Study in Adult Asthmatic Patients With Allergic Bronchopulmonary Aspergillosis

Brief Summary
A Randomized, Double-Blind, Multicenter, Placebo-Controlled, Phase 2 Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Itraconazole Administered as a Dry Powder for Inhalation (PUR1900) in Adult Asthmatic Patients With Allergic Bronchopulmonary Aspergillosis
Brief Title
Study in Adult Asthmatic Patients With Allergic Bronchopulmonary Aspergillosis
Detailed Description
This is a randomized, double-blind, multicenter, placebo controlled, multiple-arm study.

Following screening and confirmation of eligibility, subjects will be randomly assigned (1:1:1:1) into 4 arms of 16 subjects each and will receive 10 mg, 20 mg, or 35 mg of PUR1900 or placebo, administered via dry powder inhalation daily for 28 days. The doses of PUR1900 are stated in this protocol as the respective nominal doses of itraconazole.

Subject eligibility for the study will be determined within 28 days before the first dose of study drug (Day 1) and will be confirmed between 9 and 6 days before dosing and again on Day 1.

Eligible subjects will begin daily dosing with study drug (PUR1900 or placebo) on Day 1.

Subjects will return to the study site for visits on Days 2, 7, 14, and 28 and will be dosed at the study site. The remaining daily doses of study drug will be self-administered at home.

A follow-up visit will occur 7 to 10 days after the last dose of study drug.
Completion Date
Completion Date Type
Actual
Conditions
Allergic Bronchopulmonary Aspergillosis
Eligibility Criteria
Inclusion Criteria:

* Is a male or female, 18 to 75 years old (inclusive) at the time of signing the informed consent.
* Has a body mass index of 18.0 to 35.0 kg/m2 (inclusive) at screening.
* Has a historical diagnosis of asthma, as per the Global Initiative for Asthma (GINA) 2018 update.
* Has a confirmed historical diagnosis of ABPA, as per the Modified International Society for Human and Animal Mycology (ISHAM) working group 2013 criteria.
* Is currently considered to be in one of the following stages of ABPA: Stage 2 (Response), Stage 4 (Remission), Stage 5a (Treatment-dependent ABPA), or Stage 5b (Glucocorticoid-dependent asthma)
* Has a serum immunoglobulin (Ig) E ≥1000 IU/mL during screening (Visit 1 or Visit 2).
* Can perform a valid, reproducible spirometry test with demonstration of a prebronchodilator FEV1 ≥50% of predicted normal for age, sex, race, and height (Quanjer et al 2012) at a screening visit.
* Has a documented stable asthma medication regimen during screening (Day 28 to Day 1), including SABA, LABA, and LTRA use and inhaled and/or oral GCS.
* Subjects who are sexually active, male subjects able to father a child, and female subjects of childbearing potential must agree to follow the contraception requirements of this protocol.
* Can demonstrate the correct inhalation technique for the use of the delivery device at screening and before dosing.

Exclusion Criteria:

* Is a female of childbearing potential who is pregnant or lactating or who plans to become pregnant during the study. A woman is considered to be of childbearing potential unless she is either permanently sterile (hysterectomy, bilateral salpingectomy, bilateral oophorectomy, bilateral tubal occlusion/ligation) or postmenopausal (had no menses for 12 months without an alternative medical cause).
* Has a history of life-threatening asthma within the last 5 years, defined as an asthma episode that required intubation and/or was associated with hypercapnia, respiratory arrest, and/or hypoxic seizures.
* Had an occurrence of asthma or ABPA exacerbations within the 28 days before screening or during the 28-day period before Day 1.
* Had an occurrence of clinically significant bacterial, viral, or fungal infection that required systemic (oral or intravenous) antibiotics, antivirals, or antifungals within the 28 days before screening. Topical treatments, other than antifungals, are allowed.
* Received any investigational medical product in a clinical research study within the previous 3 months before dosing in this study.
* Has previously received PUR1900.
* Has a history of any significant drug or alcohol abuse in the past 2 years before screening, as judged by the investigator.
* Has current tobacco or inhaled marijuana use or history of smoking tobacco or marijuana within the last 6 months before screening.
* Is a current user of e-cigarettes or has used these products within the last 6 months before screening.
* Has a positive urine test result for drugs of abuse, alcohol, or cotinine at screening
* Has a history of allergies to or hypersensitivity reactions after dosing of itraconazole or other antifungal azoles.
* Had a major trauma or surgery within the last 28 days before screening.
Inclusion Criteria
Inclusion Criteria:

* Is a male or female, 18 to 75 years old (inclusive) at the time of signing the informed consent.
* Has a body mass index of 18.0 to 35.0 kg/m2 (inclusive) at screening.
* Has a historical diagnosis of asthma, as per the Global Initiative for Asthma (GINA) 2018 update.
* Has a confirmed historical diagnosis of ABPA, as per the Modified International Society for Human and Animal Mycology (ISHAM) working group 2013 criteria.
* Is currently considered to be in one of the following stages of ABPA: Stage 2 (Response), Stage 4 (Remission), Stage 5a (Treatment-dependent ABPA), or Stage 5b (Glucocorticoid-dependent asthma)
* Has a serum immunoglobulin (Ig) E ≥1000 IU/mL during screening (Visit 1 or Visit 2).
* Can perform a valid, reproducible spirometry test with demonstration of a prebronchodilator FEV1 ≥50% of predicted normal for age, sex, race, and height (Quanjer et al 2012) at a screening visit.
* Has a documented stable asthma medication regimen during screening (Day 28 to Day 1), including SABA, LABA, and LTRA use and inhaled and/or oral GCS.
* Subjects who are sexually active, male subjects able to father a child, and female subjects of childbearing potential must agree to follow the contraception requirements of this protocol.
* Can demonstrate the correct inhalation technique for the use of the delivery device at screening and before dosing.

Gender
All
Gender Based
false
Keywords
Aspergillosis
Healthy Volunteers
No
Last Update Submit Date
Maximum Age
75 Years
Minimum Age
18 Years
NCT Id
NCT03960606
Org Class
Industry
Org Full Name
Pulmatrix Inc.
Org Study Id
601-0014
Overall Status
Terminated
Phases
Phase 2
Primary Completion Date
Primary Completion Date Type
Actual
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Phase 2 Study to Evaluate the Safety, Tolerability, & Pharmacokinetics of Itraconazole Administered as a Dry Powder for Inhalation (PUR1900) in Asthmatic Patients With ABPA
Primary Outcomes
Outcome Measure
Incidence of treatment-emergent adverse events
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Measure
Incidence of intraday FEV1 declines
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Measure
Respiratory rate
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Description
Systolic pressure over diastolic pressure
Outcome Measure
Blood pressure
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Description
Beats per minute
Outcome Measure
Heart rate
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Description
As a percentage
Outcome Measure
Oxygen saturation
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Description
Physician's notes
Outcome Measure
Physical examination findings
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Description
Lab reports with any out of range results flagged
Outcome Measure
Clinical laboratory test results
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Outcome Description
ECG report and tracing
Outcome Measure
12-Lead electrocardiogram findings
Outcome Time Frame
From Day 1 through Follow Up (which is 7 to 10 days after the last dose)
Secondary Outcomes
Outcome Time Frame
Day 2 to Day 28
Outcome Measure
Sputum concentrations of itraconazole and hydroxy-itraconazole
Outcome Time Frame
(Day -9 to Day -6) to Day 28
Outcome Measure
Sputum eosinophils
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
To evaluate the effect of PUR1900 on pulmonary function following single- and multiple-dose administration of PUR1900
Outcome Description
Scores range between 0 (totally controlled) and 6 (severely uncontrolled).
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
Asthma Control Questionnaire-6 (ACQ 6)
Outcome Description
As assessed by quantitative PCR and sputum culture
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
Change from baseline (Day 1) to Day 28 in A fumigatus burden in sputum
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
Cmax (maximum observed concentration in plasma)
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
Tmax (time to maximum concentration in plasma)
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
AUC (area under the concentration-time curve)
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
CL/F (clearance)
Outcome Time Frame
Day 1 to Day 28
Outcome Measure
Vz/F (apparent volume of distribution)
Start Date
Start Date Type
Actual
Status Verified Date
First Submit Date
First Submit QC Date
Std Ages
Adult
Older Adult
Maximum Age Number (converted to Years and rounded down)
75
Minimum Age Number (converted to Years and rounded down)
18
Investigators
Investigator Type
Principal Investigator
Investigator Name
Golda Hudes
Investigator Email
ghudes@montefiore.org
Investigator Phone
646-229-9509