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Liposomal amikacin for

Phase 3

Cystic Fibrosis | Small molecule | Respiratory |Insmed Incorporated|Last Updated: Jun 17, 2020

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
UNCONTROLLEDDMCBiomarker
Total Trials1
Total Enrollment206
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01316276Extension Study of Liposomal Amikacin for Inhalation in Cystic Fibrosis (CF) Patients With Chronic Pseudomonas Aeruginosa (Pa) InfectionPHASE3 COMPLETED 206Oct 5, 2012Jul 16, 2015Jun 17, 202050 Austria, Belgium +15
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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

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).
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.
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Eligibility Criteria
Age Range6 Years — 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 Kingdom
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