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    Clinical Trial Results:
    Expanded Access Program for Aztreonam Lysine for Inhalation in Canadian Patients with Cystic Fibrosis and Pseudomonas aeruginosa Airway Infection Who Have Limited Treatment Options and are at Risk for Disease Progression

    Summary
    EudraCT number
    2015-000397-36
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    27 Nov 2012

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Mar 2016
    First version publication date
    05 Aug 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    EA-US-205-0122
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00989807
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Gilead Sciences
    Sponsor organisation address
    333 Lakeside Drive, Foster City, CA, United States, 94404
    Public contact
    Clinical Trial Mailbox, Gilead Sciences International Ltd, ClinicalTrialDisclosures@gilead.com
    Scientific contact
    Clinical Trial Mailbox, Gilead Sciences International Ltd, ClinicalTrialDisclosures@gilead.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?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    27 Nov 2012
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    27 Nov 2012
    Global end of trial reached?
    Yes
    Global end of trial date
    27 Nov 2012
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study is to provide expanded access to AZLI 75 mg prior to its commercial availability and establishment of reimbursement programs through Provincial Ministries of Health to patients in Canada with CF and PA airway infection who have limited treatment options and are at risk for disease progression.
    Protection of trial subjects
    The protocol and consent/assent forms were submitted by each investigator to a duly constituted Independent Ethics Committee (IEC) or Institutional Review Board (IRB) for review and approval before study initiation. All revisions to the consent/assent forms (if applicable) after initial IEC/IRB approval were submitted by the investigator to the IEC/IRB for review and approval before implementation in accordance with regulatory requirements. This study was conducted in accordance with recognized international scientific and ethical standards, including but not limited to the International Conference on Harmonization guideline for Good Clinical Practice (ICH GCP) and the original principles embodied in the Declaration of Helsinki.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    08 Feb 2010
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Canada: 45
    Worldwide total number of subjects
    45
    EEA total number of subjects
    0
    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)
    3
    Adults (18-64 years)
    41
    From 65 to 84 years
    1
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants were enrolled at study sites in Canada. The first participant was screened on 08 February 2010. The last study visit occurred on 27 November 2012.

    Pre-assignment
    Screening details
    45 participants were screened.

    Period 1
    Period 1 title
    Overall study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Arm title
    All participants
    Arm description
    Aztreonam for inhalation solution (AZLI) 3 times daily in 56-day cycles (28 days on treatment followed by 28 days off treatment).
    Arm type
    Experimental

    Investigational medicinal product name
    Aztreonam for inhalation solution
    Investigational medicinal product code
    Other name
    AZLI, Cayston®
    Pharmaceutical forms
    Powder for nebuliser solution
    Routes of administration
    Inhalation use
    Dosage and administration details
    AZLI 75 mg administered 3 times daily usung the eFlow nebulizer

    Number of subjects in period 1
    All participants
    Started
    45
    Completed
    34
    Not completed
    11
         Adverse event, non-fatal
    3
         Participant request to discontinue
    3
         Not specified
    3
         Participant non-compliance
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    All participants
    Reporting group description
    Aztreonam for inhalation solution (AZLI) 3 times daily in 56-day cycles (28 days on treatment followed by 28 days off treatment).

    Reporting group values
    All participants Total
    Number of subjects
    45 45
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    32.8 ( 12.65 ) -
    Gender categorical
    Units: Subjects
        Female
    25 25
        Male
    20 20
    Race
    Units: Subjects
        Caucasian
    40 40
        Asian or Pacific Islander
    1 1
        Other
    4 4
    FEV1 % predicted
    FEV1 % predicted is defined as FEV1 % of the patient divided by the average FEV1 % in the population for any person of similar age, sex and body composition.
    Units: percentage of FEV1 % predicted
        arithmetic mean (standard deviation)
    41.73 ( 17.376 ) -

    End points

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    End points reporting groups
    Reporting group title
    All participants
    Reporting group description
    Aztreonam for inhalation solution (AZLI) 3 times daily in 56-day cycles (28 days on treatment followed by 28 days off treatment).

    Primary: Percentage of participants experiencing any serious adverse event

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    End point title
    Percentage of participants experiencing any serious adverse event [1]
    End point description
    End point type
    Primary
    End point timeframe
    From date of first dose to study discontinuation (average 73 weeks) plus 30 days
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis was planned or performed.
    End point values
    All participants
    Number of subjects analysed
    45
    Units: percentage of participants
        number (not applicable)
    55.6
    No statistical analyses for this end point

    Adverse events

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    Adverse events information [1]
    Timeframe for reporting adverse events
    From date of first dose to study discontinuation (average 73 weeks) plus 30 days
    Adverse event reporting additional description
    All AEs are reported by system order class and preferred term as determined by the investigator.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    17.0
    Reporting groups
    Reporting group title
    All participants
    Reporting group description
    -

    Notes
    [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported.
    Justification: Per protocol, non-serious adverse events were not collected in this expanded access study.
    Serious adverse events
    All participants
    Total subjects affected by serious adverse events
         subjects affected / exposed
    25 / 45 (55.56%)
         number of deaths (all causes)
    2
         number of deaths resulting from adverse events
    0
    Surgical and medical procedures
    Lung transplant
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Chest discomfort
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    2 / 2
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Distal intestinal obstruction syndrome
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Constipation
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Lung disorder
         subjects affected / exposed
    13 / 45 (28.89%)
         occurrences causally related to treatment / all
    0 / 31
         deaths causally related to treatment / all
    0 / 1
    Infective pulmonary exacerbation of cystic fibrosis
         subjects affected / exposed
    7 / 45 (15.56%)
         occurrences causally related to treatment / all
    0 / 12
         deaths causally related to treatment / all
    0 / 0
    Lung infection pseudomonal
         subjects affected / exposed
    3 / 45 (6.67%)
         occurrences causally related to treatment / all
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Chronic respiratory failure
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Cystic fibrosis lung
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia cytomegaloviral
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia escherichia
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumothorax
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory distress
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    Respiratory tract infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Infection
         subjects affected / exposed
    2 / 45 (4.44%)
         occurrences causally related to treatment / all
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    Device related infection
         subjects affected / exposed
    1 / 45 (2.22%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    All participants
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    0 / 45 (0.00%)

    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
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    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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