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    Clinical Trial Results:
    A randomized double-blind, placebo-controlled cross-over study of inhaled alginate oligosaccharide (OligoG) for 28 days in subjects with Cystic Fibrosis using aztreonam due to chronic colonization with Burkholderia spp.

    Summary
    EudraCT number
    2014-002125-35
    Trial protocol
    DE  
    Global end of trial date
    10 May 2016

    Results information
    Results version number
    v1(current)
    This version publication date
    24 Jul 2020
    First version publication date
    24 Jul 2020
    Other versions
    Summary report(s)
    SMR2591 clinical study report synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    SMR-2591
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02453789
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    AlgiPharma AS
    Sponsor organisation address
    Industriveien 33, Sandvika, Norway, 1337
    Public contact
    Yngvar Berg, CEO, AlgiPharma AS, +47 90044903, yngvar.berg@algipharma.com
    Scientific contact
    Anne M Graver Clinical Trial Manager, AlgiPharma AS, +47 93041021, anne.graver@algipharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 Jul 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    10 May 2016
    Global end of trial reached?
    Yes
    Global end of trial date
    10 May 2016
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To explore the efficacy of OligoG in reducing the microbial burden of Burkholderia spp. as measured in expectorated sputum samples.
    Protection of trial subjects
    A Drug Safety Monitoring Board assessed unblinded data throughout the study to ensure prompt action in case of safety concerns.
    Background therapy
    Standard of Care. The patient are allowed to continue other CF treatment as long as this has been ongoing in a stable fashion the past 14 days prior to treatment start and for the entire duration of the study (until Day 112).
    Evidence for comparator
    The use of placebo as a comparator is a naturally design in order to evaluate safety, tolerability and preliminary efficacy in patients with cystic fibrosis (CF). Matching placebo DPI (dry powder for inhalation), where the OligoG is replaced with lactose, approx. 48 mg in HPMC capsules. The placebo DPI capsules will be indistinguishable from OligoG in appearance, smell, taste and packaging.
    Actual start date of recruitment
    01 Feb 2015
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 15
    Worldwide total number of subjects
    15
    EEA total number of subjects
    15
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    14
    From 65 to 84 years
    1
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    A total of 17 patients were screened across both sites in Germany. A total of 15 patients were randomised equally to the treatment sequence OligoG/placebo or placebo/OligoG.

    Pre-assignment
    Screening details
    Ability to inhale the IMP

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst, Carer, Assessor
    Blinding implementation details
    The IMP (OligoG DPI or placebo) in identical capsules

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    OligoG - Placebo
    Arm description
    OligoG for 28 days, then 4 weeks wash-out, then Placebo for 28 days
    Arm type
    Active comparator

    Investigational medicinal product name
    OligoG - Placebo (cross-over)
    Investigational medicinal product code
    OligoG - Placebo (cross-over)
    Other name
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    Ten capsules were taken by the study subjects three times daily to deliver a total daily dose of 1050 mg OligoG/Placebo

    Arm title
    Placebo - OligoG
    Arm description
    Placebo for 28 days, then 4 weeks wash-out, then OligoG for 28 days.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo - OligoG (cross-over)
    Investigational medicinal product code
    Placebo - OligoG (cross-over)
    Other name
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    Ten capsules were taken by the study subjects three times daily to deliver a total daily dose equivalent to 1050 mg OligoG/Placebo

    Number of subjects in period 1
    OligoG - Placebo Placebo - OligoG
    Started
    7
    8
    Completed
    7
    8

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall study (overall period)
    Reporting group description
    These are all patients together in both groups prior to wash-out, i.e OligoG and Placebo combined.

    Reporting group values
    Overall study (overall period) Total
    Number of subjects
    15 15
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    14 14
        From 65-84 years
    1 1
        85 years and over
    0 0
    Gender categorical
    Units: Subjects
        Female
    11 11
        Male
    4 4
    Subject analysis sets

    Subject analysis set title
    All patients
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All subjects caucasian Mean age 35.1 years, Range 23 - 71 4 male, 11 female

    Subject analysis sets values
    All patients
    Number of subjects
    15
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    14
        From 65-84 years
    1
        85 years and over
    0
    Age continuous
    Units:
        
    ±
    Gender categorical
    Units: Subjects
        Female
    11
        Male
    4

    End points

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    End points reporting groups
    Reporting group title
    OligoG - Placebo
    Reporting group description
    OligoG for 28 days, then 4 weeks wash-out, then Placebo for 28 days

    Reporting group title
    Placebo - OligoG
    Reporting group description
    Placebo for 28 days, then 4 weeks wash-out, then OligoG for 28 days.

    Subject analysis set title
    All patients
    Subject analysis set type
    Intention-to-treat
    Subject analysis set description
    All subjects caucasian Mean age 35.1 years, Range 23 - 71 4 male, 11 female

    Primary: The treatment difference OligoG – Placebo in reducing the microbial burden of Burkholderia spp.

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    End point title
    The treatment difference OligoG – Placebo in reducing the microbial burden of Burkholderia spp.
    End point description
    The log10 transformed Burkholderia rpoD gene copy number values at the end of each treatment period have been examined with analysis of covariance (ANCOVA), using treatment, treatment period and treatment sequence as fixed effects, patient as random effect and the baseline value in each period as a covariate. The 14 patients with data from both treatment periods are included in the analysis.
    End point type
    Primary
    End point timeframe
    Changes in Burkholderia spp. from start of each treatment period to Day 28 of treatment.
    End point values
    OligoG - Placebo Placebo - OligoG All patients
    Number of subjects analysed
    6
    8
    14
    Units: % reduction
        number (confidence interval 95%)
    0 (0 to 0)
    0 (0 to 0)
    0.94 (-0.0003 to 1.88)
    Statistical analysis title
    Statistical analysis
    Statistical analysis description
    The primary variable was to explore the efficacy of OligoG in reducing the microbial burden of Burkholderia spp. as measured in expectorated sputum samples.
    Comparison groups
    Placebo - OligoG v OligoG - Placebo
    Number of subjects included in analysis
    14
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0501 [1]
    Method
    ANCOVA
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.0003
         upper limit
    1.88
    Notes
    [1] - The difference is not statistically significant on a 5% level but borderline significant in favour of placebo.

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were collected and reported throughout the study; sequence 1, wash-out, and sequence 2.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17
    Reporting groups
    Reporting group title
    OligoG
    Reporting group description
    Number of patients combined receiving OligoG either in the first treatment period or second treatment period.

    Reporting group title
    Placebo
    Reporting group description
    Number of patients combined receiving placebo either in the first treatment period or the second treatment period.

    Serious adverse events
    OligoG Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Haemoptysis
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    OligoG Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    13 / 15 (86.67%)
    11 / 14 (78.57%)
    Investigations
    Eosinophil count increased
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Forced expiratory volume decreased
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Pulmonary function test abnormal
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Weight decreased
         subjects affected / exposed
    2 / 15 (13.33%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    Surgical and medical procedures
    Hospitalisation
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    2 / 15 (13.33%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Exercise tolerance decreased
         subjects affected / exposed
    1 / 15 (6.67%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Fatigue
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Pyrexia
         subjects affected / exposed
    1 / 15 (6.67%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Ear and labyrinth disorders
    Ear pain
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Tinnitus
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Abdominal pain upper
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Vomiting
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Bronchial obstruction
         subjects affected / exposed
    2 / 15 (13.33%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    Cough
         subjects affected / exposed
    1 / 15 (6.67%)
    4 / 14 (28.57%)
         occurrences all number
    1
    5
    Dysphonia
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Dyspnoea
         subjects affected / exposed
    2 / 15 (13.33%)
    2 / 14 (14.29%)
         occurrences all number
    3
    2
    Haemoptysis
         subjects affected / exposed
    1 / 15 (6.67%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Increased viscosity of bronchial secretion
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Oropharyngeal pain
         subjects affected / exposed
    0 / 15 (0.00%)
    2 / 14 (14.29%)
         occurrences all number
    0
    2
    Pulmonary haemorrhage
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Sputum discoloured
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Sputum increased
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Sputum retention
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    Skin and subcutaneous tissue disorders
    Psoriasis
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Rash
         subjects affected / exposed
    2 / 15 (13.33%)
    0 / 14 (0.00%)
         occurrences all number
    3
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Back pain
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Infections and infestations
    Clostridium difficile infection
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Infective pulmonary exacerbation of cystic fibrosis
         subjects affected / exposed
    1 / 15 (6.67%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Influenza
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Nasopharyngitis
         subjects affected / exposed
    2 / 15 (13.33%)
    3 / 14 (21.43%)
         occurrences all number
    2
    3
    Pertussis
         subjects affected / exposed
    0 / 15 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Viral infection
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Pneumonia
    Additional description: Bronchopneumonia
         subjects affected / exposed
    1 / 15 (6.67%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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