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Phase 3 N=99 Randomized Quadruple-blind Other

Validation of Patient Reported Outcome Measures in Participants With Nontuberculous Mycobacterial Lung Infection Caused by Mycobacterium Avium Complex

Mycobacterium Infections, Nontuberculous

Enrolled (actual)
99
Serious AEs
10.1%
Results posted
Jun 2024
Primary outcome: Primary: Psychometric Cross-Sectional Validation of Patient Reported Outcome (PRO): Patient Global Impression of Severity (PGI-S) Respiratory Scale Score at Baseline — 2.5; 2.4 score on scale

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
ALIS (Drug); Azithromycin (Drug); Ethambutol (Drug); ELC (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Insmed Incorporated
Primary completion
May 2023

Outcome Measures

OutcomeResultp-value
PRIMARY
Psychometric Cross-Sectional Validation of Patient Reported Outcome (PRO): Patient Global Impression of Severity (PGI-S) Respiratory Scale Score at Baseline
2.5; 2.4
PRIMARY
Psychometric Cross-Sectional Validation of PRO: PGI-S Fatigue Scale Score at Baseline
2.5; 2.5
PRIMARY
Psychometric Cross-Sectional Validation of PRO: Quality of Life Questionnaire - Bronchiectasis (QoL-B) Respiratory Symptoms Scale Score at Baseline
63.04; 66.90
PRIMARY
Psychometric Cross-Sectional Validation of PRO: Patient-Reported Outcome Measurement Information System - Fatigue-Short Form 7a (PROMIS F-SF 7a) Score at Baseline
18.3; 18.6
PRIMARY
Assessment of Test-Retest Reliability (TRTR) Reported as the Intraclass Co-relation (ICC) Estimate Among Participants Reporting no Change on Respiratory PGI-S Score Applied to QOL-B Respiratory Domain Score Between Screening and Baseline
0.69
PRIMARY
Assessment of TRTR Reported as the ICC Estimate Among Participants Reporting no Change on Fatigue PGI-S Score Applied to PROMIS F-SF 7a Score Between Screening and Baseline
0.76
PRIMARY
Response Rate as Assessed by Within-Subject Meaningful Change (WSMC) for QOL-B Respiratory Symptoms Final Score Estimated Via Anchor-Based Methods and Validated Via Empirical Cumulative Distribution Functions (eCDFs)
43.8; 33.3 0.2819
PRIMARY
Response Rate as Assessed by WSMC for PROMIS Fatigue Final Score Estimated Via Anchor-Based Methods and Validated Via eCDFs
35.5; 29.4 0.5080
SECONDARY
Percentage of Participants Achieving Culture Conversion by Month 6
80.6; 63.9 0.0712
SECONDARY
Change From Baseline in QOL-B Respiratory Symptom Score at Month 7
12.24; 7.76 0.1073
SECONDARY
Change From Baseline in PROMIS F-SF 7a Score at Month 7
-2.1; -1.6 0.6130
SECONDARY
Time to First Culture Conversion
1.0; 2.0 0.3542
SECONDARY
Time to First Negative Culture
1.0; 1.0 0.1583
SECONDARY
Percentage of Participants Who Develop a MAC Isolate With Amikacin Minimum Inhibitory Concentration (MIC) ≥ 128 Micrograms Per Millliliter (µg/mL) at More Than 1 Visit
0; 0
SECONDARY
Recurrence of MAC (Relapse) Assessed as Percentage of Participants Who Achieved Culture Conversion With a Subsequent at Least One MAC Positive Culture in Agar Media or Broth Media in at Least 2 Consecutive Visits
5.1; 22.5
SECONDARY
Recurrence of MAC (New Infection) Assessed as Percentage of Participants Who Achieved Culture Conversion With a Subsequent at Least One MAC Positive Culture in Agar Media or Broth Media in at Least 2 Consecutive Visits
5.1; 25.0
SECONDARY
Number of Participants Who Experience Any Treatment-emergent Adverse Event (TEAE)
44; 41

Summary

The primary objective of this study is to generate evidence demonstrating the domain specification (via modern psychometric methods), reliability, validity, and responsiveness (within-subject meaningful change) of the Patient-Reported Outcome (PRO) endpoints.

Eligibility Criteria

Inclusion Criteria

  • Male or female, ≥ 18 years of age (19 years or older in South Korea)
  • Current diagnosis of Mycobacterium avium Complex (MAC) lung infection
  • Positive sputum culture for MAC within 6 months prior to screening
  • A chest computed tomography (CT) scan, read locally, within 6 months prior to Screening to determine presence and size of pulmonary cavities. Participants who do not have a chest CT scan within 6 months prior to Screening will be required to obtain a chest CT scan, read locally, during Screening
  • Willingness and ability to adhere to prescribed study treatment during the study
  • Ability to produce (spontaneously or with induction) approximately 2 mL of sputum for mycobacteriology at Screening
  • Women of child-bearing potential (WOCBP) (ie, fertile following menarche and until becoming post-menopausal unless permanently sterile) and fertile men (ie, all men after puberty unless permanently sterile by bilateral orchidectomy) agree to practice a highly effective method of birth control from Day 1 to at least 90 days after the last dose. Examples of such birth controls are:
  • true abstinence (refraining from heterosexual intercourse during the entire study),
  • copper intrauterine device (IUD),
  • hormonal methods (levonorgestrel-releasing intrauterine system, progestogen implant, combined oral contraceptive pill [combined with barrier method]),
  • exclusive homosexual relationship, or
  • sole male partner who has undergone surgical sterilization with confirmation of azoospermia at least 3 months post procedure while participating in the study
  • Provide signed informed consent prior to administration of study drugs or performing any study related procedure
  • Be able to comply with study drugs use, study visits, and study procedures as defined by the protocol
  • Men with partners who are WOCBP (pregnant or non-pregnant) agree to use condoms and non-pregnant partners should practice a highly effective method of birth control

Exclusion Criteria

  • Diagnosis of cystic fibrosis (CF)
  • History of more than 3 MAC lung infections
  • Received any mycobacterial antibiotic treatment for current MAC lung infection
  • Refractory MAC lung infection, defined as having positive MAC cultures while being treated with a multidrug mycobacterial antibiotic treatment regimen for a minimum of 6 consecutive months and no documented successful treatment, defined as negative sputum culture for MAC and cessation of treatment
  • Relapse of prior MAC lung infection, defined as positive sputum culture for MAC ≤ 6 months of cessation of prior successful treatment
  • Evidence of any pulmonary cavity ≥ 2 cm in diameter, as determined by chest CT scan, read locally, within 6 months prior to Screening
  • Radiographic finding of new lobar consolidation, atelectasis, significant pleural effusion, or pneumothorax during routine clinical care within 2 months prior to Screening
  • Active pulmonary malignancy (primary or metastatic) or any malignancy requiring chemotherapy or radiation therapy within 1 year prior to Screening or anticipated during the study
  • Acute pulmonary exacerbation (eg, chronic obstructive pulmonary disease [COPD] or bronchiectasis) requiring treatment with antibiotics, or corticosteroids (intravenous [IV] or oral), within 4 weeks prior to and during Screening
  • Current smoker
  • History of lung transplantation
  • Prior exposure to amikacin liposome inhalation suspension (ALIS) (including clinical study)
  • Known hypersensitivity or contraindications to use to ALIS, aminoglycosides, or any of their excipients
  • Disseminated MAC infection
  • Positive pregnancy test or lactation at Screening. All WOCBP will be tested. Women not of childbearing potential are defined as postmenopausal (ie, amenorrheic for 12 months without an alternative medical cause or confirmed by more than one follicle stimulating hormone [FSH] measurement), or naturally or surgically sterile through bilateral oophorectomy, hysterectomy, or bilateral salpingectom
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT04677543). 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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