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CompletedNCT05453578Updated Jul 16, 2026Results posted

A Phase 1b/2 Trial of the Safety and Microbiological Activity of Bacteriophage Therapy in Cystic Fibrosis Subjects Colonized With Pseudomonas Aeruginosa

A Phase 1/2 interventional study of Placebo and WRAIR-PAM-CF1 in Bacterial Disease Carrier and Cystic Fibrosis, sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Completed at 19 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-16.

Sponsored by National Institute of Allergy and Infectious Diseases (NIAID) · Phase 1/2, Interventional, and Treatment

Phase
Phase 1/2
Study type
Interventional
Enrollment
73
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a phase 1b/2 study of a single dose of intravenous (IV) bacteriophage in males and non-pregnant females, at least 18 years old, diagnosed with Cystic Fibrosis (CF). This clinical trial is designed to assess the safety and microbiological activity of bacteriophage product Walter Reed Army Institute of Research- PAM-Cystic Fibrosis1 (WRAIR-PAM-CF1), directed at Pseudomonas aeruginosa in clinically stable CF individuals chronically colonized with P. aeruginosa. WRAIR-PAM-CF1 is a 4 component anti-pseudomonal bacteriophage mixture containing between 4 x 10\^7 and 4 x 10\^9 Plaque Forming Units (PFU) of bacteriophage. Enrollment will occur at up to 20 clinical sites in the United States. In stage 1, two eligible subjects will be assigned to each of the three dosing arms receiving a single dosage of the IV bacteriophage therapy (4 x 10\^7 PFU, 4 x 10\^8 PFU, and 4 x 10\^9 PFU; total of 6 sentinel subjects), followed by 30 plus or minus 7 days observation period. If no Serious Adverse Events (SAEs)(related to the study product) are identified during the 96 hours after bacteriophage administration for all Sentinel Subjects in Stage 1, the study will proceed to Stage 2. In Stage 2a, 32 subjects will be enrolled into one of 4 arms (placebo IV, 4 x 10\^7 PFU, 4 x 10\^8 PFU, and 4 x 10\^9 PFU) in a 1:1:1:1 allocation. An interim analysis will be performed after all subjects have completed follow up visit 5 on Day 8+3 to select the IV bacteriophage dose with the most favorable safety and microbiological activity profile. During Stage 2b, subjects will be randomized into the bacteriophage (dose selected based on Interim Analysis following Stage 2a) or placebo arm. The final sample size is expected to be up to 72 subjects total with up to 25 subjects in the placebo arm and up to 25 subjects in the Stage 2b bacteriophage dose.

Read the detailed description

This is a phase 1b/2, multicenter, randomized placebo-controlled double-blind study of a single dose of intravenous (IV) bacteriophage in males and non-pregnant females, at least 18 years old, diagnosed with Cystic Fibrosis (CF). This clinical trial is designed to assess the safety and microbiological activity of bacteriophage product Walter Reed Army Institute of Research- PAM-Cystic Fibrosis1 (WRAIR-PAM-CF1), directed at Pseudomonas aeruginosa (P. aeruginosa) in clinically stable CF individuals chronically colonized with P. aeruginosa. WRAIR-PAM-CF1 is a 4 component anti-pseudomonal bacteriophage mixture containing between 4 x 10\^7 and 4 x 10\^9 Plaque Forming Units (PFU) of bacteriophage. Enrollment will occur at up to 20 clinical sites in the United States. In stage 1, two sentinel subjects will be assigned to each of the three dosing arms receiving a single dosage of the IV bacteriophage therapy (4 x 10\^7 PFU, 4 x 10\^8 PFU, and 4 x 10\^9 PFU; total of 6 sentinel subjects), followed by 30 plus or minus 7 days observation period. If no Serious Adverse Events (SAEs) (related to the study product) are identified during the 96 hours after bacteriophage administration for all Sentinel Subjects in Stage 1, the study will proceed to Stage 2. In Stage 2a, 32 subjects will be enrolled into one of 4 arms (placebo IV, 4 x 10\^7 PFU, 4 x 10\^8 PFU, and 4 x 10\^9 PFU) in a 1:1:1:1 allocation. An interim analysis will be performed after all subjects have completed follow up visit 5 on Day 8+3 to select the IV bacteriophage dose with the most favorable safety and microbiological activity profile. During Stage 2b, subjects will be randomized into the bacteriophage (dose selected based on Interim Analysis following Stage 2a) or placebo arm. The final sample size is expected to be up to 72 subjects total with up to 25 subjects in the placebo arm and up to 25 subjects in the Stage 2b bacteriophage dose. The primary objectives of this study are to 1) describe the safety of a single dose of IV bacteriophage therapy in clinically stable CF subjects with P. aeruginosa in expectorated sputum; 2) describe the microbiological activity of a single dose of IV bacteriophage therapy in clinically stable CF subjects with P. aeruginosa in expectorated sputum; 3) describe the benefit to risk profile of a single dose of IV bacteriophage therapy in clinically stable CF subjects with P. aeruginosa in expectorated sputum.

02

Conditions studied

  • Bacterial Disease Carrier
  • Cystic Fibrosis

Keywords

  • Bacteriophage therapy
  • colonized
  • Cystic Fibrosis
  • double-blind
  • Microbiological Activity
  • placebo-controlled
  • Pseudomonas aeruginosa
  • randomized
  • Safety
03

In context

Cystic Fibrosis

1,581 studies on the registry are indexed under Cystic Fibrosis; 190 are open to participants now.

This study's enrollment of 73 is above the median of 36 across 1,034 interventional studies indexed under Cystic Fibrosis.

Browse Cystic Fibrosis studies →

Lead sponsor

National Institute of Allergy and Infectious Diseases (NIAID) is the lead sponsor of 2,401 studies on the registry; 179 are open to participants now.

Of its 396 completed or terminated interventional studies of FDA-regulated products, 294 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Subjects must meet all the inclusion criteria to be eligible to participate in the study:

  1. Adult (>/= 18 years) at the time of screening.
  2. Confirmed Cystic Fibrosis (CF) diagnosis based on a compatible clinical syndrome confirmed by either an abnormal sweat chloride testing or CFTR gene variations.*

    *Can be obtained from documentation in medical records; actual test results not necessary.

  3. Likely able to produce at least 2 mL of sputum during a 30-minute sputum collection following a hypertonic saline treatment or other approach to increase sputum production.**

    **Determined by investigator or their designee judgement. Approaches for obtaining sputum may include, but are not limited to, inhaled hypertonic saline (e.g., 3%, 7%, or 10%), inhaled hypertonic bicarbonate, inhaled mannitol, or spontaneously expectorated sputum. The same approach is recommended, whenever possible, for all sputum collections for a given subject.

  4. Pseudomonas aeruginosa (regardless of Colony Forming Units (CFU)/mL) isolated from a sputum, throat culture, or other respiratory specimen in the past 12 months.
  5. Confirmed P. aeruginosa isolation from a sample of expectorated sputum at the Screening Visit.
  6. Capable of providing informed consent.
  7. Capable and willing to complete all study visits and perform all procedures required by the protocol.

Exclusion criteria

Exclusion Criteria:

Subjects who meet any of the exclusion criteria will not be enrolled in the study:

  1. Body weight \< 30 kg.
  2. Forced Expiratory Volume in 1 second (FEV1) \< 20% of predicted value at screening, using the Hankinson equations.
  3. Elevated Elevated liver function tests (LFTs) obtained at screening.*

    *a. Alanine aminotransferase (ALT) > 5 x the upper limit of normal (ULN) or aspartate transaminase (AST) > 5 x ULN or total bilirubin > 3 x ULN, OR b. Total bilirubin > 1.5 x ULN combined with either ALT > 3 x ULN or AST > 3 x ULN. ULN reflects local laboratory ranges.

  4. Acute clinical illness requiring a new (oral, parenteral), or inhaled antibiotic(s) \</= 30 days prior to the baseline visit.*

    *Does not include chronic suppressive medications or cyclic dosing medications such as inhaled antibiotics.

  5. Women who are pregnant, planning to become pregnant during the study period, or breastfeeding.* *Women of childbearing potential must have a negative serum beta-human chorionic gonadotropin test during screening and agree to use an effective method of contraception for the duration of the trial.*

    *A female is considered of childbearing potential unless postmenopausal, or surgically sterilized and at least 3 months has passed since sterilization procedure.

    1. Female surgical sterilization procedures include tubal ligation, bilateral salpingectomy, hysterectomy, or bilateral oophorectomy.
    2. Female is considered postmenopausal if she is >45 years old and has gone at least 12 months without a spontaneous menstrual period without other known or suspected cause.
    3. Effective methods of contraception include (a) abstinence, (b) partner vasectomy, (c) intrauterine devices, (d) hormonal implants (such as Implanon), or (e) other hormonal methods (birth control pills, injections, patches, vaginal rings).
  6. Active treatment of any mycobacterial or fungal organisms \</=30 days prior to baseline. Chronic treatment for suppression of fungal populations is allowable.
  7. Anticipated need to change chronic antibiotic regimens during the study period.*

    *Subjects on cyclic dosing medications such as inhaled antibiotics, must be able and express willingness to keep the therapies at the time of screening constant (either remain on the therapy or not remain on the therapy) for the duration of the follow-up period (approximately 30 days). Subjects on chronic suppressive antimicrobial therapy must be able and express willingness to stay on the therapies for the duration of their follow-up period. This includes chronic azithromycin therapy.

  8. Known allergy to any component of the study product.
  9. Any significant finding that, in the opinion of the investigator, would make it unsafe for the subject to participate in this study.
  10. Enrolled in a clinical trial within \</=30 days of the baseline/dosing visit, or participating in a clinical trial while enrolled in this clinical trial (inclusive of vaccine trials).
  11. Currently or previously enrolled in this trial.
05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Sequential assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
73 participants (actual)

Study arms

  • Active comparator
    Stage 1/2a Arm 2

    4x10\^7 plaque forming units (PFU) of WRAIR-PAM-CF1 administered intravenously with approximately 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. Stage 1: N=2 (sentinel subjects); Stage 2a: N=8

    Biological: WRAIR-PAM-CF1

  • Active comparator
    Stage 1/2a Arm 3

    4x10\^8 plaque forming units (PFU) of WRAIR-PAM-CF1 administered intravenously with approximately 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. Stage 1: N=2 (sentinel subjects); Stage 2a: N=8

    Biological: WRAIR-PAM-CF1

  • Active comparator
    Stage 1/2a Arm 4

    4x10\^9 plaque forming units (PFU) of WRAIR-PAM-CF1 administered intravenously with approximately 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. Stage 1: N=2 (sentinel subjects); Stage 2a: N=8

    Biological: WRAIR-PAM-CF1

  • Placebo comparator
    Stage 2a Arm 1

    25 mL of 0.9 percent Sodium Chloride saline solution administered intravenously for 30 mins as a single dosage. N=8

    Other: Placebo

  • Placebo comparator
    Stage 2b Arm 1

    25 mL of 0.9 percent Sodium Chloride saline solution administered intravenously for 30 mins as a single dosage. N=17

    Other: Placebo

  • Active comparator
    Stage 2b Arm 2

    WRAIR-PAM-CF1 concentration determined after post stage 2a analysis, administered intravenously with 25 mL of 0.9 percent Sodium Chloride saline solution for 30 mins as a single dosage. N=17

    Biological: WRAIR-PAM-CF1

Interventions

  • OtherPlacebo

    0.9 percent sodium chloride

  • BiologicalWRAIR-PAM-CF1

    Bacteriophage combination composed of the following phages: PaWRA01Phi11, PaWRA01Phi39, PaWRA02Phi83, and PaWRA02Phi87.

06

What researchers measure

Primary outcomes

  1. Number of Participants That Experienced Grade 2 or Higher Treatment-emergent Adverse Events in the ITT Population

    An event that occurred during the treatment period was considered a treatment-emergent AE if it was not present before the first dose of investigational product or was present before the first dose of investigational product and increased in severity during the treatment period.

    Time frame: Day 1 through Day 30

  2. Change From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo in Stage 2a and 2b

    Mean change from baseline in log10-transformed counts of P. aeruginosa colony forming units per milliliter (CFU/mL) is presented for each time point through Day 30 as well as for each participant's minimum and maximum change from baseline. Undetectable colony counts are substituted with the limit of detection (LOD) of the assay (1 x 10\^4 CFU/mL).

    Time frame: Day 1 Post-infusion, Day 2, Day 5, Day 8, and Day 30

  3. Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit in Stage 2a and 2b

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated by: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1 x 10\^4 CFU/mL)

    Time frame: Day 1 Post-infusion, Day 2, Day 5, and Day 8

  4. Change From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo, Sensitivity Analysis for Stage 2a and 2b

    Mean change from baseline in log10-transformed counts of P. aeruginosa colony forming units per milliliter (CFU/mL) is presented for each time point through Day 30 as well as for each participant's minimum and maximum change from baseline. Undetectable colony counts are treated as missing.

    Time frame: Day 1 Post-infusion, Day 2, Day 5, Day 8, and Day 30

  5. Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit, Sensitivity Analysis for Stage 2a and 2b

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

    Time frame: Day 1 Post-infusion, Day 2, Day 5, and Day 8

  6. Number of Susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated by: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1 x 10\^4 CFU/mL)

    Time frame: Baseline through Day 8

  7. Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \>2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \<1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10\^4 CFU/mL).

    Time frame: Baseline through Day 8

  8. Number of Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \>2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \<1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10\^4 CFU/mL).

    Time frame: Baseline through Day 8

  9. Number of Not Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \>2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \<1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10\^4 CFU/mL).

    Time frame: Baseline through Day 8

  10. Number of Susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

    Time frame: Baseline through Day 8

  11. Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

    Time frame: Baseline through Day 8

  12. Number of Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

    Time frame: Baseline through Day 8

  13. Number of Not Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

    A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

    Time frame: Baseline through Day 8

07

Results

Posted Jul 16, 2026

Participant flow

The study population included male and female adults, aged 18 or higher, with a confirmed cystic fibrosis diagnosis. Participants were enrolled from 03OCT2022 to 12MAR2025.

Participant flow — Overall Study
Milestone4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2b
Started222826924
Completed222826823
Not completed0000011
Withdrew: Lost to follow-up0000001
Withdrew: Treatment not administered0000010

Outcome measures

PrimaryNumber of Participants That Experienced Grade 2 or Higher Treatment-emergent Adverse Events in the ITT Population

An event that occurred during the treatment period was considered a treatment-emergent AE if it was not present before the first dose of investigational product or was present before the first dose of investigational product and increased in severity during the treatment period.

Time frame:
Day 1 through Day 30
Reported as:
Count of participants · Participants
Number of Participants That Experienced Grade 2 or Higher Treatment-emergent Adverse Events in the ITT Population
Participants4x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2b
Number of Participants That Experienced Grade 2 or Higher Treatment-emergent Adverse Events in the ITT Population2748
PrimaryChange From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo in Stage 2a and 2b

Mean change from baseline in log10-transformed counts of P. aeruginosa colony forming units per milliliter (CFU/mL) is presented for each time point through Day 30 as well as for each participant's minimum and maximum change from baseline. Undetectable colony counts are substituted with the limit of detection (LOD) of the assay (1 x 10\^4 CFU/mL).

Time frame:
Day 1 Post-infusion, Day 2, Day 5, Day 8, and Day 30
Reported as:
Mean · log10 (CFU/mL)
Change From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo in Stage 2a and 2b
log10 (CFU/mL)4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Day 1 Post-infusion0.0 ± 1.20.1 ± 1.4
Day 2-0.3 ± 1.50.3 ± 1.4
Day 5-0.1 ± 1.30.3 ± 1.4
Day 8-0.4 ± 1.50.2 ± 1.7
Day 300.0 ± 1.70.5 ± 1.7
Maximum change1.0 ± 1.31.3 ± 1.3
Minimum change-1.4 ± 1.3-0.7 ± 1.3
PrimaryDesirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit in Stage 2a and 2b

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated by: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1 x 10\^4 CFU/mL)

Time frame:
Day 1 Post-infusion, Day 2, Day 5, and Day 8
Reported as:
Count of participants · Participants
Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit in Stage 2a and 2b
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Day 1 Post-infusion — Rank 101
Day 1 Post-infusion — Rank 255
Day 1 Post-infusion — Rank 32118
Day 1 Post-infusion — Rank 400
Day 1 Post-infusion — Missing00
Day 2 — Rank 131
Day 2 — Rank 221
Day 2 — Rank 32021
Day 2 — Rank 400
Day 2 — Missing11
Day 5 — Rank 111
Day 5 — Rank 271
Day 5 — Rank 31821
Day 5 — Rank 400
Day 5 — Missing01
Day 8 — Rank 142
Day 8 — Rank 263
Day 8 — Rank 31517
Day 8 — Rank 400
Day 8 — Missing12
Maximum — Rank 162
Maximum — Rank 2107
Maximum — Rank 31015
Maximum — Rank 400
Maximum — Missing00
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 63.8 · 95% CI 49.0 to 76.3The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryChange From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo, Sensitivity Analysis for Stage 2a and 2b

Mean change from baseline in log10-transformed counts of P. aeruginosa colony forming units per milliliter (CFU/mL) is presented for each time point through Day 30 as well as for each participant's minimum and maximum change from baseline. Undetectable colony counts are treated as missing.

Time frame:
Day 1 Post-infusion, Day 2, Day 5, Day 8, and Day 30
Reported as:
Mean · log10 (CFU/mL)
Change From Baseline to Day 30 in log10 P. Aeruginosa Total Colony Counts in Quantitative Sputum Cultures After Administration of IV Bacteriophages/Placebo, Sensitivity Analysis for Stage 2a and 2b
log10 (CFU/mL)4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Day 1 Post-infusion-0.1 ± 0.90.1 ± 1.1
Day 2-0.5 ± 1.10.1 ± 1.2
Day 5-0.3 ± 1.00.3 ± 1.3
Day 8-0.6 ± 1.30.7 ± 1.3
Day 30-0.3 ± 1.40.1 ± 1.6
Maximum change0.7 ± 1.01.0 ± 1.2
Minimum change-1.3 ± 1.2-0.7 ± 1.2
PrimaryDesirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit, Sensitivity Analysis for Stage 2a and 2b

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

Time frame:
Day 1 Post-infusion, Day 2, Day 5, and Day 8
Reported as:
Count of participants · Participants
Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit, Sensitivity Analysis for Stage 2a and 2b
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Day 1 Post-infusion — Rank 100
Day 1 Post-infusion — Rank 244
Day 1 Post-infusion — Rank 31412
Day 1 Post-infusion — Rank 400
Day 1 Post-infusion — Missing88
Day 2 — Rank 120
Day 2 — Rank 211
Day 2 — Rank 31413
Day 2 — Rank 400
Day 2 — Missing910
Day 5 — Rank 110
Day 5 — Rank 261
Day 5 — Rank 31214
Day 5 — Rank 400
Day 5 — Missing79
Day 8 — Rank 120
Day 8 — Rank 250
Day 8 — Rank 3912
Day 8 — Rank 400
Day 8 — Missing1012
Maximum — Rank 130
Maximum — Rank 2105
Maximum — Rank 3611
Maximum — Rank 400
Maximum — Missing78
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 71.1 · 95% CI 54.0 to 83.7The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated by: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1 x 10\^4 CFU/mL)

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Number of Susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit1213
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 66.3 · 95% CI 45.6 to 82.3The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Non-susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \>2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \<1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10\^4 CFU/mL).

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit1411
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 60.1 · 95% CI 38.6 to 78.2The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \>2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \<1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10\^4 CFU/mL).

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Number of Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit72
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 57.1 · 95% CI 19.4 to 88.1
PrimaryNumber of Not Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1=No SAE (related to study product) and \>2 log10 reduction in P. aeruginosa CFU/mL. Rank 2=No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3=No SAE (related to study product) and \<1 log10 reduction in P. aeruginosa CFU/mL. Rank 4=SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are substituted with the LOD of the assay (1x10\^4 CFU/mL).

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Not Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Number of Not Co-colonized With Clinically Meaningful Organism Subgroup Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit1922
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 65.3 · 95% CI 48.8 to 78.8The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Participants with Non-missing DOOR89
Participants with Missing DOOR44
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 81.3 · 95% CI 56.7 to 93.5The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Non-susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Non-susceptible to 4-bacteriophage Cocktail Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Participants with Non-missing DOOR117
Participants with Missing DOOR34
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 64.3 · 95% CI 39.9 to 83.0The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Participants With Non-missing DOOR41
Participants With Missing DOOR31
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 50.0The Confidence Interval was not estimable. The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.
PrimaryNumber of Not Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit

A DOOR rank is calculated for each participant based on the following ranking from most (rank 1) to least (rank 4) desirable outcome using each participant's greatest reduction from baseline in log10 P. aeruginosa CFU/mL by Day 8: Rank 1 = No SAE (related to study product) and \> 2 log10 reduction in P. aeruginosa CFU/mL. Rank 2 = No SAE (related to study product) and 1-2 log10 reduction in P. aeruginosa CFU/mL. Rank 3 = No SAE (related to study product) and \< 1 log10 reduction in P. aeruginosa CFU/mL. Rank 4 = SAE (related to study product). The DOOR probability is estimated using: Pr\[DOOR\]= Pr\[DOORIV \> DOORP\] + 1/2Pr\[DOORIV = DOORP\] where DOORIV and DOORP are the DOOR ranks for bacteriophage (phage) and placebo arms, Pr\[DOORIV \> DOORP\] is the proportion of DOOR ranks from IV phage dose exceeding DOOR ranks from placebo, and Pr\[DOORIV = DOORP\] is the proportion of phage and placebo DOOR ranks being the same. Undetectable colony counts are treated as missing.

Time frame:
Baseline through Day 8
Reported as:
Count of participants · Participants
Number of Not Co-colonized With Clinically Meaningful Organism Subgroup, Sensitivity Analysis Participants With Desirability of Outcome Ranking (DOOR) Probability Calculated Using the Greatest Reduction by Day 8 Follow-up Visit
Participants4x10^8 PFU - Stage 2a and 2bPlacebo - Stage 2a and 2b
Participants With Non-missing DOOR1515
Participants with Missing DOOR47
Statistical analysis
  • 4x10^8 PFU - Stage 2a and 2b vs Placebo - Stage 2a and 2b · Pr(better door in bacteriophage arm): 71.8 · 95% CI 53.1 to 85.1The DOOR probability is calculated using the Wilcoxon-Mann-Whitney statistic. The 95% confidence interval is calculated using the method described in Halperin et. al.

Adverse events

Collected over Safety was evaluated from Day 1 (post-study product administration) through Day 30. Events of special interest (ESIs) were collected from Day 1 through Day 8.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
4x10^7 PFU - Stage 10/2 (0%)0/2 (0%)1/2 (50%)
4x10^8 PFU - Stage 10/2 (0%)0/2 (0%)2/2 (100%)
4x10^9 PFU - Stage 10/2 (0%)0/2 (0%)2/2 (100%)
4x10^7 PFU - Stage 2a0/8 (0%)0/8 (0%)3/8 (37.5%)
4x10^8 PFU - Stage 2a and 2b0/26 (0%)0/26 (0%)4/26 (15.4%)
4x10^9 PFU - Stage 2a0/8 (0%)1/8 (12.5%)3/8 (37.5%)
Placebo - Stage 2a and 2b0/24 (0%)0/24 (0%)9/24 (37.5%)
Most frequent serious events
Most frequent serious events
Event4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2b
Cystic Fibrosis Pulmonary ExacerbationInfections and infestations0/20/20/20/80/261/80/24
Most frequent other events
Showing 10 of 15
Most frequent other events
Event4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2b
PalpitationsCardiac disorders1/20/20/20/80/260/80/24
Abdominal PainGastrointestinal disorders1/20/20/20/80/260/80/24
NauseaGastrointestinal disorders1/20/20/20/80/260/80/24
Infective Pulmonary Exacerbation Of Cystic FibrosisInfections and infestations0/21/20/21/80/261/83/24
Decreased AppetiteMetabolism and nutrition disorders0/20/21/20/80/260/80/24
HeadacheNervous system disorders0/21/20/20/80/260/83/24
NocturiaRenal and urinary disorders0/20/21/20/80/260/80/24
Blood Pressure Systolic IncreasedInvestigations0/20/20/20/84/260/83/24
FatigueGeneral disorders0/20/20/21/80/260/80/24
Infusion Site BruisingGeneral disorders0/20/20/21/80/260/80/24

Baseline characteristics

Age, Continuous
Age, Continuous(years)4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2bTotal
Mean60.5 ± 10.649.0 ± 5.732.0 ± 4.236.3 ± 12.945.3 ± 14.838.7 ± 15.540.8 ± 13.542.2 ± 14.2
Sex: Female, Male
Sex: Female, Male(Participants)4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2bTotal
Female20141221536
Male0214147937
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2bTotal
Hispanic or Latino00003227
Not Hispanic or Latino22282372266
Unknown or Not Reported00000000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2bTotal
American Indian or Alaska Native00000000
Asian00000000
Native Hawaiian or Other Pacific Islander00000000
Black or African American10111015
White12172482164
More than one race00000011
Unknown or Not Reported00001113
Region of Enrollment
Region of Enrollment(participants)4x10^7 PFU - Stage 14x10^8 PFU - Stage 14x10^9 PFU - Stage 14x10^7 PFU - Stage 2a4x10^8 PFU - Stage 2a and 2b4x10^9 PFU - Stage 2aPlacebo - Stage 2a and 2bTotal
United States22282692473
08

Study locations

19 sites
  • The University of Arizona - Banner University Medical Center Tucson Campus - Tucson
    Tucson, Arizona 85724-0001, United States
  • University of California, San Diego
    La Jolla, California 92037, United States
  • University of California, San Diego (UCSD) - Antiviral Research Center (AVRC)
    La Jolla, California 92121, United States
  • University of California Los Angeles Medical Center - Westwood Clinic
    Los Angeles, California 90095, United States
  • University of California Davis Health
    Sacramento, California 95816, United States
  • Stanford University
    Stanford, California 94305, United States
  • Yale North Haven Medical Center- Winchester Center for Lung Disease
    North Haven, Connecticut 06473, United States
  • University of South Florida/Tampa General Hospital
    Tampa, Florida 22612, United States
  • Emory University - Adult Cystic Fibrosis Program
    Atlanta, Georgia 30324, United States
  • Johns Hopkins University
    Baltimore, Maryland 21205, United States
  • Michigan Medicine
    Ann Arbor, Michigan 48109, United States
  • University of Minnesota Medical Center
    Minneapolis, Minnesota 55455-0341, United States
  • Northwell Health
    New Hyde Park, New York 11050, United States
  • Duke University Medical Center
    Durham, North Carolina 27710, United States
  • Case Western Reserve University
    Cleveland, Ohio 44106, United States
  • Vanderbilt University Medical Center
    Nashville, Tennessee 37232, United States
  • University of Texas Southwestern Medical Center
    Dallas, Texas 75390, United States
  • Baylor College of Medicine
    Houston, Texas 77030-3411, United States
  • University of Virginia
    Charlottesville, Virginia 22908, United States
09

References and documents

Publications

  • Tamma PD, Souli M, Billard M, Campbell J, Conrad D, Ellison DW, Evans B, Evans SR, Greenwood-Quaintance KE, Filippov AA, Geres HS, Hamasaki T, Komarow L, Nikolich MP, Lodise TP, Nayak SU, Norice-Tra C, Patel R, Pride D, Russell J, Van Tyne D, Chambers HF, FowlerJr VG, Schooley RT; Antibacterial Resistance Leadership Group. Safety and microbiological activity of phage therapy in persons with cystic fibrosis colonized with Pseudomonas aeruginosa: study protocol for a phase 1b/2, multicenter, randomized, double-blind, placebo-controlled trial. Trials. 2022 Dec 28;23(1):1057. doi: 10.1186/s13063-022-07047-5. PubMed 36578069 ↗

Study documents

  • Study protocol · Jul 19, 2024
  • Statistical analysis plan · Nov 14, 2023
  • Informed consent form · Apr 6, 2023

Documents are hosted by the registry — open the source record to download them.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT05453578
Lead sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
Responsible party
Sponsor
First posted
Jul 12, 2022
Start date
Oct 3, 2022
Primary completion
Apr 10, 2025
Completion
Apr 10, 2025
Results posted
Jul 16, 2026
Last update
Jul 16, 2026

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

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