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| ID | Type | Description | Link |
|---|---|---|---|
| 1U24HL145265-01A1 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| University of Virginia | OTHER |
| University of Michigan | OTHER |
| Pulmonary Fibrosis Foundation | OTHER |
| University of Washington |
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The purpose of this study is to compare the effect of n-acetylcysteine (NAC) plus standard care with matched placebo plus standard of care in patients diagnosed with idiopathic pulmonary fibrosis (IPF) who have the TOLLIP rs3750920 TT genotype. The study will compare the time to a composite endpoint of relative decline in lung function [10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplantation, or all-cause mortality]
The secondary objectives will be to examine the effect of NAC on the components of the primary composite endpoint, the rates of clinical events, change in physiology, change in health status, and change in respiratory symptoms.
This is a multi-center, randomized, double-blind, placebo-controlled trial of NAC or placebo in about 200 participants with IPF with a TOLLIP rs3750920 TT genotype.
Eligible participants will be randomized in a 1:1 fashion to NAC or placebo, stratified by stable concomitant IPF therapy use (i.e., pirfenidone or nintedanib administered for at least 6 weeks prior to screening) versus no pirfenidone or nintedanib use. Participants will receive 600 mg NAC orally or matched placebo to take three times daily for 24 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| N-acetylcysteine | Experimental | 600 mg oral N-acetylcysteine (NAC) three times daily for 24 months. |
|
| Placebo | Placebo Comparator | Placebo tablet three times daily for 24 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| N-acetyl cysteine | Drug | 600 mg N-acetylcysteine (NAC) oral tablets three times daily for 24 months. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to one of the following composite endpoint criteria: 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplant or death from any cause. | This is a composite endpoint of time to 10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplant or death from any cause. Respiratory hospitalizations will be determined by a blinded clinical events classification (adjudication) committee. | 24 months |
| Measure | Description | Time Frame |
|---|---|---|
| Time to one of the following composite criteria: 10% relative decline in FVC % predicted, first respiratory hospitalization, lung transplant or death from any cause. | This is a composite endpoint of time to 10% relative decline in FVC % predicted, based on the global lung initiative (GLI) reference equation, first respiratory hospitalization, lung transplant or death from any cause. Respiratory hospitalizations will be determined by a blinded clinical events classification (adjudication) committee. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Fernando J Martinez, MD | University of Massachusetts, Worcester | Principal Investigator |
| Imre Noth, MD | University of Virginia | Principal Investigator |
| Kevin Flaherty, MS, MD | University of Michigan | Principal Investigator |
| Cathie Spino, ScD | University of Michigan | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Arizona | Tucson | Arizona | 85724 | United States | ||
| University of Southern California |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36514019 | Derived | Podolanczuk AJ, Kim JS, Cooper CB, Lasky JA, Murray S, Oldham JM, Raghu G, Flaherty KR, Spino C, Noth I, Martinez FJ; PRECISIONS Study Team. Design and rationale for the prospective treatment efficacy in IPF using genotype for NAC selection (PRECISIONS) clinical trial. BMC Pulm Med. 2022 Dec 13;22(1):475. doi: 10.1186/s12890-022-02281-8. |
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The de-identified analytic data will be prepared as SAS transport files or ASCII comma-delimited files with accompanying codebooks that describe the data and data structure. The redaction will employ best practices and will be consistent with NHLBI data sharing policies.
3 years after the end of the study or 2 years after the main paper reporting the results of the trial, whichever comes first.
Data will be shared through the NHLBI Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC).
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| OTHER |
| National Heart, Lung, and Blood Institute (NHLBI) | NIH |
| Three Lakes Foundation | UNKNOWN |
Eligible participants will be randomized in a 1:1 fashion to NAC or placebo, stratified by stable concomitant IPF therapy use (i.e., pirfenidone or nintedanib administered for at least 6 weeks prior to screening) versus no pirfenidone or nintedanib use. Participants will receive 600 mg NAC orally three times daily or matched placebo for 24 months.
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The participant and site personnel will not know which study treatment the participant is receiving.
| Placebo | Drug | Matching oral placebo tablet three times daily for 24 months. |
|
| 24 months |
| Time to death from any cause | 24 months |
| Time to first respiratory hospitalization, lung transplant, or death from any cause | Respiratory hospitalizations will be determined by a blinded clinical events classification (adjudication) committee. | 24 months |
| Time to 10% relative decline in FVC, lung transplant or death from any cause | 24 months |
| Time to lung transplant, or death from any cause | 24 months |
| Time to 10% relative decline in FVC %predicted, lung transplant, or death from any cause | 24 months |
| Time to first all-cause hospitalization, lung transplant, or death from any cause | 24 months |
| Annualized rate of respiratory hospitalizations | 24 months |
| Annualized rate of non-elective, all-cause hospitalizations | 24 months |
| Absolute change in FVC % predicted from randomization at 12 months | 12 months |
| Absolute change in FVC % predicted from randomization at 24 months | 24 months |
| Absolute change in FVC from randomization at 12 months | 12 months |
| Absolute change in FVC from randomization at 24 months | 24 months |
| Absolute change in diffusing capacity of the lung for carbon monoxide (DLCO) uncorrected for hemoglobin from randomization at 12 months | 12 months |
| Absolute change in DLCO uncorrected from randomization at 24 months | 24 months |
| Absolute change in patient reported outcomes scores for the Leicester Cough Questionnaire (LCQ) from randomization at 12 months. | 12 months |
| Absolute change in patient reported outcomes scores for the EuroQoL EQ-5D Questionnaire from randomization at 12 months. | 12 months |
| Change in patient reported outcomes scores for the University of California, San Diego Shortness of Breath (UCSD-SOB) Questionnaire from randomization at 12 months. | 12 months |
| Change in patient reported outcomes scores for the King's Brief Interstitial Lung Disease (K-BILD) Questionnaire from randomization at 12 months. | 12 months |
| Change in patient reported outcomes scores for the St. George's Respiratory Questionnaire (SGRQ) from randomization at 12 months. | 12 months |
| Change in patient reported outcomes scores for the Leicester Cough Questionnaire (LCQ) from randomization at 24 months | 24 months |
| Change in patient reported outcomes scores for the EuroQoL EQ-5D Questionnaire from randomization at 24 months | 24 months |
| Change in patient reported outcomes scores for the University of California, San Diego Shortness of Breath (UCSD-SOB) Questionnaire from randomization at 24 months | 24 months |
| Change in patient reported outcomes scores for the King's Brief Interstitial Lung Disease (K-BILD) Questionnaire from randomization at 24 months | 24 months |
| Change in patient reported outcomes scores for the St. George's Respiratory Questionnaire (SGRQ) from randomization at 24 months | 24 months |
| Proportion of participants with and number of treatment-emergent adverse events, serious adverse events, adverse events leading to discontinuation, and unanticipated problems | 24 months |
| Estimated time per six months free of 10% relative decline in FVC, first respiratory hospitalization, lung transplant or death from any cause. | 24 months |
| Estimated time per six months free of 10% relative decline in FVC % predicted, first respiratory hospitalization, lung transplant or death from any cause. | 24 months |
| Estimated time lived per six months (based on all-cause mortality). | 24 months |
| Average time per six months free of first respiratory hospitalization, lung transplantation or death from any cause. | 24 months |
| Average time per six months free of 10% relative decline in FVC, lung transplant, or death from any cause. | 24 months |
| Average time per six months free of lung transplant, or death from any cause. | 24 months |
| Average time per six months free of 10% relative decline in FVC % predicted, lung transplant, or death from any cause. | 24 months |
| Average time per six months free of all-cause hospitalization, lung transplant, or death from any cause. | 24 months |
| Los Angeles |
| California |
| 90033 |
| United States |
| Stanford University | Stanford | California | 94305 | United States |
| University of Colorado | Aurora | Colorado | 80045 | United States |
| Piedmont Healthcare | Austell | Georgia | 30106 | United States |
| University of Chicago | Chicago | Illinois | 60637 | United States |
| Loyola University | Maywood | Illinois | 60153 | United States |
| Indiana University | Indianapolis | Indiana | 46202 | United States |
| University of Kansas Medical Center | Kansas City | Kansas | 66160 | United States |
| Tulane University | New Orleans | Louisiana | 70112 | United States |
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| University of Minnesota | Minneapolis | Minnesota | 55455 | United States |
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
| Weill Cornell Medicine | New York | New York | 10016 | United States |
| University of Rochester | Rochester | New York | 14642 | United States |
| Ohio State University | Columbus | Ohio | 43221 | United States |
| Temple University | Philadelphia | Pennsylvania | 19140 | United States |
| Medical University of South Carolina | Charleston | South Carolina | 29425 | United States |
| Lisa Lancaster | Nashville | Tennessee | 37204 | United States |
| University of Texas Southwestern | Dallas | Texas | 75390 | United States |
| University of Texas Health San Antonio | San Antonio | Texas | 78229 | United States |
| University of Utah Health | Salt Lake City | Utah | 84108 | United States |
| University of Virginia | Charlottesville | Virginia | 22908 | United States |
| University of Washington | Seattle | Washington | 98195 | United States |
| ID | Term |
|---|---|
| D054990 | Idiopathic Pulmonary Fibrosis |
| D011658 | Pulmonary Fibrosis |
| ID | Term |
|---|---|
| D017563 | Lung Diseases, Interstitial |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D005355 | Fibrosis |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D000111 | Acetylcysteine |
| ID | Term |
|---|---|
| D003545 | Cysteine |
| D000603 | Amino Acids, Sulfur |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
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