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Effects of Mometasone Furoate/Formoterol Combination Versus Formoterol and Mometasone Furoate Alone in Chronic Obstructive Pulmonary Disease (COPD) (Study P04230AM4)(COMPLETED)

Primary Purpose

Chronic Obstructive Pulmonary Disease (COPD)

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Mometasone furoate/formoterol (MF/F) combination
Mometasone furoate/formoterol (MF/F) combination
Mometasone furoate MDI (MF MDI)
Formoterol MDI
Placebo
Sponsored by
Organon and Co
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease (COPD)

Eligibility Criteria

40 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Moderate to severe COPD based on prebronchodilator FEV1/forced vital capacity (FVC) ratio of <=70%.
  • At Screening & Baseline, postbronchodilator FEV1 must be >= 60% predicted normal & >=25% predicted normal.
  • COPD symptoms for >=24 months.
  • >=2 COPD exacerbations requiring course of oral corticosteroid &/or antibiotics within 2-12 months before screening.
  • Ex- or current smoker with smoking history >=10 pack years.
  • Only albuterol/salbutamol for relief for at least 2 weeks prior to randomization.
  • Withdraw from parenteral & oral steroids, anticholinergics, & antibiotics 4 weeks prior to Screening.
  • No harm in changing current COPD therapy, willing to discontinue his/her anticholinergics, inhaled corticosteroids (ICS) or ICS/long-acting beta agonists (LABA) at Screening, & transferred to albuterol/salbutamol for relief for 2 weeks prior to Randomization.
  • Lab tests conducted at Screening must be acceptable to investigator. Electrocardiogram (ECG) performed at Screening or within 30 days prior to Screening must be acceptable to investigator. Chest X-ray or computerized tomography (CT) scan is acceptable within 12 months prior to Screening must be acceptable to investigator.
  • Female of childbearing potential must use birth control. Includes: hormonal contraceptives, intra-uterine device (IUD), condom in combination with spermicide, monogamous relationship with male partner who had vasectomy. Started birth control at least 3 months prior to Screening (exception condom), & must agree to continue. Female who is not currently sexually active must agree/consent to using a method should she become sexually active. Women who have been surgically sterilized or are at least 1 year postmenopausal are not considered to be of childbearing potential. Female must have negative serum pregnancy test at Screening.

Exclusion Criteria:

  • Evidence (upon visual inspection) of oropharyngeal candidiasis at Baseline with or without treatment. If there is evidence at Screening, may be treated as appropriate & visit can be scheduled upon resolution. If there is evidence at Baseline, may be treated as appropriate & visit can be rescheduled upon resolution.
  • History of renal, hepatic, cardiovascular, metabolic, neurologic, hematologic, ophthalmological, respiratory, gastrointestinal, cerebrovascular, or other which could interfere with study or require treatment which might interfere with study. Examples include (but are not limited to) hypertension treated with beta-blockers), active hepatitis, coronary artery disease, arrhythmia, significant QTc prolongation (ie QTcF or QTcB [Fridericia or Bazett corrections, respectively >500 milliseconds (msecs)]) stroke, severe rheumatoid arthritis, chronic open-angle glaucoma or posterior subcapsular cataracts, acquired immune deficiency syndrome (AIDS), or conditions that may interfere with respiratory function such as asthma, bronchiectasis, cystic fibrosis. Others which are well-controlled & stable (eg hypertension not requiring beta-blockers) will not prohibit participation if appropriate to investigator.
  • Allergy/sensitivity to glucocorticosteroids, beta-2 agonists, study drug/excipients.
  • Female who is breast-feeding, pregnant, or intends to become pregnant.
  • Illicit drug user.
  • Human immunodeficiency virus (HIV) positive (testing not conducted).
  • Unable to correctly use oral MDI.
  • Taking any restricted medications prior to Screening without meeting washout.
  • Cannot adhere to permitted concomitant & prohibited medications.
  • May not participate in this same study at another investigational site. Cannot participate in different investigational study at any site, during same time.
  • Not be randomized into study more than once.
  • No person directly associated with administration of study may participate.
  • Previously participated in MF/F trial.
  • Increase in absolute volume of >=400 milliliters (mL) at Screening or prior to Baseline within 30 minutes after administration of 4 inhalations of albuterol/salbutamol (total dose of 360 to 400 mcg), or nebulized 2.5 mg albuterol/salbutamol.
  • Asthma.
  • Lobectomy, pneumonectomy or lung volume reduction surgery.
  • Lung cancer.
  • Requires long-term administration of oxygen (>15 hours/day).
  • Alpha-1-antitrypsin deficiency.
  • A history and/or presence of intraocular pressure in either eye >=22 millimeters of mercury (mm Hg), glaucoma, and/or posterior subcapsular cataracts. A subject who has undergone incisional or intraocular surgery in which the natural lens is still present in the eye. A subject with a history of penetrating trauma to both eyes. A subject with one or more of the following Lens Opacities Classification System (LOCS) III grades at screening:

    • nuclear opalescence (NO): >=3.0,
    • nuclear color (NC): >=3.0,
    • cortical cataract (C): >=2.0,
    • posterior subcapsular (P): >=0.5.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm Type

    Experimental

    Experimental

    Experimental

    Active Comparator

    Placebo Comparator

    Arm Label

    MF/F MDI 400/10 mcg BID

    MF/F MDI 200/10 mcg BID

    MF MDI 400 mcg BID

    Formoterol MDI 10 mcg BID

    Placebo MDI BID

    Arm Description

    Outcomes

    Primary Outcome Measures

    Mean Area Under the Time Curve From 0 to 12 Hours (AUC(0-12 Hours)) of Change From Baseline to Week 13 in Forced Expiratory Volume (Liters) in 1 Second (FEV1)
    FEV1 AUC was standardized to liters. Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
    Mean Change From Baseline to Week 13 Endpoint in AM Predose FEV1
    Endpoint was the last post-baseline non-missing result through Week 13 carried forward.

    Secondary Outcome Measures

    Change From Baseline to Endpoint in St George's Respiratory Questionaire (SGRQ) Total Score
    SGRQ consisted of 76 items aggregated into 3 component scores: symptoms (frequency/severity), activity (cause or limited by breathlessness), impact (social functioning, psychological disturbances from airway disease), & total score. Best health scores have a low numeric value. All component scores & total score ranged from 0-100, with a higher score indicating greater disease burden. A 4-point increase over placebo (and Baseline) was considered the minimum clinically important difference. Endpoint was the last post-baseline non-missing result through the 26 week evaluation carried forward.
    Change From Baseline in Proportion of Chronic Obstructive Pulmonary Disease (COPD) Symptom-Free Nights (AM Diary Symptoms)
    Prior to the use of study drug rescue medication (in the morning upon awakening) the participant evaluated the COPD symptoms of wheezing, cough, and difficulty breathing. A symptom-free night was defined as a combined score of 0 (no symptoms) across all three COPD symptoms evaluated the following morning. Proportion for Baseline included data from the last week before the first dose. Proportion for Endpoint included data across the entire 26-week treatment period.
    Number of Participants With Partly Stable COPD
    Partly stable COPD was a composite measure that included the following COPD outcomes: (1) No oral steroid rescue medication; (2) No AM or PM COPD weekly average symptom score greater than 2 during at least 7 of 8 weeks; (3) No moderate or severe exacerbations; (4) No unscheduled visits due to COPD worsenings; (5) No study discontinuation due to treatment failure or treatment-related adverse event as determined by the investigator.
    Number of Participants With Mild, Moderate, or Severe COPD Exacerbations
    Mild = 12 or more inhalations/day of inhaled rescue medication or 2 or more nebulized treatments/day of inhaled rescue medication. Moderate = treatment with antibiotics or oral steroids. Severe = emergency room treatment or hospitalizations of survival curves. If an event was composed of multiple criteria, the most severe criteria was assigned to the event.

    Full Information

    First Posted
    September 29, 2006
    Last Updated
    February 7, 2022
    Sponsor
    Organon and Co
    Collaborators
    Novartis
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    1. Study Identification

    Unique Protocol Identification Number
    NCT00383721
    Brief Title
    Effects of Mometasone Furoate/Formoterol Combination Versus Formoterol and Mometasone Furoate Alone in Chronic Obstructive Pulmonary Disease (COPD) (Study P04230AM4)(COMPLETED)
    Official Title
    A Randomized, 26-Week, Placebo-Controlled Efficacy and Safety Study With a 26-Week Long-Term Safety Extension, of High- and Medium-Dose Inhaled Mometasone Furoate/Formoterol Fixed-Dose Combination Formulation Compared With Formoterol and High-Dose Inhaled Mometasone Furoate Monotherapy in Subjects With Moderate to Severe COPD
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2022
    Overall Recruitment Status
    Completed
    Study Start Date
    September 2006 (undefined)
    Primary Completion Date
    July 2010 (Actual)
    Study Completion Date
    July 2010 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Organon and Co
    Collaborators
    Novartis

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is a randomized, placebo-controlled, parallel-group, multi-site, double-blind study evaluating the efficacy of mometasone furoate/formoterol fumarate (MF/F) metered dose inhaler (MDI) 400/10 mcg twice daily (BID) and MF/F MDI 200/10 mcg BID compared with MF 400 mcg BID and F 10 mcg BID in adults at least 40 years of age, with moderate to severe chronic obstructive pulmonary disease (COPD). All placebo-treated subjects and active-treated subjects who will not participate in the safety extension will be discontinued and will have their Final Visit at Week 26. Subjects who continue into the 26-week safety extension will have their Final Visit at Week 52. Efficacy will be measured by the mean change from Baseline to Week 13 in area under the forced expiratory volume in one second concentration time curve from 0 to 12 hours (FEV1 AUC[0-12hr]) and change from Baseline to Week 13 in AM predose FEV1.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Chronic Obstructive Pulmonary Disease (COPD)

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    ParticipantInvestigator
    Allocation
    Randomized
    Enrollment
    1196 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    MF/F MDI 400/10 mcg BID
    Arm Type
    Experimental
    Arm Title
    MF/F MDI 200/10 mcg BID
    Arm Type
    Experimental
    Arm Title
    MF MDI 400 mcg BID
    Arm Type
    Experimental
    Arm Title
    Formoterol MDI 10 mcg BID
    Arm Type
    Active Comparator
    Arm Title
    Placebo MDI BID
    Arm Type
    Placebo Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Mometasone furoate/formoterol (MF/F) combination
    Other Intervention Name(s)
    SCH 418131
    Intervention Description
    MF/F 400/10 mcg via a metered dose inhaler (MDI) twice daily for 52 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Mometasone furoate/formoterol (MF/F) combination
    Other Intervention Name(s)
    SCH 418131
    Intervention Description
    MF/F 200/10 mcg via a metered dose inhaler (MDI) twice daily for 52 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Mometasone furoate MDI (MF MDI)
    Other Intervention Name(s)
    SCH 32088
    Intervention Description
    MF 400 mcg via metered dose inhaler twice daily for 52 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Formoterol MDI
    Other Intervention Name(s)
    Foradil
    Intervention Description
    Formoterol 10 mcg via metered dose inhaler twice a day for 52 weeks
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Intervention Description
    Placebo MDI twice a day for 26 weeks
    Primary Outcome Measure Information:
    Title
    Mean Area Under the Time Curve From 0 to 12 Hours (AUC(0-12 Hours)) of Change From Baseline to Week 13 in Forced Expiratory Volume (Liters) in 1 Second (FEV1)
    Description
    FEV1 AUC was standardized to liters. Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
    Time Frame
    Baseline to Endpoint (13 weeks)
    Title
    Mean Change From Baseline to Week 13 Endpoint in AM Predose FEV1
    Description
    Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
    Time Frame
    Baseline to Endpoint (13 weeks)
    Secondary Outcome Measure Information:
    Title
    Change From Baseline to Endpoint in St George's Respiratory Questionaire (SGRQ) Total Score
    Description
    SGRQ consisted of 76 items aggregated into 3 component scores: symptoms (frequency/severity), activity (cause or limited by breathlessness), impact (social functioning, psychological disturbances from airway disease), & total score. Best health scores have a low numeric value. All component scores & total score ranged from 0-100, with a higher score indicating greater disease burden. A 4-point increase over placebo (and Baseline) was considered the minimum clinically important difference. Endpoint was the last post-baseline non-missing result through the 26 week evaluation carried forward.
    Time Frame
    Baseline to Endpoint (26 weeks)
    Title
    Change From Baseline in Proportion of Chronic Obstructive Pulmonary Disease (COPD) Symptom-Free Nights (AM Diary Symptoms)
    Description
    Prior to the use of study drug rescue medication (in the morning upon awakening) the participant evaluated the COPD symptoms of wheezing, cough, and difficulty breathing. A symptom-free night was defined as a combined score of 0 (no symptoms) across all three COPD symptoms evaluated the following morning. Proportion for Baseline included data from the last week before the first dose. Proportion for Endpoint included data across the entire 26-week treatment period.
    Time Frame
    Baseline to Endpoint (26 weeks)
    Title
    Number of Participants With Partly Stable COPD
    Description
    Partly stable COPD was a composite measure that included the following COPD outcomes: (1) No oral steroid rescue medication; (2) No AM or PM COPD weekly average symptom score greater than 2 during at least 7 of 8 weeks; (3) No moderate or severe exacerbations; (4) No unscheduled visits due to COPD worsenings; (5) No study discontinuation due to treatment failure or treatment-related adverse event as determined by the investigator.
    Time Frame
    Endpoint (26 weeks)
    Title
    Number of Participants With Mild, Moderate, or Severe COPD Exacerbations
    Description
    Mild = 12 or more inhalations/day of inhaled rescue medication or 2 or more nebulized treatments/day of inhaled rescue medication. Moderate = treatment with antibiotics or oral steroids. Severe = emergency room treatment or hospitalizations of survival curves. If an event was composed of multiple criteria, the most severe criteria was assigned to the event.
    Time Frame
    Endpoint (26 weeks)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Moderate to severe COPD based on prebronchodilator FEV1/forced vital capacity (FVC) ratio of <=70%. At Screening & Baseline, postbronchodilator FEV1 must be >= 60% predicted normal & >=25% predicted normal. COPD symptoms for >=24 months. >=2 COPD exacerbations requiring course of oral corticosteroid &/or antibiotics within 2-12 months before screening. Ex- or current smoker with smoking history >=10 pack years. Only albuterol/salbutamol for relief for at least 2 weeks prior to randomization. Withdraw from parenteral & oral steroids, anticholinergics, & antibiotics 4 weeks prior to Screening. No harm in changing current COPD therapy, willing to discontinue his/her anticholinergics, inhaled corticosteroids (ICS) or ICS/long-acting beta agonists (LABA) at Screening, & transferred to albuterol/salbutamol for relief for 2 weeks prior to Randomization. Lab tests conducted at Screening must be acceptable to investigator. Electrocardiogram (ECG) performed at Screening or within 30 days prior to Screening must be acceptable to investigator. Chest X-ray or computerized tomography (CT) scan is acceptable within 12 months prior to Screening must be acceptable to investigator. Female of childbearing potential must use birth control. Includes: hormonal contraceptives, intra-uterine device (IUD), condom in combination with spermicide, monogamous relationship with male partner who had vasectomy. Started birth control at least 3 months prior to Screening (exception condom), & must agree to continue. Female who is not currently sexually active must agree/consent to using a method should she become sexually active. Women who have been surgically sterilized or are at least 1 year postmenopausal are not considered to be of childbearing potential. Female must have negative serum pregnancy test at Screening. Exclusion Criteria: Evidence (upon visual inspection) of oropharyngeal candidiasis at Baseline with or without treatment. If there is evidence at Screening, may be treated as appropriate & visit can be scheduled upon resolution. If there is evidence at Baseline, may be treated as appropriate & visit can be rescheduled upon resolution. History of renal, hepatic, cardiovascular, metabolic, neurologic, hematologic, ophthalmological, respiratory, gastrointestinal, cerebrovascular, or other which could interfere with study or require treatment which might interfere with study. Examples include (but are not limited to) hypertension treated with beta-blockers), active hepatitis, coronary artery disease, arrhythmia, significant QTc prolongation (ie QTcF or QTcB [Fridericia or Bazett corrections, respectively >500 milliseconds (msecs)]) stroke, severe rheumatoid arthritis, chronic open-angle glaucoma or posterior subcapsular cataracts, acquired immune deficiency syndrome (AIDS), or conditions that may interfere with respiratory function such as asthma, bronchiectasis, cystic fibrosis. Others which are well-controlled & stable (eg hypertension not requiring beta-blockers) will not prohibit participation if appropriate to investigator. Allergy/sensitivity to glucocorticosteroids, beta-2 agonists, study drug/excipients. Female who is breast-feeding, pregnant, or intends to become pregnant. Illicit drug user. Human immunodeficiency virus (HIV) positive (testing not conducted). Unable to correctly use oral MDI. Taking any restricted medications prior to Screening without meeting washout. Cannot adhere to permitted concomitant & prohibited medications. May not participate in this same study at another investigational site. Cannot participate in different investigational study at any site, during same time. Not be randomized into study more than once. No person directly associated with administration of study may participate. Previously participated in MF/F trial. Increase in absolute volume of >=400 milliliters (mL) at Screening or prior to Baseline within 30 minutes after administration of 4 inhalations of albuterol/salbutamol (total dose of 360 to 400 mcg), or nebulized 2.5 mg albuterol/salbutamol. Asthma. Lobectomy, pneumonectomy or lung volume reduction surgery. Lung cancer. Requires long-term administration of oxygen (>15 hours/day). Alpha-1-antitrypsin deficiency. A history and/or presence of intraocular pressure in either eye >=22 millimeters of mercury (mm Hg), glaucoma, and/or posterior subcapsular cataracts. A subject who has undergone incisional or intraocular surgery in which the natural lens is still present in the eye. A subject with a history of penetrating trauma to both eyes. A subject with one or more of the following Lens Opacities Classification System (LOCS) III grades at screening: nuclear opalescence (NO): >=3.0, nuclear color (NC): >=3.0, cortical cataract (C): >=2.0, posterior subcapsular (P): >=0.5.

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf http://engagezone.msd.com/ds_documentation.php
    Citations:
    PubMed Identifier
    25044280
    Citation
    Maspero J, Cherrez I, Doherty DE, Tashkin DP, Kuna P, Kuo WL, Gates D, Nolte H, Chylack LT Jr. Appraisal of lens opacity with mometasone furoate/formoterol fumarate combination in patients with COPD or asthma. Respir Med. 2014 Sep;108(9):1355-62. doi: 10.1016/j.rmed.2014.04.015. Epub 2014 May 2.
    Results Reference
    derived
    PubMed Identifier
    22334770
    Citation
    Tashkin DP, Doherty DE, Kerwin E, Matiz-Bueno CE, Knorr B, Shekar T, Gates D, Staudinger H. Efficacy and safety characteristics of mometasone furoate/formoterol fumarate fixed-dose combination in subjects with moderate to very severe COPD: findings from pooled analysis of two randomized, 52-week placebo-controlled trials. Int J Chron Obstruct Pulmon Dis. 2012;7:73-86. doi: 10.2147/COPD.S29444. Epub 2012 Feb 3.
    Results Reference
    derived
    PubMed Identifier
    22334769
    Citation
    Doherty DE, Tashkin DP, Kerwin E, Knorr BA, Shekar T, Banerjee S, Staudinger H. Effects of mometasone furoate/formoterol fumarate fixed-dose combination formulation on chronic obstructive pulmonary disease (COPD): results from a 52-week Phase III trial in subjects with moderate-to-very severe COPD. Int J Chron Obstruct Pulmon Dis. 2012;7:57-71. doi: 10.2147/COPD.S27320. Epub 2012 Feb 3.
    Results Reference
    derived

    Learn more about this trial

    Effects of Mometasone Furoate/Formoterol Combination Versus Formoterol and Mometasone Furoate Alone in Chronic Obstructive Pulmonary Disease (COPD) (Study P04230AM4)(COMPLETED)

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