NCT03843541

Brief Summary

This is a phase 3, multicenter, randomized, rater- and patient-blind, placebo- and active-controlled, 3-arm parallel group clinical trial. Patients will be randomized to N-acetylcysteine (NAC) or ambroxol or placebo in a 1:1:1 ratio. A total of approximately 333 patients in China will be randomized. The total study duration will be approximately 8 months including the enrolment period of approximately 7 months and the patient participation duration of 1 month or 4 weeks. Each patient will undergo a screening period of up to 1 week, a 1-week treatment period and a 2-week follow-up period. This study will be conducted in approximately 15-25 sites in China.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
333

participants targeted

Target at P50-P75 for phase_3

Timeline
Completed

Started Jun 2019

Geographic Reach
1 country

32 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 13, 2019

Completed
5 days until next milestone

First Posted

Study publicly available on registry

February 18, 2019

Completed
4 months until next milestone

Study Start

First participant enrolled

June 25, 2019

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 23, 2021

Completed
13 days until next milestone

Study Completion

Last participant's last visit for all outcomes

February 5, 2021

Completed
1.9 years until next milestone

Results Posted

Study results publicly available

January 5, 2023

Completed
Last Updated

September 5, 2025

Status Verified

September 1, 2025

Enrollment Period

1.6 years

First QC Date

February 13, 2019

Results QC Date

January 20, 2022

Last Update Submit

September 3, 2025

Conditions

Keywords

N-acetylcysteine (NAC)ambroxol hydrochloridebronchitiscystic fibrosisfibrosis bronchiectasisincreased sputum viscositycoughChronic Obstructive Pulmonary Disease (COPD)

Outcome Measures

Primary Outcomes (2)

  • Change From Baseline to Day 7 of Mean Sputum Viscosity Score of NAC and Placebo

    The superiority of slow intravenous infusion of NAC to placebo in terms of change from baseline in sputum viscosity score was demonstrated. Sputum viscosity was assessed by ordinal categorical 4-point scales \[0 = Liquid (normal viscosity), 1= Fluid (mildly increased viscosity), 2 = Viscous (moderately increased viscosity), 3 = Sticky (severely increased viscosity)\] with 0 = best and 3= worst.

    From baseline upto Day 7

  • Change From Baseline to Day 7 Treatment of Mean Expectoration Difficulty Score of NAC and Placebo

    The superiority of slow intravenous infusion of NAC 600 mg twice daily to placebo in terms of change from baseline in expectoration difficulty score was demonstrated. Expectoration difficulty was assessed by ordinal categorical 4-point scales \[0 = No difficulty, 1 = Mild difficulty, 2 = Moderate difficulty, 3 = Marked difficulty\] with 0 = best and 3 = worst.

    From Baseline upto Day 7

Secondary Outcomes (12)

  • Change From Baseline to Day 3 in Mean Sputum Viscosity Score of NAC and Placebo

    From Baseline to Day 3

  • Change From Baseline to Day 3 in Mean Expectoration Difficulty Score of NAC and Placebo

    From Baseline to Day 3

  • Change From Baseline to Day 3 and to Day 7 in Mean Sputum Color Score of NAC and Placebo

    From Baseline upto Day 3 and Day 7

  • Change From Baseline to Day 3 and to Day 7 in Mean Cough Severity Score of NAC and Placebo

    From Baseline upto Day 3 and Day 7

  • Change From Baseline to Day 3 and to Day 7 of Mean Sputum Volume of NAC and Placebo

    From Baseline upto Day 3 and Day 7

  • +7 more secondary outcomes

Other Outcomes (1)

  • Number of Participants With Adverse Events

    From screening to follow-up after the last administration of the investigational medicinal product (IMP) [assessed up to 19 months]

Study Arms (3)

Active test treatment-NAC

EXPERIMENTAL

NAC 600mg will be administered by slow intravenous infusion twice daily for the 1-week treatment period.

Drug: N-acetylcysteine (NAC) 600 mg

Active control treatment-Ambroxol hydrochloride

ACTIVE COMPARATOR

Ambroxol hydrochloride 30 mg will be administered by slow intravenous infusion twice daily for the 1-week treatment period.

Drug: Ambroxol hydrochloride 30 mg

Placebo

PLACEBO COMPARATOR

Placebo will be administered by slow intravenous infusion twice daily for the 1-week treatment period.

Other: placebo

Interventions

NAC will be administered twice a day, morning and evening, during treatment period.

Also known as: Fluimucil®
Active test treatment-NAC

Ambroxol hydrochloride will be administered twice a day, morning and evening, during treatment period.

Also known as: Mucosolvan®, Fluibron®
Active control treatment-Ambroxol hydrochloride
placeboOTHER

Placebo will be administered twice a day, morning and evening, during treatment period.

Placebo

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Male or female adult (≥18 years old) hospitalized patients with respiratory tract diseases and abnormal mucus secretions such as: acute bronchitis, chronic bronchitis and exacerbations, emphysema, mucoviscidosis and bronchiectasis.
  • Chinese ethnicity and/or Chinese
  • Signed the informed consent form before any study-related procedure
  • Sputum viscosity score ≥ 2 at randomization visit
  • Expectoration difficulty score ≥ 2 at randomization visit
  • Willingness and ability to comply with study procedures

You may not qualify if:

  • Intolerance or contra-indication to treatment with NAC or ambroxol or allergy to any component of the study treatments
  • (For female patients) ongoing pregnancy or lactation, or childbearing potential but unwillingness to adopt abstinence or contraception measures during the study
  • Intake of an investigational drug within 1 month before the screening visit
  • Use of expectorants or drugs with expectorant effect within 2 days before randomization visit
  • Diagnosis of active tuberculosis, lung cancer, pulmonary fibrosis, acute pulmonary thromboembolism or any other respiratory condition that might, in the opinion of the investigator, compromise the safety of the patient or affect the interpretation of the results
  • Medical history of and/or illness (including laboratory abnormality) and/or treatment that in the investigator's opinion may interfere with the patient's safety, compliance, or study evaluations
  • Serum alanine aminotransferase and/or aspartate transaminase more than 3 times above the upper limit of normal at screening visit
  • Serum creatinine more than 3 times above the upper limit of normal at screening visit
  • Addiction to alcohol or drugs
  • Mental illness, or other reasons for non-cooperation in the investigator's opinion

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (32)

Wuxi Peoples' Hospital affiliated to Nanjing Medical University

Wuxi, No. 299, Qing Yang Rd., Wuxi City, Jiangsu, China

Location

Inner Mongolia Baogang Hospital

Baotou, China

Location

Beijing Hospital

Beijing, China

Location

Beijing Tongren Hospital

Beijing, China

Location

China-Japan Friendship Hospital

Beijing, China

Location

Peking University Shougang Hospital

Beijing, China

Location

Jilin Province People's Hospital

Changchun, China

Location

The First Bethune Hospital of Jilin University

Changchun, China

Location

Chengdu Fifth People's Hospital

Chengdu, China

Location

West China Hospital, Sichuan University

Chengdu, China

Location

The First Affiliated Hospital of Chongqing Medical University

Chongqing, China

Location

Deyang People's Hospital

Deyang, China

Location

Inner Mongolia People's Hospital

Hohhot, China

Location

Jinhua city central hospital/Jinhua hospital ,School of Medicine,Zhejiang UNIVERSITY

Jinhua, China

Location

Nanchang University-The Second Affiliated Hospital

Nanchang, China

Location

Nanjing First Hospital

Nanjing, China

Location

Zhongda Hospital, Southeast University - Pulmonology

Nanjing, China

Location

Jiangxi Pingxiang People's Hospital

Pingxiang, China

Location

Qingdao Municipal Hospital

Qingdao, China

Location

Minhang District Central Hospital

Shanghai, China

Location

Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

Shanghai, China

Location

Shanghai General Hospital

Shanghai, China

Location

Shanghai Pulmonary Hospital

Shanghai, China

Location

Suining Central Hospital

Suining, China

Location

First Hospital of Shanxi Medical University

Taiyuan, China

Location

The First Hospital of Shanxi Medical University

Taiyuan, China

Location

Tongji Hospital, Tongji Medical College of Huazhong University Science and Technology

Wuhan, China

Location

Wuxi Peoples' Hospital affiliated to Nanjing Medical University

Wuxi, China

Location

Yangzhou First People's Hospital

Yangzhou, China

Location

General Hospital of Ningxia Medical University

Yinchuan, China

Location

Affiliated Hospital of Guangdong Medical University - Respiration

Zhanjiang, China

Location

The First People's Hospital of Zigong

Zigong, China

Location

MeSH Terms

Conditions

Respiratory Tract DiseasesBronchitisCystic FibrosisCoughPulmonary Disease, Chronic Obstructive

Interventions

AcetylcysteineAmbroxol

Condition Hierarchy (Ancestors)

Respiratory Tract InfectionsInfectionsBronchial DiseasesLung Diseases, ObstructiveLung DiseasesPancreatic DiseasesDigestive System DiseasesGenetic Diseases, InbornCongenital, Hereditary, and Neonatal Diseases and AbnormalitiesInfant, Newborn, DiseasesRespiration DisordersSigns and Symptoms, RespiratorySigns and SymptomsPathological Conditions, Signs and SymptomsChronic DiseaseDisease AttributesPathologic Processes

Intervention Hierarchy (Ancestors)

CysteineAmino Acids, SulfurSulfur CompoundsOrganic ChemicalsAmino AcidsAmino Acids, Peptides, and ProteinsBromhexineAniline CompoundsAminesCyclohexylamines

Results Point of Contact

Title
Valentina Zanin
Organization
Zambon S.p.A.

Publication Agreements

PI is Sponsor Employee
No
Restriction Type
OTHER
Restrictive Agreement
Yes

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Masking Details
Both rater and patient will be blinded.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: There will be 3 treatment groups of NAC, ambroxol and placebo. A total of 333 patients will be randomized to NAC or ambroxol or placebo in a 1:1:1 ratio. Approximately 111 patients will be randomized in each treatment group.
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 13, 2019

First Posted

February 18, 2019

Study Start

June 25, 2019

Primary Completion

January 23, 2021

Study Completion

February 5, 2021

Last Updated

September 5, 2025

Results First Posted

January 5, 2023

Record last verified: 2025-09

Locations