Clinical Trial: Safety of AZLI in Children With Cystic Fibrosis (CF) and Chronic Pseudomonas Aeruginosa in the Lower Airways

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Open-Label Phase 3 Trial to Evaluate the Safety of Aztreonam 75 mg Powder and Solvent for Nebuliser Solution/Aztreonam for Inhalation Solution (AZLI) in Children With Cystic Fibrosis (CF) and Chronic

Brief Summary: This was an open-label, multicenter study in children ≤ 12 years of age with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa (PA) infection in the lower airways using three 28-day courses of Aztreonam for Inhalation Solution (AZLI) 75 mg three times daily, each followed by 28 days off AZLI. The total treatment duration was to be 6 months.

Detailed Summary:
Sponsor: Gilead Sciences

Current Primary Outcome: Percentage of Participants Who Discontinued Study Drug Due to Safety or Tolerability Reasons [ Time Frame: Baseline to Day 168 ]

Participants who discontinued study drug due to safety or tolerability reasons were defined as those with "Adverse Event (AE)/Safety or Tolerability" on the Study Drug Completion electronic case report form as the reason for early discontinuation. The 95% confidence interval (CI) was calculated using the exact binomial method.


Original Primary Outcome: Percentage of subjects who have discontinued the study drug due to safety or tolerability reasons by Day 168 [ Time Frame: treatment period of 6 Months ]

Current Secondary Outcome:

  • Change From Baseline in FEV1 % Predicted in Subjects Aged ≥ 6 Years [ Time Frame: Baseline to Day 28, 84, and 140 ]

    The change in FEV1 % predicted was assessed at the end of each 28-day AZLI treatment course.

    FEV1 % predicted is defined as FEV1 of the patient divided by the average FEV1 in the population for any person of similar age, sex, race, and body composition.

  • Change From Baseline in CFQ-R Respiratory Symptoms Scale (RSS) Score in Subjects Aged ≥ 6 Years [ Time Frame: Baseline to Day 28, 84, and 140 ]

    The change in CFQ-R RSS score was assessed at the end of each 28-day AZLI treatment course.

    The range of scores (units) was 0 to 100 with higher scores indicating fewer symptoms.

  • Change in Pseudomonas Aeruginosa (PA) Sputum Density [ Time Frame: Baseline to Day 28, 84, and 140 ]
    The change in PA sputum density (log10 colony-forming units per gram [cfu/g]) was assessed at the end of each 28-day AZLI treatment course.
  • Percentage of Participants Who Used Additional (Non-study) Antipseudomonal Antibiotics [ Time Frame: Baseline to Day 168 ]
    The percentage of participants who used additional (non-study) antipseudomonal antibiotics (IV, inhaled, oral, IV/inhaled, IV/inhaled/oral) was summarized (number and percent) for all subjects.
  • Percentage of Participants Hospitalized at Least Once Due to a Respiratory Event [ Time Frame: Baseline to Day 168 ]
  • Number of Days Participants Were Hospitalized Due to a Respiratory Event [ Time Frame: Baseline to Day 168 ]
    The average number of days hospitalized due to a respiratory event, among the 11 participants who were hospitalized for respiratory event, was reported.
  • Percentage of Participants With Pulmonary Exacerbations [ Time Frame: Baseline to Day 168 ]
    Pulmonary exacerbations were defined as respiratory hospitalizations or discrete courses of non-study IV/inhaled antipseudomonal antibiotics. Use of oral antibiotics alone for respiratory signs or symptoms was considered to be representative of milder clinical events and, therefore, was not included in the definition of pulmonary exacerbations.
  • Time to Pulmonary Exacerbation [ Time Frame: Baseline to Day 168 ]
    The median days to first pulmonary exacerbation was summarized using Kaplan-Meier (KM) summary statistics.
  • Percentage of Participants With Study-drug Induced Bronchospasm [ Time Frame: Pretreatment at Baseline to 30 minutes following treatment ]
    Study-drug induced bronchospasm (airway reactivity) was assessed at the baseline visit as the percent change in FEV1 from the pretreatment measurement to 30 minutes following treatment for subjects ≥ 6 years or as from the Investigator's assessment for subjects < 6 years.
  • Adverse Event Rates Adjusted for Study Duration [ Time Frame: Baseline to Day 168 ]
    Adverse events occurring in ≥ 5% of participants adjusted for study duration were summarized. The adjustment was made by using a standardized rate calculated as the sum of study duration across patients divided by 28 for the total number of patient months. Rate calculations presented are the number of adverse events (AEs) per patient month.


Original Secondary Outcome:

  • Change in FEV1 % predicted at end of each 28-day-on-treatment cycle of AZLI [ Time Frame: 6 months ]
  • Change in CFQ-R respiratory symptoms scale (RSS) score at the end of each 28-day-on-treatment cycle of AZLI [ Time Frame: 6 months ]
  • Change in PA sputum density at end of each 28-day-on-treatment cycle of AZLI [ Time Frame: 6 months ]
  • Number and time to PA exacerbations [ Time Frame: 6 months ]


Information By: Gilead Sciences

Dates:
Date Received: July 26, 2011
Date Started: December 2011
Date Completion:
Last Updated: May 12, 2014
Last Verified: May 2014