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Clinical Trial Details — Status: Active, not recruiting

Administrative data

NCT number NCT04602468
Other study ID # RECOVER
Secondary ID
Status Active, not recruiting
Phase Phase 4
First received
Last updated
Start date September 3, 2020
Est. completion date July 1, 2029

Study information

Verified date May 2024
Source Royal College of Surgeons, Ireland
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

RECOVER is a prospective, multicenter observational study designed to measure the real world clinical effectiveness of elexacaftor, tezacaftor and ivacaftor triple combination therapy (Kaftrio) in people with cystic fibrosis over a two year period. Measured outcomes include measures of lung function, lung inflammation, lung imaging, abdominal symptoms, gut inflammation, liver function, pancreatic exocrine function, nasal inflammation, quality of life and adherence to therapy. The study will examine outcomes in children aged six years and above over a period of two years. The first phase of the study will commence in 2020, recruiting children 12 years and older who have started on clinical treatment with Kaftrio.


Description:

Our aim with RECOVER is to examine the clinical impact of Kaftrio on key clinical outcomes in people with CF in a real-world setting. For this study, in addition to some of the more traditional ways of monitoring clinical outcomes in people with CF such a standard lung function, nutrition, exacerbations and liver disease, we are proposing to include some novel outcome measures not typically used in clinical trials such as lung clearance index (LCI) and spirometry controlled chest CT. By implementing an extensive study protocol that will include important outcomes in a number of areas of health in people with CF, and matching this to a comprehensive biosample collection plan, we will have the power to gain important insight into how Kaftrio works, and what impact it has on rescue of CFTR function in this group of people. Data on the following outcomes will be collected during the study: Lung Clearance Index Ultra-low dose, spirometry-controlled CT scanning Sweat Chloride Nasal Lavage (inflammatory markers and microbiome) Fraction of Exhaled Nitric Oxide (FeNO) Liver Ultrasound Liver examination (signs of liver disease) Sputum Collection (inflammatory markers and microbiome) Stool Collection (inflammation, microbiome, fecal elastase) Abdominal symptom questionnaire CFQ-R (quality of life) Adherence to treatment Height, weight, BMI Forced Expiratory volume in 1 second (FEV1) Microbiological culture of airway specimens (clinical laboratories at sites) The Lead Investigator is Paul McNally, with Prof. Jane Davies as Co-Lead Investigator. The study will operate in collaboration with our academic and clinical partners and the CF registries in Ireland and the UK. The study is supported by the European CF Society Clinical Trials Network (ECFS-CTN). The study is being run as a CTIMP in the UK clinical sites, as determined by the MHRA. In the Irish sites, the HPRA has determined this study to be an observational research study.


Recruitment information / eligibility

Status Active, not recruiting
Enrollment 237
Est. completion date July 1, 2029
Est. primary completion date April 1, 2029
Accepts healthy volunteers No
Gender All
Age group 6 Years and older
Eligibility Inclusion Criteria: Inclusion criteria People with CF aged 12 years and over: Participants may only be selected for inclusion in RECOVER if they have been independently determined by their treating physician to be suitable for treatment with Kaftrio in compliance with the official marketing authorization and summary of product characteristics (SPC). The decision to include participants in the study is independent of decision to prescribe Kaftrio. Participants will receive treatment only through prescription by their physician through usual clinical treatment pathways. Children aged 6-11 years: Children aged 6-11 years will be included in the study only if and when Kaftrio is licenced, approved and funded for this age group. Participants may only be selected for inclusion in RECOVER if they have been independently determined by their treating physician to be suitable for treatment with Kaftrio in compliance with the official marketing authorization and summary of product characteristics (SPC). The decision to include participants in the study is independent of decision to prescribe Kaftrio. Participants will receive treatment only through prescription by their physician through usual clinical treatment pathways. Subjects on Kaftrio In exceptional circumstances where baseline clinical data has been collected prior to the start of treatment either through clinical care or ethically approved research projects (including a cohort of subjects initially recruited to this study on the understanding that it was a non-regulated observational study) subjects already receiving Kaftrio may be recruited to this study and undergo on-treatment visits. Any additional patient data can only be added with written informed consent from the patients/parents concerned. All Subjects (people with CF aged 12 years and over, children aged 6-11 years and subjects on Kaftrio) must be taking the full dose of Kaftrio (in accordance with the age appropriate posology in the SmPC). All subjects must have a signed informed consent form and/or signed assent form when appropriate, as determined by the subjects age and individual site and country standards. Male and female participants of childbearing potential must agree to adhere to contraception requirements as detailed in the local Kaftrio SmPC and in line with the standard of care. Exclusion Criteria: Patients not willing to comply with study procedures or assessments. Individuals on clinical trials of investigational CFTR modulators. Clinical instability at baseline assessments. Subjects undergoing an active exacerbation and at the beginning of their treatment should be excluded from the study as this is likely to skew the data. Any contraindication to Katrio treatment as per the local approved SmPC. Severe hepatic impairment. Pregnant and breastfeeding women.

Study Design


Intervention

Drug:
Kaftrio
The intervention is the same for both study groups. In addition to all the assessments in the standard arm, the advanced arm subjects will undergo spirometry controlled CT, nasal lavage and sputum sample collection.

Locations

Country Name City State
Ireland Children's Health Ireland at Crumlin Dublin Leinster
Ireland Children's Health Ireland at Temple Street Dublin
Ireland St. Vincent's University Hospital Dublin
Ireland University Hospital Limerick Limerick
Ireland Children's Health Ireland at Tallaght Tallaght
United Kingdom Royal Belfast Hospital for Sick Children Belfast
United Kingdom Royal Brompton Hospital London

Sponsors (12)

Lead Sponsor Collaborator
Royal College of Surgeons, Ireland Amsterdam UMC, Cystic Fibrosis Registry of Ireland, Erasmus Medical Center, Imperial College London, Medizinische Hochschule Brandenburg Theodor Fontane, Queen's University, Belfast, St. James's Hospital, Ireland, Teagasc, The Hospital for Sick Children, University College Dublin, University of Limerick

Countries where clinical trial is conducted

Ireland,  United Kingdom, 

Outcome

Type Measure Description Time frame Safety issue
Primary To determine the effect of treatment with TCMT on pulmonary function (FEV1 and LCI) in children and adults with CF over a period of 2 years. Spirometry, LCI 24 month period
Secondary To determine the effect of treatment with TCMT on spirometry-controlled CT scores in children and adults with CF over a two-year period. Spirometry controlled CT 24 month period
Secondary To determine the effect of treatment with TCMT on airway infection and inflammation in children and adults with CF Sputum sample collection, Nasal lavage, airway sampling (microbiology), Sinus sypmptoms (CFQ-R), FeNO 24 month period
Secondary To determine the effect of treatment with TCMT on nutrition, gastrointestinal symptoms, gut inflammation and pancreatic function in children and adults with CF over a two-year period Abdominal symptom questionnaire, fecal sample, liver examination, liver ultrasound, liver function tests 24 month period
Secondary To determine the effect of treatment with TCMT on antibiotic treatment of pulmonary disease in children and adults with CF over a two-year period Medication possession ratio (MPR) 24 month period
Secondary To assess the impact of the introduction of TCMT on adherence with overall medical treatments for CF MEMs caps, adherence questionnaires, Medication possession ratio (MPR) 24 month period
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