Status:
COMPLETED
Asthma Clinical Research Network (ACRN) Trial - Macrolides in Asthma (MIA)
Lead Sponsor:
Milton S. Hershey Medical Center
Collaborating Sponsors:
National Heart, Lung, and Blood Institute (NHLBI)
Conditions:
Asthma
Eligibility:
All Genders
18-60 years
Phase:
PHASE3
Brief Summary
Asthma can be caused by a variety of factors, including tobacco smoke, allergens, and respiratory airway infections. Many people use inhaled corticosteroid medications to treat their symptoms. These m...
Detailed Description
Asthma prevalence has steadily increased in the United States since the early 1980s; currently, more than 20 million people are diagnosed with asthma. Individuals with this disease may experience peri...
Eligibility Criteria
Inclusion
- History of physician-diagnosed asthma
- Methacholine PC20 less than or equal to 16 mg/ml and/or FEV1 improvement greater than or equal to 12% in response to 180 mcg albuterol
- Stable asthma for at least 6 weeks prior to study entry
- FEV1 greater than or equal to 60% of predicted result following 180 mcg albuterol
- Juniper ACQ score greater than or equal to 1.5 (optimal ACQ score cut-off point for asthma that is "not well-controlled" by NIH/Global Initiative for Asthma \[GINA\] guidelines)
- Nonsmoker (less than 10 pack-per-year lifetime smoking history and no smoking in the year prior to study entry)
- Able to perform spirometry, as per American Thoracic Society criteria
- 75% adherence with diary cards, fluticasone (monitored with Doser), and placebo pill trial (monitored electronically with Electronic Drug Exposure Monitor \[eDEM\] pill dose counter) for the final 2 weeks of the four-week run-in period
- At Visit 1, in steroid-naïve participants, no significant adrenal suppression, defined as a plasma cortisol concentration less than 5 mcg/dL. If adrenal suppression occurs, a 250 mcg corticotropin (ACTH) stimulation test will be performed. Plasma cortisol levels will be collected at baseline, and 30 and 60 minutes after the ACTH stimulation test. Participants must have a cortisol concentration greater than 20 mcg/dL on at least one of the post-ACTH time points
- Absence of bronchoscopy-induced exacerbation; if bronchoscopy-induced exacerbation has occurred, prednisone therapy must have stopped at least 6 weeks prior to study entry
- Absence of respiratory tract infection; if infection has occurred, infection-related symptoms must have stopped at least 6 weeks prior to study entry
- Has experienced no more than two exacerbations or respiratory tract infections prior to study entry
- If female and able to conceive, willing to utilize two medically acceptable forms of contraception (one non-barrier method with single barrier method OR double barrier method)
Exclusion
- Presence of lung disease other than asthma
- Presence of vocal cord dysfunction, due to potential confounding of ACQ score
- Significant medical illness other than asthma
- History of atrial or ventricular tachyarrhythmia
- Use of any medication that has a significant interaction with clarithromycin, including herbal or alternative therapies
- Asthma exacerbation within 6 weeks of the screening visit or during the run-in period prior to bronchoscopy
- Use of systemic steroids or change in dose of controller therapy within 6 weeks of the screening visit
- Inability, in the opinion of the study investigator, to coordinate use of dry powder or metered-dose inhaler or to comply with medication regimens
- Inability or unwillingness to perform required study procedures
- Prolonged heart rate corrected QT-interval (greater than 450 msec in women and greater than 430 msec in men) on echocardiogram (ECG) at study entry
- Low potassium or magnesium levels (based on local Asthma Clinical Research Network laboratory definitions)
- Abnormal elevation of liver function tests (AST, ALT, total bilirubin, or alkaline phosphatase)
- Abnormal prothrombin time (PT) or partial thromboplastin time (PTT) results
- Reduced creatinine clearance
- Contraindication to bronchoscopy, as determined by medical history or physical examination
- Regular consumption of grapefruit or grapefruit juice
- Pregnant or breastfeeding
Key Trial Info
Start Date :
June 1 2006
Trial Type :
INTERVENTIONAL
Allocation :
ACTUAL
End Date :
April 1 2009
Estimated Enrollment :
92 Patients enrolled
Trial Details
Trial ID
NCT00318708
Start Date
June 1 2006
End Date
April 1 2009
Last Update
March 23 2018
Active Locations (10)
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1
University of California, San Diego
San Diego, California, United States, 92093
2
University of California, San Francisco
San Francisco, California, United States, 94143
3
National Jewish Medical and Research Center
Denver, Colorado, United States, 80206
4
Brigham & Women's Hospital
Boston, Massachusetts, United States, 02115