Prospective Treatment Efficacy in IPF Using Genotype for Nac Selection (PRECISIONS) Trial


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Trial ID: NCT04300920


The purpose of this study is to compare the effect of n-acetylcysteine (NAC) plus standard care with matched placebo plus standard of care in patients diagnosed with idiopathic pulmonary fibrosis (IPF) who have the TOLLIP rs3750920 TT genotype. The study will compare the time to a composite endpoint of relative decline in lung function [10% relative decline in forced vital capacity (FVC), first respiratory hospitalization, lung transplantation, or all-cause mortality] The secondary objectives will be to examine the effect of NAC on the components of the primary composite endpoint, the rates of clinical events, change in physiology, change in health status, and change in respiratory symptoms.

Official Title

Prospective Treatment Efficacy in IPF Using Genotype for Nac Selection (PRECISIONS) Trial

Stanford Investigator(s)

Rishi Raj
Rishi Raj

Clinical Professor, Medicine - Pulmonary, Allergy & Critical Care Medicine

Joshua Mooney
Joshua Mooney

Clinical Assistant Professor, Medicine - Pulmonary, Allergy & Critical Care Medicine


Inclusion Criteria:

   - ≥ 40 years of age

   - Diagnosed with IPF according to 2018 ATS/ERS/JRS/ALAT, confirmed by enrolling

   - Signed informed consent

   - If taking pirfenidone or nintedanib, must be on stable dose for at least 6 weeks prior
   to enrollment visit

   - Confirmed rs3570920 TT TOLLIP genotype

Exclusion Criteria:

   - Pregnancy or planning to become pregnant

   - Women of childbearing potential not willing to remain abstinent (refrain from
   heterosexual intercourse) or use two adequate methods of contraception, including at
   least one method with a failure rate of <1% per year during study participation

   - Significant medical, surgical or psychiatric illness that in the opinion of the
   investigator would affect subject safety, including liver and renal failure

   - Receipt of an investigational drug or biological agent within the previous 4 weeks of
   the screening visit or 5 times the half-life, if longer

   - Supplemental or prescribed NAC therapy within 60 days of enrollment

   - Listed for lung transplantation at the time of screening

   - History of lung cancer

   - Inability to perform spirometry

   - Forced vital capacity (FVC) less than 45% predicted, using the global lung function
   index (GLI) equation at Visit 1

   - Active respiratory infection requiring treatment with antibiotics within 4 weeks of
   Visit 1


drug: N-acetyl cysteine

drug: Placebo


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Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Joshua Mooney, MD, MS