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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00571701
Other study ID # 1U01DC007946-01A2
Secondary ID U01DC007946NIH g
Status Completed
Phase Phase 2
First received December 10, 2007
Last updated May 13, 2015
Start date February 2008
Est. completion date January 2015

Study information

Verified date May 2015
Source Northwell Health
Contact n/a
Is FDA regulated No
Health authority United States: Federal Government
Study type Interventional

Clinical Trial Summary

This is a randomized double blind controlled study to determine if celebrex (celecoxib), a selective COX-2 inhibitor, can decrease the rate of recurrence in adult and pediatric patients with recurrent respiratory papillomatosis. All patients will be evaluated for disease severity at enrollment and at 3 month intervals for 30 months. After randomization, patients in the early treatment arm will begin celecoxib 6 months after enrollment. The delayed treatment arm will begin celecoxib 18 months after enrollment. All patients will receive celecoxib for 1 year. During the time that patients do no receive celecoxib, they will receive a placebo capsule with the same appearance. Follow-up visits will occur at three month intervals for the duration of the study.


Description:

This is a randomized double blind placebo-controlled study,with plans to include 5 additional U.S. centers in the near future. The primary goal of this study is to determine whether celecoxib has efficacy in elimination or reduction of recurrent disease in patients with RRP. Our secondary goals are to determine whether continued celecoxib is required to maintain response, to correlate response with select patient demographics and persistence of latent HPV DNA, and to determine whether celecoxib is acting through inhibition of COX-2, in order to begin to determine mechanism of effects in vivo on RRP. The study design encompasses a 30-month period, which can be divided into three segments:

Segment A: This is a 6 month run-in period in which all patients are assessed by direct laryngoscopy/bronchoscopy for disease severity, to permit growth rate stabilization and confirm accuracy of training of participating physicians. Patients will be treated by conventional surgery at three months and six months after enrollment.

Segment B: Patients begin 12 months of 400mg(adults), 100 mg (pediatric weight between 12 and 25 kg)or 200 mg (pediatric weight > 25kg) celecoxib daily or placebo treatment in addition to surgical removal of all papillomas at each 3 month interval. This segment directly tests the hypothesis that celecoxib is an efficacious treatment for moderate to severe RRP and forms the basis for the primary statistical analyses.

Segment C: The primary purpose of this segment is to determine whether gains made during celecoxib therapy are maintained after it is discontinued, or whether celecoxib will need to be taken indefinitely. This will be determined by a 12 month period on placebo after cessation of celecoxib for the early treatment group.


Other known NCT identifiers
  • NCT00297999

Recruitment information / eligibility

Status Completed
Enrollment 51
Est. completion date January 2015
Est. primary completion date January 2015
Accepts healthy volunteers No
Gender Both
Age group 2 Years and older
Eligibility Inclusion Criteria:

- Moderate to severe disease, defined as:

Patients who have rapid regrowth of papillomas, requiring endoscopic removal at least 3 times within the past 12 months AND A papilloma growth rate from 0.03 to 0.06 (moderate) or >0.06 (severe) at time of initial direct endoscopy OR Having tracheal and/or bronchial or pulmonary papillomatosis (severe)

- Age > 2 years

- Gender- no restriction

- Race- no restriction

Exclusion Criteria:

- Fewer than 3 surgical procedures in previous year, without tracheal disease

- Age < 2 years

- Pregnancy, trying to become pregnant, breastfeeding or not willing to comply with birth control methods if sexually active female

- Serum creatinine > 1.5 X normal

- History of documented peptic ulcer disease or gastritis persisting despite treatment

- Abnormal liver function tests, as total bilirubin >1.5 X normal and SGOT > 3 X normal

- Allergy to NSAIDs, sulfa containing drugs or symptoms of Stevens-Johnson Syndrome

- Patients with connective tissue diseases such as SLE, Raynaud's or Systemic Sclerosis

- Patients with known diabetes

- Patients on warfarin, or on loop or thiazide diuretics

- Patients with a history of cardiovascular disease, myocardial infarct or stroke

- Patients with congestive heart failure

- Patients regularly taking > 81 mg of aspirin/day

- Patients with uncontrolled hypertension

- Patients with RRP associated malignancy currently receiving chemotherapy and/or radiation

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
celebrex (celecoxib)
Adults: 400 mg daily Pediatrics: 100 mg daily for weight between 12-25 kg or 200 mg daily for weight >25 kg
placebo capsules
Not relevant

Locations

Country Name City State
United States University of Alabama Birmingham Birmingham Alabama
United States University of Iowa Iowa City Iowa
United States Vanderbilt University Nashville Tennessee
United States Long Island Jewish Medical Center New Hyde Park New York
United States Eastern Virginia Medical School Norfolk Virginia
United States UCSF Medical Center San Francisco California
United States Sanford Health /USD Sioux Falls South Dakota

Sponsors (2)

Lead Sponsor Collaborator
Northwell Health National Institute on Deafness and Other Communication Disorders (NIDCD)

Country where clinical trial is conducted

United States, 

References & Publications (1)

Wu R, Abramson AL, Shikowitz MJ, Dannenberg AJ, Steinberg BM. Epidermal growth factor-induced cyclooxygenase-2 expression is mediated through phosphatidylinositol-3 kinase, not mitogen-activated protein/extracellular signal-regulated kinase kinase, in recurrent respiratory papillomas. Clin Cancer Res. 2005 Sep 1;11(17):6155-61. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary What is the efficacy of celebrex response relative to conventional endoscopy and surgical removal in reducing recurrence,and is improvement maintained when celecoxib therapy stops? 24 months No
Secondary Do any clinical characteristics (age of onset, gender, HPV type) predict response? 24 months No
Secondary Do molecular markers suggest inhibitions of COX-2 as mechanism of response? 24 months No
Secondary Does celebrex reduce persistence of HPV DNA or alter HPV expression. 24 months No
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