Literature DB >> 21075062

Safety, efficacy and convenience of tobramycin inhalation powder in cystic fibrosis patients: The EAGER trial.

Michael W Konstan1, Patrick A Flume, Matthias Kappler, Raphaël Chiron, Mark Higgins, Florian Brockhaus, Jie Zhang, Gerhild Angyalosi, Ellie He, David E Geller.   

Abstract

BACKGROUND: A light-porous-particle, dry-powder formulation of tobramycin was developed, using PulmoSphere® technology, to improve airway delivery efficiency, substantially reduce delivery time, and improve patient convenience and satisfaction. We evaluated the safety, efficacy and convenience of tobramycin inhalation powder (TIP™) versus tobramycin inhalation solution (TIS, TOBI®) for treating Pseudomonas aeruginosa infection in cystic fibrosis (CF) patients aged ≥6 years.
METHODS: In this open-label study, 553 patients were randomized 3:2 to TIP (total 112mg tobramycin) via the Novartis T-326 Inhaler or TIS 300mg/5mL via PARI LC® PLUS nebulizer twice daily for three treatment cycles (28 days on-drug, 28 days off-drug). Safety, efficacy, and treatment satisfaction outcomes were evaluated.
RESULTS: TIP was generally well-tolerated; adverse events were similar in both groups. The rate of cough suspected to be study drug related was higher in TIP-treated patients (TIP: 25.3%; TIS: 4.3%), as was the overall discontinuation rate (TIP: 26.9%; TIS: 18.2%). Increases in FEV(1)% predicted from baseline to Day 28 of Cycle 3 were similar between groups; the mean reduction in sputum P. aeruginosa density (log(10) CFU/g) on Day 28 of Cycle 3 was also comparable between groups. Administration time was significantly less for TIP (mean: 5.6 versus 19.7min, p<0.0001). Treatment satisfaction was significantly higher for TIP for effectiveness, convenience, and global satisfaction.
CONCLUSIONS: TIP has a safety and efficacy profile comparable with TIS, and offers a far more convenient treatment option for pseudomonas lung infection in CF. Copyright Â
© 2010 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

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Year:  2010        PMID: 21075062      PMCID: PMC4086197          DOI: 10.1016/j.jcf.2010.10.003

Source DB:  PubMed          Journal:  J Cyst Fibros        ISSN: 1569-1993            Impact factor:   5.482


  21 in total

1.  Treatment with tobramycin solution for inhalation reduces hospitalizations in young CF subjects with mild lung disease.

Authors:  Timothy D Murphy; Ran D Anbar; Lucille A Lester; Samya Z Nasr; Bruce Nickerson; Donald R VanDevanter; Andrew A Colin
Journal:  Pediatr Pulmonol       Date:  2004-10

2.  Mucoid Pseudomonas aeruginosa is a marker of poor survival in cystic fibrosis.

Authors:  R L Henry; C M Mellis; L Petrovic
Journal:  Pediatr Pulmonol       Date:  1992-03

3.  Effect of dry powder inhaler resistance on the inspiratory flow rates and volumes of cystic fibrosis patients of six years and older.

Authors:  H A Tiddens; D E Geller; P Challoner; R J Speirs; K C Kesser; S E Overbeek; D Humble; S B Shrewsbury; T A Standaert
Journal:  J Aerosol Med       Date:  2006

4.  Changes in the normal maximal expiratory flow-volume curve with growth and aging.

Authors:  R J Knudson; M D Lebowitz; C J Holberg; B Burrows
Journal:  Am Rev Respir Dis       Date:  1983-06

Review 5.  Pathophysiology and management of pulmonary infections in cystic fibrosis.

Authors:  Ronald L Gibson; Jane L Burns; Bonnie W Ramsey
Journal:  Am J Respir Crit Care Med       Date:  2003-10-15       Impact factor: 21.405

6.  Inhalation of a dry powder tobramycin PulmoSphere formulation in healthy volunteers.

Authors:  Michael T Newhouse; Peter H Hirst; Sarma P Duddu; Yulia H Walter; Thomas E Tarara; Andrew R Clark; Jeffry G Weers
Journal:  Chest       Date:  2003-07       Impact factor: 9.410

7.  Intermittent administration of inhaled tobramycin in patients with cystic fibrosis. Cystic Fibrosis Inhaled Tobramycin Study Group.

Authors:  B W Ramsey; M S Pepe; J M Quan; K L Otto; A B Montgomery; J Williams-Warren; M Vasiljev-K; D Borowitz; C M Bowman; B C Marshall; S Marshall; A L Smith
Journal:  N Engl J Med       Date:  1999-01-07       Impact factor: 91.245

Review 8.  Early intervention and prevention of lung disease in cystic fibrosis: a European consensus.

Authors:  Gerd Döring; Niels Hoiby
Journal:  J Cyst Fibros       Date:  2004-06       Impact factor: 5.482

9.  Long-term follow up of changes in FEV1 and treatment intensity during Pseudomonas aeruginosa colonisation in patients with cystic fibrosis.

Authors:  M Ballmann; P Rabsch; H von der Hardt
Journal:  Thorax       Date:  1998-09       Impact factor: 9.139

10.  Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease.

Authors:  Mark J Atkinson; Anusha Sinha; Steven L Hass; Shoshana S Colman; Ritesh N Kumar; Meryl Brod; Clayton R Rowland
Journal:  Health Qual Life Outcomes       Date:  2004-02-26       Impact factor: 3.186

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  81 in total

Review 1.  Fungal Pathogens in CF Airways: Leave or Treat?

Authors:  A Singh; A Ralhan; C Schwarz; D Hartl; A Hector
Journal:  Mycopathologia       Date:  2017-08-02       Impact factor: 2.574

Review 2.  Inhaled antibiotics in cystic fibrosis: what's new?

Authors:  Simon Langton Hewer
Journal:  J R Soc Med       Date:  2012-06       Impact factor: 5.344

3.  Evaluation of the pharmacokinetics and pharmacodynamics of liposomal amikacin for inhalation in cystic fibrosis patients with chronic pseudomonal infections using data from two phase 2 clinical studies.

Authors:  Olanrewaju O Okusanya; Sujata M Bhavnani; Jeffrey P Hammel; Alan Forrest; Catharine C Bulik; Paul G Ambrose; Renu Gupta
Journal:  Antimicrob Agents Chemother       Date:  2014-03-31       Impact factor: 5.191

Review 4.  Building global development strategies for cf therapeutics during a transitional cftr modulator era.

Authors:  N Mayer-Hamblett; S van Koningsbruggen-Rietschel; D P Nichols; D R VanDevanter; J C Davies; T Lee; A G Durmowicz; F Ratjen; M W Konstan; K Pearson; S C Bell; J P Clancy; J L Taylor-Cousar; K De Boeck; S H Donaldson; D G Downey; P A Flume; P Drevinek; C H Goss; I Fajac; A S Magaret; B S Quon; S M Singleton; J M VanDalfsen; G Z Retsch-Bogart
Journal:  J Cyst Fibros       Date:  2020-06-07       Impact factor: 5.482

Review 5.  Unmet needs in cystic fibrosis: the next steps in improving outcomes.

Authors:  Natalie E West; Patrick A Flume
Journal:  Expert Rev Respir Med       Date:  2018-06-19       Impact factor: 3.772

Review 6.  Devices for dry powder drug delivery to the lung.

Authors:  Kai Berkenfeld; Alf Lamprecht; Jason T McConville
Journal:  AAPS PharmSciTech       Date:  2015-05-12       Impact factor: 3.246

Review 7.  Cough as an adverse effect on inhalation pharmaceutical products.

Authors:  Rachel Yoon Kyung Chang; Philip Chi Lip Kwok; Sussan Ghassabian; John D Brannan; Heikki O Koskela; Hak-Kim Chan
Journal:  Br J Pharmacol       Date:  2020-08-07       Impact factor: 8.739

8.  Resource Use Evaluation of Tobramycin Formulations in a State Medicaid Program.

Authors:  Shellie L Keast
Journal:  J Pediatr Pharmacol Ther       Date:  2018 Mar-Apr

9.  In vitro evaluation of tobramycin and aztreonam versus Pseudomonas aeruginosa biofilms on cystic fibrosis-derived human airway epithelial cells.

Authors:  Qianru Yu; Edward F Griffin; Sophie Moreau-Marquis; Joseph D Schwartzman; Bruce A Stanton; George A O'Toole
Journal:  J Antimicrob Chemother       Date:  2012-07-26       Impact factor: 5.790

Review 10.  Management of Pseudomonas aeruginosa infection in cystic fibrosis patients using inhaled antibiotics with a focus on nebulized liposomal amikacin.

Authors:  Zarmina Ehsan; John P Clancy
Journal:  Future Microbiol       Date:  2015-11-17       Impact factor: 3.165

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