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The project was a student driven study. The student graduated prior to the subjects completing all research related activities. As a result, the study was closed prematurely.
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Inhaled tobramycin is a Cystic Fibrosis Foundation recommended effective treatment for individuals with cystic fibrosis for the management of Pseudomonas aeruginosa airway colonization and improves the FEV1 and reduces the number of acute pulmonary exacerbations of CF. Patients typically use the inhaled tobramycin for a period of 28 days. Unfortunately, the standard nebulizer method for delivering tobramycin inhaled solution (TIS) is time-consuming and may result in missed therapy doses and suboptimal care. A new inhaled formulation and delivery device, the TOBI Podhaler (TPI), an alternative method of administering inhaled Tobramycin will be used and assessed. This new pocket-sized disposable inhaler is maintenance-free, requires no refrigeration or power source, and should greatly increase patient mobility and improve time management.
Adult cystic fibrosis patients from the Rush University Medical Center Adult Cystic Fibrosis Program will be recruited for a prospective before and after cohort study to evaluate patient preference for either the TOBI Podhaler or inhaled tobramycin solution and compare the efficacy of the TOBI Podhaler to tobramycin inhaled solution. This project will evaluate the potential differences in efficacy, medication adherence, treatment time, side effects/adverse effects, quality of life, and identify patient preferences between the use of TIP and TIS. Measurements after a 28-day cycle of tobramycin inhaled solution, first 28-day cycle of TOBI Podhaler and third 28-day cycle of TOBI Podhaler will include FEV1, number of acute pulmonary exacerbations, adherence, cough frequency, sputum characteristics, and side effects or adverse events. The quality of life as assessed by the Cystic Fibrosis Questionnaire-Revised (CFQ-R) will be measured after a 28-day cycle of tobramycin inhaled solution and the third 28-day cycle of TOBI Podhaler. The FEV1 values, number of missed treatments, and total treatment time will be analyzed through a repeated measures analysis of variance. Comparisons of the CFQ-R data before and after the switch to the TPI will be made with the Student's t-test.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Adults- Cystic Fibrosis | Adults with cystic fibrosis who have respiratory colonization with Pseudomonas Aeruginosa. The actual study will involve instructing adult patients with CF on the use of a new form of Tobramycin for inhalation (powder) and then assessing this new form of TOBI podhaler vs the old TOBI solution related to patient preference on use, time involved in taking the new medication vs the old, and impact on their pulmonary function and subsequent exacerbation rate plus quality of life. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TOBIpodhaler | Drug |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Increased Adherence to the Medical Therapeutic Regimen | Number of Participants with Adherence to Tobramycin Inhaled Solution Treatment compared with TOBI Podhaler Treatment based on improved efficacy and time required for administration and translate into improved respiratory status for adult patients with cystic fibrosis. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Preference for TOBIpodhaler Treatment | The subject will indicate a preference for TOBIpodhaler vs prior treatment. | 6 months |
| Spirometry Data | spirometry was performed at baseline and at the end of the study. |
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Inclusion Criteria:
Exclusion Criteria:
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Adult (≥ 18 years) diagnosed with cystic fibrosis
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| Name | Affiliation | Role |
|---|---|---|
| Robert A Balk, MD | Rush University Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Rush University Medical Center | Chicago | Illinois | 60612 | United States |
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Subjects were asked to compare the time and satisfaction of the TOBIpodhaler treatment to their prior inhaled antibiotic administration time and satisfaction and to compare their Quality of Life (using CFR-Q) measured before and after the TOBIpodhaler.
Recruitment was very slow related to cost of the medication. We also experienced difficulty getting subjects to return the questionnaire related to time involved and satisfaction with the treatment.
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| ID | Title | Description |
|---|---|---|
| FG000 | Adults- Cystic Fibrosis | Adults with cystic fibrosis who have respiratory colonization with Pseudomonas Aeruginosa. The actual study will involve instructing adult patients with CF on the use of a new form of Tobramycin for inhalation (powder) and then assessing this new form of TOBI podhaler vs the old TOBI solution related to patient preference on use, time involved in taking the new medication vs the old, and impact on their pulmonary function and subsequent exacerbation rate plus quality of life. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
5 individuals actually started the study and participated in the initial data collection
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| ID | Title | Description |
|---|---|---|
| BG000 | Subject Response to TOBIpodhaler Were Compared to Baseline | Individuals who were on inhaled antibiotic therapy as part of their CF management of Pseudomonas in the airway were selected if they were able to change their inhaled antibiotic to the TOBIpodhaler. These subjects would then compare their time involved in airway treatment, satisfaction with the treatment, and FEV1 to their prior-to-change value. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Increased Adherence to the Medical Therapeutic Regimen | Number of Participants with Adherence to Tobramycin Inhaled Solution Treatment compared with TOBI Podhaler Treatment based on improved efficacy and time required for administration and translate into improved respiratory status for adult patients with cystic fibrosis. | 4 of 5 patients preferred TOBIpodhaler | Posted | Number | participants | 6 months |
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6 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Tobramycin Inhaled Solution | Before and after study of patients with cystic fibrosis and Pseudomonas colonization comparing the time spent with TOBIsolutions vs TOBIpodhaler. The preference was evaluated including changing lung function over the course of the study. |
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There was limited enrollment and lack of follow up survey completion. Study was terminated early.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Robert Balk | Rush University Medical Center | 3129426744 | Robert_Balk@rush.edu |
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| ID | Term |
|---|---|
| D003550 | Cystic Fibrosis |
| ID | Term |
|---|---|
| D010182 | Pancreatic Diseases |
| D004066 | Digestive System Diseases |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| 6 months |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | U.S. adult patients using inhaled TOBI and planning to switch to TOBIpodhaler | Count of Participants | Participants |
|
| FEV1 | spirometry was performed on carefusion Vmax calibrated spirometer | 4 subjects did not return for evaluation 1 subject lost to follow-up All 5 subjects did not complete the study | Count of Participants | Participants |
|
|
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| Secondary | Preference for TOBIpodhaler Treatment | The subject will indicate a preference for TOBIpodhaler vs prior treatment. | Data were not collected since patients did not return for follow-up. | Posted | 6 months |
|
|
| Secondary | Spirometry Data | spirometry was performed at baseline and at the end of the study. | Data were not collected since patients did not return for follow-up. | Posted | 6 months |
|
|
| 0 |
| 5 |
| 0 |
| 5 |
| 0 |
| 5 |
| EG001 | TOBI Podhaler | patient with cystic fibrosis using TOBI podhaler treatment. | 0 | 5 | 0 | 5 | 0 | 5 |
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| D030342 |
| Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007232 | Infant, Newborn, Diseases |