Aerosol Liposomal Cyclosporine for Chronic Rejection in Lung Transplant Recipients
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Purpose
This is a single-center pilot study to investigate the efficacy and safety of aerosolized liposomal cyclosporine A in the treatment of chronic rejection in lung transplant recipients with bronchiolitis obliterans syndrome (BOS).
The primary objective is to evaluate the efficacy of liposomal cyclosporine A in the treatment of chronic rejection. Pulmonary function and changes in BOS grade are the primary end points.
| Condition | Intervention | Phase |
|---|---|---|
|
Disorder Related to Lung Transplantation Bronchiolitis Obliterans Decreased Immunologic Activity Chronic Rejection of Lung Transplant |
Drug: liposomal aerosol cyclosporine Other: standard immune suppression, oral |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Pilot Study to Demonstrate Efficacy and Safety of Aerosol Liposomal Cyclosporine (L-CsA) in the Treatment of Bronchiolitis Obliterans Syndrome After Lung Transplantation |
- Lung Function [ Time Frame: 2 years ] [ Designated as safety issue: No ]Preservation of lung function is an indication of overall health of the lung allograft
- Cytokine analysis from BAL fluid in lung [ Time Frame: 2 years ] [ Designated as safety issue: No ]This is a surrogate marker of lung inflammation that may be used in addition to biopsy data
| Estimated Enrollment: | 30 |
| Study Start Date: | June 2012 |
| Estimated Study Completion Date: | February 2015 |
| Estimated Primary Completion Date: | February 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: liposomal aerosol cyclosporine
aerosol liposomal cyclosporine inhalational therapy for 6 months at two doses to be defined by transplant type
|
Drug: liposomal aerosol cyclosporine
inhaled form of immune suppression
|
|
Active Comparator: conventional immune suppression
standard immune suppression oral for lung transplant recipients tacrolimus, mycophenolate mofetil and prednisone
|
Other: standard immune suppression, oral
conventional drug
|
Detailed Description:
This is a randomized single-center pilot study to investigate the efficacy and safety of aerosolized liposomal cyclosporine A (L-CsA) in the treatment of chronic rejection in lung transplant recipients with Grade 1 or 2 BOS.
The primary endpoints will include:
- Improvement or stabilization of pulmonary function test (FEV1) from baseline
- Stabilization of histology (no deterioration from baseline)
- Safety of the preparation
The secondary endpoints will include:
- Pharmacokinetics and distribution of CsA in blood -
- Change in cytokine levels from BAL specimens.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Chronic rejection
- Bronchiolitis obliterans diagnosed by bronchiolitis obliterans syndrome and > 20% decline from the individual patient's best FEV1 is observed
- Recipient of a double or single lung transplant
- Receiving immunosuppressive treatment according to institutional standards
Exclusion criteria:
- Active invasive bacterial, viral or fungal infection
- Current mechanical ventilation
- Pregnant or breast-feeding woman
- Known hypersensitivity to cyclosporine A
- Serum creatinine value of more than 265 μmol/L (3 mg/dL) or chronic dialysis
- Receipt of an investigational drug as part of a clinical trial
Contacts and Locations| Contact: Aldo T Iacono, MD | 410-328-2864 | aiacono@medicine.umaryland.edu |
| United States, Maryland | |
| University of Maryland Medical Center | Recruiting |
| Baltimore, Maryland, United States, 21201 | |
| Contact: Jennifer Davis, BS, RRT 410-328-1473 jdavis2@medicine.umaryland.edu | |
| Contact: Aldo T Iacono, MD 4103282864 aiacono@medicine.umaryland.edu | |
| Principal Investigator: Aldo T Iacono, MD | |
| Principal Investigator: | Aldo T Iacono, MD | University of Maryland |
More Information
Publications:
| Responsible Party: | Aldo Iacono, Professor of Medicine Medical Director of Lung Transplantation, University of Maryland |
| ClinicalTrials.gov Identifier: | NCT01650545 History of Changes |
| Other Study ID Numbers: | AI001 |
| Study First Received: | June 27, 2012 |
| Last Updated: | July 23, 2012 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Maryland:
|
case-control study aerosolized liposomal cyclosporine A bronchiolitis obliterans syndrome Lung Transplantation Lung function |
Additional relevant MeSH terms:
|
Bronchiolitis Obliterans Bronchiolitis Bronchitis Bronchial Diseases Respiratory Tract Diseases Lung Diseases, Obstructive Lung Diseases Respiratory Tract Infections Cyclosporins Cyclosporine Enzyme Inhibitors |
Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Immunosuppressive Agents Immunologic Factors Physiological Effects of Drugs Antifungal Agents Anti-Infective Agents Therapeutic Uses Dermatologic Agents Antirheumatic Agents |
ClinicalTrials.gov processed this record on June 17, 2013