E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic lung infections with Pseudomonas aeruginosa in subjects with non-cystic fibrosis bronchiectasis |
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E.1.1.1 | Medical condition in easily understood language |
Lung infection tht includes the bacteria Pseudomonas aeruginosa due to non-cystic fibrosis bronchiectasis. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10057582 |
E.1.2 | Term | Lung infection pseudomonal |
E.1.2 | System Organ Class | 100000004862 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 16.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10006446 |
E.1.2 | Term | Bronchiectasis NOS |
E.1.2 | System Organ Class | 100000004855 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The main objective of this study is to evaluate the efficacy of Pulmaquin compared to placebo in the management of chronic lung infections with P. aeruginosa (a type of bacteria) in subjects with noncystic fibrosis bronchiectasis by evaluating the time to first pulmonary exacerbation (worsening). |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of this study are to evaluate: - Efficacy of Pulmaquin compared to placebo as assessed by clinical outcomes (including pulmonary exacerbations), pulmonary function, patient-reported outcomes, and exercise testing in the Double-Blind Phase. - Microbiological response. - Safety and tolerability of Pulmaquin compared to placebo in the Double-Blind Phase. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Subjects will be entered into this study only if they meet all of the following criteria: 1. Are willing and able to provide written informed consent. 2. Are males or females who are 18 year of age or older and are able to walk. 3. Have had a confirmed diagnosis of non-CF bronchiectasis per computerized tomography showing bronchial wall dilatation (internal bronchial lumen diameter greater than accompanying pulmonary artery or lack of tapering) with or without bronchial wall thickening. 4. Have a documented history of at least 2 pulmonary exacerbations treated with courses of antibiotics within the last 12 months. 5. Have been off any antibiotic treatment for a minimum of 28 days prior to Visit 1, except for macrolides (azithromycin or erythromycin) used chronically at a stable dose. 6. Have FEV1 ≥ 25% of predicted values at the Screening Visit (Visit 0). 7. Have positive documented P. aeruginosa in a sputum/deep-throat swab culture (or bronchoalveolar lavage [BAL] or bronchoscopic specimen) prior to the Screening Visit (Visit 0). 8. Have positive P. aeruginosa in the sputum/deep-throat swab culture collected at the Screening Visit (Visit 0). If sputum sample is negative, sputum/swab culture can be repeated on up to 3 occasions during Screening to document P. aeruginosa presence. 9. Are clinically stable and capable of performing the 6mwt without supplemental oxygen. 10. Are willing and able to comply with the requirements for participation in the study. 11. Female subjects of childbearing potential must have a negative pregnancy test at the Screening Visit and must use an acceptable method of contraception for at least 3 months prior to the first dose of study drug and for 28 days after the last dose of study drug. Acceptable methods of contraception for women are orally administered or implantable hormonal contraceptives, surgical intervention, intrauterine device (IUD), and sexual abstinence. To be considered "not of childbearing potential", female subjects must be postmenopausal for at least 1 year as confirmed by an elevated follicle-stimulating hormone (FSH) level (≥ 30 mIU/mL) at Screening and 1 year of amenorrhea, or have been irreversibly surgically sterilized by hysterectomy, oophorectomy, or bilateral tubal ligation for at least 3 months prior to the first dose of study drug. Male subjects whose female partners are of childbearing potential (definition as above) must agree to use an acceptable method of birth control for the duration of study treatment and for 28 days after the last dose of study drug. |
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E.4 | Principal exclusion criteria |
Subjects will be randomized into this study only if they meet none of the following criteria: 1. Have a pulmonary exacerbation during the Screening Phase (between Visit 0 and randomization), defined as requiring acute treatment with inhaled, oral, or intravenous antibiotics prior to the first dose of study drug. 2. Have a clinical diagnosis of CF. 3. Have primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD) related to smoking history of greater than 10 pack years. 4. Have a current diagnosis of active allergic bronchopulmonary aspergillosis. 5. Have received any intravenous, oral, or inhaled anti-pseudomonal antibiotic (except chronic macrolides erythromycin or azithromycin with a stable dose) within 28 days prior to Visit 1. 6. Have an allergy to ciprofloxacin, gemifloxacin, levofloxacin, moxifloxacin, or norfloxacin. 7. Have a known allergy to soy products. 8. Have used tizanidine within 28 days prior to Visit 1 and would need to use tizanidine during the study (because tizanidine is contraindicated due to a pharmacokinetic interaction with ciprofloxacin). 9. Have initiated supplemental oxygen within 28 days prior to Visit 1. 10. Have used any intravenous or intramuscular corticosteroid or have used oral corticosteroid > 10 mg/day or > 20 mg every other day within 28 days of Visit 1. 11. Have had changes in either the treatment regimen or initiation of treatment with any of the following medications within 28 days prior to Visit 1: a. Macrolides, e.g., azithromycin or erythromycin b. Inhaled hypertonic saline or inhaled mannitol c. Mucolytics d. Bronchodilator medications e. Oral corticosteroid 12. Have had changes in physiotherapy technique or frequency within 28 days prior to Visit 1. 13. Have a history of solid organ (e.g., lung) transplantation. 14. Have a non-tuberculosis mycobacterial infection requiring treatment. 15. Have active tuberculosis. 16. Have serum creatinine levels ≥ 2.0x upper limit of normal (ULN) at the Screening Visit (Visit 0). 17. Have serum transaminase levels > 3x ULN at the Screening Visit (Visit 0). 18. Have a febrile illness within 1 week prior to Visit 1. 19. Have had massive hemoptysis (greater than or equal to 300 mL or requiring blood transfusion) within 6 months prior to Visit 1. 20. Have received an investigational drug or device within 28 days prior to Visit 1. 21. Have any serious or active medical or psychiatric illness, which in the opinion of the Investigator, would interfere with subjects' treatment, assessment, or compliance with the protocol. 22. Have a history or suspicion of unreliability, poor cooperation, or noncompliance with medical treatment. 23. Are unable to use nebulizers. 24. Are unable either to understand the instructions for use of the study drug or to complete the QoL-B questionnaire at Visit 1. 25. Have previously been enrolled in this study. 26. Are pregnant, plan to become pregnant during this study, are nursing mothers or are unwilling to use an acceptable method of contraception for the duration of the study. 27. Have any other condition that, in the opinion of the Investigator, would prohibit the subject from participating in the study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint of this study is the time to first pulmonary exacerbation from baseline (Day 1) to Week 48. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From baseline (Day 1) to Week 48. |
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E.5.2 | Secondary end point(s) |
- Number of pulmonary exacerbations from baseline (Day 1) to Week 48. - Number of severe pulmonary exacerbations from baseline (Day 1) to Week 48. - Change in Respiratory Symptoms Domain score of Qol-B from baseline (Day 1) to Week 48. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
From baseline (Day 1) to Week 48. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 12 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 35 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Canada |
Italy |
Netherlands |
New Zealand |
Romania |
Australia |
Germany |
Hungary |
Spain |
Israel |
Poland |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The study will close when all subjects have completed the followup telephone call at Day 394 (±2 days), which will take place 30 days after the subject receives the last dose of openlabel study drug at Visit 15 (Day 364). Therefore End of Study is defined as when the last patient completes Visit 16 (Study Day 394) – or the last early withdrawal visit, whichever is later. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 11 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 11 |