse Events (AEs) and Serious Adverse Events (SAEs)

    Rate is defined as the number of events per participant follow-up week.

    Measured: 18 weeks follow up

  3. Change in Lung Function

    Absolute Change in Forced Expiratory Volume over one second (FEV1) % predicted between Baseline and Week 16. Global Lung Initiative equations were used to calculate FEV1 %predicted.

    Measured: Baseline (Visit 2) to Week 16

  4. Change in Growth Endpoints

    Absolute change in Body Mass Index (BMI) (kg/m^2) between Baseline and Week 16.

    Measured: Baseline (Visit 2) to Week 16

  5. Time to First Pulmonary Exacerbation

    Median time to first pulmonary exacerbation (PEx) between baseline (Visit 2) and end of follow up (Week 18)

    Measured: Baseline (Visit 2) to end of follow up (Week 18)

  6. Number of Pulmonary Exacerbations

    The total number of PEx between baseline (Visit 2) and end of follow up (Week 18).

    Measured: Baseline (Visit 2) to end of follow up (Week 18)

  7. Number of Participants With Pulmonary Exacerbations

    Number (%) with at least one protocol-defined PEx between baseline (Visit 2) and end of follow up (Week 18).

    Measured: Baseline (Visit 2) to end of follow up (Week 18)

  8. Number of Participants Hospitalized

    Number (%) of participants with at least one hospitalization between Baseline (Visit 2) and end of follow up (Week 18).

    Measured: Baseline (Visit 2) to end of followup (Week 18)

Timeline

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

  1. First posted21 May 2013 (estimated)
  2. Study startJun 2013
  3. Primary completionApr 2015
  4. Study completionJul 2016

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
73 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01859390
Sponsor's protocol ID
13-1557
Other IDs
AQUADEK12K1
Acronym
AquADEKs-2
Status last verified
Jun 2017
First submitted
17 May 2013
Last updated
14 Jul 2017
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Sagel SD, Sontag MK, Anthony MM, Emmett P, Papas KA. Effect of an antioxidant-rich multivitamin supplement in cystic fibrosis. J Cyst Fibros. 2011 Jan;10(1):31-6. doi: 10.1016/j.jcf.2010.09.005. Epub 2010 Oct 20.

    PubMed 20961818
  • Papas KA, Sontag MK, Pardee C, Sokol RJ, Sagel SD, Accurso FJ, Wagener JS. A pilot study on the safety and efficacy of a novel antioxidant rich formulation in patients with cystic fibrosis. J Cyst Fibros. 2008 Jan;7(1):60-7. doi: 10.1016/j.jcf.2007.05.001. Epub 2007 Jun 13.

    PubMed 17569601
  • Jain R, Baines A, Khan U, Wagner BD, Sagel SD. Evaluation of airway and circulating inflammatory biomarkers for cystic fibrosis drug development. J Cyst Fibros. 2021 Jan;20(1):50-56. doi: 10.1016/j.jcf.2020.06.017. Epub 2020 Jul 1.

    PubMed 32622665
  • Sagel SD, Khan U, Jain R, Graff G, Daines CL, Dunitz JM, Borowitz D, Orenstein DM, Abdulhamid I, Noe J, Clancy JP, Slovis B, Rock MJ, McCoy KS, Strausbaugh S, Livingston FR, Papas KA, Shaffer ML. Effects of an Antioxidant-enriched Multivitamin in Cystic Fibrosis. A Randomized, Controlled, Multicenter Clinical Trial. Am J Respir Crit Care Med. 2018 Sep 1;198(5):639-647. doi: 10.1164/rccm.201801-0105OC.

    PubMed 29688760

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing AquADEKs-2 in people with Cystic Fibrosis, run by University of Colorado, Denver at 15 sites in United States.

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 12 inclusion and 22 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 14 Jul 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 15 sites in United States. 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. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 8 Jun 2017). 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 in Sputum Myeloperoxidase (MPO) Level (time frame: Baseline (Visit 2) to Week 16 (Visit 4)). 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 NCT01859390, which also lists 4 linked publications.

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 14 Jul 2017.

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