Confirmatory Dose Finding Study of 2 Dosages of CHF 4226 pMDI (Carmoterol) in Patients With COPD
Primary Purpose
Chronic Obstructive Pulmonary Disease
Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
carmoterol (CHF 4226)
carmoterol (CHF 4226)
placebo
salmeterol
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease
Eligibility Criteria
Inclusion Criteria:
- Signed IRB approved Informed Consent form
- Male or non-pregnant female, 40 -75 years old, inclusive
- Current or past cigarette smoking history of at least 15 pack-years
- Clinical diagnosis of COPD in accordance with recommendations of the National Heart Lung and Blood Institute/World Health Organization (NHLBI/WHO) Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Patient meets following requirements after FEV1 albuterol reversibility test (i.e., 30 minutes after 200μg (metered dose) albuterol MDI):
- FEV1/FVC < 70%
- FEV1 is at least 0.9L
- FEV1 30% - 80%, inclusive, of patient's predicted normal value; ∆FEV1 > 5% of pre-albuterol value
- If ∆FEV1 < 5% of pre-albuterol value, requirement must be met after retesting during run-in period, at least 24 hours prior to Period 1/Visit 1.
Exclusion Criteria:
- History of asthma
- Blood eosinophil count > 500/microliters
- History of allergic rhinitis or atopy
- COPD exacerbation or lower respiratory tract infection within 8 weeks prior to screening, or during run-in period, that resulted in use of an antibiotic, or oral or parenteral corticosteroids
- Inhaled corticosteroid that has been initiated, or effective dose has been changed, within 4 weeks prior to screening or during run-in period
- Uncontrolled cardiovascular (e.g., uncontrolled hypertension), respiratory, hematologic, immunologic, renal, neurologic, hepatic, endocrine (e.g., uncontrolled diabetes mellitus) or other disease, or any condition that might, in Investigator's judgment, place patient at undue risk or potentially compromise study results or interpretation
- History of coronary artery disease, cerebrovascular disease, cardiac arrhythmias
- Lung cancer or history of lung cancer
- Active cancer or history of cancer with < 5 years disease free survival time (with or without evidence of local recurrence or metastases). Localized basal cell carcinoma (without metastases) of skin is acceptable.
- Serum potassium value ≤ 3.5 mEq/L or > 5.5mEq/L and/or fasting serum glucose value ≥ 140 mg/dL
- Abnormal QTcF interval value in Screening visit ECG test (i.e., > 450 msec in males or > 470 msec in females)
- Cor Pulmonale
- Long term oxygen therapy, i.e., > 16 hours/24-hour period, every day, unless patient resides at elevation > 4000ft
Use of any of the following medications prior to Screening, without meeting specified minimum washout period:
- Long acting anti-cholinergic agent (i.e., tiotropium): 7 days
- Short acting anti-cholinergics: 8 hours
- Fixed combinations of β2-agonists and inhaled corticosteroids: 48 hours
- Fixed combinations of an anti-cholinergic and short acting β2-agonist: 8 hours
- Long-acting β2-agonists: 48 hours
- Short acting β2-agonists (other than those prescribed in the study): 6 hours
- Theophylline and other xanthines: 1 week
- Parenteral or oral corticosteroids: 1 month
- Patient has taken any non-permitted medication
- Patient has received live-attenuated virus vaccination within two weeks prior to screening or during run-in (inactivated Influenza vaccination is acceptable if given > 48 hours prior to Screening)
- Known intolerance/hypersensitivity to β2-adrenergic agonists, propellant gases/excipients
- Patient is pregnant or lactating female, or female at risk of pregnancy (i.e., not using adequate contraceptive method: surgical sterilization [e.g., bilateral tubal ligation], hormonal contraception [implantable, patch, oral], IUD, and double-barrier methods [any double combination of: male or female condom with spermicidal gel, diaphragm, sponge, cervical cap]).
- Patient is mentally or legally incapacitated
- Patient has participated in another investigational study within 30 days prior to screening
- Abuse of alcohol or other substances
- Patient does not maintain regular day/night, waking/sleeping cycles (e.g., night shift worker)
- Patient is potentially non-compliant or unable to perform required protocol outcome measurements
Sites / Locations
- Horizon Clinical Research Associates, PLLC
- Pulmonary Associates, PA
- UCLA David Geffen School of Medicine
- University Clinical Research - DeLand, LLC
- Pulmonary Medicine and Critical Care
- Sneeze, Wheeze & Itch Associates, LLC
- Commonwealth BioMedical Research
- North Carolina Clinical Research
- New Horizons Clinical Research
- Lynn Health Science Institute
- Clinical Research Institute of Southern Oregon, PC
- Asthma Allergy Associates
- Spartanburg Medical Research
- Reichman Associates
- University of Utah
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Placebo Comparator
Active Comparator
Arm Label
A
B
C
D
Arm Description
CHF 4226 (carmoterol) 2 μg once a day, in the morning
CHF 4226 (carmoterol) 4 μg once a day, in the morning
placebo once a day, in the morning
salmeterol 50 μg twice daily, in the morning and in the evening
Outcomes
Primary Outcome Measures
FEV1 AUC0-24 standardized by time
Secondary Outcome Measures
FEV1(L)
blood pressure
heart rate
FEV1 percent change
Full Information
NCT ID
NCT00640484
First Posted
March 18, 2008
Last Updated
August 24, 2010
Sponsor
Chiesi Farmaceutici S.p.A.
1. Study Identification
Unique Protocol Identification Number
NCT00640484
Brief Title
Confirmatory Dose Finding Study of 2 Dosages of CHF 4226 pMDI (Carmoterol) in Patients With COPD
Official Title
Evaluation of the Effect of 2 Weeks Treatment With CHF 4226 pMDI 2µg and 4µg, Given Once Daily in the Morning, on 24-Hour FEV1 in Patients With COPD
Study Type
Interventional
2. Study Status
Record Verification Date
August 2010
Overall Recruitment Status
Completed
Study Start Date
April 2008 (undefined)
Primary Completion Date
October 2008 (Actual)
Study Completion Date
October 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Chiesi Farmaceutici S.p.A.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to confirm the dose of CHF 4226 (carmoterol) that should be given once a day to patients with COPD in order for the effect to last for 24 hours.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
57 (Actual)
8. Arms, Groups, and Interventions
Arm Title
A
Arm Type
Experimental
Arm Description
CHF 4226 (carmoterol) 2 μg once a day, in the morning
Arm Title
B
Arm Type
Experimental
Arm Description
CHF 4226 (carmoterol) 4 μg once a day, in the morning
Arm Title
C
Arm Type
Placebo Comparator
Arm Description
placebo once a day, in the morning
Arm Title
D
Arm Type
Active Comparator
Arm Description
salmeterol 50 μg twice daily, in the morning and in the evening
Intervention Type
Drug
Intervention Name(s)
carmoterol (CHF 4226)
Other Intervention Name(s)
CHF 4226, TA2005
Intervention Description
carmoterol (CHF 4226) 2 μg once a day, in the morning
(1 puff of carmoterol 2 μg + 1 puff of placebo pMDI)
Intervention Type
Drug
Intervention Name(s)
carmoterol (CHF 4226)
Other Intervention Name(s)
CHF 4226, TA2005
Intervention Description
carmoterol (CHF 4226) 4 μg once a day, in the morning
(1 puff of carmoterol 2 µg + 1 puff of carmoterol 2µg)
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
placebo once a day, in the morning
(1 puff of placebo pMDI + 1 puff of placebo pMDI)
Intervention Type
Drug
Intervention Name(s)
salmeterol
Other Intervention Name(s)
Serevent Diskus/Accuhaler
Intervention Description
Salmeterol 50 μg twice daily, in the morning and in the evening
(1 blister of Serevent Diskus BID)
Primary Outcome Measure Information:
Title
FEV1 AUC0-24 standardized by time
Time Frame
on Day 15 (after 14 days of dosing)
Secondary Outcome Measure Information:
Title
FEV1(L)
Time Frame
30 min, 1, 2 ,3, 4, 6, 10, 12, 14, 16, 22, 23, and 24 hrs post dose at Visit 2 at all treatment periods
Title
blood pressure
Time Frame
at the beginning and end of each of the four 14-day treatment periods
Title
heart rate
Time Frame
at the beginning and end of each of the four 14-day treatment periods
Title
FEV1 percent change
Time Frame
30 min, 1, 2 ,3, 4, 6, 10, 12, 14, 16, 22, 23, and 24 hrs post dose at Visit 2 at all treatment periods
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed IRB approved Informed Consent form
Male or non-pregnant female, 40 -75 years old, inclusive
Current or past cigarette smoking history of at least 15 pack-years
Clinical diagnosis of COPD in accordance with recommendations of the National Heart Lung and Blood Institute/World Health Organization (NHLBI/WHO) Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Patient meets following requirements after FEV1 albuterol reversibility test (i.e., 30 minutes after 200μg (metered dose) albuterol MDI):
FEV1/FVC < 70%
FEV1 is at least 0.9L
FEV1 30% - 80%, inclusive, of patient's predicted normal value; ∆FEV1 > 5% of pre-albuterol value
If ∆FEV1 < 5% of pre-albuterol value, requirement must be met after retesting during run-in period, at least 24 hours prior to Period 1/Visit 1.
Exclusion Criteria:
History of asthma
Blood eosinophil count > 500/microliters
History of allergic rhinitis or atopy
COPD exacerbation or lower respiratory tract infection within 8 weeks prior to screening, or during run-in period, that resulted in use of an antibiotic, or oral or parenteral corticosteroids
Inhaled corticosteroid that has been initiated, or effective dose has been changed, within 4 weeks prior to screening or during run-in period
Uncontrolled cardiovascular (e.g., uncontrolled hypertension), respiratory, hematologic, immunologic, renal, neurologic, hepatic, endocrine (e.g., uncontrolled diabetes mellitus) or other disease, or any condition that might, in Investigator's judgment, place patient at undue risk or potentially compromise study results or interpretation
History of coronary artery disease, cerebrovascular disease, cardiac arrhythmias
Lung cancer or history of lung cancer
Active cancer or history of cancer with < 5 years disease free survival time (with or without evidence of local recurrence or metastases). Localized basal cell carcinoma (without metastases) of skin is acceptable.
Serum potassium value ≤ 3.5 mEq/L or > 5.5mEq/L and/or fasting serum glucose value ≥ 140 mg/dL
Abnormal QTcF interval value in Screening visit ECG test (i.e., > 450 msec in males or > 470 msec in females)
Cor Pulmonale
Long term oxygen therapy, i.e., > 16 hours/24-hour period, every day, unless patient resides at elevation > 4000ft
Use of any of the following medications prior to Screening, without meeting specified minimum washout period:
Long acting anti-cholinergic agent (i.e., tiotropium): 7 days
Short acting anti-cholinergics: 8 hours
Fixed combinations of β2-agonists and inhaled corticosteroids: 48 hours
Fixed combinations of an anti-cholinergic and short acting β2-agonist: 8 hours
Long-acting β2-agonists: 48 hours
Short acting β2-agonists (other than those prescribed in the study): 6 hours
Theophylline and other xanthines: 1 week
Parenteral or oral corticosteroids: 1 month
Patient has taken any non-permitted medication
Patient has received live-attenuated virus vaccination within two weeks prior to screening or during run-in (inactivated Influenza vaccination is acceptable if given > 48 hours prior to Screening)
Known intolerance/hypersensitivity to β2-adrenergic agonists, propellant gases/excipients
Patient is pregnant or lactating female, or female at risk of pregnancy (i.e., not using adequate contraceptive method: surgical sterilization [e.g., bilateral tubal ligation], hormonal contraception [implantable, patch, oral], IUD, and double-barrier methods [any double combination of: male or female condom with spermicidal gel, diaphragm, sponge, cervical cap]).
Patient is mentally or legally incapacitated
Patient has participated in another investigational study within 30 days prior to screening
Abuse of alcohol or other substances
Patient does not maintain regular day/night, waking/sleeping cycles (e.g., night shift worker)
Patient is potentially non-compliant or unable to perform required protocol outcome measurements
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Donald P. Tashkin, MD
Organizational Affiliation
University of California, Los Angeles
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Steven E. Linberg, PhD
Organizational Affiliation
Chiesi Farmaceutici S.p.A.
Official's Role
Study Director
Facility Information:
Facility Name
Horizon Clinical Research Associates, PLLC
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85295
Country
United States
Facility Name
Pulmonary Associates, PA
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
UCLA David Geffen School of Medicine
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
University Clinical Research - DeLand, LLC
City
DeLand
State/Province
Florida
ZIP/Postal Code
32720
Country
United States
Facility Name
Pulmonary Medicine and Critical Care
City
Austell
State/Province
Georgia
ZIP/Postal Code
30106
Country
United States
Facility Name
Sneeze, Wheeze & Itch Associates, LLC
City
Normal
State/Province
Illinois
ZIP/Postal Code
61761
Country
United States
Facility Name
Commonwealth BioMedical Research
City
Madisonville
State/Province
Kentucky
ZIP/Postal Code
42431
Country
United States
Facility Name
North Carolina Clinical Research
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27607
Country
United States
Facility Name
New Horizons Clinical Research
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
Facility Name
Lynn Health Science Institute
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73112
Country
United States
Facility Name
Clinical Research Institute of Southern Oregon, PC
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Asthma Allergy Associates
City
Portland
State/Province
Oregon
ZIP/Postal Code
97213
Country
United States
Facility Name
Spartanburg Medical Research
City
Spartanburg
State/Province
South Carolina
ZIP/Postal Code
29303
Country
United States
Facility Name
Reichman Associates
City
Sugar Land
State/Province
Texas
ZIP/Postal Code
77074
Country
United States
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84108
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
17352511
Citation
Matera MG, Cazzola M. ultra-long-acting beta2-adrenoceptor agonists: an emerging therapeutic option for asthma and COPD? Drugs. 2007;67(4):503-15. doi: 10.2165/00003495-200767040-00002.
Results Reference
background
PubMed Identifier
16022567
Citation
Cazzola M, Matera MG, Lotvall J. Ultra long-acting beta 2-agonists in development for asthma and chronic obstructive pulmonary disease. Expert Opin Investig Drugs. 2005 Jul;14(7):775-83. doi: 10.1517/13543784.14.7.775.
Results Reference
background
PubMed Identifier
9443940
Citation
Kikkawa H, Isogaya M, Nagao T, Kurose H. The role of the seventh transmembrane region in high affinity binding of a beta 2-selective agonist TA-2005. Mol Pharmacol. 1998 Jan;53(1):128-34. doi: 10.1124/mol.53.1.128.
Results Reference
background
PubMed Identifier
15655502
Citation
Rossoni G, Manfredi B, Razzetti R, Civelli M, Bongrani S, Berti F. Positive interaction of the beta2-agonist CHF 4226.01 with budesonide in the control of bronchoconstriction induced by acetaldehyde in the guinea-pigs. Br J Pharmacol. 2005 Feb;144(3):422-9. doi: 10.1038/sj.bjp.0706096.
Results Reference
background
PubMed Identifier
16533614
Citation
Rossoni G, Manfredi B, Razzetti R, Civelli M, Berti F. Positive interaction of the novel beta2-agonist carmoterol and tiotropium bromide in the control of airway changes induced by different challenges in guinea-pigs. Pulm Pharmacol Ther. 2007;20(3):250-7. doi: 10.1016/j.pupt.2006.01.004. Epub 2006 Mar 14.
Results Reference
background
PubMed Identifier
7965739
Citation
Voss HP, Shukrula S, Wu TS, Donnell D, Bast A. A functional beta-2 adrenoceptor-mediated chronotropic response in isolated guinea pig heart tissue: selectivity of the potent beta-2 adrenoceptor agonist TA 2005. J Pharmacol Exp Ther. 1994 Oct;271(1):386-9.
Results Reference
background
PubMed Identifier
7820105
Citation
Kikkawa H, Kanno K, Ikezawa K. TA-2005, a novel, long-acting, and selective beta 2-adrenoceptor agonist: characterization of its in vivo bronchodilating action in guinea pigs and cats in comparison with other beta 2-agonists. Biol Pharm Bull. 1994 Aug;17(8):1047-52. doi: 10.1248/bpb.17.1047.
Results Reference
background
PubMed Identifier
1359974
Citation
Voss HP, Donnell D, Bast A. Atypical molecular pharmacology of a new long-acting beta 2-adrenoceptor agonist, TA 2005. Eur J Pharmacol. 1992 Dec 1;227(4):403-9. doi: 10.1016/0922-4106(92)90158-r.
Results Reference
background
PubMed Identifier
1687479
Citation
Kikkawa H, Naito K, Ikezawa K. Tracheal relaxing effects and beta 2-selectivity of TA-2005, a newly developed bronchodilating agent, in isolated guinea pig tissues. Jpn J Pharmacol. 1991 Oct;57(2):175-85. doi: 10.1254/jjp.57.175.
Results Reference
background
PubMed Identifier
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Citation
Spadari-Bartfisch RC, Santos IN, Vanderlei LC, Marcondes FK. Pharmacological evidence for beta2-adrenoceptor in right atria from stressed female rats. Can J Physiol Pharmacol. 1999 Jun;77(6):432-40.
Results Reference
background
PubMed Identifier
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Citation
Matsukawa M, Takeda K, Shima H, Tagawa K, Banno K, Sato T. Enzyme-linked immunosorbent assay for TA-2005-glucuronide in human plasma. J Pharm Biomed Anal. 1998 Jun;17(2):245-54. doi: 10.1016/s0731-7085(97)00186-6.
Results Reference
background
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Confirmatory Dose Finding Study of 2 Dosages of CHF 4226 pMDI (Carmoterol) in Patients With COPD
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