Cystic Fibrosis Clinical Trial
Official title:
A Randomized-Controlled Trial of Inhaled Hypertonic Saline (7%) to Evaluate the Lung Clearance Index as a Short-term Pharmacodynamic Biomarker in Patients With Cystic Fibrosis.
The Lung Clearance Index (LCI) is a non invasive measure of lung function that is more sensitive than FEV1. It can be used to measure lung function in children younger than 6 years of age. Therefore, it has a future role in assessing novel therapeutics in the Cystic Fibrosis (CF) population. As such, determining if it can be used as a short term pharmacodynamic biomarker is paramount.
Inhaled Hypertonic saline (7%) is a treatment intervention for Cystic Fibrosis patients and
has previously been shown to improve lung function and decrease the number of pulmonary
exacerbations. The Cystic Fibrosis Transmembrane Regulator Gene (CFTR) protein is essential
for maintaining fluid and electrolyte homeostasis in the lung and CFTR defects cause
depletion of the periciliary liquid layer which results in impaired mucociliary clearance.
Inhaled hypertonic saline (7%) acts as an osmotic agent in the lungs; it repletes the airway
surface liquid (ASL) and improves mucociliary clearance.
In addition, we have recently demonstrated that the Lung Clearance Index (LCI) is also a
responsive outcome measure. In an intervention study in which patients were treated with
hypertonic saline inhalation twice daily for 28 days, LCI but not FEV1 significantly
improved in 17 pediatric Cystic Fibrosis (CF) patients with mild lung disease. In this
study, LCI was more sensitive to a change in response to treatment than spirometry in a
small number of patients. However, it still remains unknown if the LCI will be able to
detect a treatment effect on a shorter time scale after an intervention. Its use as a
short-term pharmacodynamic biomarker in CF patients remains unknown. The ability of the LCI
to detect treatment effects within hours after an intervention would be invaluable to the
development of new therapeutic interventions for CF patients.
;
Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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