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Effect of Azithromycin on Lung Function in 6-18 Year-olds With Cystic Fibrosis (CF) Who Are Not Infected With P. Aeruginosa

This study has been completed.
Sponsor:
Collaborator:
Cystic Fibrosis Foundation
Information provided by (Responsible Party):
CF Therapeutics Development Network Coordinating Center
ClinicalTrials.gov Identifier:
NCT00431964
First received: February 2, 2007
Last updated: February 11, 2013
Last verified: February 2013
  Purpose

This is a study to examine the safety, effect on lung function, and frequency of symptoms relating to cystic fibrosis during 24 weeks of treatment with the antibiotic azithromycin in 6-18 year-olds with CF who are not infected with Pseudomonas aeruginosa.


Condition Intervention Phase
Cystic Fibrosis
Drug: azithromycin 250 mg tablets
Drug: placebo tablets
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Multi-center, Multi-national, Randomized, Placebo-Controlled Trial of Azithromycin in Subjects With Cystic Fibrosis 6-18 Years Old, Culture Negative for Pseudomonas Aeruginosa

Resource links provided by NLM:


Further study details as provided by CF Therapeutics Development Network Coordinating Center:

Primary Outcome Measures:
  • Change in FEV1 from baseline to end of treatment [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Safety, frequency of pulmonary exacerbations, changes in other measures of lung function, treatment emergent pathogens, weight, and serum inflammatory markers [ Time Frame: 24 weeks ] [ Designated as safety issue: Yes ]

Enrollment: 263
Study Start Date: February 2007
Study Completion Date: November 2009
Primary Completion Date: July 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
azithromycin 250 mg tablets
Drug: azithromycin 250 mg tablets
  • One (1) tablet three times weekly for patients who weigh 40-79 lbs
  • Two (2) tablets three times weekly for patients who weigh greater than or equal to 80 lbs
Other Name: Zithromax
Placebo Comparator: 2
placebo tablets (matched to active drug in appearance)
Drug: placebo tablets
  • One (1) tablet three times weekly for patients who weigh 40-79 lbs
  • Two (2) tablets three times weekly for patients who weigh greater than or equal to 80 lbs
Other Name: inactive pill

Detailed Description:

Azithromycin is an antibiotic that has been shown to improve lung function in patients with cystic fibrosis (CF) whose lungs are infected with a bacterium called Pseudomonas aeruginosa. Scientists are not sure how azithromycin works in cystic fibrosis. It does not appear to work by killing the bacteria Pseudomonas aeruginosa, but it may make these bacteria and other bacteria less damaging to the lungs by reducing their ability to attach to the lining of the lung, or by reducing the bacteria's ability to make substances that damage the lungs of patients with cystic fibrosis. Azithromycin may also work directly on the cells in the lungs to improve lung function. This could occur by reducing inflammation (swelling) in the lungs, and/or making the mucus less sticky, or by affecting the salt channel that doesn't function correctly in CF. If azithromycin works in one or more of these ways; it may also be effective in improving lung function in cystic fibrosis patients who are not infected with Pseudomonas aeruginosa.

We are conducting this research study to examine the safety, effect on lung function and frequency of symptoms relating to cystic fibrosis during 24 weeks of treatment with the antibiotic azithromycin. This study is designed to determine if patients with cystic fibrosis whose lungs are not infected with the bacteria Pseudomonas aeruginosa will benefit from 24 weeks of treatment with the antibiotic azithromycin. Benefit will be determined as having better pulmonary function tests and getting sick less often compared to a placebo (sugar pill). This study is also designed to determine if azithromycin is safe when administered for 24 weeks to cystic fibrosis patients not infected with Pseudomonas aeruginosa. By doing this study, we hope to learn more about CF and improve the way in which we treat it.

Comparison: Three times weekly azithromycin tablets added to standard care, compared to three times weekly placebo tablets added to standard care.

  Eligibility

Ages Eligible for Study:   6 Years to 18 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Male or female, 6-18 years of age at enrollment
  • Confirmed diagnosis of CF
  • Written informed consent (and assent when applicable)
  • Clinically stable at enrollment as assessed by the site investigator
  • FEV1 % predicted > 50%
  • Ability to comply with medication use, study visits, and study procedures
  • Ability to swallow a 250 mg tablet

Exclusion Criteria:

  • Weight less than 18.0 kg
  • Respiratory culture positive for P. aeruginosa, NTM, or B. cepacia complex within 1 year or at screening, or AFB positive at screening
  • Allergy to macrolide antibiotics
  • Use of macrolide antibiotics (e.g., azithromycin, clarithromycin) within 60 days of screening
  • Use of systemic corticosteroids or intravenous or oral antibiotics within 14 days of screening
  • Initiation of high dose ibuprofen, Pulmozyme®, hypertonic saline or aerosolized antibiotics within 30 days of screening
  • Chronic therapy with drugs known to have rare but serious interactions with azithromycin: amiodarone, digoxin, disopyramide, lovastatin, pimozide, rifabutin, and nelfinavir
  • Investigational drug use within 30 days of screening
  • Laboratory abnormalities (creatinine, liver function or neutropenia) at screening and confirmed at follow-up testing prior to randomization
  • History of biliary cirrhosis, portal hypertension, or splenomegaly, or splenomegaly on physical exam
  • History of ventricular arrhythmia
  • Other major organ dysfunction, excluding pancreatic dysfunction
  • History of lung transplantation or currently on lung transplant list
  • Relative decrease in FEV1 % predicted ≥ 20% between the screening and enrollment visit
  • Positive serum pregnancy test at screening
  • Pregnant, breastfeeding, or if post-menarche female, unwilling to practice birth control during participation in the study
  • History of alcohol, illicit drug or medication abuse within 1 year of screening in the judgment of the site investigator
  • Presence of a condition or abnormality that in the opinion of the site investigator would compromise the safety of the subject or the quality of the data
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00431964

  Show 40 Study Locations
Sponsors and Collaborators
CF Therapeutics Development Network Coordinating Center
Cystic Fibrosis Foundation
Investigators
Principal Investigator: Lisa Saiman, MD, MPH Columbia University
Principal Investigator: Michael Anstead, MD University of Kentucky
Principal Investigator: Felix Ratjen, MD The Hospital for Sick Children, Toronto, Ontario
Principal Investigator: Larry Lands, MD Montreal Children's Hospital of the MUHC
  More Information

Publications:
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: CF Therapeutics Development Network Coordinating Center
ClinicalTrials.gov Identifier: NCT00431964     History of Changes
Other Study ID Numbers: AZ0004
Study First Received: February 2, 2007
Last Updated: February 11, 2013
Health Authority: United States: Food and Drug Administration
United States: Institutional Review Board
Canada: Health Canada

Keywords provided by CF Therapeutics Development Network Coordinating Center:
azithromycin, Zithromax

Additional relevant MeSH terms:
Cystic Fibrosis
Fibrosis
Digestive System Diseases
Genetic Diseases, Inborn
Infant, Newborn, Diseases
Lung Diseases
Pancreatic Diseases
Pathologic Processes
Respiratory Tract Diseases
Azithromycin
Anti-Bacterial Agents
Anti-Infective Agents
Pharmacologic Actions
Therapeutic Uses

ClinicalTrials.gov processed this record on November 19, 2014