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Phase 4 N=347 Randomized Double-blind Treatment

Effect of Nintedanib on Biomarkers of Extracellular Matrix Turnover in Patients With Idiopathic Pulmonary Fibrosis and Limited Forced Vital Capacity Impairment

Idiopathic Pulmonary Fibrosis

Enrolled (actual)
347
Serious AEs
13.4%
Results posted
Aug 2019
Primary outcome: Primary: The Rate of Change (Slope) in Blood C-reactive Protein Degraded by Matrix Metalloproteinase-1/8 (CRPM) From Baseline to Week 12. — -0.00190; -0.00257 nanogram/ millitre/ month (ng/ mL/ mth) — p=0.8146

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
nintedanib (Drug); placebo (Drug)
Age
Adult, Older Adult · 40+ yrs
Sex
All
Sponsor
Boehringer Ingelheim
Primary completion
Aug 2017

Outcome Measures

OutcomeResultp-value
PRIMARY
The Rate of Change (Slope) in Blood C-reactive Protein Degraded by Matrix Metalloproteinase-1/8 (CRPM) From Baseline to Week 12.
-0.00190; -0.00257 0.8146
SECONDARY
Percentage of Patients With Disease Progression as Defined by Absolute Forced Vital Capacity (FVC) Decline >=10% or Death Until Week 52
30.43; 25.00 0.2084
SECONDARY
The Rate of Change in Blood Collagen 1 Degraded by Matrix Metalloproteinase-2/9/13 (C1M) From Baseline to Week 12
0.00041; 0.00162 0.5469
SECONDARY
The Rate of Change in Blood Collagen 3 Degraded by Matrix Metalloproteinase-9 (C3M) From Baseline to Week 12
-0.00091; -0.00398 0.2429

Summary

Identifying biomarkers to predict the clinical course and benefits of therapy early in the course of the disease remains one of the most urgent and relevant challenges to improve overall patient management, to prevent treatment delay or overtreatment. This study is conducted to examine the effect of nintedanib treatment on change in biomarkers indicative of extracellular matrix turnover which have been shown recently to correlate with disease progression. This study further aims to confirm the association of biomarker course during the first three months of treatment and disease progression.

Eligibility Criteria

Inclusion criteria

  • Written informed consent consistent with International Conference on Harmonisation Good Clinical Practice and local laws, signed prior to participation in the trial including any study related procedures being performed;
  • Male or female patients aged >=40 years at Visit 1;
  • A clinical diagnosis of Idiopathic pulmonary fibrosis (IPF) within the last 3 years from visit 0, based upon the American Thoracic Society/ European Respiratory Society /Japanese Respiratory Society/ Latin American Thoracic Association 2011 guideline;
  • Chest high resolution computed tomography (HRCT) scan performed within 18 months of Visit 0;
  • Combination of HRCT pattern, and surgical lung biopsy pattern (the latter if available) as assessed by central review are consistent with the diagnosis of Idiopathic pulmonary fibrosis;
  • Forced vital capacity (FVC) >=80% of predicted normal at Visit 1.

Exclusion criteria

  • Alanine transaminase, Aspartate aminotransferase > 1.5 fold upper limit of normal (ULN) at Visit 1;
  • Total bilirubin > 1.5 fold ULN at Visit 1;
  • Patients with underlying chronic liver disease (Child Pugh A, B or C hepatic impairment);
  • Relevant airways obstruction, i.e. pre-bronchodilator Forced expiratory volume in 1 second / Forced vital capacity 2 at Visit 1;
  • Prothrombin time (PT) and partial thromboplastin time (PTT) > 150% of ULN at Visit 1;
  • Planned major surgery during the trial participation, including lung transplantation, major abdominal or major intestinal surgery;
  • History of thrombotic event (including stroke and transient ischemic attack) within 12 months of Visit 1;
  • Creatinine clearance 15 mg daily or >30 mg every 2 days OR use of other systemic corticosteroids as well as any investigational drugs within 4 weeks of Visit 2;
  • Known hypersensitivity to nintedanib, peanut, soya or to any other components of the study medication;
  • Prior discontinuation of nintedanib treatment due to intolerability/ adverse events considered drug related;
  • A disease or condition which in the opinion of the investigator may interfere with testing procedures or put the patient at risk when participating in this trial;
  • Alcohol or drug abuse which in the opinion of the treating physician would interfere with the treatment and would affect patient's ability to participate in this trial;
  • Patients not able to understand and follow any study procedures such as but not limited to home spirometry, including completion of self-administered questionnaires without help;
  • Women who are pregnant, nursing, who plan to become pregnant while in the trial or female patients with positive pregnancy (ß-HCG) test at Visit 1 and/or Visit 2;
  • Women of childbearing potential4 not willing or able to use highly effective methods of birth control per International Conference on Harmonisation (ICH) M3 (R2) that result in a low failure rate of less than 1% per year when used consistently and correctly.
  • Patients with acute IPF exacerbation or any respiratory tract infection in the four weeks prior to Visit 1 or during the screening period;
  • Patients who are or have been participating in another trial with investigational drug/s within one month prior to Visit 1 and patients who have previously been enrolled in this trial;
  • Further exclusion criteria apply.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02788474). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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