A study to evaluate the safety, tolerability, and efficacy of galicaftor/navocaftor/ABBV-119 combination therapy in subjects with cystic fibrosis

ISRCTN ISRCTN48897533
DOI https://doi.org/10.1186/ISRCTN48897533
ClinicalTrials.gov (NCT) NCT04853368
Clinical Trials Information System (CTIS) 2020-005805-25
Integrated Research Application System (IRAS) 1004477
Protocol serial number M19-771, IRAS 1004477, CPMS 51119
Sponsor AbbVie (United Kingdom)
Funder AbbVie
Submission date
28/01/2022
Registration date
07/03/2022
Last edited
05/01/2024
Recruitment status
Stopped
Overall study status
Stopped
Condition category
Nutritional, Metabolic, Endocrine
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Cystic Fibrosis (CF) is a rare, life-threatening, genetic disease that affects the lungs and digestive system, significantly impairing the quality of life, with those affected having a median age of death at 40. The main objective of this study is to assess how safe and effective is the combination therapy of galicaftor/navocaftor/ABBV-119 in adult participants with CF

Who can participate?
Patients with CF, and the F508del CFTR mutation (the most common CF gene mutation)

What does the study involve?
Galicaftor/navocaftor/ABBV-119 combination therapy is being developed as an investigational drug for the treatment of CF. Study doctors place participants in 1 of the 4 groups, called treatment arms. Each group receives a different treatment. Around 90 adult participants with a diagnosis of CF will be enrolled in the study around approximately 35 sites worldwide.
Participants in arm 1 will receive oral capsules of galicaftor/navocaftor dual combination for 28 days followed by galicaftor/navocaftor/ABBV-119 triple combination for 28 days. Participants in arms 2 and 3 will receive the galicaftor/navocaftor/ABBV-119 triple combination or placebo for 28 days. Participants in arm 4 will receive galicaftor/navocaftor/ABBV-119 triple combination therapy for 28 days. For all study arms, galicaftor, navocaftor, will be given once daily and ABBV-119 twice a day.

What are the possible benefits and risks of participating?
Benefits:
Not provided at time of registration
Risks:
ABBV-119 A small number of healthy volunteers who received ABBV-119 for up to 14 days had elevated blood levels of liver enzymes (ALT and AST), a possible sign of injury to the liver. The volunteers did not have any complaints along with these abnormal blood tests. The tests returned to normal or near normal levels within the next 2 weeks. There could be a risk of side effects related to sunlight exposure or ultraviolet (UV) light exposure. It is not known whether exposure to sunlight might lead to skin irritation or cause one to break out in a rash or sunburn. If possible, patients should avoid direct exposure to the sun for long periods of time while participating in this clinical study. Protective clothing and sunglasses as well as sunscreen (SPF 30 or higher) should be used if exposed to sunlight. In addition, patients should not expose themselves to sun lamps, tanning booths, or tanning beds.
Most common side effects of the combination of galicaftor and navocaftor: Headache/Fatigue/Back pain/Constipation/Dry lips/Decreased urination/Nausea/Rash
Risks related to Study Procedures:
Blood Testing: may cause pain, bleeding, and/or bruising
Sweat collection: may cause tingling of the skin. The sticky pads may result in “irritation” of the skin. There is a remote possibility of a burn due to the test.
Lung Function Testing: may feel the need to cough, or feel a bit short of breath and lightheaded
5-day washout may lead to withdrawal symptoms

Where is the study run from?
St James's University Hospital (UK)

When is the study starting and how long is it expected to run for?
January 2022 to December 2022

Who is funding the study?
AbbVie Ltd (UK)

Who is the main contact?
Dr Daniel Peckham, daniel.peckham@nhs.net

Contact information

Dr Daniel Peckham
Principal investigator

St James's University Hospital
Beckett St
Leeds
LS9 7TF
United Kingdom

Phone +44 113 206 7170
Email Daniel.Peckham@nhs.net

Study information

Primary study designInterventional
Study designInterventional double blind randomized parallel group placebo controlled trial
Secondary study designRandomised controlled trial
Scientific titleA phase 2 study of galicaftor/navocaftor/ABBV-119 combination therapy in subjects with cystic fibrosis who are homozygous or heterozygous for the F508del mutation
Study objectivesThe primary objective is to evaluate the safety, tolerability, and efficacy for galicaftor/navocaftor/ABBV-119 combination therapy in adult subjects with CF who are homozygous or heterozygous for the F508del mutation.
Ethics approval(s)Approval pending, HRA Fast Track REC, ref: 22/FT/0001
Health condition(s) or problem(s) studiedCystic Fibrosis
InterventionStudy doctors place participants in 1 of the 4 groups, called treatment arms. Each group receives a different treatment. Around 90 adult participants with a diagnosis of CF will be enrolled in the study at approximately 35 sites worldwide.
Participants in arm 1 will receive oral capsules of galicaftor/navocaftor dual combination for 28 days followed by galicaftor/navocaftor/ABBV-119 triple combination for 28 days.
Participants in arms 2 and 3 will receive the galicaftor/navocaftor/ABBV-119 triple combination or placebo for 28 days.
Participants in arm 4 will receive galicaftor/navocaftor/ABBV-119 triple combination therapy for 28 days.
For all study arms, galicaftor, navocaftor, will be given once daily and ABBV-119 twice a day.
Intervention typeDrug
PhasePhase II
Drug / device / biological / vaccine name(s)galicaftor, navocaftor, ABBV-119
Primary outcome measure(s)

The primary endpoint is the absolute change from Baseline through Day 29 in percent predicted forced expiratory volume in 1 second (ppFEV1) measured using spirometry

Key secondary outcome measure(s)

Measured using spirometry unless noted otherwise:
1. Absolute change from Baseline through Day 29 in Sweat Chloride (SwCl) measured using sweat samples
2. Absolute change from Baseline through Day 29 in forced vital capacity [FVC]
3. Absolute change from Baseline through Day 29 in forced expiratory flow at mid-lung capacity [FEF25-75]
4. Relative changes from Baseline through Day 29 in ppFEV1
5. Relative changes from Baseline through Day 29 in FVC
6. Relative changes from Baseline through Day 29 in FEF25-75
7. Absolute change in CF Questionnaire-Revised (CFQ-R) respiratory domain score from Baseline through Day 29

Completion date16/12/2022
Reason abandoned (if study stopped)Objectives no longer viable

Eligibility

Participant type(s)Patient
Age groupAdult
SexAll
Target sample size at registration90
Key inclusion criteria1. Confirmed clinical diagnosis of CF, and genotype homozygous for the F508del CFTR mutation for Cohort 1 and Cohort 3, heterozygous for F508del CFTR mutation and a minimal function mutation for Cohort 2 and Cohort 3.
2. ppFEV1 ≥40% and ≤90% of predicted normal for age, gender, and height (Global Lung Function Initiative [GLI] equations) at Screening.
3. No clinically significant laboratory values at Screening that would pose undue risk for the subject or interfere with safety assessments (per the investigator).
4. Absence of clinically significant abnormality detected on ECG regarding rate, rhythm, or conduction (e.g., QT interval corrected for heart rate using Fridericia's formula [QTcF] should be < 450 msec for males and <460 msec for females).
5. Stable pulmonary status, i.e., no respiratory infections or exacerbations requiring a change in therapy (including antimicrobials) or causing an acute decline in ppFEV1 of >10% from usual ppFEV1 level within 4 weeks.
6. SwCl at screening visit must be ≥60 mmol/L for Cohort 1 and Cohort 2, and this criterion does not apply to Cohort 3.
7. No history of diseases aggravated or triggered by ultraviolet radiation and no history of abnormal reaction photosensitivity or photoallergy to sunlight, or artificial source of intense light, especially ultraviolet light.
Key exclusion criteria1. Cirrhosis with or without portal hypertension (e.g., splenomegaly, esophageal varices) or history of clinically significant liver disease
2. History of malignancy within past 5 years (except for excised basal cell carcinoma of the skin with no recurrence, or treated carcinoma in situ of the cervix with no recurrence)
3. Recent (within the past 6 months) history of drug or alcohol abuse that might preclude adherence to the protocol, in the opinion of the investigator
4. Smoking or vaping tobacco or cannabis products within 6 months before Screening
5. History of solid organ or hematopoietic transplantation
6. History of known sensitivity to any component of the study drug
7. Need for supplemental oxygen while awake, or >2 L/minute while sleeping.
8. Evidence of active SARS-CoV-2 infection. If a subject has signs/symptoms suggestive of SARS CoV-2 infection, they should undergo molecular (e.g., polymerase chain reaction [PCR]) testing to rule out SARS-CoV-2 infection.
Date of first enrolment28/07/2021
Date of final enrolment16/12/2022

Locations

Countries of recruitment

  • United Kingdom
  • England
  • Scotland
  • Belgium
  • Canada
  • France
  • Hungary
  • Netherlands
  • Puerto Rico
  • Serbia
  • Slovakia
  • Spain

Study participating centres

The Adult Cystic Fibrosis Centre
Royal Papworth Hospital NHS FT
Papworth Road
Cambridge
CB2 0AY
United Kingdom
Queen Elizabeth University Hospital
1345 Govan Road
Glasgow
G51 4TF
United Kingdom
All Wales Adult Cystic Fibrosis Centre
Cardiff and Vale University Health Board
Penlan Road
Cardiff
CF64 2XX
United Kingdom
King's College Hospital
Denmark Hill
London
SE5 9RS
United Kingdom
Royal Brompton Hospital
Sydney Street
London
SW3 6NP
United Kingdom
Manchester Adult Cystic Fibrosis Centre
Wythenshawe Hospital
Southmoor Road
Wythenshawe
Manchester
M23 9LT
United Kingdom
Southampton General Hospital
Tremona Road
Southampton
SO16 6YD
United Kingdom

Results and Publications

Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
IPD sharing planThe datasets generated during and/or analysed during the current study are not expected to be made available.

Editorial Notes

05/01/2024: The results from Cohorts 1 and 2 of trial M19-771 showed that the compound combination of triple therapy was not effective, and the HRA would not approve a protocol amendment to change one of the compounds for cohort 3 as the study wasn’t designed as a complex protocol. Therefore, the study was withdrawn during (cohort 3) set up and there was no recruitment.
29/04/2022: Contact details.
01/04/2022: added CPMS number to Protocol /serial number field.
05/03/2022: ISRCTN received notification of combined HRA/MHRA approval for this trial on 05/03/2022
28/01/2022: Trial's existence confirmed by NHS HRA.