Clinical trial NCT00815347: Bosentan for Poorly Controlled Asthma
Official title: The Effect of the ET-1 Receptor Antagonist, Bosentan on Patients With Poorly Controlled Asthma-A 17 Week, Double-blind, Placebo Controlled Crossover Trial
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Asthma
Keywords: Asthma
Lead sponsor: UConn Health
Sponsor class: OTHER
Collaborators: name: Actelion
First posted: 2008-12-30
Enrollment: 11
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: Hypothesis: The endothelin-1 receptor antagonist, bosentan when added to the treatment of asthma patients who are symptomatic despite the use of controller therapy will improve asthma symptoms and physiology.

Twenty patients with a diagnosis of asthma, between the ages of 21 and 70 who are symptomatic despite the use of at least one controller medication will be randomized to either placebo or active medication for an 8 week period (initial 4 weeks is at 1/2 of final dose as per package insert and FDA approval). Measures of lung function and symptoms will be recorded. Patients will then cross over, so that patients initially on placebo will receive active drug for 8 weeks and those initially on active drug will receive placebo. The same endpoints will be measured. The acute bronchodilator effects of the drug will also be tested on the first day of therapy at the full therapeutic dose.


Eligibility criteria: Inclusion Criteria:

* Diagnosis of asthma, maintained on a minimum of 1 anti-inflammatory/controller and daily long acting B-agonist therapy with inadequate control of symptoms. (Defined as symptoms including wheezing, chest tightness or shortness of breath occurring at least 3 times a week or requiring use of "rescue" short-acting B-agonist at least 3 times a week).
* FEV1 less than 80% of predicted and greater than 40% at screening visit.
* A minimum of 12% reversibility of FEV1 after albuterol on screening visit or previously documented during the prior two years.
* Women of childbearing potential must use 2 non-hormonal methods of birth control (2 methods between the subject and her partner) while on the study and for 1 month after the last dose of study medication.
* Male subjects must use two non hormonal methods of birth control (2 methods between the subject and his partner) while on the study and for 1 month after the last dose of study medication.

Exclusion Criteria:

* History of liver disease, clinically significant cardiac disease, renal disease or pulmonary disease other than asthma. Patients with clinically significant laboratory abnormalities of LFTs/bilirubin (AST/ALT, TBili, alkaline phosphatase) and clinically significant anemia will be excluded. Clinically significant anemia will be defined as any anemia resulting in serum Hgb more than 1 gm/dl below the LLN, Patients with isolated minimal elevations of bilirubin (eg. as occurs in Gilbert's disease) or minimal elevations in transaminases (less than 1.2 x ULN) without a history of liver disease, risk factors for liver disease or symptoms of liver disease may still be included in the study at the investigator's discretion, but will have LFT testing at each study visit.)
* Cigarette history of \>10 pack years.
* Predicted inability to adhere to medication regimen or documentation requirements of the study (symptom and medication diaries).
* Respiratory infection during 30 days preceding screening visit.
* Requirement for change in scheduled asthma medication use, including oral steroid dose change, or acute medical care for asthma during the 30 days preceding screening visit.
* Predicted inability to safely refrain from B-agonist use for the required amount of time on study visit days.
* Use of tiotropium
* Pregnancy, breast feeding or the use of hormonal methods of birth control as the only means of birth control during the study.
* Use of potent CYP3A4 and CYP2C9 inhibitors, including, but not limited to azole antifungals, amiodarone, glyburide, warfarin, cyclosporine, ritonavir, other medications potentially toxic to the liver or bone marrow.
* Use of any illegal drugs or alcohol abuse.

Primary outcomes:
measure: Change in FEV1
timeFrame: 1, 2, 4 hours after dosing
measure: Peak Flow
timeFrame: last 7 days of each dosing period
measure: Symptom Scores
timeFrame: Last 7 days of each dosing period
Secondary outcomes:
measure: FEV1
timeFrame: end of dosing period
measure: Rescue Beta-agonist
timeFrame: end of each dosing period
measure: Asthma Control Test Questionnaire
timeFrame: end of each dosing period
Other outcomes:
measure: Requirement for Escalation of Controller Medication.
timeFrame: 17 weeks
measure: Requirement for Urgent Medical Care for Asthma.
timeFrame: 17 weeks
measure: Ability to Taper Systemic Steroids Among Those Patients Who Are on Systemic Steroids at Study Entry.
timeFrame: 17 weeks
Locations:
city: Farmington
country: United States
facility: University of Connecticut Health Center
state: Connecticut
Study officials:
affiliation: UConn Health
name: Mark L Metersky, MD
role: PRINCIPAL_INVESTIGATOR
References: