Effect of Azithromycin on Lung Function in 6-18 Year-olds With Cystic Fibrosis (CF) Not Infected With P. Aeruginosa

CF Therapeutics Development Network Coordinating Center

Status and phase

Completed

Phase 4

Conditions

Cystic Fibrosis

Treatments

Drug: azithromycin 250 mg tablets

Drug: placebo tablets

Study type

Interventional

Funder types

Other

NETWORK

Identifiers

NCT00431964

AZ0004

Details and patient eligibility

About

This is a study to examine the safety, effect on lung function, and frequency of symptoms relating to cystic fibrosis during 24 weeks of treatment with the antibiotic azithromycin in 6-18 year-olds with CF who are not infected with Pseudomonas aeruginosa.

Full description

Azithromycin is an antibiotic that has been shown to improve lung function in patients with cystic fibrosis (CF) whose lungs are infected with a bacterium called Pseudomonas aeruginosa. Scientists are not sure how azithromycin works in cystic fibrosis. It does not appear to work by killing the bacteria Pseudomonas aeruginosa, but it may make these bacteria and other bacteria less damaging to the lungs by reducing their ability to attach to the lining of the lung, or by reducing the bacteria's ability to make substances that damage the lungs of patients with cystic fibrosis. Azithromycin may also work directly on the cells in the lungs to improve lung function. This could occur by reducing inflammation (swelling) in the lungs, and/or making the mucus less sticky, or by affecting the salt channel that doesn't function correctly in CF. If azithromycin works in one or more of these ways; it may also be effective in improving lung function in cystic fibrosis patients who are not infected with Pseudomonas aeruginosa.

We are conducting this research study to examine the safety, effect on lung function and frequency of symptoms relating to cystic fibrosis during 24 weeks of treatment with the antibiotic azithromycin. This study is designed to determine if patients with cystic fibrosis whose lungs are not infected with the bacteria Pseudomonas aeruginosa will benefit from 24 weeks of treatment with the antibiotic azithromycin. Benefit will be determined as having better pulmonary function tests and getting sick less often compared to a placebo (sugar pill). This study is also designed to determine if azithromycin is safe when administered for 24 weeks to cystic fibrosis patients not infected with Pseudomonas aeruginosa. By doing this study, we hope to learn more about CF and improve the way in which we treat it.

Comparison: Three times weekly azithromycin tablets added to standard care, compared to three times weekly placebo tablets added to standard care.

Enrollment

263 patients

Sex

All

Ages

6 to 18 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Male or female, 6-18 years of age at enrollment
Confirmed diagnosis of CF
Written informed consent (and assent when applicable)
Clinically stable at enrollment as assessed by the site investigator
FEV1 % predicted > 50%
Ability to comply with medication use, study visits, and study procedures
Ability to swallow a 250 mg tablet

Exclusion criteria

Weight less than 18.0 kg
Respiratory culture positive for P. aeruginosa, NTM, or B. cepacia complex within 1 year or at screening, or AFB positive at screening
Allergy to macrolide antibiotics
Use of macrolide antibiotics (e.g., azithromycin, clarithromycin) within 60 days of screening
Use of systemic corticosteroids or intravenous or oral antibiotics within 14 days of screening
Initiation of high dose ibuprofen, Pulmozyme®, hypertonic saline or aerosolized antibiotics within 30 days of screening
Chronic therapy with drugs known to have rare but serious interactions with azithromycin: amiodarone, digoxin, disopyramide, lovastatin, pimozide, rifabutin, and nelfinavir
Investigational drug use within 30 days of screening
Laboratory abnormalities (creatinine, liver function or neutropenia) at screening and confirmed at follow-up testing prior to randomization
History of biliary cirrhosis, portal hypertension, or splenomegaly, or splenomegaly on physical exam
History of ventricular arrhythmia
Other major organ dysfunction, excluding pancreatic dysfunction
History of lung transplantation or currently on lung transplant list
Relative decrease in FEV1 % predicted ≥ 20% between the screening and enrollment visit
Positive serum pregnancy test at screening
Pregnant, breastfeeding, or if post-menarche female, unwilling to practice birth control during participation in the study
History of alcohol, illicit drug or medication abuse within 1 year of screening in the judgment of the site investigator
Presence of a condition or abnormality that in the opinion of the site investigator would compromise the safety of the subject or the quality of the data