A Phase 4 interventional study of TBM100 in Pulmonary Infections and Pseudomonas Aeruginosa in Cystic Fibrosis, sponsored by Novartis Pharmaceuticals. Completed at 49 sites in 10 countries. Open to participants aged 6 Years and older. Per ClinicalTrials.gov, last updated 2015-02-10.
Sponsored by Novartis Pharmaceuticals · Phase 4, Interventional, and Treatment
This study assessed the long term safety data for the use of tobramycin inhalation powder in patients suffering from cystic fibrosis who have a chronic pulmonary infection with Pseudomonas aeruginosa.
1,581 studies on the registry are indexed under Cystic Fibrosis; 190 are open to participants now.
This study's enrollment of 157 is above the median of 36 across 1,034 interventional studies indexed under Cystic Fibrosis.
Browse Cystic Fibrosis studies →Novartis Pharmaceuticals is the lead sponsor of 2,673 studies on the registry; 228 are open to participants now.
Of its 576 completed or terminated interventional studies of FDA-regulated products, 431 (75%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Other protocol-defined inclusion/exclusion criteria may apply.
Eligible patients were assigned to four capsules of TIP at 28mg dosage strength, inhaled b.i.d. in the morning and in the evening via the T-326 inhaler, for 28 days (on treatment), followed by 28 days of no study treatment (off treatment). Each treatment therefore consisted of 112mg tobramycin (4 capsules of 28mg each) with the total daily dose = 224mg tobramycin (112mg b.i.d.). These 56 days represented 1 cycle of therapy.
Drug: TBM100
Tobramycin inhalation powder was assigned as four capsules at 28mg dosage strength. It was inhaled b.i.d in the morning and in the evening via the T-326 Inhaler.
Percentage of Participants With Treatment Emergent Adverse Events, Serious Adverse Events (SAEs) and Deaths
Adverse events were deemed treatment-emergent if the onset date/time was on or after the date and time of first study drug. All adverse events were included after this time during both on and off-treatment periods.
Time frame: 337 days
Relative Change From Baseline in Forced Expiratory Volume in One Second (FEV1) Percent Predicted
Spirometry was performed at each visit. FEV1, FVC, and FEF25-75 were recorded at all visits according to American Thoracic Society (ATS) guidelines. FEV1 = the volume of air expired in 1 second. FEV1 % predicted is a normalized value of FEV1 calculated using the Knudsen equation, based upon participant's age, gender and height. FVC (forced vital capacity) = the maximal volume of air exhaled with maximally forced effort from a position of maximal inspiration. FEF25-75 = forced expiratory flow from 25% to 75% of the FVC. Relative change in FEV1 % predicted from baseline to pre-dose day X = ((pre-dose day X FEV1 % predicted - baseline FEV1 % predicted) / baseline FEV1 % predicted) • 100.
Time frame: Baseline, day 29, day 85, day 141, day 197, day 253, day 309, day 337. All study visits except baseline and day 337 occurred at the end of a 28-day on-treatment period of a cycle. Day 337 was the end of the final 28-day off treatment period.
Relative Change From Baseline in FVC Percent Predicted
Spirometry was performed at each visit. FEV1, FVC, and FEF25-75 were recorded at all visits according to American Thoracic Society (ATS) guidelines. FEV1 = the volume of air expired in 1 second. FEV1 % predicted is a normalized value of FEV1 calculated using the Knudsen equation, based upon participant's age, gender and height. FVC (forced vital capacity) = the maximal volume of air exhaled with maximally forced effort from a position of maximal inspiration. FEF25-75 = forced expiratory flow from 25% to 75% of the FVC. Relative change in FVC % predicted from baseline to pre-dose day X = ((pre-dose day X FVC % predicted - baseline FVC % predicted) / baseline FVC % predicted) • 100.
Time frame: Baseline, day 29, day 85, day 141, day 197, day 253, day 309, day 337. All study visits except baseline and day 337 occurred at the end of a 28-day on-treatment period of a cycle. Day 337 was the end of the final 28-day off treatment period.
Relative Change From Baseline in FEF Rate Over 25 to 75 Percent of Vital Capacity Predicted
Spirometry was performed at each visit. FEV1, FVC, and FEF25-75 were recored at all visits according to American Thoracic Society (ATS) guidelines. FEV1 = the volume of air expired in 1 second. FEV1 % predicted is a normalized value of FEV1 calculated using the Knudsen equation, based upon participant's age, gender and height. FVC (forced vital capacity) = the maximal volume of air exhaled with maximally forced effort from a position of maximal inspiration. FEF25-75 = forced expiratory flow from 25% to 75% of the FVC. Relative change in FEEF25-75 from baseline to pre-dose day X = ((pre-dose day X FEF25-75 - baseline FEF25-75) / baseline FEF25-75) • 100.
Time frame: Baseline, day 29, day 85, day 141, day 197, day 253, day 309, day 337. All study visits except baseline and day 337 occurred at the end of a 28-day on-treatment period of a cycle. Day 337 was the end of the final 28-day off treatment period.
Change From Baseline in Pseudomonas Aeruginosa Colony Forming Units in Sputum
Sputum was collected in sterile containers and cultured for Pseudomonas aeruginosa (Pa.) (quantitative test) and other typical Cystic Fibrosis respiratory pathogens. The Pa. biotypes measured were mucoid, dry and small colony variant. Results are presented for the sum of all biotypes of Pa, with data transformed using a base 10 logarithm.
Time frame: Baseline, day 1, day 29, day 85, day 141, day 197, day 253, day 309, day 337
Tobramycin MIC 50 and MIC 90 Values Over All Isolates for the Sum of All Biotypes (Mucoid, Dry and Small Colony Variant) of Pseudomonas Aeruginosa
Tobramycin MIC 50 and MIC 90 values were defined as the lowest concentration of tobramycin required to inhibit 50% and 90%, respectively, of the P. aeruginosa strains tested.
Time frame: Baseline, day 29, day 85, day 141, day 197, day 253, day 309, day 337
Percentage of Participants Hospitalized Due to Serious Respiratory-related Adverse Events
Time frame: Day 337
Number of Hospitalization Days Due to Serious Respiratory-related Adverse Events
The total number of hospitalization days due to serious respiratory-related adverse events was analyzed.
Time frame: Day 337
Time to First Hospitalization Due to Serious Respiratory-related Adverse Events
The day of first hospitalization due to serious respiratory-related adverse events was analyzed.
Time frame: Day 337
Percentage of Participants Who Used New Anti-pseudomonal Antibiotics
Time frame: Day 337
Number of Days of New Anti-pseudomonal Antibiotic Use
The total number of days of new anti-pseudomonal antibiotic use was analyzed.
Time frame: Day 337
Time to Use of New Anti-pseudomonal Antibiotic
Time to first use of new anti-pseudomonal antibiotic was analyzed.
Time frame: Day 337
| Milestone | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Started | 157 |
| Completed | 96 |
| Not completed | 61 |
| Withdrew: Protocol deviation | 6 |
| Withdrew: Lost to follow-up | 3 |
| Withdrew: Withdrawal by subject | 17 |
| Withdrew: Lack of efficacy | 6 |
| Withdrew: Adverse event | 29 |
Adverse events were deemed treatment-emergent if the onset date/time was on or after the date and time of first study drug. All adverse events were included after this time during both on and off-treatment periods.
| Percentage of participants | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Adverse events (serious and non-serious) | 85.4 |
| Serious adverse events | 31.2 |
| Deaths | 0.0 |
Spirometry was performed at each visit. FEV1, FVC, and FEF25-75 were recorded at all visits according to American Thoracic Society (ATS) guidelines. FEV1 = the volume of air expired in 1 second. FEV1 % predicted is a normalized value of FEV1 calculated using the Knudsen equation, based upon participant's age, gender and height. FVC (forced vital capacity) = the maximal volume of air exhaled with maximally forced effort from a position of maximal inspiration. FEF25-75 = forced expiratory flow from 25% to 75% of the FVC. Relative change in FEV1 % predicted from baseline to pre-dose day X = ((pre-dose day X FEV1 % predicted - baseline FEV1 % predicted) / baseline FEV1 % predicted) • 100.
| Percent change | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Day 29, Cycle 1 (n=149) | 0.8 ± 17.17 |
| Day 85, Cycle 2 (n=146) | 0.0 ± 17.09 |
| Day 141, Cycle 3 (n=128) | 0.2 ± 15.13 |
| Day 197, Cycle 4 (n=116) | -0.2 ± 15.36 |
| Day 253, Cycle 5 (n=105) | -1.5 ± 17.19 |
| Day 309, Cycle 6 (n=100) | -1.9 ± 14.55 |
| Day 337, Completion (n=93) | -3.5 ± 16.81 |
Spirometry was performed at each visit. FEV1, FVC, and FEF25-75 were recorded at all visits according to American Thoracic Society (ATS) guidelines. FEV1 = the volume of air expired in 1 second. FEV1 % predicted is a normalized value of FEV1 calculated using the Knudsen equation, based upon participant's age, gender and height. FVC (forced vital capacity) = the maximal volume of air exhaled with maximally forced effort from a position of maximal inspiration. FEF25-75 = forced expiratory flow from 25% to 75% of the FVC. Relative change in FVC % predicted from baseline to pre-dose day X = ((pre-dose day X FVC % predicted - baseline FVC % predicted) / baseline FVC % predicted) • 100.
| Percent change | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Day 29, Cycle 1 (n=149) | -2.5 ± 12.95 |
| Day 85, Cycle 2 (n=146) | -2.8 ± 12.81 |
| Day 141, Cycle 3 (n=128) | -2.1 ± 12.25 |
| Day 197, Cycle 4 (n=116) | -1.8 ± 12.64 |
| Day 253, Cycle 5 (n=105) | -3.5 ± 13.11 |
| Day 309, Cycle 6 (n=100) | -3.1 ± 12.17 |
| Day 337, Completion (n=93) | -2.8 ± 13.50 |
Spirometry was performed at each visit. FEV1, FVC, and FEF25-75 were recored at all visits according to American Thoracic Society (ATS) guidelines. FEV1 = the volume of air expired in 1 second. FEV1 % predicted is a normalized value of FEV1 calculated using the Knudsen equation, based upon participant's age, gender and height. FVC (forced vital capacity) = the maximal volume of air exhaled with maximally forced effort from a position of maximal inspiration. FEF25-75 = forced expiratory flow from 25% to 75% of the FVC. Relative change in FEEF25-75 from baseline to pre-dose day X = ((pre-dose day X FEF25-75 - baseline FEF25-75) / baseline FEF25-75) • 100.
| Percent change | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Day 29, Cycle 1 (n=149) | 10.3 ± 36.05 |
| Day 85, Cycle 2 (n=146) | 9.4 ± 55.35 |
| Day 141, Cycle 3 (n=128) | 5.5 ± 31.82 |
| Day 197, Cycle 4 (n=116) | 6.0 ± 30.96 |
| Day 253, Cycle 5 (n=105) | 2.9 ± 33.23 |
| Day 309, Cycle 6 (n=100) | 4.3 ± 32.44 |
| Day 337, Completion (n=93) | 0.7 ± 33.78 |
Sputum was collected in sterile containers and cultured for Pseudomonas aeruginosa (Pa.) (quantitative test) and other typical Cystic Fibrosis respiratory pathogens. The Pa. biotypes measured were mucoid, dry and small colony variant. Results are presented for the sum of all biotypes of Pa, with data transformed using a base 10 logarithm.
| log10 Colony Forming Unit (CFU) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Sum of all biotypes, Day 29, Cycle 1 (n=141) | -1.6 ± 2.28 |
| Sum of all biotypes, Day 85, Cycle 2 (n=135) | -1.1 ± 1.80 |
| Sum of all biotypes, Day 141, Cycle 3 (n=119) | -1.2 ± 1.98 |
| Sum of all biotypes, Day 197, Cycle 4(n=107) | -1.1 ± 2.11 |
| Sum of all biotypes. Day 253, Cycle 5 (n=98) | -1.3 ± 2.23 |
| Sum of all biotypes, Day 309, Cycle 6 (n=89) | -1.2 ± 2.09 |
| Sum of all biotypes, Day 337, Completion (n=85) | -0.4 ± 2.08 |
Tobramycin MIC 50 and MIC 90 values were defined as the lowest concentration of tobramycin required to inhibit 50% and 90%, respectively, of the P. aeruginosa strains tested.
| ug/mL | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Baseline - MIC 50 (n=156) | 2 |
| Cycle 1, day 29 - MIC 50 (n=144) | 2 |
| Cycle 2, day 85 - MIC 50 (n=137) | 2 |
| Cycle 3, day 141 - MIC 50 (n=124) | 2 |
| Cycle 4, day 197 - MIC 50 (n=108) | 2 |
| Cycle 5, day 253 - MIC 50 (n=98) | 2 |
| Cycle 6, day 309 - MIC 50 (n=90) | 4 |
| Completion, day 337 - MIC 50 (n=89) | 2 |
| Baseline - MIC 90 (n=156) | 128 |
| Cycle 1, day 29 - MIC 90 (n=144) | 256 |
| Cycle 2, day 85 - MIC 90 (n=137) | 256 |
| Cycle 3, day 141 - MIC 90 (n=124) | 256 |
| Cycle 4, day 197 - MIC 90 (n=108) | 128 |
| Cycle 5, day 253 - MIC 90 (n=98) | 256 |
| Cycle 6, day 309 - MIC 90 (n=90) | 256 |
| Completion, day 337 - MIC 90 (n=89) | 512 |
| Percentage of participants | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Percentage of Participants Hospitalized Due to Serious Respiratory-related Adverse Events | 26.8 |
The total number of hospitalization days due to serious respiratory-related adverse events was analyzed.
| Days | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Number of Hospitalization Days Due to Serious Respiratory-related Adverse Events | 18.1 ± 17.14 |
The day of first hospitalization due to serious respiratory-related adverse events was analyzed.
| Days | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Time to First Hospitalization Due to Serious Respiratory-related Adverse Events | NA (NA to NA) |
| Percentage of participants | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Percentage of Participants Who Used New Anti-pseudomonal Antibiotics | 65.6 |
The total number of days of new anti-pseudomonal antibiotic use was analyzed.
| Days | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Number of Days of New Anti-pseudomonal Antibiotic Use | 33.1 ± 25.17 |
Time to first use of new anti-pseudomonal antibiotic was analyzed.
| Days | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Time to Use of New Anti-pseudomonal Antibiotic | 136 (97 to 170) |
Non-serious events are listed at a 3% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Tobramycin Inhalation Powder (TIP) | — | 49/157 (31.2%) | 121/157 (77.1%) |
| Event | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Infective pulmonary exacerbation of cystic fibrosisInfections and infestations | 39/157 |
| HaemoptysisRespiratory, thoracic and mediastinal disorders | 5/157 |
| PneumoniaInfections and infestations | 3/157 |
| InfluenzaInfections and infestations | 2/157 |
| Supraventricular tachycardiaCardiac disorders | 1/157 |
| TachyarrhythmiaCardiac disorders | 1/157 |
| Deafness unilateralEar and labyrinth disorders | 1/157 |
| TinnitusEar and labyrinth disorders | 1/157 |
| GastritisGastrointestinal disorders | 1/157 |
| Gastrooesophageal reflux diseaseGastrointestinal disorders | 1/157 |
| Event | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Infective pulmonary exacerbation of cystic fibrosisInfections and infestations | 66/157 |
| CoughRespiratory, thoracic and mediastinal disorders | 37/157 |
| HaemoptysisRespiratory, thoracic and mediastinal disorders | 33/157 |
| NasopharyngitisInfections and infestations | 20/157 |
| Sputum increasedRespiratory, thoracic and mediastinal disorders | 16/157 |
| Upper respiratory tract infectionInfections and infestations | 15/157 |
| PyrexiaGeneral disorders | 12/157 |
| Oropharyngeal painRespiratory, thoracic and mediastinal disorders | 12/157 |
| DiarrhoeaGastrointestinal disorders | 11/157 |
| HeadacheNervous system disorders | 11/157 |
| Age, Continuous(Years) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 27.8 ± 10.82 |
| Sex: Female, Male(Participants) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Female | 60 |
| Male | 97 |
| Weight(kilograms (kg)) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 57.4 ± 13.52 |
| Body Mass Index(kg/m^2) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 20.5 ± 3.35 |
| FEV1 % predicted(percent) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 50.2 ± 13.95 |
| FVC % predicted(percent) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 73.9 ± 15.88 |
| FEF25-75 % predicted(percent) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 21.8 ± 12.75 |
| Sputum density of P. aeruginosa - sum of all biotypes(log10 Colony Forming Units (CFU)) | Tobramycin Inhalation Powder (TIP) |
|---|---|
| Mean | 7.6 ± 1.65 |
1 further baseline measures are reported on the registry.
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