The goal of this trial was to explore the utility of evaluating emphysema progression through CT scans measuring lung density during a 2 year period of weekly infusions of either placebo or human alpha-1-antitrypsin (AAT; Prolastin®). Exacerbation data recorded in patient diaries were also collected. All efficacy data were analyzed for potential use in evaluating Prolastin efficacy in this and other clinical trials.
This is a one to one randomized, placebo-controlled, clinical, exploratory study with the aim of collecting information on possible clinical endpoints i.e., the progression of emphysema by lung density measurements with CT scan and frequency of exacerbations that could be used for a subsequent placebo controlled clinical trial. Progression of disease will be investigated in 80 patients with alpha-1-antitrypsin deficiency, who will be treated with human alpha-1-antitrypsin (AAT; Prolastin®) or placebo weekly for two years to analyze the effect of treatment on lung density and exacerbations. Targeted augmentation therapy with weekly infusions of Prolastin® will be a dose of 60 mg/kg body weight (range of 51.72 to 71.43 mg per kg body weight). Therefore, this study focuses on several questions: * Is the 15th percentile point calculated by analysis of CT lung histograms a useful endpoint for clinical trials in AAT deficiency? * Is quantitation of exacerbations in AAT-deficient patients a useful endpoint for clinical trials in AAT deficiency? * Are there significant differences between the treatments in favor of Prolastin®?
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
77
Weekly infusion of 60 mg/kg body weight for 2 years
Weekly infusion for 2 years. Albumin (Human) 20% will be diluted with 5% glucose to a final concentration of 2.0%.
Gentofte Hospital Department of Respiratory Medicine
Hellerup, Denmark
Department of Pulmonary Medicine, Malmö University Hospital
Malmo, Sweden
Queen Elizabeth Hospital
Birmingham, England, United Kingdom
The Progression Rate of Emphysema Determined by Change in 15th Percentile of Lung Density Measured by Annual CT Scan of the Whole Lung
Time frame: 24 or 30 months
Change in Lung Density at Each Visit as Measured by Computed Tomography
Time frame: 24 or 30 months
The Frequency of Exacerbations as Determined by Patient Diary.
Time frame: 24 or 30 months
The Deterioration of the Lung Function Will be Assessed by Measurement of the Change in Forced Expiratory Volume at One Second (FEV1) and Transfer Factor of Carbon Monoxide (KCO)
Time frame: 24 or 30 months
Duration and Severity of the Exacerbations
Time frame: 24 or 30 months
Mortality
Time frame: 24 or 30 months
Quality of Life With a Disease Specific Instrument, the St. George's Respiratory Questionnaire
Time frame: 24 or 30 months
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