Treatment of Chronic Cough in Idiopathic Pulmonary Fibrosis With Thalidomide
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Purpose
Idiopathic Pulmonary Fibrosis (IPF) is a rapidly progressive lung disorder that is often associated with a chronic, intractable cough. The etiology of the cough associated with IPF is unclear but it is often so severe that it adversely effects the patient's quality of life. We propose that thalidomide specifically suppresses the cough associated with idiopathic pulmonary fibrosis via its anti-inflammatory properties, by suppressing the excessive functional up-regulation of sensory fibers with in the respiratory tract of patients with IPF.
This study is a Phase III, double blinded, randomized, placebo controlled, crossover trial testing the efficacy of thalidomide in suppressing the chronic cough of IPF. The primary objective of this study is to determine the efficacy of thalidomide administered daily for 12 weeks to suppress the chronic cough in patients with idiopathic pulmonary fibrosis as measured by cough specific questionnaires, scales and improved quality of life.
| Condition | Intervention | Phase |
|---|---|---|
|
Idiopathic Pulmonary Fibrosis Cough |
Drug: Thalidomide Drug: Placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Treatment of Chronic Cough in Idiopathic Pulmonary Fibrosis With Thalidomide |
- Efficacy of thalidomide in suppressing the chronic cough of idiopathic pulmonary fibrosis [ Time Frame: 6 month trial ] [ Designated as safety issue: No ]
| Enrollment: | 25 |
| Study Start Date: | December 2007 |
| Study Completion Date: | September 2011 |
| Primary Completion Date: | September 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: 1 |
Drug: Thalidomide
thalidomide 50 - 100 mg by mouth daily
|
| Placebo Comparator: 2 |
Drug: Placebo
Placebo 50-100 mg by mouth per day
|
Detailed Description:
This study is a Phase III, double blinded, randomized, placebo controlled, crossover trial testing the efficacy of thalidomide in suppressing the chronic cough of IPF. All subjects will be randomized to either begin the study receiving the active study drug - (thalidomide) or inactive drug (placebo). Study drug will be administered in escalating dose starting at 50 mg a day increasing to 100 mg a day if cough is still present after 2 weeks. Study drug will be taken by mouth at bedtime. Patients will remain on their initial treatment for 12 weeks. After 12 weeks of treatment, the subjects will be administered the Cough Specific Quality of Life Questionnaire (CQLQ), a visual cough analogue scale, and St. Georges Respiratory Questionnaire (SGRQ). In addition, investigators will collect the subjects cough diary. After 12 weeks of treatment all subjects will enter a 2 week wash-out phase in which all drugs will be discontinued. After the 2 week wash-out phase, all subjects will again be administered the Cough Specific Quality of Life Questionnaire (CQLQ), a visual cough analogue scale, and St. Georges Respiratory Questionnaire (SGRQ). In addition, investigators will collect the subjects cough diary. All subjects will then be crossed over to the other treatment arm for an additional 12 weeks of treatment. After the second 12 weeks of treatment, the subjects will be administered the Cough Specific Quality of Life Questionnaire (CQLQ), a visual cough analogue scale, and St. Georges Respiratory Questionnaire (SGRQ). In addition, investigators will collect the subjects cough diary.
Eligibility| Ages Eligible for Study: | 50 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Idiopathic pulmonary fibrosis for >3 months <5 years
- High resolution CT scan of chest consistent with IPF within the previous 12 months
- FVC > 40% and < 90% predicted, TLC >40% <80%, DLCo >30% <90%
- Chronic Cough - cough >8 weeks
- Age >50
- Non-child bearing potential
Exclusion Criteria:
- Pregnant or lactating women
- Women of child bearing potential
- Known etiology of lung fibrosis other than IPF
- Significant respiratory toxin exposure
- Collagen Vascular Disease
- Use of narcotic anti-cough agent in last week
- significant peripheral vascular disease or neuropathy
- history of seizures
- poorly controlled diabetes
- allergy to thalidomide
Contacts and Locations| United States, Maryland | |
| Johns Hopkins Bayview Medical Center | |
| Baltimore, Maryland, United States, 21224 | |
| Principal Investigator: | Maureen Horton, MD | Johns Hopkins University |
More Information
No publications provided by Johns Hopkins University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Maureen R. Horton, Associate Professor of Medicine, Johns Hopkins University |
| ClinicalTrials.gov Identifier: | NCT00600028 History of Changes |
| Other Study ID Numbers: | CG-0747, CG-0747 |
| Study First Received: | January 11, 2008 |
| Last Updated: | September 18, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by Johns Hopkins University:
|
idiopathic pulmonary fibrosis cough |
Additional relevant MeSH terms:
|
Cough Fibrosis Pulmonary Fibrosis Idiopathic Pulmonary Fibrosis Respiration Disorders Respiratory Tract Diseases Signs and Symptoms, Respiratory Signs and Symptoms Pathologic Processes Lung Diseases Idiopathic Interstitial Pneumonias Lung Diseases, Interstitial Thalidomide |
Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Pharmacologic Actions Leprostatic Agents Anti-Bacterial Agents Anti-Infective Agents Therapeutic Uses Angiogenesis Inhibitors Angiogenesis Modulating Agents Growth Substances Growth Inhibitors Antineoplastic Agents |
ClinicalTrials.gov processed this record on May 19, 2013