In some participants with cystic fibrosis (CF), the disease is caused by a nonsense mutation (premature stop codon) in the gene that makes the cystic fibrosis transmembrane regulator (CFTR) protein. Ataluren has been shown to partially restore CFTR production in animals with CF due to a nonsense mutation. The main purpose of this study is to understand whether ataluren can safely increase functional CFTR protein in the cells of participants with CF due to a nonsense mutation.
In this study, participants with CF due to a nonsense mutation will be treated with a new investigational drug called ataluren. Evaluation procedures to determine if a participant qualifies for the study will be performed within 21 days prior to the start of treatment. Eligible participants who elect to enroll in the study will then participate in two 28-day treatment and follow-up periods (56 days total). There will be a 2-night stay at the clinical research center at the beginning and at the end of each 14 days of ataluren treatment, which means that there will be four 2-night stays at the clinical research center during the study. One of the measurements for the study is transepithelial potential difference (TEPD), which is also known as nasal potential difference and provides a sensitive evaluation of sodium and chloride transport directly in secretory epithelial cells. TEPD assessments are made on the nasal epithelium cells lining the inferior turbinate because these cells are easier to access than the respiratory epithelial cells lining the lower airways and have been shown to have the same ion transport characteristics. As an endpoint, TEPD has the advantage that it can detect chloride transport changes that are a quantitative integration of the presence, functional activity, and apical location of the CFTR in airway cells. Furthermore, it is a direct measure of CFTR activity that is not likely to be affected by supportive or palliative treatments for CF (with the possible exception of systemically administered aminoglycoside antibiotics).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
24
Ataluren will be provided as a vanilla-flavored powder to be mixed with water.
Hadassah University Hospital - Mount Scopus
Jerusalem, Israel
Change From Baseline to End of Treatment in Total Chloride Transport
Time frame: Baseline of Cycle 1 and Cycle 2, Day 14 and Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Number of Participants With a Chloride Transport Response
Time frame: Baseline of Cycle 1 and Cycle 2 and Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Number of Participants With a Chloride Transport Normalization Between Baseline and End of Treatment
Time frame: Baseline of Cycle 1 and Cycle 2 and Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Change From Baseline in Nasal Chloride Secretion as Assessed by Transepithelial Potential Difference (TEPD)
Time frame: Baseline of Cycle 1 and Cycle 2, Day 14 and Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Change From Baseline in Sweat Chloride Concentration as Determined by Pilocarpine Iontophoresis
Time frame: Baseline, Day 41
Change From Baseline in CFTR Protein in Nasal Mucosa as Determined by Immunofluorescence
Time frame: Baseline of Cycle 1 and Cycle 2, Day 14 and Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Change From Baseline in Nonsense Mutation CFTR mRNA in Nasal Mucosa as Determined by Quantitative Polymerase Chain Reaction (PCR) Assay
Time frame: Baseline of Cycle 1 and Cycle 2, Day 14 and Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Change From Baseline in Number of Neutrophils in Blood
Time frame: Baseline Up to Day 56
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Change From Baseline in Pulmonary Function as Measured by Spirometry
Time frame: Baseline of Cycle 1 and Cycle 2, Day 14 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Change From Baseline in Body Weight
Time frame: Baseline of Cycle 1 and Cycle 2, Day 28 of Cycle 1 and Cycle 2 (1 cycle=28 days)
Compliance with Study Treatment
Time frame: Baseline Up to Day 56
Pharmacokinetics (PK): Time to Maximum Concentration (Tmax) of Ataluren
Time frame: 0 (predose), 1, 2, 3, and 4 hours (hrs) postdose of the midday dose; 0 (predose), 1, 2, 3, 4, and 12 hrs postdose of the evening dose on Day 1 and Day 27
PK: Maximum Plasma Concentration (Cmax) of Ataluren
Time frame: 0 (predose), 1, 2, 3, and 4 hrs postdose of the morning dose; 0 (predose), 1, 2, 3, and 4 hrs postdose of the midday dose; and 0 hrs (predose), 1, 2, 3, 4, and 12 hrs postdose of the evening dose on Days 1 and 13 of Cycles 1 and 2 (1 cycle=28 days)
PK: Area Under the Plasma Concentration Time Curve (AUC) of Ataluren
Time frame: 0 (predose), 1, 2, 3, and 4 hrs postdose of the morning dose; 0 (predose), 1, 2, 3, and 4 hrs postdose of the midday dose; and 0 hrs (predose), 1, 2, 3, 4, and 12 hrs postdose of the evening dose on Days 1 and 13 of Cycles 1 and 2 (1 cycle=28 days)
PK: Terminal Elimination Half Life (T1/2) of Ataluren
Time frame: 0 (predose), 1, 2, 3, and 4 hrs postdose of the morning dose; 0 (predose), 1, 2, 3, and 4 hrs postdose of the midday dose; and 0 hrs (predose), 1, 2, 3, 4, and 12 hrs postdose of the evening dose on Days 1 and 13 of Cycles 1 and 2 (1 cycle=28 days)