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Idiopathic Pulmonary FibrosisPhase 3CleanUp-IPFNCT02759120

CleanUP IPF for the Pulmonary Trials Cooperative

A Phase 3 study testing Antimicrobial therapy: Co-trimoxazole or Doxycycline in people with Idiopathic Pulmonary Fibrosis, run by Weill Medical College of Cornell University at 31 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The purpose of this study is to compare the effect of standard care, versus standard of care plus antimicrobial therapy (co-trimoxazole or doxycycline), on clinical outcomes in patients diagnosed with idiopathic pulmonary fibrosis (IPF). Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
Idiopathic Pulmonary Fibrosis
What is being tested?
Antimicrobial therapy: Co-trimoxazole or Doxycycline
Could I receive a placebo?
No, everyone receives an active treatment
How many people
513 participants
Where
31 sitesUnited States
Study dates
22 Mar 2017to 16 Mar 2020
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 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • ≥ 40 years of age
  • Diagnosed with idiopathic pulmonary fibrosis (IPF) by enrolling investigator
  • Signed informed consent

Who cannot join

  • Received antimicrobial therapy in the past 30 days
  • Contraindicated for antibiotic therapy, including but not exclusive to:
  • Allergy or intolerance to both tetracyclines AND trimethoprim, sulfonamides or their combination
  • Allergy or intolerance to tetracyclines AND known potassium level > 5 mEq/L in the past 90 days.
  • If the enrolling physician feels the potassium level has normalized, documentation to that effect must be provided.
  • Allergy or intolerance to tetracyclines AND concomitant use of angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), potassium sparing diuretic, dofetilide, methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide
Show all 13Show fewer
  • Allergy or intolerance to tetracyclines AND known glucose-6-phosphate dehydrogenase deficiency
  • Allergy or intolerance to tetracyclines AND untreated folate or B12 deficiency
  • Allergy or intolerance to tetracyclines AND known renal insufficiency (defined as a glomerular filtration rate (GFR) < 30 ml within the previous 90 days)
  • If the enrolling physician feels the renal dysfunction has resolved, documentation to that effect must be provided.
  • Pregnant or anticipate becoming pregnant
  • Use of an investigational study agent for IPF therapy within the past 30 days, or an IV infusion with a half-life of four (4) weeks.
  • Concomitant immunosuppression with azathioprine, mycophenolate, cyclophosphamide, or cyclosporine.

Trial locations and contacts

31 sites in 1 country.

31 sites in 1 country

United States31 sites
  • Albany Medical College

    Albany, New York, 12208

  • University of Michigan

    Ann Arbor, Michigan, 48109

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35294

  • Massachusetts General Hospital

    Boston, Massachusetts, 02114

  • Brigham and Women's Hospital

    Boston, Massachusetts, 02115

  • Beth Israel Deaconess Medical Center

    Boston, Massachusetts, 02215

  • University of Virginia

    Charlottesville, Virginia, 22908

  • Loyola University Chicago

    Chicago, Illinois, 60153

  • Northwestern University

    Chicago, Illinois, 60611

  • University of Chicago

    Chicago, Illinois, 60637

  • University of Cincinnati

    Cincinnati, Ohio, 45267

  • Cleveland Clinic

    Cleveland, Ohio, 44195

  • Ohio State

    Columbus, Ohio, 43221

  • INOVA

    Falls Church, Virginia, 22042

  • Spectrum Health

    Grand Rapids, Michigan, 49503

  • Pennsylvania State University

    Hershey, Pennsylvania, 17033

  • University of Kansas

    Kansas City, Kansas, 66160

  • Dartmouth-Hitchcock Medical Center

    Lebanon, New Hampshire, 03756

  • University of Minnesota

    Minneapolis, Minnesota, 55455

  • Vanderbilt

    Nashville, Tennessee, 37232

  • Columbia University

    New York, New York, 10032

  • Weill Cornell Medicine

    New York, New York, 10065

  • Temple University

    Philadelphia, Pennsylvania, 19122

  • University of Rochester

    Rochester, New York, 14642

  • Mayo Clinic

    Rochester, New York, 55905

  • University of California Davis Medical Center

    Sacramento, California, 95817

  • University of Utah

    Salt Lake City, Utah, 84108

  • University of Texas at San Antonio

    San Antonio, Texas, 78229

  • Washington University

    Seattle, Washington, 98195

  • Stanford

    Stanford, California, 94305

  • University of Arizona

    Tucson, Arizona, 85724

Other trials in United States

About this study

Official title: Study of Clinical Efficacy of Antimicrobial Therapy Strategy Using Pragmatic Design in Idiopathic Pulmonary Fibrosis

The purpose of this study is to compare the effect of standard care, versus standard of care plus antimicrobial therapy (co-trimoxazole or doxycycline), on clinical outcomes in patients diagnosed with idiopathic pulmonary fibrosis (IPF).

Read the detailed description

This is a randomized, un-blinded, phase III, multi-center clinical trial of an antimicrobial therapy strategy in idiopathic pulmonary fibrosis patients. Our overall hypothesis is that reducing harmful microbial impact with antimicrobial therapy will reduce the risk of non-elective, respiratory hospitalization or death in patients with Idiopathic Pulmonary Fibrosis (IPF).

Subjects will be randomized 1:1 to either receive a prescription drug voucher for oral antimicrobial therapy in the form of one double strength 160 milligrams (mg) trimethoprim/800mg sulfamethoxazole (double strength co-trimoxazole) twice daily plus folic acid 5 mg daily OR doxycycline 100mg once daily if weight < 50 kilograms (kg) or 100mg twice daily if weight > 50 kg. Patients randomized to receive antimicrobial therapy will be given co-trimoxazole unless they have an allergy, contraindication to co-trimoxazole, renal insufficiency (glomerular filtration rate (GFR) < 30 milliliters (ml)), are hyperkalemic (potassium > 5 milliequivalents(mEq)/liter(L)), or are concomitantly taking an angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), or potassium sparing diuretic in which case they will receive doxycycline.

Participation in this study will be between 12 months and 36 months depending on time of enrollment.

Being tested
Antimicrobial therapy: Co-trimoxazole or Doxycycline, No Intervention: Standard of Care
Keywords
Idiopathic Pulmonary Fibrosis, IPF, pulmonary fibrosis, antimicrobial therapy, doxycycline, co-trimoxazole
Medical subject headings
Idiopathic Pulmonary Fibrosis, Pulmonary Fibrosis

What participants receive

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

  • Antimicrobial therapy: Co-trimoxazole or DoxycyclineDrug

    160mg trimethoprim/800mg sulfamethoxazole (double strength co-trimoxazole) twice daily plus folic acid 5 mg daily OR doxycycline 100mg once daily if weight < 50 kilograms or 100mg twice daily if weight > 50 kilograms for up to 36 months

  • No Intervention: Standard of CareOther

    Standard of care

Study groups in NCT02759120
Study groupRoleWhat they receive
Antimicrobial therapyExperimentalCo-trimoxazole OR doxycycline
Receives: Drug: Antimicrobial therapy: Co-trimoxazole or Doxycycline
Standard of careOtherStandard of care for patients with IPF for comparison
Receives: Other: No Intervention: Standard of Care

What is being measured

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

  1. Number of Participants With First Non-elective, Respiratory Hospitalization or All-cause Mortality

    Measured: Randomization to up to 35 months

Secondary outcomes (16)
  1. Number of Participants With Death From Any Cause

    Measured: Randomization to up to 35 months

  2. Number of Participants With First Non-elective, Respiratory Hospitalization

    Measured: Randomization to up to 35 months

  3. Number of Participants With First Non-elective, All-cause Hospitalization

    Measured: Randomization to up to 35 months

  4. Total Number of Non-elective Respiratory Hospitalizations

    Measured: Randomization to up to 35 months

  5. Total Number of Non-elective All-cause Hospitalizations

    Measured: Randomization to up to 35 months

  6. Percent Change in Forced Vital Capacity (FVC)

    Measured: Randomization to 12 months

  7. Percent Change in Diffusion Capacity of Lungs for Carbon Monoxide (DLCO)

    Measured: Randomization to 12 months

  8. Total Number of Respiratory Infections

    Measured: Randomization to up to 35 months

  9. Change in UCSD-Shortness of Breath Questionnaire

    Change in University of California San Diego (UCSD) Shortness of Breath Questionnaire (0 - 120 range). A lower score indicates a better health score. The UCSD-Shortness of Breath Questionnaire assesses the severity of shortness of breath during specific activities of daily living.

    Measured: Randomization to 12 months

  10. Change in Fatigue Severity Scale Score

    Fatigue Severity Scale score (1 - 7 range). A lower score indicates a better health score. The Fatigue Severity Scale measures the severity of fatigue and its effect on a person's activities and lifestyle.

    Measured: Randomization to 12 months

  11. Change in Leicester Cough Questionnaire Score

    Leicester Cough Questionnaire score (3 - 21 range). A higher score indicates a better health score. The Leicester Cough Questionnaire measures quality of life in people with a chronic cough.

    Measured: Randomization to 12 months

  12. Change in EuroQol Index (EQ-5D) Score

    European Quality of Life-5 dimensions (EQ-5D) score (0 - 1 range). A higher score indicates a better health score. The EQ-5D measures quality of life across 5 dimensions (1. Mobility, 2. Self-care, 3. Usual activities, 4. Pain/discomfort, 5. Anxiety/depression.

    Measured: Randomization to 12 months

  13. Change in ICEpop CAPability Measure for Older People (ICECAP-O) Score

    Change in ICEpop (Investigating Choice Experiments for the Preferences of Older People) CAPability measure for Older people (ICECAP-O) score (0 - 1 range). A lower score indicates a better health score. The ICEpop CAPability measure for Older people (ICECAP-O) is intended for use in economic evaluations of care services for older people.

    Measured: Randomization to 12 months

  14. Change in Short Form-12 Health Survey (SF-12) 6D Score

    Change in Short Form-12 health survey (SF-12) 6D score (0.29 - 1.00 range). A higher indicates a better health score. The SF-12 6D score provides and economic evaluation.

    Measured: Randomization to 12 months

  15. Change in Short Form-12 Health Survey (SF-12) Physical Score

    Change in short form-12 health survey (SF-12) physical component summary (PSC) score (0 - 100 range). A higher score indicates a better health score.

    The short form-12 health survey physical score assesses limitations in physical activities because of health problems.

    Measured: Randomization to 12 months

  16. Change in SF-12 Health Survey (SF-12) Mental Score

    Change in short form-12 health survey (SF-12) mental component summary (MCS) score (0 - 100 range). A higher score indicates a better health score.

    The short form-12 health survey (SF-12) mental component summary (MCS) assesses general mental health.

    Measured: Randomization to 12 months

Timeline

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

  1. First posted3 May 2016 (estimated)
  2. Study start22 Mar 2017
  3. Primary completion16 Mar 2020
  4. Study completion16 Mar 2020

Why it stopped: Terminated for futility after review of first planned interim analysis.

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
None (open label)
Enrolment
513 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02759120
Sponsor's protocol ID
1504016087
Other IDs
U01HL128954
Acronym
CleanUp-IPF
Status last verified
Mar 2021
First submitted
28 Apr 2016
Last updated
8 Apr 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: All collected IPD will be uploaded in a de-identified manner into BioLINCC with open access for interested investigators

Publications

  • Kim JS, Murray S, Yow E, Anstrom KJ, Kim HJ, Flaherty KR, Martinez FJ, Noth I. Comparison of Pirfenidone and Nintedanib: Post Hoc Analysis of the CleanUP-IPF Study. Chest. 2024 May;165(5):1163-1173. doi: 10.1016/j.chest.2023.11.035. Epub 2023 Nov 27.

    PubMed 38030064
  • Martinez FJ, Yow E, Flaherty KR, Snyder LD, Durheim MT, Wisniewski SR, Sciurba FC, Raghu G, Brooks MM, Kim DY, Dilling DF, Criner GJ, Kim H, Belloli EA, Nambiar AM, Scholand MB, Anstrom KJ, Noth I; CleanUP-IPF Investigators of the Pulmonary Trials Cooperative. Effect of Antimicrobial Therapy on Respiratory Hospitalization or Death in Adults With Idiopathic Pulmonary Fibrosis: The CleanUP-IPF Randomized Clinical Trial. JAMA. 2021 May 11;325(18):1841-1851. doi: 10.1001/jama.2021.4956.

    PubMed 33974018
  • Anstrom KJ, Noth I, Flaherty KR, Edwards RH, Albright J, Baucom A, Brooks M, Clark AB, Clausen ES, Durheim MT, Kim DY, Kirchner J, Oldham JM, Snyder LD, Wilson AM, Wisniewski SR, Yow E, Martinez FJ; CleanUP-IPF Study Team. Design and rationale of a multi-center, pragmatic, open-label randomized trial of antimicrobial therapy - the study of clinical efficacy of antimicrobial therapy strategy using pragmatic design in Idiopathic Pulmonary Fibrosis (CleanUP-IPF) clinical trial. Respir Res. 2020 Mar 12;21(1):68. doi: 10.1186/s12931-020-1326-1.

    PubMed 32164673

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Antimicrobial therapy: Co-trimoxazole or Doxycycline in people with Idiopathic Pulmonary Fibrosis, run by Weill Medical College of Cornell University at 31 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 3 inclusion and 13 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: stopped early, as of the sponsor's last update on 8 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 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 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 3 Mar 2021). 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?

Number of Participants With First Non-elective, Respiratory Hospitalization or All-cause Mortality (time frame: Randomization to up to 35 months). 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 NCT02759120, which also lists 3 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 8 Apr 2021.

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