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Liposomal Amikacin

Phase 3

Cystic Fibrosis | Small Molecules | Respiratory |Insmed Incorporated|Trials Updated: Jun 17, 2020

Liposomal Amikacin target and mechanism

ModalitySmall Molecules

Also known as Liposomal Amikacin for Inhalation, Liposomal amikacin for inhalation (LAI)

Success Probability

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Market & Valuation

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Trial Design

UNCONTROLLEDDMC
Total Trials2
Total Enrollment296

FDA Designations

No designations recorded

Liposomal Amikacin clinical trials

Liposomal Amikacin · 2 trials · 2 indications

Phase 3 1Phase 2 1
NCT01316276Extension Study of Liposomal Amikacin for Inhalation in Cystic Fibrosis (CF) Patients With Chronic Pseudomonas Aeruginosa (Pa) InfectionCystic Fibrosis
COMPLETED206 Analytics
PHASE3COMPLETED
Extension Study of Liposomal Amikacin for Inhalation in Cystic Fibrosis (CF) Patients With Chronic Pseudomonas Aeruginosa (Pa) Infection
Cystic FibrosisUnlock trial analytics

Study Endpoints

Primary Endpoints

Treatment Emergent Adverse Events (TEAEs) up to Day 672
From Study Initiation up to Day 672

Treatment emergent adverse events including serious adverse events (SAE) and adverse events (AE) leading to permanent discontinuation of study drug

Laboratory Abnormalities up to Day 672
Baseline, Day 377 and Day 672

* Number of Subjects with Grade 3 or Higher Abnormalities in Clinical Laboratory Values * Number of Subjects with Grade 3 or Higher Hematology Laboratory Value Abnormalities * Number of Subjects with Grade 3 or Higher Chemistry Laboratory Value Abnormalities

Acute Tolerability as Measured by Pulmonary Function Test (PFT) Changes Pre to Post Dose
Day 1, Day 84, Day 196, Day 281, Day 337, Day 449, Day 532 and Day 644

Number of Subjects with a \>15% in Decline in Forced Expiratory Volume in 1 Second (FEV1) From Predose to Postdose

Respiratory Rate: Change From Baseline to Day 672
From Study Initiation up to Day 672

Respiratory rate was recorded at every visit as per standard practice at each investigational site.

Heart Rate: Change From Baseline From Day 672
From Study Initiation up to Day 672

Pulse rate (after at least 5-minute rest) was recorded at every visit as per standard practice at each investigational site.

Systolic BP: Change From Baseline at Day 672
From Study Initiation up to Day 672

Sitting blood pressure was recorded at every visit as per standard practice at each investigational site.

Diastolic BP: Change From Baseline at Day 672
From Study Initiation up to Day 672

Sitting blood pressure was recorded at every visit as per standard practice at each investigational site.

Body Temperature: Change From Baseline at Day 672
From Study Initiation up to Day 672

Body temperature was recorded at every visit as per standard practice at each investigational site.

Oxygen Saturation: Change From Baseline at Day 672
From Study Initiation up to Day 672

Change in oxygen saturation as measured with pulse oximetry was performed via finger probes placed on the extremity opposite arterial lines and noninvasive blood pressure monitoring devices so that pulsatile flow was not interrupted.

Minimum Inhibitory Concentrations (MICs) for Pseudomonas Aeruginosa (Pa) and Burkholderia Species From Day 1 to Days 169, 337, 505 and 672
Day 1, Day 169, Day 337, Day 505 and Day 672

Sputum was cultured for quantitative microbiological evaluation of Pa and Burkholderia species in designated regional central microbiology laboratories. A standard microbiology protocol was used for Pa culture and identification for each morphologically distinct Pa phenotype. Although planned in the Statistical Analysis Plan (SAP), MICs of amikacin Burkholderia species were not determined due to the small number of isolates with Burkholderia. In addition, susceptibility testing of isolates of Pa and Burkholderia species against a panel of commonly used antipseudomonal antibiotics was planned but was not performed. The results of the following analyses for Pa isolates are presented. * Frequency of MIC of Amikacin * Frequency of MIC of Tobramycin MIC50: lowest concentration of the antibiotic at which 50 % of the isolates were inhibited.

Evaluation of Audiology
Day 337 and Day 672

Hearing was evaluated using air conduction \[AC\]. Bone conduction was required if the AC testing demonstrated a decrease of \>20 decibels \[dB\]. Hearing loss was categorized using Common Terminology Criteria for Adverse Events as follows: GRADE 1 (best): Adults \[A\] on a Monitoring Program \[MP\]: Threshold shift of 15-25 dB; Pediatric \[P\]: Threshold shift \>20 dB at 8 kilohertz (kHz). GRADE 2: \[A\] on a MP: Threshold shift of \>25 dB; \[A\] not enrolled in MP: hearing loss; hearing aid/intervention not indicated; \[P\]: Threshold shift \>20 dB at 4 kHz and above. GRADE 3: \[A\] enrolled in MP: Threshold shift of \>25 dB; therapeutic intervention indicated; \[A\]: Not enrolled in MP: hearing aid/intervention; \[P\]: therapeutic intervention, including hearing aids: Threshold shift \>20 dB at 3 kHz and above; additional speech-language related services. GRADE 4 (worst): \[A\]: Profound bilateral hearing loss; non-serviceable hearing; \[P\]: cochlear implant \& additional speech-language related services.

Change in Serum Creatinine Throughout the Study
Baseline, Day 337 and Day 672

* Common Terminology Criteria for Adverse Events (CTCAE) Grade 1: \> ULN-1.5 × ULN * CTCAE Grade 2: \> 1.5 × ULN to 3.0 x ULN

Change in Semi-Quantitative Mycobacterial Culture Results From Baseline to Day 84.
Baseline and end of double-blind phase of 84 days

The endpoint used the 7-step semi-quantitative scale (SQS) for mycobacterial culture reporting in both solid and liquid growth media, with step 1 = culture negative in both solid and liquid media, step 2 = growth in liquid medium only, 3 = solid medium positive, 4 = 50 to 100 colonies in solid medium \& growth in liquid, 5 = \>100 to 200 colonies in solid medium \& growth in liquid, 6 = \>200 to 500 colonies in solid medium \& growth in liquid, 7 = \>500 colonies in solid medium \& growth in liquid. Full scale range is 1 (best score) to 7 (worst score). The change in step measures the growth at Day 84 compared to the growth at Baseline. The negative values represent reduction in colony growth.

Secondary Endpoints

Percent Change in FEV1 Throughout the Study
Baseline, Day 337 and Day 672
Number of Subjects Experiencing a Protocol Defined Pulmonary Exacerbation
From Study Initiation up to Day 700
Number of Subjects Initiating Treatment.
From Study Initiation up to Day 672
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Study Design & Arms

AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
LAIEXPERIMENTAL590 mg LAI QD via a PARI Investigational eFlow® Nebulizer System (eFlow®) for 28 days followed by a 28-day off-treatment period. This cycle (28 days on treatment, 28 days off treatment) was to be repeated for up to 12 cycles, divided into 2 periods of 6 cycles each (approximately 12 months each).
LAI 590 mg QDEXPERIMENTALLAI 590 mg QD
PlaceboPLACEBO_COMPARATORplacebo QD

Interventions

NameTypeDescription
Liposomal amikacin for inhalationDRUG* Liposomal amikacin for inhalation is provided as a sterile aqueous liposomal dispersion for inhalation via nebulization. * 590 mg of liposomal amikacin for inhalation is administered once daily using the PARI Investigational eFlow® Nebulizer. * Administration time is approximately 13 minutes. * Liposomal amikacin for inhalation will be administered in two consecutive extension periods, each consisting of 6 cycles for a total of 12 cycles. Each cycle consists of 28 days on-treatment followed by 28 days off-treatment.
Liposomal amikacin for inhalation (LAI)DRUG* Liposomal amikacin for inhalation is provided as a sterile aqueous liposomal dispersion for inhalation via nebulization. * 590 mg of liposomal amikacin for inhalation is administered once daily using the PARI Investigational eFlow® Nebulizer. * Administration time is approximately 13 minutes. * Liposomal amikacin for inhalation will be administered for 84 days in the double-blind, randomized portion of the study. * Subjects can continue with 84 additional days of dosing in the open label extension.
placeboDRUG* Placebo is provided as a sterile aqueous lipid dispersion for inhalation via nebulization. * Administration procedures, volume and administration time are similar to LAI. * Placebo will be administered for 84 days only during the double-blind, randomized portion of the study.
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Eligibility Criteria

Age Range6 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites50

Key Inclusion Criteria: * Written informed consent or assent * Subject has completed study TR02-108, and has been compliant with the study protocol * Women of childbearing potential must agree to use reliable methods of contraception for the duration of the study Key Exclusion Criteria: * Subject...

Countries:AustriaBelgiumBulgariaCanadaDenmarkFranceGermanyGreeceHungaryIrelandItalyNetherlandsPolandSerbiaSlovakiaSpainUnited KingdomUnited States
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Competitive Landscape -Cystic Fibrosis 20 trials

Frequently asked questions about Liposomal Amikacin

What is Liposomal Amikacin for Inhalation used for?

Liposomal Amikacin for Inhalation is an investigational therapy being studied for cystic fibrosis in patients with chronic Pseudomonas aeruginosa infection and for nontuberculous mycobacterial infections. It is delivered as an inhaled formulation and is in Phase 3 development. It is not yet approved for commercial use.

Who is developing Liposomal Amikacin for Inhalation?

Liposomal Amikacin for Inhalation is being developed by Insmed Incorporated, which trades on the Nasdaq under the ticker INSM. Insmed is the sponsor of the clinical trials evaluating this inhaled antibiotic candidate for respiratory infections.

What phase is Liposomal Amikacin for Inhalation in?

Liposomal Amikacin for Inhalation is in Phase 3 clinical development. The Phase 3 trial in cystic fibrosis has been completed, and a Phase 2 trial in nontuberculous mycobacterial infections has also been completed. The drug remains investigational and has not been approved by the FDA.

What clinical trials is Liposomal Amikacin for Inhalation in?

Liposomal Amikacin for Inhalation has been studied in two completed trials: NCT01316276, a Phase 3 extension study in cystic fibrosis patients with chronic Pseudomonas aeruginosa infection that enrolled 206 participants across Europe and Canada, and NCT01315236, a Phase 2 trial in nontuberculous mycobacterial infections that enrolled 90 participants in the United States and Canada.

Is Liposomal Amikacin for Inhalation the same as Liposomal Amikacin for?

Yes, Liposomal Amikacin for Inhalation is also known as Liposomal amikacin for inhalation (LAI). These names refer to the same investigational drug candidate developed by Insmed Incorporated for respiratory infections.