Long term effects of denufosol tetrasodium in patients with cystic fibrosis.
BACKGROUND
Denufosol stimulates chloride secretion independent of the chloride channel which is dysfunctional in cystic fibrosis (CF) and therefore has the potential to benefit CF patients regardless of genotype.


OBJECTIVE
To assess the efficacy of denufosol in CF patients with mild lung function impairment age 5 years and older.


METHODS
This multicenter, randomized, parallel group double-blind placebo-controlled trial was conducted at 102 CF care centers in Australia, Canada and the United States (NCT00625612) The active group (n=233) received 60 mg denufosol via inhalation three times daily The primary efficacy endpoint was change in FEV(1) in liters from Day 0 to week 48.


RESULTS
685 patients were screened for the study and 466 patients (233 in each group) were randomized to study treatment. The adjusted mean change in FEV(1)was 40 mL for denufosol and 32 mL for placebo with a resulting treatment effect of 8 mL (95% CI -0.040, 0.056). The average rate of change in FEV(1) percent of predicted over 0 to 48 weeks was -3.04% for placebo vs. -2.30 for denufosol (a difference of 24% relative to placebo) among all patients. The incidence of pulmonary exacerbation was 26% vs. 21% for the placebo and denufosol groups with no differences in the time to first event. The study treatments were well tolerated and there was no evidence of systemic effects in any safety parameter assessed.


CONCLUSIONS
In patients with CF treatment with denufosol for 48 weeks did not improve pulmonary function or reduce the incidence of pulmonary exacerbations.
Division of Respiratory Medicine, Department of Pediatrics, and Program in Physiology and Experimental Medicine, SickKids Research Institute, The Hospital for Sick Children, and University of Toronto, Toronto, Canada. felix.ratjen@sickkids.ca
Felix
F
Ratjen
Todd
T
Durham
Tomas
T
Navratil
Amy
A
Schaberg
Frank J
FJ
Accurso
Claire
C
Wainwright
Matthew
M
Barnes
Richard B
RB
Moss
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002712:Chlorides / Q000378:metabolism*; D003550:Cystic Fibrosis / Q000188:drug therapy* / Q000453:epidemiology; D003845:Deoxycytosine Nucleotides / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D004311:Double-Blind Method; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008168:Lung / Q000187:drug effects* / Q000502:physiology; D008171:Lung Diseases / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D016896:Treatment Outcome; D014529:Uridine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics; D055815:Young Adult
D002712:Chlorides; D003845:Deoxycytosine Nucleotides; C465279:denufosol tetrasodium; D014529:Uridine