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Efficacy and Safety of Two Dry Power Inhalers (DPIs) Used for the Application of Mometasone in the Treatment of Asthma

Primary Purpose

Asthma

Status
Completed
Phase
Phase 3
Locations
Brazil
Study Type
Interventional
Intervention
OXIMAX
ASMANEX TWISTHALER
Sponsored by
Mantecorp Industria Quimica e Farmaceutica Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asthma focused on measuring Asthma, Mometasone furoate, Inhalation devices, Forced expiratory volume

Eligibility Criteria

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

Inclusion Criteria:

  • A diagnosis of asthma for at least 6 months
  • Baseline FEV1 must be > = 55% and < = 85% of predicted
  • Increase in absolute FEV1 of >12%, with an absolute volume increase of at least 200 mL after reversibility testing
  • Use of an adequate form of birth control by non-pregnant women of childbearing potential
  • Absence of use of the following medication prior to the inclusion:

    • Beta 2 agonist short-acting (inhaled, oral)-12 Hours
    • Beta 2 agonist long-acting (inhaled)-48 Hours
    • Ipratropium bromide-12 hours
    • Cromolyn sodium, nedocromil-07 days
    • Astemizole-03 months
    • Cetotifeno-03 months
    • Another investigational drug-01 month
    • Theophyline-2 weeks
    • Antihistamines-07 days
    • Anticholinergics-07 days
    • Leukotriene modifiers-2 weeks
    • Oral decongestant long-acting-72 hours
    • Oral decongestant short-acting-24 hours

Exclusion Criteria:

  • Women who were pregnant, breast-feeding, or are pre-menarcheal.
  • Subjects who have used any investigational drug within the last 30 days
  • Subjects who were receiving immunotherapy
  • Subjects requiring the use of >12 puffs per day of Salbutamol on any 2 consecutive days
  • Smokers or ex-smokers
  • Subjects who are allergic to corticosteroids or beta-agonists
  • Subjects who have required inpatient hospitalization for asthma control within the previous 3 months
  • Subjects who have required ventilator support for respiratory failure secondary to their asthma within the last 5 years
  • Subjects who have been treated in the emergency room (for a severe asthma exacerbation), or admitted to the hospital for management of airway obstruction, on two or more occasions within the last six months
  • Subjects with clinical evidence of emphysema, chronic bronchitis, bronchiectasis, or cystic fibrosis
  • Subjects with a significant history of renal, hepatic, cardiovascular, metabolic, neurologic, hematological, respiratory, gastrointestinal, cerebrovascular, or other significant medical illness or disorder which, in the judgment of the investigator, could have interfered with the study, or required treatment which might have interfered with the study
  • Subjects who have experienced an upper or lower respiratory tract infection (viral or bacterial) within the previous 2 weeks prior to enrollment
  • Subjects who have clinically significant abnormalities on chest x-ray at the Screening Visit or within the previous year
  • Subjects who are known to be HIV positive
  • Subjects who are known to be illicit drug abusers
  • Subjects with hypothalamic-pituitary-adrenal (HPA) axis disturbances
  • Subjects with severe pulmonary airflow obstruction showing to be life-threatening characterized by cyanosis, confusion, somnolence, coma or tiredness, thorax silent to hearing or showing weak respiration,PEFR <25% of the predicted normal, bradycardia (heartbeats bellow 60 beats per minute)
  • Subjects with baseline FEV1 < 55% of the predicted normal
  • Subjects with uncontrolled hypertension
  • Subjects with suspected pneumonia, pneumothorax, pneumomediastinum, pulmonary tuberculosis, alpha-1 anti-trypsin deficiency, lung mycosis (blastomycosis, histoplasmic) or pulmonary cystic fibrosis
  • Subjects with history of thoracic surgery or any previous malignancy of the lung
  • Subjects with significant heart disease (e.g., previous acute myocardial infarction, angina pectoris, pulmonary edema or other cardiovascular disease which is characterized as life-threatening
  • Subjects receiving beta-adrenergic blocking agents

Sites / Locations

  • Hospital Universitário da Universidade Federal de Juíz de Fora
  • UNIRIO
  • Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
  • Hospital do Servidor Público Estadual
  • Hospital Heliópolis

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Monodose device

Multidose device

Arm Description

Mometasone furoate 400 µg DPI capsules administered through a monodose device.

Mometasone furoate 400 µg DPI capsules administered through a multidose device

Outcomes

Primary Outcome Measures

Difference in Forced Expired Volume in one second (FEV1) and Peak Expiratory Flow Rate (PEFR) measured by spirometry; number of puffs/day of rescue medication (Salbutamol) used by the subjects.

Secondary Outcome Measures

PEFR daily measurements, daily scores for asthma symptoms, response to therapy made by the Investigator, safety (hypothalamic-pituitary-adrenal axis evaluation and clinical laboratory measurements) and tolerability (adverse events).

Full Information

First Posted
August 12, 2009
Last Updated
September 9, 2009
Sponsor
Mantecorp Industria Quimica e Farmaceutica Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT00975741
Brief Title
Efficacy and Safety of Two Dry Power Inhalers (DPIs) Used for the Application of Mometasone in the Treatment of Asthma
Official Title
An Open-label, Comparative, Randomized, Parallel, Multicenter Study to Determine the Efficacy and Safety of Two Dry Powder Inhalers (DPIs) Used for the Application of Mometasone in the Treatment of Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
September 2009
Overall Recruitment Status
Completed
Study Start Date
October 2002 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
August 2003 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Mantecorp Industria Quimica e Farmaceutica Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Mometasone furoate (MF) is a new potent synthetic corticosteroid. Internationally, MF is administered by a breath-actuated DPI and supplied in multidose devices. Capsules to be administered through a monodose device that would offer an alternative to MF DPI multidose treatment in terms of cost-effectiveness were developed in Brazil. The aim of the present non-inferiority clinical study was to evaluate both devices in terms of efficacy and safety.
Detailed Description
Background: Internationally, MF is administered by a breath-actuated DPI and supplied in multidose devices. Capsules to be administered through a monodose device that would offer an alternative to MF DPI multidose treatment in terms of cost-effectiveness were developed in Brazil. Results of laboratory analysis for respirable fraction, content uniformity of emitted dose and of the bulk powder and for percentage of particles < 1 micra of both MF 200 µg and MF 400 µg capsules have indicated their equivalent performance in comparison to MF DPI multidose. Aim: The aim of the present non-inferiority clinical study was to evaluate both devices in terms of efficacy and safety. Methods: Ninety-seven adult patients with moderate persistent asthma were randomized in two groups to receive for 60 days a dose of 400 µg of DPI MF once daily (at evening) using multidose or monodose device. Follow-up visits were scheduled at Days 7, 14, 28, 42 and 56. Efficacy was assessed by means of pulmonary function tests (spirometry - FEV1 and PEFR) at each visit. In addition, subjects have recorded twice daily PEFR, symptom scores and use of rescue medication throughout the study. Response to therapy was also assessed. Safety evaluations included monitoring of adverse events, vital signs, clinical laboratory tests (plasma cortisol concentrations were assessed at enrollment and repeated after 60 days of MF treatment; cortrosyn test was performed at the enrollment and after 60 days of MF treatment), and physical examination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma
Keywords
Asthma, Mometasone furoate, Inhalation devices, Forced expiratory volume

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
97 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Monodose device
Arm Type
Experimental
Arm Description
Mometasone furoate 400 µg DPI capsules administered through a monodose device.
Arm Title
Multidose device
Arm Type
Active Comparator
Arm Description
Mometasone furoate 400 µg DPI capsules administered through a multidose device
Intervention Type
Device
Intervention Name(s)
OXIMAX
Intervention Type
Device
Intervention Name(s)
ASMANEX TWISTHALER
Primary Outcome Measure Information:
Title
Difference in Forced Expired Volume in one second (FEV1) and Peak Expiratory Flow Rate (PEFR) measured by spirometry; number of puffs/day of rescue medication (Salbutamol) used by the subjects.
Time Frame
56 days after initiation of therapy
Secondary Outcome Measure Information:
Title
PEFR daily measurements, daily scores for asthma symptoms, response to therapy made by the Investigator, safety (hypothalamic-pituitary-adrenal axis evaluation and clinical laboratory measurements) and tolerability (adverse events).
Time Frame
56 days after initiation of therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: A diagnosis of asthma for at least 6 months Baseline FEV1 must be > = 55% and < = 85% of predicted Increase in absolute FEV1 of >12%, with an absolute volume increase of at least 200 mL after reversibility testing Use of an adequate form of birth control by non-pregnant women of childbearing potential Absence of use of the following medication prior to the inclusion: Beta 2 agonist short-acting (inhaled, oral)-12 Hours Beta 2 agonist long-acting (inhaled)-48 Hours Ipratropium bromide-12 hours Cromolyn sodium, nedocromil-07 days Astemizole-03 months Cetotifeno-03 months Another investigational drug-01 month Theophyline-2 weeks Antihistamines-07 days Anticholinergics-07 days Leukotriene modifiers-2 weeks Oral decongestant long-acting-72 hours Oral decongestant short-acting-24 hours Exclusion Criteria: Women who were pregnant, breast-feeding, or are pre-menarcheal. Subjects who have used any investigational drug within the last 30 days Subjects who were receiving immunotherapy Subjects requiring the use of >12 puffs per day of Salbutamol on any 2 consecutive days Smokers or ex-smokers Subjects who are allergic to corticosteroids or beta-agonists Subjects who have required inpatient hospitalization for asthma control within the previous 3 months Subjects who have required ventilator support for respiratory failure secondary to their asthma within the last 5 years Subjects who have been treated in the emergency room (for a severe asthma exacerbation), or admitted to the hospital for management of airway obstruction, on two or more occasions within the last six months Subjects with clinical evidence of emphysema, chronic bronchitis, bronchiectasis, or cystic fibrosis Subjects with a significant history of renal, hepatic, cardiovascular, metabolic, neurologic, hematological, respiratory, gastrointestinal, cerebrovascular, or other significant medical illness or disorder which, in the judgment of the investigator, could have interfered with the study, or required treatment which might have interfered with the study Subjects who have experienced an upper or lower respiratory tract infection (viral or bacterial) within the previous 2 weeks prior to enrollment Subjects who have clinically significant abnormalities on chest x-ray at the Screening Visit or within the previous year Subjects who are known to be HIV positive Subjects who are known to be illicit drug abusers Subjects with hypothalamic-pituitary-adrenal (HPA) axis disturbances Subjects with severe pulmonary airflow obstruction showing to be life-threatening characterized by cyanosis, confusion, somnolence, coma or tiredness, thorax silent to hearing or showing weak respiration,PEFR <25% of the predicted normal, bradycardia (heartbeats bellow 60 beats per minute) Subjects with baseline FEV1 < 55% of the predicted normal Subjects with uncontrolled hypertension Subjects with suspected pneumonia, pneumothorax, pneumomediastinum, pulmonary tuberculosis, alpha-1 anti-trypsin deficiency, lung mycosis (blastomycosis, histoplasmic) or pulmonary cystic fibrosis Subjects with history of thoracic surgery or any previous malignancy of the lung Subjects with significant heart disease (e.g., previous acute myocardial infarction, angina pectoris, pulmonary edema or other cardiovascular disease which is characterized as life-threatening Subjects receiving beta-adrenergic blocking agents
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carlos Alberto C Pereira, MD, PhD
Organizational Affiliation
Hospital do Servidor Público Estadual, São Paulo
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Universitário da Universidade Federal de Juíz de Fora
City
Juíz de Fora
State/Province
Minas Gerais
Country
Brazil
Facility Name
UNIRIO
City
Rio de Janeiro
Country
Brazil
Facility Name
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
City
São Paulo
Country
Brazil
Facility Name
Hospital do Servidor Público Estadual
City
São Paulo
Country
Brazil
Facility Name
Hospital Heliópolis
City
São Paulo
Country
Brazil

12. IPD Sharing Statement

Citations:
PubMed Identifier
20835586
Citation
Pereira CA, Vianna FF, Cukier A, Stelmach R, Oliveira JC, Carvalho EV, Gomes EP, Mayo SV, Chibante AM, Domingues CP. Efficacy and safety of two dry-powder inhalers for the administration of mometasone furoate in asthma patients. J Bras Pneumol. 2010 Jul-Aug;36(4):410-6. doi: 10.1590/s1806-37132010000400004. English, Portuguese.
Results Reference
derived

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Efficacy and Safety of Two Dry Power Inhalers (DPIs) Used for the Application of Mometasone in the Treatment of Asthma

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