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Single-Dose Cross-Over Study of the Effects of Albuterol-HFA in Exercise Induced Bronchoconstriction

Primary Purpose

Asthma, Bronchospasm

Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
albuterol (Armstrong Albuterol HFA)
Albuterol Sulfate (Provenetil-HFA)
Placebo-HFA
Sponsored by
Amphastar Pharmaceuticals, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Asthma

Eligibility Criteria

12 Years - 50 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female subjects, aged 12 - 50 years, and in general good health.
  2. A documented history of mild to moderate asthma, for at-least 6-months, requiring inhaled B-adrenergic agonists for symptom control.
  3. Having a history of exercise-induced bronchoconstriction, that can be prevented or relieved by the use of an inhaled B-agonist.
  4. Satisfying asthma stability requirement, such that over the 30 days prior to the screening, there are no significant changes in asthma therapy and no asthma-related hospitalization or emergency medical visits.
  5. Being able to withhold treatment with inhaled bronchodilators and/or restricted medications for the minimum washout periods indicated in Appendix II prior to pulmonary function testing at Screening Visit and Clinical Visits 1, 2 and 3.
  6. Having a baseline forced expiratory volume in the 1st second (FEV1) that is greater than nor equal to 65.0% of predicted normal values.
  7. Demonstrating a greater than or equal to 20.0%, but <50.0%, fall in FEV1 during a Standard Exercise Challenge test per current ATS guidance, at Screening.
  8. Demonstrating satisfactory techniques in the correct use of metered-dose inhaler (MDIs).
  9. Female patients of child-bearing potential being non-pregnant and non-lactating, and using an acceptable method of contraception.
  10. Willingness and ability to sign the informed consent and HIPPA forms to participate in this trial.

Exclusion Criteria:

  1. A smoking history of ≥10 pack-years, or having smoked within the past 12 months prior to Screening.
  2. Any current or past significant respiratory diseases that might significantly interfere with pharmacodynamic response to the study drugs, such as cystic fibrosis, bronchiectasis, emphysema, pulmonary malignancies, etc, other than asthma.
  3. Clinically significant cardiovascular, hematological, renal, neurologic, hepatic, and endocrine disorders, or psychiatric diseases, or any other significant health conditions that in the opinion of the investigator might interfere with bronchodilator responses.
  4. Recent upper or lower respiratory tract infection (within 4 weeks) prior to Screening.
  5. Recent (per Appendix II, Part I) use of orally ingested or systemically administered corticosteroids, B-adrenergic bronchodilators, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), B-blockers, or drugs that affect study drug performance.
  6. Taking >1,000 mcg daily of inhaled beclomethasone dipropionate or budesonide, or >500 mcg daily of inhaled fluticasone propionate, or taking high doses of other orally inhaled corticosteroids that suggest severe asthma state, in the opinion of the investigator, within four weeks of Screening.
  7. Demonstrating clinically significant abnormal 12-lead ECG results, upon Screening.
  8. Any significant physical (e.g., musculoskeletal, overweight, etc) conditions that, in the opinion of the investigator, could limit the subject's ability to perform the exercise challenge test.
  9. Known intolerance or hypersensitivity to any component of the MDI formulation (albuterol, HFA-134a, oleic acid and alcohol).
  10. Known or reasonably suspected substance abuses.

Sites / Locations

  • Colorado Allergy and Asthma Center
  • Colorado Allergy and Asthma Center
  • Colorado Allergy and Asthma Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

T

R

P

Arm Description

Armstrong Albuterol HFA Inhalation Aerosol

2 inhalations Proventil-HFA Albuterol Sulfate, 108 mcg, prior to exercise

Placebo-HFA

Outcomes

Primary Outcome Measures

The maximum percentage fall in FEV1, from the Pre-Exercise FEV1, between Albuterol-HFA and Placebo-HFA.

Secondary Outcome Measures

Evaluation of relative broncho-protective efficacy of Albuterol-HFA, in comparison to the active comparator, Proventil®-HFA, using the Max % fall in Post-Exercise FEV1, from the Pre-exercise FEV1
Pre-exercise FEV1 values (volume in Liters, recorded ), indicative of bronchodilator responsiveness.
Number and percentage of subjects who demonstrate a <20.0% fall in FEV1, from the Pre-exercise FEV1.
Area Under-the-Curve of percentage fall in FEV1, from the Pre-exercise FEV1.
Time to recovery, as the time point where FEV1 recovers from maximum percent fall in FEV1 to be within 5.0% of the Pre-Exercise FEV1 values.
Number of subjects who cannot complete the exercise at specified intensity and length, due to asthma symptoms.
Number of subjects requiring B2-agonist rescue inhalations during exercise, and during the 90 min post-exercise period.
The following baseline and post-dose safety parameters before and after each exercise-challenge tests will be assessed: Vital signs: blood pressure (SBP/DBP) and heart rate (HR).
12-lead ECG: HR, QT and QTc intervals, before and after treatment with Albuterol-HFA, versus the active control, and placebo control.
Pre-study (Screening) and End-of-Study laboratory tests for CBC, blood chemistry panel, urinalysis and urine pregnancy test.
Adverse events and side effects will be documented when observed by investigators or reported by subjects.

Full Information

First Posted
March 7, 2008
Last Updated
July 11, 2013
Sponsor
Amphastar Pharmaceuticals, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00634829
Brief Title
Single-Dose Cross-Over Study of the Effects of Albuterol-HFA in Exercise Induced Bronchoconstriction
Official Title
Randomized, Double-Blind, Controlled, Single-Dose, Three-Treatment, Cross-Over Study of The Protective Effects Of Albuterol-HFA In Preventing Exercise-Induced Bronchoconstriction In Adolescent And Adult Asthmatic Patients
Study Type
Interventional

2. Study Status

Record Verification Date
July 2013
Overall Recruitment Status
Terminated
Why Stopped
IND voluntarily withdrawn, without prejudice
Study Start Date
February 2008 (undefined)
Primary Completion Date
October 2008 (Actual)
Study Completion Date
October 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amphastar Pharmaceuticals, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This clinical study will evaluate and establish the protective effects of Amphastar's Albuterol Sulfate HFA Inhalation Aerosol (Albuterol-HFA), in preventing exercise-induced bronchoconstriction (EIB) in adolescent and adult asthmatic patients, in comparison with (1) Proventil®-HFA (Reference drug and Active Control ), and (2) Placebo-HFA control (HFA propellant only). Safety of the test drug, Albuterol-HFA, will also be evaluated in comparison to the Active and Placebo Controls. Analyses will be performed to determine if the Armstrong's Albuterol-HFA has resulted in a significant bronchoprotective effect, with attenuated Max % Fall in FEV1, in comparison to the Placebo-HFA control.
Detailed Description
The prevalence of exercise-induced bronchoconstriction (EIB) has been reported to be around 70% to 75% among patients with clinically established asthma. Airway cooling and drying are thought to cause the release of inflammatory mediators, such as histamine and leukotrienes, which then mediate clinical EIB symptoms. Pretreatment with a variety of medications will ameliorate EIB. Albuterol has been found to be more effective in minimizing EIB than theophylline, ipratropiom, cromoglycate, etc. Tested using a treadmill exercise challenge, the newer formulations of albuterol MDI with HFA as propellant have been demonstrated to be as effective as those with CFC as propellant in protecting asthma patients from EIB in children and adults. As a part of the Amphastar Pharmaceuticals' clinical development plan, the current study examines the clinical efficacy of A004, Armstrong Pharmaceuticals' Albuterol HFA oral inhalation MDI, in preventing EIB in adolescent and adult asthmatic patients. This is a randomized, double-blind, active and placebo-controlled, three-treatment, cross-over study, to be conducted in adolescent and adult patients with mild to moderate asthma and demonstrable EIB. All subjects will be screened against the inclusion/exclusion criteria for enrollment. A computer-generated randomization code will be created by the Amphastar Pharmaceuticals' IT Department, so that each enrolled subject will receive all three double-blinded treatments in randomized sequence. Each treatment is followed by a standardized exercise challenge and a series of FEV1 measurements during the 90 min post-exercise period. The three crossover Treatment Arms are: Treatment T (Armstrong's Test Drug: Albuterol-HFA); Treatment R (Reference Drug and Active Control: Proventil®-HFA); Treatment P (Placebo-HFA). By the definition of the crossover design, the three Treatment Arms are expected to consist comparably of 24 evaluable subjects. The consecutive study sessions will be separated by an interval of 1-14 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma, Bronchospasm

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
T
Arm Type
Experimental
Arm Description
Armstrong Albuterol HFA Inhalation Aerosol
Arm Title
R
Arm Type
Active Comparator
Arm Description
2 inhalations Proventil-HFA Albuterol Sulfate, 108 mcg, prior to exercise
Arm Title
P
Arm Type
Placebo Comparator
Arm Description
Placebo-HFA
Intervention Type
Drug
Intervention Name(s)
albuterol (Armstrong Albuterol HFA)
Other Intervention Name(s)
A004, Albuterol-HFA Inhalation Aerosol
Intervention Description
2 inhalations of 108 mcg albuterol sulfate prior to exercise, single dose
Intervention Type
Drug
Intervention Name(s)
Albuterol Sulfate (Provenetil-HFA)
Other Intervention Name(s)
Provenetil-HFA, albuterol sulfate-HFA
Intervention Description
2 inhalations of Proventil-HFA, 108 mcg/inhalation prior to exercise
Intervention Type
Drug
Intervention Name(s)
Placebo-HFA
Intervention Description
Placebo containing HFA propellant without active drug substance
Primary Outcome Measure Information:
Title
The maximum percentage fall in FEV1, from the Pre-Exercise FEV1, between Albuterol-HFA and Placebo-HFA.
Time Frame
90 minutes post exercise
Secondary Outcome Measure Information:
Title
Evaluation of relative broncho-protective efficacy of Albuterol-HFA, in comparison to the active comparator, Proventil®-HFA, using the Max % fall in Post-Exercise FEV1, from the Pre-exercise FEV1
Time Frame
90 minutes post exercise
Title
Pre-exercise FEV1 values (volume in Liters, recorded ), indicative of bronchodilator responsiveness.
Time Frame
20-30 min post dose
Title
Number and percentage of subjects who demonstrate a <20.0% fall in FEV1, from the Pre-exercise FEV1.
Time Frame
90 min post-exercise
Title
Area Under-the-Curve of percentage fall in FEV1, from the Pre-exercise FEV1.
Time Frame
90 min post-exercise
Title
Time to recovery, as the time point where FEV1 recovers from maximum percent fall in FEV1 to be within 5.0% of the Pre-Exercise FEV1 values.
Time Frame
concurrent with study visit
Title
Number of subjects who cannot complete the exercise at specified intensity and length, due to asthma symptoms.
Time Frame
concurrent with study visit
Title
Number of subjects requiring B2-agonist rescue inhalations during exercise, and during the 90 min post-exercise period.
Time Frame
90 minutes post exercise
Title
The following baseline and post-dose safety parameters before and after each exercise-challenge tests will be assessed: Vital signs: blood pressure (SBP/DBP) and heart rate (HR).
Time Frame
concurrent with study visit
Title
12-lead ECG: HR, QT and QTc intervals, before and after treatment with Albuterol-HFA, versus the active control, and placebo control.
Time Frame
concurrent with study visit
Title
Pre-study (Screening) and End-of-Study laboratory tests for CBC, blood chemistry panel, urinalysis and urine pregnancy test.
Time Frame
Throughout study
Title
Adverse events and side effects will be documented when observed by investigators or reported by subjects.
Time Frame
throughout study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female subjects, aged 12 - 50 years, and in general good health. A documented history of mild to moderate asthma, for at-least 6-months, requiring inhaled B-adrenergic agonists for symptom control. Having a history of exercise-induced bronchoconstriction, that can be prevented or relieved by the use of an inhaled B-agonist. Satisfying asthma stability requirement, such that over the 30 days prior to the screening, there are no significant changes in asthma therapy and no asthma-related hospitalization or emergency medical visits. Being able to withhold treatment with inhaled bronchodilators and/or restricted medications for the minimum washout periods indicated in Appendix II prior to pulmonary function testing at Screening Visit and Clinical Visits 1, 2 and 3. Having a baseline forced expiratory volume in the 1st second (FEV1) that is greater than nor equal to 65.0% of predicted normal values. Demonstrating a greater than or equal to 20.0%, but <50.0%, fall in FEV1 during a Standard Exercise Challenge test per current ATS guidance, at Screening. Demonstrating satisfactory techniques in the correct use of metered-dose inhaler (MDIs). Female patients of child-bearing potential being non-pregnant and non-lactating, and using an acceptable method of contraception. Willingness and ability to sign the informed consent and HIPPA forms to participate in this trial. Exclusion Criteria: A smoking history of ≥10 pack-years, or having smoked within the past 12 months prior to Screening. Any current or past significant respiratory diseases that might significantly interfere with pharmacodynamic response to the study drugs, such as cystic fibrosis, bronchiectasis, emphysema, pulmonary malignancies, etc, other than asthma. Clinically significant cardiovascular, hematological, renal, neurologic, hepatic, and endocrine disorders, or psychiatric diseases, or any other significant health conditions that in the opinion of the investigator might interfere with bronchodilator responses. Recent upper or lower respiratory tract infection (within 4 weeks) prior to Screening. Recent (per Appendix II, Part I) use of orally ingested or systemically administered corticosteroids, B-adrenergic bronchodilators, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), B-blockers, or drugs that affect study drug performance. Taking >1,000 mcg daily of inhaled beclomethasone dipropionate or budesonide, or >500 mcg daily of inhaled fluticasone propionate, or taking high doses of other orally inhaled corticosteroids that suggest severe asthma state, in the opinion of the investigator, within four weeks of Screening. Demonstrating clinically significant abnormal 12-lead ECG results, upon Screening. Any significant physical (e.g., musculoskeletal, overweight, etc) conditions that, in the opinion of the investigator, could limit the subject's ability to perform the exercise challenge test. Known intolerance or hypersensitivity to any component of the MDI formulation (albuterol, HFA-134a, oleic acid and alcohol). Known or reasonably suspected substance abuses.
Facility Information:
Facility Name
Colorado Allergy and Asthma Center
City
Denver
State/Province
Colorado
ZIP/Postal Code
80230
Country
United States
Facility Name
Colorado Allergy and Asthma Center
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80112
Country
United States
Facility Name
Colorado Allergy and Asthma Center
City
Lakewood
State/Province
Colorado
ZIP/Postal Code
80401
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Single-Dose Cross-Over Study of the Effects of Albuterol-HFA in Exercise Induced Bronchoconstriction

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