Study to Evaluate ARINA-1 in the Prevention of Bronchiolitis Obliterans Progression in Participants With Bilateral Lung Transplant

NCT ID: NCT05654922

Last Updated: 2025-12-09

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-10

Study Completion Date

2026-11-30

Brief Summary

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The goal of this Phase 3 clinical trial is to compare ARINA-1 (a nebulized immunomodulatory agent) plus Standard of Care vs Standard of Care alone. The main question it aims to answer are:

* Evaluate the effectiveness of ARINA-1 in preventing bronchiolitis obliterans syndrome (BOS) progression in participants with a bilateral lung transplant
* To evaluate the effectiveness of ARINA-1 on improving quality of life decline and preventing or delaying the use of augmented immunosuppression in participants with pre-BOS relative to SOC.

Participants will have clinic visits at screening, randomization (day 1) and weeks 4, 12, 18, and 24. After week 24, participants will have clinic visits at weeks 32, 40, and 48.

Participants will also have a telehealth visit on day 2 and phone calls to assess adverse events (AEs), serious adverse events (SAEs), and review patient education will occur during weeks 5, 8, 36, and 44.

Detailed Description

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Conditions

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Pre-Bronchiolitis Obliterans Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
For individuals performing spirometry, every attempt will be made to keep them masked to treatment.

Study Groups

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ARINA-1 plus standard of care

ARINA-1 (88 mg/mL ascorbic acid, ASC; 150 mg/mL reduced glutathione, GSH); fixed dose, 4 mL solution inhaled twice daily via nebulization plus standard 3-therapy immunosuppression regimen and azithromycin

Group Type EXPERIMENTAL

ARINA-1

Intervention Type DRUG

ARINA-1 (88 mg/mL ascorbic acid, ASC; 150 mg/mL reduced glutathione, GSH)

Standard of care only

Standard 3-therapy immunosuppression regimen and azithromycin

Group Type OTHER

Standard of care only

Intervention Type OTHER

Standard 3-therapy immunosuppression regimen and azithromycin

Interventions

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ARINA-1

ARINA-1 (88 mg/mL ascorbic acid, ASC; 150 mg/mL reduced glutathione, GSH)

Intervention Type DRUG

Standard of care only

Standard 3-therapy immunosuppression regimen and azithromycin

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Bilateral lung transplant \>12 months from the time of Visit 1 / Randomization
2. Age 18-75 years old at the time of consent
3. Routinely followed at enrolling site
4. Willing and able to comply with visit schedule and at-home requirements
5. 10-24% decrease in FEV1 from the post-transplant baseline within the last 12 months.
6. Capable of giving informed consent
7. On a stable maintenance regimen of azithromycin for \>4 weeks prior to the Screening Visit
8. On a stable 2-agent or 3-agent immunosuppression regimen that includes a steroid, a calcineurin inhibitor (CNI), and, optionally, a cell cycle inhibitor (e.g., mycophenolate, azathioprine) \>4 weeks prior to Screening
9. If a woman of childbearing potential (WOCBP), must agree to use a reliable method of birth control for the entire duration of the study.

Exclusion Criteria

1. Positive urine pregnancy test at screening and baseline visit
2. Diagnosis of active congestive heart failure or symptomatic coronary artery disease \> grade 3 based on the New York Heart Association Functional Classification (NYHA) criteria
3. Restrictive allograft syndrome (RAS) defined by radiographic interstitial or alveolar opacities on chest X-ray or CT scan that are consistent with RAS
4. Have advanced BOS, defined by \>24% decrease in FEV1 in post-transplant baseline
5. A diagnosis of probable antibody-mediated rejection (AMR) \<12 months prior to the baseline visit
6. Donor-specific antibodies (DSA) identified \<6 months prior to the baseline visit. \*The presence of DSA \>6 months from the baseline visit is acceptable for enrollment into the study.
7. Unresolved diffuse alveolar damage
8. Receiving mechanical ventilation
9. Chronic kidney disease stage IV or higher, including on dialysis
10. Initiating a new maintenance therapy or changing immunosuppression maintenance therapy (e.g., changing tacrolimus to cyclosporine) \<30 days prior to the baseline visit.
11. Have initiated or changed mTOR maintenance therapy \<3 months prior to Clinic Visit 1 (mTOR use for \>3 months is allowed)
12. Initiating or changing antibiotic (including azithromycin), antiviral, or antifungal therapy \<14 days prior to the baseline visit.
13. Use of alemtuzumab \<6 months prior to the baseline visit
14. Use of anti-thymocyte therapies (e.g., anti-thymocyte globulin) or photopheresis \<90 days prior to the Screening Visit. Prior use of Trikafta (elexacaftor, ivacaftor, and tezacaftor is allowed as long as the participant has been on stable dose for \>90 days prior to the Screening Visit.
15. Initiating a multivitamin or other supplement (inhaled, oral, or IV) containing vitamin C, glutathione, or N-acetylcysteine \<90 days prior to the baseline visit
16. Significant unstable comorbidities, in the opinion of the site investigator
17. Allery or previous adverse reaction to azithromycin
18. A diagnosis of dynamic collapse / tracheobrochomalacia \<90 days of the baseline visit.
19. Subjects currently participating in, or who have participated in an interventional (drug or device) clinical study \<30 days of the baseline visit.
20. Have been diagnosed with ARAD within 6 weeks of the Screening Visit.
21. Have used belatacept \<6 months prior to Clinic Visit 1
22. Have had an initial treatment of bronchial stents or cryotherapy within 12 months of the Screening Visit, or had bronchial stents removed within the last 3 months of the Screening Visit.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Renovion, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tim Whelan, MD

Role: PRINCIPAL_INVESTIGATOR

Medical University of South Carolina

Locations

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Dignity Health - St. Joseph's Hospital and Medical Center

Phoenix, Arizona, United States

Site Status WITHDRAWN

University of California Los Angeles School of Medicine

Los Angeles, California, United States

Site Status RECRUITING

University of California San Diego Health

San Diego, California, United States

Site Status RECRUITING

Advent Health

Orlando, Florida, United States

Site Status RECRUITING

University of South Florida

Tampa, Florida, United States

Site Status RECRUITING

Loyola University Medical Center

Maywood, Illinois, United States

Site Status RECRUITING

University of Iowa Hospital

Iowa City, Iowa, United States

Site Status RECRUITING

Johns Hopkins Hospital

Baltimore, Maryland, United States

Site Status RECRUITING

University of Minnesota Medical School

Minneapolis, Minnesota, United States

Site Status WITHDRAWN

Washington University School of Medicine

St Louis, Missouri, United States

Site Status RECRUITING

Columbia University Irving Medical Center

New York, New York, United States

Site Status RECRUITING

Cleveland Clinic

Cleveland, Ohio, United States

Site Status RECRUITING

The Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status RECRUITING

Temple University Hospital

Philadelphia, Pennsylvania, United States

Site Status NOT_YET_RECRUITING

Medical University of South Carolina

Charleston, South Carolina, United States

Site Status RECRUITING

University of Texas Southwestern Medical Center

Dallas, Texas, United States

Site Status RECRUITING

Baylor Scott and White Research Institute

Dallas, Texas, United States

Site Status RECRUITING

Baylor St. Luke's Medical Center

Houston, Texas, United States

Site Status RECRUITING

Houston Methodist Hospital

Houston, Texas, United States

Site Status RECRUITING

Inova Fairfax Hospital

Falls Church, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Carolyn Durham, PhD

Role: CONTACT

919-240-7034

Will Anderson

Role: CONTACT

919-240-7034

Facility Contacts

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Paul Lopez

Role: primary

310-794-8595

Amber Martineau

Role: primary

619-471-0817

Zoe Bancilhon, MPH

Role: primary

4076094574

Role: backup

Michelle Beck

Role: primary

Josie Corral

Role: primary

888-584-7888

Mary Teresi

Role: primary

319-384-7546

Joby Mathew

Role: primary

410-550-6458

Brigitte Mittler

Role: primary

314-747-1931

Leo Suarez

Role: primary

646 528-9006

Joanne Baran

Role: primary

216-894-3826

Sydney Martin

Role: primary

614 366-2775

Sara Garcia, MS

Role: primary

8437925885

Rama Diallo

Role: primary

Kristen Paasch

Role: primary

214-865-4994

Felicia Padilla

Role: backup

214-820-1771

Maria Perea, MD

Role: primary

(832) 355-9494

Serene Shaham, RN

Role: primary

346-238-4586

Paige Thibodeaux

Role: primary

703.776.4353

Other Identifiers

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RVN-001

Identifier Type: -

Identifier Source: org_study_id

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