A Randomized, Double-Blind, Placebo-Controlled Trial to Assess the Efficacy, Safety, and Pharmacokinetics of Epetraborole in Adults With Mycobacterium Abscessus Lung Disease
Led by Kevin Winthrop · Updated on 2026-05-06
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Participants Needed
1
Research Sites
21 weeks
Total Duration
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Kevin Winthrop
Lead Sponsor
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AN2 Therapeutics, Inc
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are evaluating epetraborole (EBO) monotherapy for adults with mild to moderate Mycobacterium abscessus complex (MABc) Lung Disease. This phase 2, double-blind, randomized, placebo-controlled trial aims to assess the efficacy, safety, and pharmacokinetics of two oral EBO doses compared to placebo. MABc lung disease is a chronic infection that requires complicated treatments, and EBO represents a potential new oral therapy option due to its ability to inhibit bacterial protein synthesis and its promising preclinical and pharmacokinetic data.
Participants will be randomly assigned to one of four groups: 750 mg daily EBO, 500 mg daily EBO, or matching placebos for each dose. The treatment period lasts 84 days, during which patients take the assigned tablets daily. Some sites will collect pharmacokinetic samples to study drug levels. The study includes oversight by a Data Safety Monitoring Board and uses a comprehensive statistical analysis plan to evaluate results.
Throughout the approximately six-month participation, patients will undergo clinical and microbiological assessments, including sputum cultures and symptom evaluations. Quality of life and symptom questionnaires will be completed, and safety will be monitored with clinical and laboratory tests. The primary outcomes include symptom improvement, sputum culture conversion, and quality of life changes by day 84. Secondary outcomes include additional symptom scales and microbiological measures.
CONDITIONS
Brief Title
Epetraborole in Patients With Mycobacterium Abscessus Lung Disease
Who Can Participate
Age: 18Years +
All Genders
Eligibility Criteria
You may qualify if you...
Male or female patients aged 18 years or older
Willing and able to provide written informed consent
Diagnosis of Mycobacterium abscessus lung disease confirmed by at least one MABc-positive respiratory specimen within 6 months prior to consent
Presence of at least one MABc-positive sputum sample at screening
At least two patient-reported clinical symptoms such as chest pain, chronic cough, coughing up blood, fatigue, fever, mucus production, night sweats, poor appetite, shortness of breath, or unintentional weight loss
Chest CT scan within 4 months prior to consent or during screening showing abnormalities consistent with MABc lung disease
Not expected to require antibiotic treatment for MABc lung disease within the next 6 months as judged by the investigator
Willing to comply with all study procedures
Use of effective birth control methods if applicable, including females of childbearing potential and sexually active males
Expected to survive with continued antimycobacterial therapy and supportive care through long-term follow-up
You will not qualify if you...
Presence of cavitary lung disease with cavities larger than 2 cm
Diagnosis of cystic fibrosis or other inherited airway ciliary dysfunction disorders
Active allergic bronchopulmonary mycosis
Planned or anticipated lung surgery for MABc lung disease
Disseminated MABc infection or other non-pulmonary infections requiring antimicrobial therapy
Concurrent pulmonary infections requiring antimicrobials, including fungal, viral, or non-MABc bacterial infections
Use of brensocatib without stable dosing for at least 12 weeks
Active pulmonary malignancy or malignancy requiring chemotherapy or radiation within 1 year
Severe kidney impairment with creatinine clearance under 30 mL/min
Hemoglobin under 11.0 g/dL or recent blood donation or hemorrhage within 28 days
Pre-existing blood disorders affecting hemoglobin
Severe hemoptysis within 28 days
Severe liver impairment or signs of end-stage liver disease
Pregnancy or breastfeeding
Prolonged QT interval over 500 msec on ECG
Immunodeficiency conditions including lung transplantation, advanced HIV/AIDS, neutropenia, or immunosuppressive therapy
Planned new antimycobacterial therapy between screening and end of treatment
Participation in another investigational drug trial within 30 days prior to screening
Prior exposure to epetraborole
Hypersensitivity to epetraborole excipients
History of eosinophilic interstitial pneumonitis
Any condition interfering with safe study completion or compliance
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Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Up to 84 days
Participants receive daily oral doses of Epetraborole or placebo as part of a randomized treatment regimen for their lung disease.
Visits occur at baseline and periodically through Day 84
Microbiological and Clinical Outcomes of Treating Non-Mycobacterium Avium Complex Nontuberculous Mycobacterial Pulmonary Disease: A Systematic Review and Meta-Analysis.