Extension Trial on Efficacy / Safety of L-CsA + SoC in Treating BOS in Post Single or Double Lung Transplant (BOSTON-3)

NCT ID: NCT04039347

Last Updated: 2025-01-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

262 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-12

Study Completion Date

2025-12-31

Brief Summary

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The objective of the trial is to assess the long-term safety and efficacy of L-CsA plus Standard of Care (SoC) in the treatment of BOS in single (SLT) and double lung transplant (DLT) recipients.

Detailed Description

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This is a Phase III, multicenter, open-label, extension clinical trial of L-CsA for the treatment of BOS.

Enrollment will be limited to patients who have completed 48 weeks participation in either the BT-L-CsA-301-SLT (BOSTON-1) or BT-L-CsA-302-DLT (BOSTON-2) trial. All patients in this clinical trial will receive L-CsA in addition to SoC, regardless of the randomization arm in prior trials.

IMP will be administered by BID inhalation (morning/evening) using the L-CsA eFlow. Patients who did not receive L-CsA in BOSTON-1 or BOSTON-2 must remain in the clinic for at least 4 hours for observation after the first inhalation. At all subsequent visits, one dose administered via inhalation will be monitored by the clinical trial center personnel. In case patients receiving L-CsA undergo the last visit for BOSTON-1 or BOSTON-2 (Visit 9) on the same day as for Visit 1 for BOSTON-3, they will take the first dose for Boston 3 in the evening of this day. This first dose will not be supervised by the site staff. Nebulization time per inhalation dose is approximately 6-10 minutes for the 5 mg dose and 9-13 minutes for the 10 mg dose. Inhalations will be performed BID approximately 12 hours apart through a mouthpiece by slow and deep respiration using the L-CsA eFlow. A high efficiency particulate air filter is used to prevent environmental contamination during exhalation.

Conditions

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Bronchiolitis Obliterans Obliterative Bronchiolitis Bronchiolitis Obliterans Syndrome

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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L-CsA 5 mg plus Standard of Care

L-CsA 5 mg twice daily plus Standard of Care for up to 144 weeks for patients post Single Lung Transplant

Group Type EXPERIMENTAL

Liposomal Cyclosporine A 5 mg

Intervention Type DRUG

delivered via the PARI eFlow® device, which is a new technology of nebulizing liquid drugs with a perforated vibrating membrane resulting in an aerosol with a low ballistic momentum and a high percentage of droplets in a respirable size range of 3-5 μm

L-CsA 10 mg plus Standard of Care

L-CsA 10 mg twice daily plus Standard of Care for up to 144 weeks for patients post Double Lung Transplant

Group Type EXPERIMENTAL

Liposomal Cyclosporine A 10 mg

Intervention Type DRUG

delivered via the PARI eFlow® device, which is a new technology of nebulizing liquid drugs with a perforated vibrating membrane resulting in an aerosol with a low ballistic momentum and a high percentage of droplets in a respirable size range of 3-5 μm

Interventions

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Liposomal Cyclosporine A 5 mg

delivered via the PARI eFlow® device, which is a new technology of nebulizing liquid drugs with a perforated vibrating membrane resulting in an aerosol with a low ballistic momentum and a high percentage of droplets in a respirable size range of 3-5 μm

Intervention Type DRUG

Liposomal Cyclosporine A 10 mg

delivered via the PARI eFlow® device, which is a new technology of nebulizing liquid drugs with a perforated vibrating membrane resulting in an aerosol with a low ballistic momentum and a high percentage of droplets in a respirable size range of 3-5 μm

Intervention Type DRUG

Other Intervention Names

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L-CsA L-CsA

Eligibility Criteria

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Inclusion Criteria

1. Patients who have completed all visits through the End of Treatment Visit in either BOSTON-1 or BOSTON-2, did not withdraw informed consent, and did not prematurely terminate study drug administration.
2. Patients should be on a three-drug maintenance regimen of immunosuppressive agents including tacrolimus or another CNI, a second agent such as but not limited to MMF or azathioprine, and a systemic corticosteroid such as prednisone.
3. Patients capable of understanding the purposes and risks of the clinical trial, who have given written informed consent and agree to comply with the clinical trial requirements/visit schedules, and who are capable of aerosol inhalation.
4. Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to Visit 1 and must agree to use one of the methods of contraception listed in Appendix II through their End of Study Visit.

Exclusion Criteria

1. Known hypersensitivity to L-CsA or to cyclosporine A.
2. Patients who experienced an AE related to study drug that led to permanent study drug discontinuation in BOSTON-1 or BOSTON-2.
3. Patients with new onset of malignancy while participating in BOSTON-1 or BOSTON-2, including post-transplant lymphoproliferative disorder, with the exception of treated, localized basal and squamous cell carcinomas.
4. Pregnant women or women who are unwilling to use appropriate birth control to avoid pregnancy through their End of Study Visit.
5. Women who are currently breastfeeding.
6. Receipt of an investigational drug, other than L-CsA, as part of a clinical trial within 4 weeks prior to Visit 1. This is defined as any treatment that is implemented under an Investigational New Drug (IND) or compassionate use.
7. Patients who are currently participating in an interventional clinical trial, other than BOSTON-1 or BOSTON-2.
8. Psychiatric disorders or altered mental status precluding understanding of the informed consent process and/or completion of the necessary procedures.
9. Any co-existing medical condition that in the Investigator's judgment will substantially increase the risk associated with the patient's participation in the clinical trial.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zambon SpA

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Paola R Castellani, MD

Role: STUDY_DIRECTOR

Zambon SpA, Chief Medical Officer

Locations

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Banner - University Medical Center

Phoenix, Arizona, United States

Site Status

David Geffen School of Medicine at UCLA

Los Angeles, California, United States

Site Status

UCSF

San Francisco, California, United States

Site Status

UCSF Center for Advanced Lung Disease

Stanford, California, United States

Site Status

University of Florida Dept of Pulmonary Medicine

Gainesville, Florida, United States

Site Status

Indiana University

Indianapolis, Indiana, United States

Site Status

UK Albert B. Chandler Hospital

Lexington, Kentucky, United States

Site Status

University of Maryland

Baltimore, Maryland, United States

Site Status

Johns Hopkins University Hospital

Baltimore, Maryland, United States

Site Status

Barnes-Jewish Hospital

St Louis, Missouri, United States

Site Status

Columbia University Medical Center

New York, New York, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

OSU Wexner Medical Center

Columbus, Ohio, United States

Site Status

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

Baylor University Medical Center

Dallas, Texas, United States

Site Status

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Houston Methodist Hospital

Houston, Texas, United States

Site Status

Waehringer Guertel

Vienna, , Austria

Site Status

Hôpital Erasme

Brussels, , Belgium

Site Status

Universitair Ziekenhuis Leuven

Leuven, , Belgium

Site Status

Copenhagen University Hospital

Copenhagen, , Denmark

Site Status

Hopital Marie Lannelongue

Le Plessis-Robinson, , France

Site Status

CHU Hopital Nord

Marseille, , France

Site Status

Hopitaux Universitaires de Strasbourg

Strasbourg, , France

Site Status

Hannover Medical School

Hanover, , Germany

Site Status

LMU Klinikum Groshadern

Munich, , Germany

Site Status

Rabin Medical Center

Petah Tikva, , Israel

Site Status

Complexo Hospitalario de A Coruna

A Coruña, , Spain

Site Status

Hospital Universitari Vall d'Hebron

Barcelona, , Spain

Site Status

Hospital Universitario Puerta de Hierro - Unidad de Trasplante Pulmonar

Madrid, , Spain

Site Status

Hospital Marques de Valdecilla

Santander, , Spain

Site Status

Unidad de Trasplante Pulmonar del Hospital La Fe

Valencia, , Spain

Site Status

Royal Papworth Hospital NHS Foundation Trust

Cambridge, , United Kingdom

Site Status

University of Manchester

Manchester, , United Kingdom

Site Status

Countries

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United States Austria Belgium Denmark France Germany Israel Spain United Kingdom

Other Identifiers

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2019-002987-29

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

BT - L-CsA - 303 - FU

Identifier Type: -

Identifier Source: org_study_id

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