Clinical trial NCT00546663: Tolerability of Inhaled Hypertonic Saline in Infants With Cystic Fibrosis
Official title: A Pilot Study to Evaluate the Tolerability of Inhaled 7% Hypertonic Saline in Infants With Cystic Fibrosis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Cystic Fibrosis
Keywords: Cystic Fibrosis, hypertonic saline
Lead sponsor: CF Therapeutics Development Network Coordinating Center
Sponsor class: NETWORK
Collaborators: name: Cystic Fibrosis Foundation
First posted: 2007-10-19
Enrollment: 19
Sex: ALL
Minimum age (years): 12
Maximum age (years): 30
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This is an open-label pilot study of the safety and tolerability of 7% hypertonic saline inhaled twice daily for 14 days in infants with CF, 12 to 30 months of age.

Detailed description: The efficacy and safety of hypertonic saline (HS) in CF patients over 6 years of age has been demonstrated in clinical trials of 2 to 48 weeks' duration. Based on these results, a large randomized, placebo-controlled trial of the efficacy and safety of 7% HS administered twice daily for 48 weeks to infants with CF, 4 to 15 months of age at enrollment, is planned (the Infant Study of Inhaled Saline (ISIS) trial). It is anticipated that 150 infants at up to 16 sites will be enrolled in the ISIS trial.

To date, the only evaluations of the safety of HS in infants with CF have been small single-dose studies. There has been no evaluation of the tolerability of chronic HS administration. The goal of this study is to assess the safety and tolerability of exposure to 14 days of 7% HS administered twice daily in infants with CF, prior to enrolling subjects in the planned large, randomized, controlled trial. Conduct of this study will provide evidence for the tolerability of chronic HS administration in infants with CF and estimates of the proportion of infants who do not tolerate chronic HS treatment. The results will be used to establish the appropriate measures of tolerability at enrollment in the ISIS trial, and to refine sample size estimates to account for withdrawal due to intolerance of HS.

Eligibility criteria: Inclusion Criteria:

* Diagnosis of CF as defined by one or more clinical features of CF and a documented sweat chloride ≥ 60 mEq/L by quantitative pilocarpine iontophoresis test or a genotype showing two well characterized disease causing mutations
* Informed consent by parent or legal guardian
* 12-30 months of age at enrollment

Exclusion Criteria:

* Wheezing at the baseline evaluation at the enrollment visit
* Oxygen saturation \< 95 % at the baseline evaluation at the enrollment visit
* Acute intercurrent respiratory infection, defined as an increase in cough, wheezing, or respiratory rate, or new rhinorrhea, nasal congestion or rhinorrhea, with onset in the week preceding the enrollment visit
* Investigational drug use within 30 days prior to the enrollment visit
* Known intolerance of albuterol
* Current enrollment in a therapeutic clinical trial
* Condition or situation which, in the opinion of the investigator, would affect the ability of the patient or family to complete study procedures

Primary outcomes:
measure: The proportion of infants who are intolerant of single and repeated doses of HS according to protocol-defined criteria
timeFrame: At the enrollment visit, during the period of home administration (Days 0 to 14), and at the final study visit.
Secondary outcomes:
measure: New or increased cough, increased qualitative breathing rate, new or increased noisy breathing, or new or increased emesis at home as noted by parents on the daily symptom report
timeFrame: During the period of home administration (Days 0 to 14)
measure: Change in respiratory rate, oxygen saturation, or cough frequency between the baseline measurement and measurements obtained after HS administration
timeFrame: At the enrollment visit
measure: Change in respiratory rate, oxygen saturation, or cough frequency between the baseline value at the enrollment visit and the value at the final study visit
timeFrame: Over two weeks of study participation
measure: Unanticipated adverse events
timeFrame: Over two weeks of study participation
measure: Adherence, as measured by (1) the number of doses of HS administered per the home symptom report and (2) returned study drug vials
timeFrame: During the period of home administration (Days 0 to 14)
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: University of North Carolina
state: North Carolina
city: Seattle
country: United States
facility: Children's Hospital and Regional Medical Center
state: Washington
city: Toronto
country: Canada
facility: Hospital for Sick Children
state: Ontario
Study officials:
affiliation: Seattle Children's Hospital
name: Margaret Rosenfeld, MD, MPH
role: PRINCIPAL_INVESTIGATOR
affiliation: University of North Carolina
name: Stephanie Davis, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: The Hospital for Sick Children
name: Felix Ratjen, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: