Clinical trial NCT02483637: Safety and Feasibility Study of Rejuvenair™ for Treating Chronic Bronchitis Patients
Official title: A Prospective Safety and Feasibility Study of the RejuvenAir™ System Metered Cryospray Therapy for Chronic Bronchitis Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Bronchitis, Chronic
Cryotherapy Effect
Keywords: spray cryotherapy
cryotherapy
chronic bronchitis
airflow restrictions
Lead sponsor: CSA Medical, Inc.
Sponsor class: INDUSTRY
First posted: 2015-06-29
Enrollment: 30
Sex: ALL
Minimum age (years): 40
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: RejuvenAir
Primary purpose: TREATMENT

Brief summary: This study evaluates the safety of RejuvenAir Cryospray therapy to treat symptomatic chronic bronchitis patients with airflow restrictions.

Detailed description: Prospective, open label, single arm study with sequential accrual of subjects with known chronic bronchitis. There are two phases to this study. Phase A will enroll up to 12 subjects and will treat a single lobe to assess safety, feasibility and histology/immunology. After review of the data by the Data Safety Monitoring Board, Phase B of the study would begin. In Phase B of the study, Phase A subjects would have their remaining two lobes treated. In addition up to 24 subjects will be enrolled and will have all upper and lower lobes treated to assess safety, feasibility and immunology.

Eligibility criteria: Inclusion Criteria:

* Males and females ≥40 to ≤75 years of age.
* Subject is able to read, understand, and sign a written Informed Consent in order to participate in the study.
* Subject agrees to continue maintenance pulmonary/COPD medications for the duration of the study.
* Diagnosis of chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD) for a minimum of two years. (Chronic Bronchitis is defined clinically as chronic productive cough for 3 months in each of 2 successive years in a patient in whom other causes of productive cough have been excluded.)
* Pre-procedure post bronchodilator FEV1 of greater than or equal to 30% and less than or equal to 80% of predicted within 3 months of enrollment.
* Smoking history of at least 10 pack years.
* Non-smoking for a minimum of 6 months prior to consent and agrees to continue not smoking for the duration of the study.
* Subject is able to adhere to and undergo 3 (4 if in Phase A) bronchoscope procedures that includes lung biopsies and multiple MCS treatments in the opinion of the investigator

Exclusion Criteria:

* Subject has had an acute pulmonary infection or pneumonia within prior 6 weeks of study bronchoscopy.
* Subject has had a CB and/or COPD exacerbation (requiring steroids and/or antibiotics) within 6 weeks prior to study bronchoscopy, as defined by their treating physician
* Subject has clinically significant bronchiectasis or other respiratory disease other than chronic bronchitis and COPD.
* Diagnosis of asthma with an onset before 30 years of age
* Subject has bullous emphysema characterized as large bullae \>30 millimeters on CT.
* Subject has had a transplant.
* Subject has the inability to walk \>140 meters
* Subject has PaC02 \>8kPa, or a PaO2\<7kPa at room air.
* Subject has a RVSP \>45mmHg or a LVEF\<45% on 2D-cardiac echo.
* Subject has undergone lung surgery: pneumonectomy, lobectomy, bullectomy, lung volume reduction surgery
* Subject has had a prior lung device procedure, including emphysema stent(s) implanted, lung coils, valves, lung denervation or other devices for emphysema.
* Subject is unable to temporarily discontinue use of anticoagulant therapy:

warfarin, Coumadin, LMWH, heparin, clopidogrel (or equal)

* Subject is on \>10 mg of prednisolone/day.
* Subject has a serious medical condition, such as: uncontrolled congestive heart failure, uncontrolled angina, myocardial infarction in the past year, renal failure, liver disease, cerebrovascular accident within the past 6 months, uncontrolled diabetes, hypertension, autoimmune disease or uncontrolled gastric reflux
* Subject is pregnant, nursing, or planning to get pregnant during study duration.
* Subject has received chemotherapy within the past 6 months or is expected to receive chemotherapy during participation in this study.
* Subject is or has been in another clinical investigational study within 6 weeks of baseline.
* Subject has known sensitivity to medication required to perform bronchoscopy (such as lidocaine, atropine, and benzodiazepines).
* Subject has been in another clinical investigational study within 6 weeks of baseline.

Primary outcomes:
measure: Adverse and Serious Adverse Events
timeFrame: Change from Baseline to 3-Months Following Completion of Treatments
measure: Ability to Complete all 3 MCS Treatments
timeFrame: Change from Baseline to 3-Months Following Completion of Treatments
measure: Patient Reported Outcome Instrument: St. George's Respiratory Questionnaire (SGRQ)
timeFrame: Change from Baseline to 3-Months Following Completion of Treatments
Secondary outcomes:
measure: Spirometry Testing
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: 6 Minute Walk Test
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: Leicester Cough Questionnaire (LCQ)
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: COPD Assessment Test (CAT)
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: Visual Analog Scale (VAS)
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: Modified Medical Research Council (mMRC)
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
Other outcomes:
measure: Exacerbation Rate
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: Airway Wall Thickness Using HRCT
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
measure: Plasma Fibrinogen
timeFrame: Change from Baseline to 3-Months, 1 year, 2 year and 3 year Following Completion of Treatments
Locations:
city: Vancouver
country: Canada
facility: St. Paul's Hospital
state: British Columbia
city: Groningen
country: Netherlands
facility: University Medical Center Groningen
city: London
country: United Kingdom
facility: Chelsea and Westminster Hosptial/Royal Brompton Hosptial
Study officials:
affiliation: CSA Medical
name: Heather Nigro
role: STUDY_DIRECTOR
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