Non Cystic Fibrosis BronchiectasisPhase 3PROMIS-IINCT03460704
Trial in Non-cystic Fibrosis Bronchiectasis Patients With Chronic Lung Infections Treated With Colistimethate Sodium.
A Phase 3 study testing CMS in people with Non Cystic Fibrosis Bronchiectasis, run by Zambon SpA at 89 sites in 12 countries.
Trial summary
The primary objective of the trial was to investigate the effect of the use of inhaled colistimethate sodium (CMS), administered twice a day (b.i.d.) via a specific nebulizer for 12 months, compared to placebo in subjects with non-cystic fibrosis bronchiectasis (NCFB) chronically infected with P. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Non Cystic Fibrosis Bronchiectasis
- What is being tested?
- CMS
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 287 participants
- Where
- 89 sitesin 12 countries
- Study dates
- 29 Jan 2018to 15 Mar 2022
- 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 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- are able and willing to give informed consent, following a detailed explanation of partecipation in the protocol and signed consent obtained;
- aged 18 years or older of either gender;
- diagnosed with NCFB by computerised tomography (CT) or high-resolution CT(HRCT) as recorded in the subject's notes and this is their predominant condition being treated;
- had at least 2 NCFB pulmonary exacerbations requiring oral or inhaled antibiotics or 1 NCFB pulmonary exacerbation requiring intravenous antibiotics in the 12 months preceding the Screening Visit (Visit 1) and had no pulmonary exacerbation with or without treatment during the period between Visit 1 and Visit 2;
- have a documented history of P. aeruginosa infection;
- are clinically stable and have not required a change in pulmonary treatment for at least 30 days before the Screening Visit (Visit 1);
- have pre-bronchodilator FEV1 ≥25% of predicted;
- had a positive sputum culture for P. aeruginosa from an adequate sample taken at the Screening Visit (Visit 1) or during the screening period.
Who cannot join
- known bronchiectasis as a consequence of cystic fibrosis (CF);
- known history of hypogammaglobulinaemia requiring treatment with immunoglobulin, unless fully replaced and considered immuno-competent by the Investigator;
- myasthenia gravis or porphyria;
- severe cardiovascular disease such as severe uncontrolled hypertension, ischaemic heart disease or cardiac arrhythmia and any other conditions that would confound the evaluation of safety, in the opinion of the Investigator;
- had major surgery in the 3 months prior to the Screening Visit (Visit 1) or planned inpatient major surgery during the study period;
- receiving treatment for allergic bronchopulmonary aspergillosis (ABPA);
Show all 20Show fewer
- massive haemoptysis (greater than or equal to 300 mL or requiring blood transfusion) in the preceding 4 weeks before Screening Visit (Visit 1) or between Visit 1 and Visit 2;
- respiratory failure that would compromise patient safety or confound the evaluation of safety or efficacy of the study in the opinion of the Investigator;
- current active malignancy, except for basal cell carcinoma or squamous cell carcinoma of the skin without metastases;
- taking immunosuppressive medications (such as azathioprine, cyclosporine, tacrolimus, sirolimus, mycophenolate, rituximab), and/or anti cytokine medications (such as anti-IL-6 and anti-tumour alpha necrosis factor products) in the preceding year before the Screening Visit (Visit 1);
- known history of human immunodeficiency virus (HIV);
- current treatment for non-tuberculous mycobacterial (NTM) lung disease or tuberculosis;
- known or suspected to be allergic or unable to tolerate colistimethate sodium (intravenous or inhaled) or other polymixins, including evidence of bronchial hyper-reactivity following inhaled colistimethate sodium;
- treatment with long term (≥ 30 days) prednisone at a dose of greater than 15 mg a day (or equivalent dose of any other corticosteroid) started within six months of the Screening Visit (Visit 1);
- new maintenance treatment with any oral macrolides ( (e.g. azithromycin/erythromycin/clarithromycin) within 30 days of the Screening Visit (Visit 1) or started between Visit 1 and Visit 2;
- use of any intravenous or intramuscular or oral or inhaled anti-pseudomonal antibiotic (except chronic macrolides with a stable dose) within 30 days prior to the Screening Visit (Visit 1) and between Visit 1 and Visit 2;
- pregnant or breast feeding or plan to become pregnant over the next two years or of child- bearing potential and unwilling to use a reliable method of contraception for at least one month before randomisation and throughout their involvement in the trial;
- significant abnormality in clinical evaluations and/or laboratory tests (physical examination, vital signs, haematology, clinical chemistry, clinically relevant impaired renal function, defined as serum creatinine levels ≥2.0x upper limit of normal, ECG) endangering the safe participation of the patient in the study at the Screening Visit (Visit 1) and during the study;
- participated in another investigational, interventional trial within 30 days prior to the Screening Visit (Visit 1);
- in the opinion of the Investigator not suitable for inclusion for whatever reason.
Trial locations and contacts
89 sites in 12 countries.
89 sites in 12 countries
United States27 sites
ZambonInvestigative Site
Abingdon, Virginia, 24210
Zambon Investigative Site
Centennial, Colorado, 80112
Zambon investigative site
Chapel Hill, North Carolina, 27514
Zambon Investigative Site
Chesterfield, Missouri, 63017-3625
Zambon Investigative Site
Chicago, Illinois, 60637
Zambon Investigative Site
Durham, North Carolina, 27705
Zambon Investigative Site
Jacksonville, Florida, 32204
Zambon Investigative Site
Kissimmee, Florida, 34741
Zambon Investigative Site
Lebanon, New Hampshire, 03756-1000
Zambon Investigative Site
Louisville, Kentucky, 40202
Zambon Investigative Site
Michigan City, Indiana, 46360
Zambon Investigative Site
New York, New York, 10016
Zambon Investigative Site
Newport Beach, California, 92663
Zambon Investigative Site
Northwest, Washington, 20007
Zambon Investigative Site
Orlando, Florida, 32803
Zambon Investigative Site
Palm Springs, California, 92262
Zambon Investigative Site
Portland, Oregon, 97239
Zambon Investigative Site
Reseda, California, 91324
Zambon investigative site
Richmond, Virginia, 23219
Zambon Investigative Site
Rochester, Minnesota, 55905
Zambon investigative site
San Diego, California, 92103
Zambon Investgative Site
San Diego, California, 92120-5241
Zambon investigative Site
St. Petersburg, Florida, 33704
Zambon Investigative Site
St. Petersburg, Florida, 33707
Zambon Investigative Site
Tyler, Texas, 75708
Zambon Investigative Site
Weston, Florida, 33331
Zambon investigative site
Winston-Salem, North Carolina, 27265
Poland14 sites
Zambon Investigative Site
Bialystok, 15-044
Zambon Investigative Site
Bielsko-Biala, 43-300
Zambon Investigative Site
Grudziądz, 86300
Zambon Investigative Site
Krakow, 31-066
Zambon Investigative Site
Legnica, 59220
Zambon Investigative Site
Lodz, 94-048
Zambon Investigative Site
Lublin, 20-089
Zambon Investigative Site
Ostrowiec Świętokrzyski, 27-400
Zambon Investigative Site
Piaseczno, 05-500
Zambon Investigative Site
Proszowice, 32-100
Zambon Investigative Site
Rzeszów, 35-205
Zambon Investigative Site
Sosnowiec, 41-200
Zambon Investigative Site
Warsaw, 01-456
Zambon Investigative Site
Wroclaw, 51-162
Argentina11 sites
Zambon Investigative Site
Buenos Aires, 1425
Zambon Investigative Site
Buenos Aires, 1426
Zambon Investigative Site
Buenos Aires, 1704
Zambon Investigative Site
Buenos Aires, 1842
Zambon Investigative Site
Buenos Aires, 1888
Zambon Investigative Site
Buenos Aires, B1602DQD
Zambon Investigative Site
Buenos Aires, B1900BNJ
Zambon investigative site
Buenos Aires, C1425AZB
Zambon Investigative Site
Quilmes, B1878FNR
Zambon Investigative Site
San Miguel de Tucumán, 4000
Zambon Investigative Site
Santa Fe, S3000ASF
France10 sites
Zambon Investigative Site
Amiens, 80054
Zambon investigative site
Brest, 29200
Zambon Investigative Site
Créteil, 94010
Zambon investigative site
La Tronche, 38700
Zambon investigative site
Lyon, 69004
Zambon Investigative Site
Montpellier, 34295
Zambon investigative site
Nice, 51069
Zambon Investigative Site
Pessac, 33604
Zambon investigative site
Reims, 51092
Zambon Investigative Site
Toulouse, 31059
Canada7 sites
Zambon investigative Site
Burlington, L7N 3V2
Zambon investigative site
Kelowna, VIY 3H2
Zambon Investigative Site
London, N6A 5W9
Zambon Investigative Site
Montreal, H2X03E4
Zambon Investigative Site
Ottawa, K1H8L6
Zambon Investigative Site
Québec, G1V 4G5
Zambon Investigative Site
Winnipeg, R2H 2A6
Australia6 sites
Zambon Investigative Site
Adelaide, 5000
Zambon investigative site
Concord, 2139
Zambon investigative site
Greenslopes, 4120
Zambon Investigative Site
Kent Town, 5067
Zambon Investigative Site
South Brisbane, 4101
Zambon investigative site
Spearwood, 6163
New Zealand4 sites
Zambon Investigative Site
Christchurch, 8011
Zambon Investigative Site
Havelock North, 4130
Zambon Investigative Site
Mount Cook, 6021
Zambon Investigative Site
Tauranga, 3110
Israel3 sites
Zambon Investigative Site
Haifa, 34362
Zambon Investigative Site
Jerusalem, 9703102
Zambon Investigative Site
Kfar Saba, 4428164
Germany2 sites
Zambon Investigative Site
Frankfurt, 60596
Zambon Investigative Site
Hanover, 30625
Italy2 sites
Zambon Investigative Site
Milan, 20122
Zambon Investigative Site
Monza, 20900
Portugal2 sites
Zambon Investigative Site
Guimarães, 4835-044
Zambon Investigative Site
Lisbon, 1649035
About this study
Official title: Efficacy and Safety of 12 Months of Therapy With Inhaled Colistimethate Sodium in Subjects With Non-cystic Fibrosis Bronchiectasis Chronically Infected With P. Aeruginosa
The primary objective of the trial was to investigate the effect of the use of inhaled colistimethate sodium (CMS), administered twice a day (b.i.d.) via a specific nebulizer for 12 months, compared to placebo in subjects with non-cystic fibrosis bronchiectasis (NCFB) chronically infected with P. aeruginosa on the annualised frequency of pulmonary exacerbations.
Read the detailed description
This was a randomised, multi-centre, double-blind, placebo-controlled, parallel-group interventional trial in subjects with NCFB chronic P. aeruginosa infection. Subjects were randomised to CMS or placebo in a 1:1 ratio. The study consisted of 7 clinic visits with a follow-up phone call 12.5 month after randomisation or 2 weeks after discontinuation of treatment. Additional clinic visits, where feasible, and weekly phone calls were conducted during or after pulmonary exacerbations (or any episodes of pneumonia) until resolution.
Every effort was made to have all planned and unscheduled visits at the study site. Mandatory on-site visits were Screening Visit (Visit 1) and Randomisation (Visit 2). However, if one of the visits after Visit 2 could not be performed at site due to COVID-19, remote visits (e.g., by telephone) were permitted. If the final visit (Visit 7) had to be conducted remotely, the subjects were asked to return to the clinic for on-site assessments at the earliest opportunity.
After consulting with the US Food and Drug Administration, the study was brought to an early close primarily due to the difficulty of recruiting subjects in the context of the COVID pandemic, but also due to the potential for loss of scientific equipoise and the ethical implications of continuing to expose subjects to placebo given the positive results from PROMIS I. Recruitment to PROMIS II was stopped as of 27 October 2021, with the study terminated as of 15 March 2022. The study was not stopped prematurely due to any safety or futility concerns and the accrued data were fully analysed and are presented.
- Conditions
- Non Cystic Fibrosis Bronchiectasis
- Being tested
- CMS, Placebo
- Keywords
- NCFB, NCFB pulmonary exacerbation, Bronchiectasis
- Medical subject headings
- Bronchiectasis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CMSDrug
Also called Promixin
1 MIU equivalent to 80 mg colistimethate sodium diluted in 1 mL saline solution 0.45%. Investigational Medicinal Product (IMP) glass vials were shrink wrapped in opaque white plastic and provided in boxes of 30 vials (two weeks of b.i.d. dosing).
The 1 MIU/ml CMS/0.45% saline solution was transferred from the glass vial into a specific nebuliser system fitted with a 0.3 mL medication chamber, for administration by inhalation. This delivered a nominal dose of 0.3 MIU/24 mg CMS (11 mg CBA) from the device.
The first dose of the IMP was administered at the site under the supervision of the site staff and subjects were instructed how to prepare and self-administer the IMP at home via a specific nebuliser system, b.i.d. (morning and evening) over aperiod of 12 month.
At least 10 minutes (min) before each administration, an inhaled short-acting bronchodilator (e.g. salbutamol/albuterol), supplied by the Sponsor, could be taken to improve tolerability.
PlaceboOther
Also called Saline Solution
1 mL saline solution 0.45%. The placebo was made up of identical empty glass vials to which the same saline solution diluent was added in exactly the same way as the reconstitution of the active treatment by injecting the diluent through the rubber stopper. The glass vials were shrink wrapped with opaque white plastic to mantain the blind.
| Study group | Role | What they receive |
|---|---|---|
| CMS (Colistimethate Sodium) | Experimental | Inhaled colistimethate sodium twice daily. The active pharmaceutical ingredient consisting of pure CMS one million international units (MIU) / 80 mg of CMS / 33 mg colistin base activity (CBA) was provided as a powder for nebuliser solution in 10R Internation Organization for Standardization (ISO) glass vials. Receives: Drug: CMS |
| Placebo | Placebo comparator | Saline solution inhaled twice daily, provided and administered at the same way of the IMP. Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Annual Non-cystic Fibrosis Bronchiectasis (NCFB) Pulmonary Exacerbation Rate
The primary efficacy assessment for an individual subject was the frequency of pulmonary exacerbations (exacerbation rate). A pulmonary exacerbation was defined as the presence concurrently of at least three of the following eight symptoms/signs for at least 24 hours:
- increased cough;
- increased sputum volume and/or consistency;
- increased sputum purulence;
- new or increased haemoptysis;
- increased wheezing;
- increased dyspnoea;
- increased fatigue/malaise and
- episodes of fever (temperature ≥38°C). AND It was clinically determined that the subject required and was prescribed systemic antibiotic therapy. AND The episode of exacerbation lasted for at least 24 hours. The overall episode of exacerbation needs to last at least 24 hours, but individual symptoms/signs can last less than 24 hours (e.g, a temperature)
Measured: 12 months
Secondary outcomes (19)
Time to First NCFB Pulmonary Exacerbation
Time to First NCFB Pulmonary Exacerbation (PE) (days) = start date of first NCFB PE - date of randomization.
Subjects who completed or discontinued the trial with no NCFB PE are censored at the date of treatment completion/discontinuation.
Measured: 12 months
Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score
The Saint George's Respiratory Questionnaire (SGRQ) is a validated 50-item symptom questionnaire developed to measure health status and Quality of Life (QoL) in subjects with obstructive airway diseases.
The scores range from 0 (best possible health status) to 100 (worst possible health status).
The total score is calculated as: (sum of the weights of the positive items of all domains / sum of the weights of all items of all domains)*100.
Change from Baseline was calculated as the SGRQ total score at the visit minus Baseline.
Change from baseline in SGRQ total score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate. An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
P. Aeruginosa Density: Change From Baseline at Visit 3 and at Visit 7
The P. aeruginosa density as determined by the change in log10 CFU/mL sputum from baseline (Visit 2) to Day 28 (Visit 3) was compared between the treatment groups by an ANCOVA model including treatment, pooled site, i.e. country and use of stable concomitant therapy with oral macrolides as fixed effects and baseline value as covariate. Least square means in each treatment group, least square mean difference between treatments, their 95% CIs and associated p-value were estimated.
Measured: Visit 3 (28 days) and Visit 7 (12 months) / EoT
P. Aeruginosa Density: Change From Baseline
Summary statistics of the P. aeruginosa density (i.e. quantification, log10 CFU/mL sputum) and absolute change from baseline were provided by treatment group for each trial visit.
Measured: Up to Visit 7 (12 months) / EoT
Mean Annual Severe Non-cystic Fibrosis Bronchiectasis (NCFB) Pulmonary Exacerbation Rate
A severe pulmonary exacerbation was defined as requiring intravenous antibiotics and/or hospitalisation.
Measured: 12 months
Time to First Severe NCFB Pulmonary Exacerbation
Time to First severe NCFB Pulmonary Exacerbation (PE) (days) = start date of first severe NCFB PE - date of randomization.
Subjects who completed or discontinued the trial with no severe NCFB PE are censored at the date of treatment completion/discontinuation.
Severe exacerbations are defined as those requiring IV antibiotics and/or hospitalisation.
Measured: 12 months
NCFB Pulmonary Exacerbation Free Days
Annualised number of exacerbation-free days = (follow-up time [days] - sum of durations of NCFB pulmonary exacerbations [days]) / follow-up time (years).
For NCFB pulmonary exacerbations with a resolution date after the treatment completion/discontinuation, the number of days of duration after the treatment completion/discontinuation will be subtracted from the sum of durations of NCFB pulmonary exacerbations.
Non-parametric ANCOVA model with a randomisation-based methodology was used. The model included treatment group, country, and use of stable concomitant therapy with oral macrolides as covariates.
Measured: 12 months
Days of Work Absence
Number of Days Work Absence is computed for each subject by summing all days of work absence.
Measured: 12 months
Days of Work Absence Per Employment Month
Number of Days Work Absence per Employment Month = Number of Days of Work Absence / Overall Employment Time (months).
Number of Days Work Absence is computed for each subject by summing all days of work absence.
Measured: 12 months
Subjects With Hospitalisations Due to NCFB Pulmonary Exacerbations
The number and percentage of subjects with at least one hospitalisation for a NCFB pulmonary exacerbation are provided. Percentages were computed on the total number of subjects with at least one pulmonary exacerbation.
Measured: 12 months
Mean Annual Hospitalisation for NCFB Pulmonary Exacerbation Rate
The annual rate of hospitalisation for NCFB pulmonary exacerbation
Measured: 12 months
Change From Baseline in QoL-B Physical Functioning Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Physical Functioning Domain, the items 1, 2, 3, 4, 16 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Role Functioning Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Role Functioning Domain, the items 17, 20, 25, 27, 28 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Vitality Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Vitality Domain the items 6, 8, 9 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Emotional Functioning Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Emotional Functioning Domain the items 7, 10, 11, 23 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Social Functioning Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Social Functioning Domain the items 18, 19, 22, 26 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Treatment Burden Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Treatment Burden Domain the items 12, 13, 14 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Health Perceptions Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Health Perceptions Domain the items 5, 15, 21, 24 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Respiratory Symptoms Domain Score
The Quality of Life Bronchiectasis (QoL-B) is a validated self-administered, patient reported outcome measure assessing symptoms, functioning and health-related QoL for subjects with NCFB.
It contains 37 items in 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden).
Each QoL-B domain is assessed on a scale of 0 to 100, higher scores indicate better health status.
For the Respiratory Symptoms Domain the items from 29 to 37 are considered. Change from baseline in QoL-B domain score at Visit 3, Visit 4, Visit 5, Visit 6 and Visit 7 were analysed using a linear mixed model for repeated measures including treatment, visit, treatment-by-visit interaction, use of stable concomitant therapy with oral macrolides and pooled site, i.e. country, as fixed effects and baseline value as covariate.
An unstructured covariance matrix was assumed and the Kenward-Roger adjustment was used for the degrees of freedom.
Measured: Up to Visit 7 (12 months) / EoT
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Mar 2018
- Study start29 Jan 2018
- Primary completion15 Mar 2022
- Study completion15 Mar 2022
Why it stopped: The study was brought to an early close in March 2022 due to major ongoing recruitment issues primarily related to the COVID-19 pandemic and concerns regarding the continued randomization and exposure of subjects to placebo in the study.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Non Cystic Fibrosis BronchiectasisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 287 participants (actual)
Sponsor and investigators
- Lead sponsor
- Zambon SpA
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Paola Castellani, MD, Principal investigator, Zambon S.p.A.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03460704
- Sponsor's protocol ID
- Z7224L02
- Other IDs
- 2016-004558-13, 2016
- Acronym
- PROMIS-II
- Status last verified
- Sep 2026
- First submitted
- 14 Feb 2018
- Last updated
- 15 Oct 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 15 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy and Safety of 12 Months of Therapy With Inhaled Colistimethate Sodium in Subjects With Non-cystic Fibrosis Bronchiectasis Chronically Infected With P. Aeruginosa
- ClinicalTrials.gov ID
- NCT03460704
- Acronym / sponsor ID
- PROMIS-II / Z7224L02
- Conditions
- Non Cystic Fibrosis Bronchiectasis
- Keywords
- NCFB, NCFB pulmonary exacerbation, Bronchiectasis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: The study was brought to an early close in March 2022 due to major ongoing recruitment issues primarily related to the COVID-19 pandemic and concerns regarding the continued randomization and exposure of subjects to placebo in the study.
- Enrolment
- 287 participants (actual)
- Lead sponsor
- Zambon SpAIndustry (pharma, biotech, devices)
- Study start
- 29 Jan 2018 (actual)
- Primary completion
- 15 Mar 2022 (actual)
- Study completion
- 15 Mar 2022 (actual)
- First posted
- 9 Mar 2018 (actual)
- Results
- Posted 29 Dec 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective of the trial was to investigate the effect of the use of inhaled colistimethate sodium (CMS), administered twice a day (b.i.d.) via a specific nebulizer for 12 months, compared to placebo in subjects with non-cystic fibrosis bronchiectasis (NCFB) chronically infected with P. aeruginosa on the annualised frequency of pulmonary exacerbations.
Detailed description
This was a randomised, multi-centre, double-blind, placebo-controlled, parallel-group interventional trial in subjects with NCFB chronic P. aeruginosa infection. Subjects were randomised to CMS or placebo in a 1:1 ratio. The study consisted of 7 clinic visits with a follow-up phone call 12.5 month after randomisation or 2 weeks after discontinuation of treatment. Additional clinic visits, where feasible, and weekly phone calls were conducted during or after pulmonary exacerbations (or any episodes of pneumonia) until resolution.
Every effort was made to have all planned and unscheduled visits at the study site. Mandatory on-site visits were Screening Visit (Visit 1) and Randomisation (Visit 2). However, if one of the visits after Visit 2 could not be performed at site due to COVID-19, remote visits (e.g., by telephone) were permitted. If the final visit (Visit 7) had to be conducted remotely, the subjects were asked to return to the clinic for on-site assessments at the earliest opportunity.
After consulting with the US Food and Drug Administration, the study was brought to an early close primarily due to the difficulty of recruiting subjects in the context of the COVID pandemic, but also due to the potential for loss of scientific equipoise and the ethical implications of continuing to expose subjects to placebo given the positive results from PROMIS I. Recruitment to PROMIS II was stopped as of 27 October 2021, with the study terminated as of 15 March 2022. The study was not stopped prematurely due to any safety or futility concerns and the accrued data were fully analysed and are presented.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| CMS (Colistimethate Sodium) | Experimental | Drug: CMSInhaled colistimethate sodium twice daily. The active pharmaceutical ingredient consisting of pure CMS one million international units (MIU) / 80 mg of CMS / 33 mg colistin base activity (CBA) was provided as a powder for nebuliser solution in 10R Internation Organization for Standardization (ISO) glass vials. |
| Placebo | Placebo comparator | Other: PlaceboSaline solution inhaled twice daily, provided and administered at the same way of the IMP. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- are able and willing to give informed consent, following a detailed explanation of partecipation in the protocol and signed consent obtained;
- aged 18 years or older of either gender;
- diagnosed with NCFB by computerised tomography (CT) or high-resolution CT(HRCT) as recorded in the subject's notes and this is their predominant condition being treated;
- had at least 2 NCFB pulmonary exacerbations requiring oral or inhaled antibiotics or 1 NCFB pulmonary exacerbation requiring intravenous antibiotics in the 12 months preceding the Screening Visit (Visit 1) and had no pulmonary exacerbation with or without treatment during the period between Visit 1 and Visit 2;
- have a documented history of P. aeruginosa infection;
Key exclusion criteria (20 listed)
- known bronchiectasis as a consequence of cystic fibrosis (CF);
- known history of hypogammaglobulinaemia requiring treatment with immunoglobulin, unless fully replaced and considered immuno-competent by the Investigator;
- myasthenia gravis or porphyria;
- severe cardiovascular disease such as severe uncontrolled hypertension, ischaemic heart disease or cardiac arrhythmia and any other conditions that would confound the evaluation of safety, in the opinion of the Investigator;
- had major surgery in the 3 months prior to the Screening Visit (Visit 1) or planned inpatient major surgery during the study period;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CMSAlso: Promixin1 MIU equivalent to 80 mg colistimethate sodium diluted in 1 mL saline solution 0.45%. Investigational Medicinal Product (IMP) glass vials were shrink wrapped in opaque white plastic and provided in boxes of 30 vials (two weeks of b.i.d. dosing). The 1 MIU/ml CMS/0.45% saline solution was transferred from the glass vial into a specific nebuliser system fitted with a 0.3 mL medication chamber, for administration by inhalation. This delivered a nominal dose of 0.3 MIU/24 mg CMS (11 mg CBA) from the device. The first dose of the IMP was administered at the site under the supervision of the site staff and subjects were instructed how to prepare and self-administer the IMP at home via a specific nebuliser system, b.i.d. (morning and evening) over aperiod of 12 month. At least 10 minutes (min) before each administration, an inhaled short-acting bronchodilator (e.g. salbutamol/albuterol), supplied by the Sponsor, could be taken to improve tolerability. | Drug | CMS (Colistimethate Sodium) |
| PlaceboAlso: Saline Solution1 mL saline solution 0.45%. The placebo was made up of identical empty glass vials to which the same saline solution diluent was added in exactly the same way as the reconstitution of the active treatment by injecting the diluent through the rubber stopper. The glass vials were shrink wrapped with opaque white plastic to mantain the blind. | Other | Placebo |
Primary outcome
Mean Annual Non-cystic Fibrosis Bronchiectasis (NCFB) Pulmonary Exacerbation Rate
Time frame: 12 months
The primary efficacy assessment for an individual subject was the frequency of pulmonary exacerbations (exacerbation rate). A pulmonary exacerbation was defined as the presence concurrently of at least three of the following eight symptoms/signs for at least 24 hours: * increased cough; * increased sputum volume and/or consistency; * increased sputum purulence; * new or increased haemoptysis; * increased wheezing; * increased dyspnoea; * increased fatigue/malaise and * episodes of fever (temperature ≥38°C). AND It was clinically determined that the subject required and was prescribed systemic antibiotic therapy. AND The episode of exacerbation lasted for at least 24 hours. The overall episode of exacerbation needs to last at least 24 hours, but individual symptoms/signs can last less than 24 hours (e.g, a temperature)
19 secondary outcomes
Time to First NCFB Pulmonary Exacerbation
Time frame: 12 months
Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score
Time frame: Up to Visit 7 (12 months) / EoT
P. Aeruginosa Density: Change From Baseline at Visit 3 and at Visit 7
Time frame: Visit 3 (28 days) and Visit 7 (12 months) / EoT
P. Aeruginosa Density: Change From Baseline
Time frame: Up to Visit 7 (12 months) / EoT
Mean Annual Severe Non-cystic Fibrosis Bronchiectasis (NCFB) Pulmonary Exacerbation Rate
Time frame: 12 months
Time to First Severe NCFB Pulmonary Exacerbation
Time frame: 12 months
NCFB Pulmonary Exacerbation Free Days
Time frame: 12 months
Days of Work Absence
Time frame: 12 months
Days of Work Absence Per Employment Month
Time frame: 12 months
Subjects With Hospitalisations Due to NCFB Pulmonary Exacerbations
Time frame: 12 months
Mean Annual Hospitalisation for NCFB Pulmonary Exacerbation Rate
Time frame: 12 months
Change From Baseline in QoL-B Physical Functioning Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Role Functioning Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Vitality Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Emotional Functioning Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Social Functioning Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Treatment Burden Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Health Perceptions Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Change From Baseline in QoL-B Respiratory Symptoms Domain Score
Time frame: Up to Visit 7 (12 months) / EoT
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 15 Oct 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Paola Castellani, MD principal investigator
Zambon S.p.A.
89 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing CMS in people with Non Cystic Fibrosis Bronchiectasis, run by Zambon SpA at 89 sites in 12 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 8 inclusion and 20 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 15 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 89 sites in United States, Poland, Argentina, France, Canada and 7 more countries. 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 29 Dec 2023). 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?
Mean Annual Non-cystic Fibrosis Bronchiectasis (NCFB) Pulmonary Exacerbation Rate (time frame: 12 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 15 Oct 2026.