Protocol summary

Study aim
Comparison effects of Itraconazole and Prednisone on Fibroblast Growth Factor 2 gene expression, clinical manifestation and other tests in patients with persistent severe asthma
Design
Interventional clinical trial in 2 - 3 phase with control group, design of 70 patients as a sample group, parallel groups, double blind, using permuted block randomization by STATََA software and concealed in numbered drug containers.
Settings and conduct
In pulmonary private office after filling questionnaire including asking about clinical manifestation and asthma control test, spirometry respiratory test, analyzing lung ct scan and rule out of other diseases, counting blood cells and being in definition of severe asthma as well, 70 randomized patients will participate in study after taking phlegm smear in two itraconazole and prednisone groups then after 32 weeks all tests will take again, blinding by numbered uniform drug containers that is not assignable for patients and office staff.
Participants/Inclusion and exclusion criteria
Inclusion criteria: age older than 18 years old; no response to high dose inhaled corticosteroids and long acting beta agonist with antileukotriene; forced expiratory volume in one second less than 80 percent with fungal sensitization. Exclusion criteria: drug interaction or sensitivity to Itraconazole; pregnancy or breastfeeding periods; interstitial disease like vasculitis or churg strauss; severe heart disease; being smoker.
Intervention groups
In experimental group Itraconazole capsule 100 mg twice a day and in control group prednisone capsule 5mg twice a day with uniform containers and lable
Main outcome variables
Wheezing; decreasing Fgf2 expression; reducing the number of eosinophils and neutrophils in sputum; increasing spirometric parameters; decreased expiratory nitric oxide; increased bronchial diameter on CT scan

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20181225042116N1
Registration date: 2020-12-18, 1399/09/28
Registration timing: prospective

Last update: 2020-12-18, 1399/09/28
Update count: 0
Registration date
2020-12-18, 1399/09/28
Registrant information
Name
Mahsa Manafi Varkiani
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 51 3605 5216
Email address
mahsafall_2005@yahoo.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2020-12-21, 1399/10/01
Expected recruitment end date
2021-09-22, 1400/06/31
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Comparison effects of Itraconazole and Prednisone on Fibroblast Growth Factor 2 gene expression, clinical manifestation and other tests in patients with persistent severe asthma
Public title
Comparison effects of Itraconazole and Prednisone in patients with persistent severe asthma
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
Age older than 18 years old No response to high dose inhaled corticosteroids and long acting beta agonist with antileukotriene Forced expiratory volume in one second less than 80 percent Fungal sensitization
Exclusion criteria:
Sensitivity and drug interaction with Itraconazole History of taking Itraconazole Gastroesophageal reflux disease Known and untreated Severe heart disease Known liver and kidney disease Chronic eosinophilic pneumonia Charge Strauss syndrome Chronic Obstructive Pulmonary Disease Total IgE more than 1000IU/ml Pregnancy or breastfeeding Lack of access to Appropriate RNA in patient sputum sample Sarcoidosis Hypersensitivity pneumonitis Impaired vocal cords Filarisis Central airway obstruction Sleep apnea
Age
From 18 years old
Gender
Both
Phase
2-3
Groups that have been masked
  • Participant
  • Care provider
  • Investigator
  • Outcome assessor
  • Data analyser
Sample size
Target sample size: 70
Randomization (investigator's opinion)
Randomized
Randomization description
Assignment of individuals to study groups is a block randomization method using 7 blocks of 10; This is done with stata software version 16, this software generates random groups, each block has 5 people in the intervention group and 5 people in the control group, whose order is also random and the numbers assigned to each person are different then labeled onto medicine boxes that have the same shape , and all ten drugs that belong to a block are placed in a separate package, and one is randomly picked and given to the patient.
Blinding (investigator's opinion)
Double blinded
Blinding description
All drugs, both prednisone and itraconazole, have been purchased from the pharmaceutical company in the form of a pure white substance. Then, the drugs are filled in capsules of the same size and color with the cooperation of Mashhad School of Pharmacy; medicine cans are packed in the same shape with the same drug label, random numbers are pasted on them and placed in packs of 10 that are already divided into blocks, then these packages are transferred to a specialized asthma clinic.then nurse is given a can of medicine to the patient after the doctor's examination and being included in the criteria for studying.At the end of each course of the drug, the same can of medicine with the previous code is given again until the end of the study. Also, the person entering the information in Excel enters all the patient information only according to the code on the medicine. During the study, none of the people are aware of the type of medicine used. At the end of the study, the person who had no role in the study is asked to Assign 1 and 2 to the table of random numbers for each drug that can be analyzed for statistics without knowing the drug.
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Central Organization of Islamic Azad University
Street address
Bazarche Sarab Ave.,Imam Khomeini Blvd,
City
Mashhad
Province
Razavi Khorasan
Postal code
9133745938
Approval date
2020-08-05, 1399/05/15
Ethics committee reference number
IR.IAU.MSHD.REC.1399.088

Health conditions studied

1

Description of health condition studied
Asthma
ICD-10 code
J45.5
ICD-10 code description
Severe persistent asthma

Primary outcomes

1

Description
Fibroblast growth factor2 gene expression measurement
Timepoint
Measuring fibroblast growth factor 2 gene expression before intervention and 8 months after taking Itraconazole drug or prednisone
Method of measurement
Real time Polymerase Chain Reaction

2

Description
Number of sputum eosinophils and neutrophils
Timepoint
Before intervention and 8 months after treatment
Method of measurement
Preparation of thin smear after sputum centrifugation with DDT 0.01%, and staining with hematoxin and eosin and counting with light microscope

3

Description
Bronchial size changes include bronchial thickness, internal lumen, external lumen, wall area percentage
Timepoint
Before intervention and 8 months after treatment
Method of measurement
Chest High-resolution computed tomography

4

Description
Spirometric parameters include FEV1, FVC, Fef25-75
Timepoint
Before intervention and 8 months after treatment
Method of measurement
Spirometer device

Secondary outcomes

1

Description
Measurement of fractional nitric oxide concentration in exhaled breath
Timepoint
Before the intervention and after 8 months of treatment
Method of measurement
Bedfont NO breath device for Measuring nitric oxide

2

Description
Asthma Symptom Questionnaire
Timepoint
Before the intervention and after 8 months of treatment
Method of measurement
Asthma control questionnaire (ACQ)

3

Description
Clinical symptoms of patients include wheezing
Timepoint
Before the intervention and after 2 weeks, then every month until the end of the treatment period
Method of measurement
According to the examination by stethoscope

Intervention groups

1

Description
The first intervention group: Itraconazole capsules 100 mg twice a day for 8 months Tehran Daru company
Category
Treatment - Drugs

2

Description
Control group: prednisone tablets 5 mg twice a day for 8 months Iran Hormone company
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Private lung office
Full name of responsible person
Mahsa Manafi Varkiani
Street address
No50.,Faramarz Abbasi38.,Ferdowsi Blvd
City
Mashhad
Province
Razavi Khorasan
Postal code
9197948937
Phone
+98 51 3605 5216
Email
mahsafall_2005@yahoo.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Islamic Azad University
Full name of responsible person
Saeed Abtahi
Street address
Bazarche Sarab Ave.,Imam Khomeini Blvd,
City
Mashhad
Province
Razavi Khorasan
Postal code
9133745938
Phone
+98 51 3225 0041
Email
ethics.mshdiau@gmail.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Islamic Azad University
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Islamic Azad University
Full name of responsible person
Mahsa Manafi Varkiani
Position
Student
Latest degree
A Level or less
Other areas of specialty/work
General Practitioner
Street address
No.50,Faramarz Abbasi 38,Ferdowsi Blvd
City
Mashhad
Province
Razavi Khorasan
Postal code
9197948937
Phone
+98 51 3605 5216
Fax
Email
mahsafall_2005@yahoo.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Islamic Azad University
Full name of responsible person
Majid Mirsadraee
Position
Professor
Latest degree
Subspecialist
Other areas of specialty/work
pulmonary,allergy
Street address
Iman Building., Between 4th and 6th Noth Kosar.,Vakilabad Blvd,
City
mashhad
Province
Razavi Khorasan
Postal code
91977958963
Phone
+98 51 3605 5216
Email
mahsafall_2005@yahoo.com

Person responsible for updating data

Contact
Name of organization / entity
Islamic Azad University
Full name of responsible person
Mahsa Manafi Varkiani
Position
student
Latest degree
A Level or less
Other areas of specialty/work
General Practitioner
Street address
NO.50, Faramarz Abbasi 38 Ave.,Ferdowsi Blvd.,
City
mashhad
Province
Razavi Khorasan
Postal code
9197948937
Phone
+98 51 3605 5216
Fax
Email
mahsafall_2005@yahoo.com
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
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