Oral Ifetroban for treating Idiopathic Pulmonary Fibrosis
A Randomized, Double-Blind, Placebo-Controlled Phase II Study to Determine the Safety and Efficacy of Oral Ifetroban in Patients With Idiopathic Pulmonary Fibrosis (IPF)
This study is testing if a new oral medication called ifetroban can help people with Idiopathic Pulmonary Fibrosis feel better and stay safe over a year.
Quick facts
| Phase | Phase 2 |
|---|---|
| Study type | Interventional |
| Enrollment | 128 (estimated) |
| Ages | 40 Years and up |
| Sex | All |
| Sponsor | Cumberland Pharmaceuticals Industry-sponsored |
| Drugs / interventions | prednisone, radiation |
| Locations | 19 sites (La Mesa, California and 18 other locations) |
| Trial ID | NCT05571059 on ClinicalTrials.gov |
What this trial studies
This phase II clinical trial evaluates the safety and efficacy of oral ifetroban in patients diagnosed with Idiopathic Pulmonary Fibrosis (IPF). It is a multicenter, randomized, placebo-controlled study where participants will receive either ifetroban or a placebo daily for 12 months. The study aims to assess treatment effects through various efficacy assessments and the collection of blood and urine samples for biomarker analysis. Participants will be monitored for safety throughout the trial duration.
Who should consider this trial
Good fit: Ideal candidates are adults aged 40 and older with a confirmed diagnosis of IPF meeting specific diagnostic criteria.
Not a fit: Patients who are currently receiving certain antifibrotic therapies or have not been off these therapies for the required duration may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could provide a new therapeutic option for patients suffering from Idiopathic Pulmonary Fibrosis.
How similar studies have performed: While there have been studies on antifibrotic treatments, the specific use of oral ifetroban in this context is a novel approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. Male or female age 40 years or older
2. IPF Diagnosis:
1. Satisfying the 2022 American Thoracic Society/European Respiratory Society /Japanese Respiratory Society/Latin American Thoracic Association (ATS/ERS/JRS/ALAT) diagnostic criteria (Raghu 2022) confirmed by the investigator
2. UIP or probable UIP based on chest HRCT obtained within 2 months of Day 0, or historical lung biopsy consistent with UIP.
3. If receiving antifibrotic agents pirfenidone or nintedanib, patients must be receiving a stable dose for ≥ 2 months prior to Day 0 and planning to stay on stable background therapy; if not receiving pirfenidone or nintedanib, patients must be naive to both drugs or not have received either for at least 4 weeks prior to Day 0 and remain off background therapy with no intention to start or re-start (combination of nintedanib and pirfenidone not allowed).
4. If receiving monotherapy for the treatment of pulmonary hypertension (e.g. phosphodiesterase 5 inhibitors, endothelin receptor antagonists or inhaled or oral prostanoid therapy), patients must be receiving a stable dose for ≥ 4 weeks prior to Day 0 and planning to remain on a stable dose throughout the study.
5. FVC ≥ 40% of predicted normal according to Global Lung Initiative (GLI)
6. Diffusion Capacity of Carbon Monoxide (DLCO) \[corrected for hemoglobin\] ≥ 25% to \<80% of predicted normal
Exclusion Criteria:
1. Relevant airways obstruction (pre-bronchodilator Forced Expiratory Volume in one second to forced vital capacity ratio less than 70% (FEV1/FVC \< 0.7))
2. In the opinion of the Investigator, other clinically significant pulmonary abnormalities.
3. Known significant PAH, defined as previous clinical or echocardiographic evidence of significant right heart failure, history of right heart catheterization showing a cardiac index \< 2 L/min/m2, or PAH requiring combination of PAH-specific therapies or any PAH parenteral therapy.
4. Emphysema ≥ 50% on HRCT assessed by the investigator, or the extent of emphysema is greater than the extent of fibrosis according to reported results from the most recent chest HRCT.
5. Acute IPF exacerbation within 6 weeks prior to screening and/or during the screening period (investigator-determined).
6. ILD associated with other known causes
7. Lower respiratory tract infection requiring antibiotics within 4 weeks prior to Day 0 and/or during the screening period.
8. Major surgery (major according to the investigator's assessment) performed within six weeks prior to Day 0 or planned during the course of the trial. (Being on a transplant list is allowed).
9. AST or ALT \> 1.5 x ULN, Bilirubin \> 1.5 x ULN, Creatinine clearance \< 30 mL/min calculated by Cockcroft-Gault formula.
10. Underlying chronic liver disease (Child Pugh A, B or C hepatic impairment).
11. Cardiovascular diseases, any of the following:
1. Severe hypertension, uncontrolled despite treatment (≥160/100 mmHg)
2. Myocardial infarction within 6 months of Day 0
3. Unstable cardiac angina
12. Bleeding risk, any of the following:
1. Known genetic predisposition to bleeding.
2. Patients who require:
i. Fibrinolysis, full-dose therapeutic anticoagulation (e.g. vitamin K antagonists, direct thrombin inhibitors, direct oral anticoagulants, heparin, hirudin) ii. High dose antiplatelet therapy (\> 325 mg/day of aspirin; \> 75 mg/day ticlodipine or clopidogrel; any dose of other 2b3a anti-platelet agents)
13. History of hemorrhagic central nervous system (CNS) event within 12 months of Day 0
14. Any of the following within 3 months of Day 0:
1. Hemoptysis or hematuria
2. Active gastro-intestinal (GI) bleeding needing hospitalization/intervention or peptic ulcer disease
15. Coagulation parameters: International normalized ratio (INR) \>2, prolongation of prothrombin time (PT) and activated partial thromboplastin time (aPTT) by \>1.5 x ULN
Note: Prophylactic low dose heparin or heparin flush as needed for maintenance of an indwelling intravenous device (e.g. less than or equal to enoxaparin 40 mg subcutaneously (SC) per day or heparin 5000 units SC every eight hours), low-dose FXa inhibitors (rivaroxaban/apixaban: 2.5mg twice daily (max 5mg/day), edoxaban: 15mg/day), as well as prophylactic use of antiplatelet therapy (e.g. acetyl salicylic acid \[ASA\] up to 325 mg/day, or clopidogrel at 75 mg/day, or equivalent doses of other antiplatelet therapy) are not prohibited.
16. History of thrombotic event (including stroke and transient ischemic attack) within 12 months of Day 0
17. Use of disease-modifying antirheumatic drugs, B-cell depleting therapies or immunosuppressive medications, within 6 months of Day 0.
18. Use of systemic corticosteroids equivalent to prednisone \>15mg/day within 2 weeks of Day 0.
19. Simultaneous use of pirfenidone and nintedanib at screening.
20. Other disease that may interfere with testing procedures or in the judgment of the Investigator may interfere with trial participation or may put the patient at risk when participating in this trial.
21. Any documented active or suspected malignancy within 5 years prior to Day 0, except appropriately treated basal cell carcinoma of the skin, in situ squamous cell carcinoma of the skin or "under surveillance" prostate cancer.
22. Evidence of active infection (chronic or acute) based on clinical exam or laboratory findings.
23. The patient has a confirmed infection with Severe Acute Respiratory Syndrome- Coronvirus-2 (SARS-CoV-2) within the four weeks prior to Day 0 or during the screening period.
24. Women who are pregnant, nursing, or who plan to become pregnant while in the trial.
25. Women of childbearing potential not willing or able to use highly effective methods of birth control per ICH M3 (R2) that result in a low failure rate of less than 1% per year when used consistently for 28 days prior to and three months after Investigational Medicinal Product (IMP) administration.
Note: A woman is considered of childbearing potential, i.e. fertile, following menarche and until becoming post-menopausal unless permanently sterile. Permanent sterilization methods include hysterectomy, bilateral salpingectomy and bilateral oophorectomy
26. In the opinion of the Investigator, active alcohol or drug abuse.
27. Patients not able to understand or follow trial procedures including completion of self- administered questionnaires without help.
Where this trial is running
La Mesa, California and 18 other locations
- Biosolutions Clinical Research — La Mesa, California, United States (Recruiting)
- University of California San Francisco — San Francisco, California, United States (Recruiting)
- Mayo Clinic Jacksonville — Jacksonville, Florida, United States (Recruiting)
- Miami VA Health System — Miami, Florida, United States (Recruiting)
- Northwestern Medicine — Chicago, Illinois, United States (Recruiting)
- Indiana University Health — Indianapolis, Indiana, United States (Recruiting)
- University of Kansas — Kansas City, Kansas, United States (Recruiting)
- University of Louisville — Louisville, Kentucky, United States (Recruiting)
- Beaumont Hospital, Royal Oak — Royal Oak, Michigan, United States (Recruiting)
- Icahn School of Medicine at Mount Sinai — New York, New York, United States (Recruiting)
- University of Rochester — Rochester, New York, United States (Recruiting)
- UNC Chapel Hill — Chapel Hill, North Carolina, United States (Recruiting)
- Bend Memorial Hospital — Bend, Oregon, United States (Recruiting)
- Temple University Hospital — Philadelphia, Pennsylvania, United States (Recruiting)
- Avera Research Institute — Sioux Falls, South Dakota, United States (Recruiting)
- Pulmonary & Sleep Specialists — Dickson, Tennessee, United States (Recruiting)
- Baylor University Medical Center — Dallas, Texas, United States (Recruiting)
- Premier Pulmonary Critical Care and Sleep Medicine — Denison, Texas, United States (Recruiting)
- UW Health University Hospital — Madison, Wisconsin, United States (Recruiting)
Study contacts
- Principal investigator: Todd Rice, MD, MSc — Cumberland Pharmaceuticals
- Study coordinator: Ines Macias-Perez, PhD
- Email: imaciasperez@cumberlandpharma.com
- Phone: 6159795778
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.