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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00396006
Registration number
NCT00396006
Ethics application status
Date submitted
3/11/2006
Date registered
6/11/2006
Date last updated
13/05/2021
Titles & IDs
Public title
Efficacy and Safety Study of Augmentation Therapy With ARALAST Fraction IV-1 (Human Alpha 1 - Proteinase Inhibitor)
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Scientific title
The Effect of Augmentation Therapy With ARALAST Fraction IV-1 (ARALAST) Alpha1-Proteinase Inhibitor (a1-PI) on the Level of a1-PI and Other Analytes in the Bronchoalveolar (BAL) Epithelial Lining Fluid (ELF)
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Secondary ID [1]
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460502
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Alpha 1-Antitrypsin Deficiency
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Condition category
Condition code
Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Respiratory
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Other - Alpha1-Proteinase Inhibitor
Treatment: Other: Alpha1-Proteinase Inhibitor
60 mg/kg, weekly, intravenous infusion
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Change in Bronchoalveolar Lavage (BAL) Epithelial Lining Fluid (ELF) Alpha1-Proteinase Inhibitor (a1-PI) Level
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Assessment method [1]
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Median change BAL ELF antigenic a1-PI level the from baseline to post-treatment
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Timepoint [1]
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BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)
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Primary outcome [2]
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The Number of Adverse Events (AEs) Related to the Infusion of ARALAST Fr. IV 1 Administered at a Rate of 0.2 mL/kg/Min
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Assessment method [2]
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Timepoint [2]
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During 8 consecutive weeks of treatment
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Primary outcome [3]
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Number of Changes in the Rate of Infusion
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Assessment method [3]
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Number of decreases in the rate or discontinuations of infusion at 0.2 mL/kg/min
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Timepoint [3]
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During 8 consecutive weeks of treatment
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Secondary outcome [1]
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Ratio of Post- to Pre-treatment BAL ELF Antineutrophil Elastase Capacity (ANEC) Levels
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Assessment method [1]
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Median ratio of post- to pre-treatment BAL ELF ANEC levels
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Timepoint [1]
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BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)
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Secondary outcome [2]
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Change in in the Ratio of BAL ELF a1-PI to Human Neutrophil Elastase (HNE) Complex Concentration
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Assessment method [2]
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Median change in the ratio of BAL ELF a1-PI to HNE complex concentration from baseline to post-treatment
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Timepoint [2]
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BAL procedures were performed at baseline and after 8 consecutive weeks of treatment (minimum of 12 weeks)
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Secondary outcome [3]
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Change in the a1-PI Plasma Level
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Assessment method [3]
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Mean change in the plasma level of a1-PI from baseline to post-treatment
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Timepoint [3]
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Blood samples were collected at baseline and after 8 consecutive weeks of treatment
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Secondary outcome [4]
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Change in the Plasma Antineutrophil Elastase Capacity (ANEC) Level
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Assessment method [4]
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Mean change in the plasma ANEC level from baseline to post-treatment
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Timepoint [4]
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Blood samples were collected at baseline and after 8 consecutive weeks of treatment
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Secondary outcome [5]
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Clinically Significant Changes in Vital Signs From Pre- to Post-Infusion
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Assessment method [5]
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Clinically significant changes in vital signs from pre- to post-infusion are: • Heart rate: 25% increase above pre-infusion value • Blood pressure: = 30 mm Hg change from pre-infusion blood pressure (systolic or diastolic) • Temperature: an increase in body temperature to \>38°C (\>100.4°F). If the pre-infusion body temperature was already \>38°C (\>100.4°F), then any further increase in body temperature by 1.1°C (1.98°F) or more was considered clinically significant. • Respiratory rate: 25% increase above pre-infusion value
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Timepoint [5]
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During 8 consecutive weeks of infusion
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Eligibility
Key inclusion criteria
* Signed and dated informed consent.
* Male or female 18 years of age or older.
* Documented, endogenous serum a1-PI level < 40 mg/dL measured at screening (unless otherwise approved by the Sponsor) after a minimum of 28-day washout of any prior replacement therapy (if applicable).
* Phenotype Pi Z (which includes Pi*Z/Z, Pi*Z/Null, or Pi*Malton/Z), or Pi*Null/Null.
* Pulmonary functions at screening meeting the following criteria:
1. Forced expiratory volume at 1 second (FEV1) >= 50% of predicted value; or
2. FEV1 > 35% of predicted value and diffusing capacity for carbon monoxide > 45% of predicated value, with no supplemental oxygen therapy and < 3 pulmonary exacerbations or bronchitis requiring antibiotics/corticosteroids within the past 12 months).
* For any female of childbearing potential, a negative urine test for pregnancy within 7 days prior to the first bronchoalveolar lavage (BAL) visit and agreement to employ adequate birth control measures for the duration of the study.
* No clinically significant abnormalities detected on a 12-lead electrocardiogram (ECG) performed at the screening visit (ECG previously obtained within the past 12 months may be used, if available).
* Laboratory results obtained at the screening visit, meeting the following criteria:
1. Serum alanine aminotransferase (ALT) <= 2 times upper limit of normal (ULN)
2. Serum aspartate aminotransferase (AST) <= 2 times ULN
3. Serum total bilirubin <= 2 times ULN
4. Proteinuria < +2 on dipstick analysis
5. Serum creatinine <= 1.5 times ULN
6. Absolute neutrophil count (ANC) >= 1500 cells/mm3
7. Hemoglobin (Hgb) >= 10.0 g/dL
8. Platelet count >= 105/mm3
* If the subject is treated with respiratory medications, such as inhaled bronchodilators or inhaled corticosteroids, or other chronic medications for the treatment of the subjects´s other medical condition(s), the subject's medication doses were unchanged for at least 14 days prior to the baseline BAL visit.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Clinically significant pulmonary impairment, other than chronic pulmonary disease (COPD).
* The subject has received any alpha 1 proteinase inhibitor (a1-PI) augmentation therapy (e.g., Prolastin, Zemaira, Aralast, or an investigational a1-PI, by any route including intravenous and inhaled) within 28 days prior to screening.
* The subject has received an investigational drug or device within 1 month prior to screening, or the subject is currently receiving an investigational drug or device. If the subject receives another investigational drug or device after enrollment, the subjects is to be withdrawn from the trial.
* Presence of clinical symptoms of any lower respiratory tract infection or acute pulmonary exacerbation within 14 days prior to screening.
* The subject has a known selective Immunoglobulin A (IgA) deficiency (IgA level less than 15 mg/dL) and/or antibody against IgA.
* The subject is pregnant or lactating, or intends to become pregnant during the course of the study.
* The subject is not a suitable candidate for a BAL procedure.
* Moderate or severe bronchiectasis (total daily sputum production > 10 mL).
* Clinically significant medical, psychiatric, or cognitive illness, or recreational drug/alcohol use that, in the opinion of the investigator, would affect subject safety or compliance.
* Prior history of adverse reaction to local anaesthetics, sedatives, pain control drugs, and other medication employed at the study center for perioperative care associated with the BAL procedure.
* Long-term use of oral or parenteral glucocorticosteroid within 28 days prior to screening.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
27/10/2006
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
14/12/2007
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Sample size
Target
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Accrual to date
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Final
21
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Recruitment in Australia
Recruitment state(s)
SA,VIC,WA
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Recruitment hospital [1]
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- Adelaide
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Recruitment hospital [2]
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- Melbourne
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Recruitment hospital [3]
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- Nedlands
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Recruitment postcode(s) [1]
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- Adelaide
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Recruitment postcode(s) [2]
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- Melbourne
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Recruitment postcode(s) [3]
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- Nedlands
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Country [2]
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New Zealand
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State/province [2]
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Hamilton
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Baxalta now part of Shire
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to evaluate the effects of weekly augmentation therapy with ARALAST Fraction IV-1 (Fr IV-1) on epithelial lining fluid (ELF) alpha 1-proteinase inhibitor levels and other ELF analytes and to assess the safety of the treatment. Eligible subjects with a diagnosis of severe congenital alpha 1-antitrypsin deficiency will receive 8 consecutive weekly treatments with 60 mg/kg/week of functional ARALAST Fr IV-1 administered intravenously. The efficacy and safety assessments will include two bronchoscopies with bronchoalveolar lavage on study initiation and on study termination and multiple imaging and laboratory safety assessments. Each subject will participate for a minimum of 12 weeks.
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Trial website
https://clinicaltrials.gov/study/NCT00396006
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Trial related presentations / publications
Li Z, Franke RM, Morris DN, Yel L. Pharmacokinetics and Biochemical Efficacy of an alpha1-Proteinase Inhibitor (Aralast NP) in alpha1-Antitrypsin Deficiency: a Cross-Product Retrospective Comparability Analysis. Pulm Ther. 2022 Sep;8(3):311-326. doi: 10.1007/s41030-022-00199-4. Epub 2022 Aug 24.
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Public notes
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Contacts
Principal investigator
Name
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Study Director
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Address
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Takeda
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT00396006
Download to PDF