Efficacy and Safety of 3 Doses of Tiotropium Compared to Placebo in Adolescents (12 to 17 Yrs) With Moderate Asthma
Primary Purpose
Asthma
Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tiotropium bromide
tiotropium bromide
tiotropium bromide
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Asthma
Eligibility Criteria
Inclusion criteria:
- All patients and legally accepted caregiver(s) must sign and date an Informed Consent form consistent with Good Clinical Practice (GCP) guidelines of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) and local legislation prior to participation in the trial.
- Male or female patients between 12 and 17 years of age.
- All patients must have at least a 3 months history of asthma and fulfill the diagnostic criteria of moderate persistent asthma, according to the current Global Initiative for Asthma (GINA) guidelines at the time of enrolment into the trial.
- All patients must have been on maintenance treatment with inhaled corticosteroids at a stable medium dose for at least 4 weeks before Visit 1.
- All patients must be symptomatic (partly controlled) at Visit 1 (screening) and prior to randomisation at Visit 2 as defined by an Asthma Control Questionnaire (ACQ) mean score of equal or above 1.5.
- All patients must have a pre-bronchodilator FEV1 above 60% and less than or equal 90% of predicted normal at Visit 1. Variation of absolute FEV1 values of Visit 1 (pre-bronchodilator) as compared to Visit 2 (pre-dose) must be within ± 30%.
- All patients must have an increase in FEV1 of equal or above 12% and 200 mL 15 min. after 400 mcg salbutamol (albuterol) at Visit 1. If patients in the lower age range (e.g., 12 to 14 year olds) exhibit a very small total lung volume, positive reversibility testing might be based solely on the relative (12%) post-bronchodilator response.
- All patients should be never-smokers or ex-smokers who stopped smoking at least one year prior to enrolment.
- Patients should be able to use the Respimat® inhaler correctly.
- Patients must be able to perform all trial related procedures including technically acceptable spirometric manoeuvres, according to American Thoracic Society (ATS) standards and the use of the electronic diary/peak flow meter.
Exclusion criteria:
- Patients with a significant disease other than asthma.
- Patients with a history of congenital or acquired heart disease, and/or have been hospitalised for cardiac syncope or failure during the past year.
- Patients with any unstable or life-threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention (e. g. pacemaker implantation) or a change in drug therapy within the past year.
- Patients with malignancy for which the patient has undergone resection, radiation therapy or chemotherapy within the last five years.
- Patients with lung diseases other than asthma, e.g. cystic fibrosis (CF). In case of ex-premature infants, a history of significant bronchopulmonary dysplasia (BPD) will be regarded as exclusion criterion
- Patients with significant alcohol or drug abuse within the past two years.
- Patients with known hypersensitivity to anticholinergic drugs, benzalkonium chloride (BAC), ethylenediaminetetraacetic acid (EDTA) or any other components of the tiotropium inhalation solution.
- Pregnant or nursing adolescent female patients, including female patients with a positive Beta HCG (serum pregnancy) testing at screening (visit 1).
- Sexually active female patients of child-bearing potential not using a highly effective method of birth control.
- Patients with a known narrow-angle glaucoma, or any other disease where anticholinergic treatment is contraindicated.
- Patients with renal impairment, as defined by a creatinine clearance less than 50 mL/min/1.73 m2 body surface area (BSA) as calculated by Schwartz Formula.
Sites / Locations
- 205.424.01002 Boehringer Ingelheim Investigational Site
- 205.424.01006 Boehringer Ingelheim Investigational Site
- 205.424.01007 Boehringer Ingelheim Investigational Site
- 205.424.01004 Boehringer Ingelheim Investigational Site
- 205.424.01001 Boehringer Ingelheim Investigational Site
- 205.424.49007 Boehringer Ingelheim Investigational Site
- 205.424.49004 Boehringer Ingelheim Investigational Site
- 205.424.49002 Boehringer Ingelheim Investigational Site
- 205.424.37104 Boehringer Ingelheim Investigational Site
- 205.424.37103 Boehringer Ingelheim Investigational Site
- 205.424.37105 Boehringer Ingelheim Investigational Site
- 205.424.37101 Boehringer Ingelheim Investigational Site
- 205.424.37102 Boehringer Ingelheim Investigational Site
- 205.424.37001 Boehringer Ingelheim Investigational Site
- 205.424.37003 Boehringer Ingelheim Investigational Site
- 205.424.37004 Boehringer Ingelheim Investigational Site
- 205.424.38604 Boehringer Ingelheim Investigational Site
- 205.424.38605 Boehringer Ingelheim Investigational Site
- 205.424.38602 Boehringer Ingelheim Investigational Site
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Experimental
Placebo Comparator
Experimental
Arm Label
Treatment A
Treatment C
Placebo
Treatment B
Arm Description
patients inhale 2 puffs (dose of 1.25 mcg) once daily in the evening via Respimat inhaler
patients inhale 2 puffs (dose of 5 mcg) once daily in the evening via Respimat inhaler
patients inhale 2 puffs of placebo matching tiotropium once daily in the evening via Respimat inhaler
patients inhale 2 puffs (dose of 2.5 mcg) once daily in the evening via Respimat inhaler
Outcomes
Primary Outcome Measures
Forced Expiratory Volume (FEV1) Peak (0-3h) Response
The FEV1 peak (0-3h) response is determined at the end of the 4 week treatment period. This is the difference between the maximum FEV1 measured within the first 3 hours post dosing and the FEV1 baseline measurement. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Secondary Outcome Measures
Trough FEV1 Response
The trough FEV1 is defined as the pre-dose FEV1 measured just prior to the last administration of randomised treatment. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
FEV1 Area Under the Curve From 0 to 3 h (AUC0-3h) Response
FEV1 (AUC0-3h) will be calculated as the area under the curve from 0 to 3hours using the trapezoidal rule divided by the observation time (3 hours) to report in litres. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
FEV1 Individual Measurements Response at Each Time-point
Individual FEV1 measurements at each time-point ("personal best"). Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Forced Vital Capacity (FVC) Peak (0-3h) Response
The FVC peak (0-3h) response is determined at the end of the 4 week treatment period. This is the difference between the maximum FVC measured within the first 3 hours post dosing and the FVC baseline measurement. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
FVC Trough Response
The trough FVC response is defined as the pre-dose FVC measured just prior to the last administration of randomised treatment. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
FVC Area Under the Curve From 0 to 3 h (AUC0-3h) Response
FVC (AUC0-3h) will be calculated as the area under the curve from 0 to 3hours using the trapezoidal rule divided by the observation time (3 hours) to report in litres. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
FVC Individual Measurements at Each Time-point
Individual FVC measurements at each time-point ("personal best"). Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Forced Expiratory Flow (FEF) 25-75% Individual Measurements Response at Each Time Point
FEF 25-75% is the mean forced expiratory flow between 25% and 75% of the FVC determined at the end of the 4-week treatment period. This is often referred to as the maximum midexpiratory flow. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Mean Morning Peak Expiratory Flow (PEF) Response
Mean morning PEF assessed by patients at home. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Mean Evening PEF Response
Mean evening PEF assessed by patients at home. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Change From Baseline in the Number of Puffs of Rescue Medication Per Day
Mean number of inhalations (puffs) of unscheduled rescue salbutamol therapy during whole day. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Control of Asthma as Assessed by Asthma Control Questionnaire (ACQ)
ACQ is a questionnaire consisting of a seven point Likert scale ranging from 0 to 6, whereby 0 represents good control and 6 represents poor control of asthma. The scale describes the frequency and severity of asthma symptoms. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Change From Baseline in Mean Number of Nighttime Awakenings
Mean number of nighttime awakenings due to asthma symptoms as assessed by patients eDiary incorporated in the AM3® device. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Full Information
NCT ID
NCT01122680
First Posted
May 11, 2010
Last Updated
May 7, 2014
Sponsor
Boehringer Ingelheim
Collaborators
Pfizer
1. Study Identification
Unique Protocol Identification Number
NCT01122680
Brief Title
Efficacy and Safety of 3 Doses of Tiotropium Compared to Placebo in Adolescents (12 to 17 Yrs) With Moderate Asthma
Official Title
A Phase II Randomised, Double-blind, Placebo-controlled, Incomplete Crossover Trial With 4-week Treatment Periods to Evaluate Efficacy and Safety of Tiotropium Inhalation Solution (Doses of 1.25 µg, 2.5 µg and 5 µg) Delivered Via Respimat® Inhaler Once Daily in the Evening in Adolescents (12 to 17 Yrs Old) With Moderate Persistent Asthma
Study Type
Interventional
2. Study Status
Record Verification Date
July 2012
Overall Recruitment Status
Completed
Study Start Date
May 2010 (undefined)
Primary Completion Date
April 2011 (Actual)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim
Collaborators
Pfizer
4. Oversight
5. Study Description
Brief Summary
The primary objective of this trial is to evaluate the efficacy and safety of tiotropium 1.25 mcg (2 actuations of 0.625 mcg), tiotropium 2.5 mcg (2 actuations of 1.25 mcg) and tiotropium 5 mcg (2 actuations of 2.5 mcg) once daily in the evening delivered by the Respimat inhaler in adolescents (12 to 17 yrs) with moderate persistent asthma, compared to placebo and on top of maintenance therapy with an inhaled corticosteroid controller medication. It is a randomised, double-blind, placebo-controlled Phase II trial with incomplete cross-over design. Patients need to be still symptomatic, i. e. not fully controlled with their maintenance treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
Double
Allocation
Randomized
Enrollment
105 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment A
Arm Type
Experimental
Arm Description
patients inhale 2 puffs (dose of 1.25 mcg) once daily in the evening via Respimat inhaler
Arm Title
Treatment C
Arm Type
Experimental
Arm Description
patients inhale 2 puffs (dose of 5 mcg) once daily in the evening via Respimat inhaler
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
patients inhale 2 puffs of placebo matching tiotropium once daily in the evening via Respimat inhaler
Arm Title
Treatment B
Arm Type
Experimental
Arm Description
patients inhale 2 puffs (dose of 2.5 mcg) once daily in the evening via Respimat inhaler
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide
Intervention Description
inhalation solution, dose of 1.25 mcg (2 puffs of 0.625 mcg)
Intervention Type
Drug
Intervention Name(s)
tiotropium bromide
Intervention Description
inhalation solution, dose of 2.5 mcg (2 puffs of 1.25 mcg)
Intervention Type
Drug
Intervention Name(s)
tiotropium bromide
Intervention Description
inhalation solution, dose of 5 mcg (2 puffs of 2.5 mcg)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
placebo inhalation solution
Primary Outcome Measure Information:
Title
Forced Expiratory Volume (FEV1) Peak (0-3h) Response
Description
The FEV1 peak (0-3h) response is determined at the end of the 4 week treatment period. This is the difference between the maximum FEV1 measured within the first 3 hours post dosing and the FEV1 baseline measurement. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Secondary Outcome Measure Information:
Title
Trough FEV1 Response
Description
The trough FEV1 is defined as the pre-dose FEV1 measured just prior to the last administration of randomised treatment. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
FEV1 Area Under the Curve From 0 to 3 h (AUC0-3h) Response
Description
FEV1 (AUC0-3h) will be calculated as the area under the curve from 0 to 3hours using the trapezoidal rule divided by the observation time (3 hours) to report in litres. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
FEV1 Individual Measurements Response at Each Time-point
Description
Individual FEV1 measurements at each time-point ("personal best"). Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks (10 min pre-dose, 30 min, 1,2,3 hours post-dose)
Title
Forced Vital Capacity (FVC) Peak (0-3h) Response
Description
The FVC peak (0-3h) response is determined at the end of the 4 week treatment period. This is the difference between the maximum FVC measured within the first 3 hours post dosing and the FVC baseline measurement. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
FVC Trough Response
Description
The trough FVC response is defined as the pre-dose FVC measured just prior to the last administration of randomised treatment. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
FVC Area Under the Curve From 0 to 3 h (AUC0-3h) Response
Description
FVC (AUC0-3h) will be calculated as the area under the curve from 0 to 3hours using the trapezoidal rule divided by the observation time (3 hours) to report in litres. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
FVC Individual Measurements at Each Time-point
Description
Individual FVC measurements at each time-point ("personal best"). Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks (10 min pre-dose, 30 min, 1,2,3 hours post-dose)
Title
Forced Expiratory Flow (FEF) 25-75% Individual Measurements Response at Each Time Point
Description
FEF 25-75% is the mean forced expiratory flow between 25% and 75% of the FVC determined at the end of the 4-week treatment period. This is often referred to as the maximum midexpiratory flow. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks (10 min pre-dose, 30 min, 1,2,3 hours post-dose)
Title
Mean Morning Peak Expiratory Flow (PEF) Response
Description
Mean morning PEF assessed by patients at home. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
Mean Evening PEF Response
Description
Mean evening PEF assessed by patients at home. Response was defined as the change from baseline. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
Change From Baseline in the Number of Puffs of Rescue Medication Per Day
Description
Mean number of inhalations (puffs) of unscheduled rescue salbutamol therapy during whole day. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and 4 weeks
Title
Control of Asthma as Assessed by Asthma Control Questionnaire (ACQ)
Description
ACQ is a questionnaire consisting of a seven point Likert scale ranging from 0 to 6, whereby 0 represents good control and 6 represents poor control of asthma. The scale describes the frequency and severity of asthma symptoms. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
4 weeks
Title
Change From Baseline in Mean Number of Nighttime Awakenings
Description
Mean number of nighttime awakenings due to asthma symptoms as assessed by patients eDiary incorporated in the AM3® device. Analysis adjusted for treatment, period, patient and baseline using a mixed model.
Time Frame
Baseline and last week of treatment (week 4)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
12 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria:
All patients and legally accepted caregiver(s) must sign and date an Informed Consent form consistent with Good Clinical Practice (GCP) guidelines of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) and local legislation prior to participation in the trial.
Male or female patients between 12 and 17 years of age.
All patients must have at least a 3 months history of asthma and fulfill the diagnostic criteria of moderate persistent asthma, according to the current Global Initiative for Asthma (GINA) guidelines at the time of enrolment into the trial.
All patients must have been on maintenance treatment with inhaled corticosteroids at a stable medium dose for at least 4 weeks before Visit 1.
All patients must be symptomatic (partly controlled) at Visit 1 (screening) and prior to randomisation at Visit 2 as defined by an Asthma Control Questionnaire (ACQ) mean score of equal or above 1.5.
All patients must have a pre-bronchodilator FEV1 above 60% and less than or equal 90% of predicted normal at Visit 1. Variation of absolute FEV1 values of Visit 1 (pre-bronchodilator) as compared to Visit 2 (pre-dose) must be within ± 30%.
All patients must have an increase in FEV1 of equal or above 12% and 200 mL 15 min. after 400 mcg salbutamol (albuterol) at Visit 1. If patients in the lower age range (e.g., 12 to 14 year olds) exhibit a very small total lung volume, positive reversibility testing might be based solely on the relative (12%) post-bronchodilator response.
All patients should be never-smokers or ex-smokers who stopped smoking at least one year prior to enrolment.
Patients should be able to use the Respimat® inhaler correctly.
Patients must be able to perform all trial related procedures including technically acceptable spirometric manoeuvres, according to American Thoracic Society (ATS) standards and the use of the electronic diary/peak flow meter.
Exclusion criteria:
Patients with a significant disease other than asthma.
Patients with a history of congenital or acquired heart disease, and/or have been hospitalised for cardiac syncope or failure during the past year.
Patients with any unstable or life-threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention (e. g. pacemaker implantation) or a change in drug therapy within the past year.
Patients with malignancy for which the patient has undergone resection, radiation therapy or chemotherapy within the last five years.
Patients with lung diseases other than asthma, e.g. cystic fibrosis (CF). In case of ex-premature infants, a history of significant bronchopulmonary dysplasia (BPD) will be regarded as exclusion criterion
Patients with significant alcohol or drug abuse within the past two years.
Patients with known hypersensitivity to anticholinergic drugs, benzalkonium chloride (BAC), ethylenediaminetetraacetic acid (EDTA) or any other components of the tiotropium inhalation solution.
Pregnant or nursing adolescent female patients, including female patients with a positive Beta HCG (serum pregnancy) testing at screening (visit 1).
Sexually active female patients of child-bearing potential not using a highly effective method of birth control.
Patients with a known narrow-angle glaucoma, or any other disease where anticholinergic treatment is contraindicated.
Patients with renal impairment, as defined by a creatinine clearance less than 50 mL/min/1.73 m2 body surface area (BSA) as calculated by Schwartz Formula.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Boehringer Ingelheim
Organizational Affiliation
Boehringer Ingelheim
Official's Role
Study Chair
Facility Information:
Facility Name
205.424.01002 Boehringer Ingelheim Investigational Site
City
Denver
State/Province
Colorado
Country
United States
Facility Name
205.424.01006 Boehringer Ingelheim Investigational Site
City
Columbia
State/Province
Missouri
Country
United States
Facility Name
205.424.01007 Boehringer Ingelheim Investigational Site
City
Warrensburg
State/Province
Missouri
Country
United States
Facility Name
205.424.01004 Boehringer Ingelheim Investigational Site
City
Boys Town
State/Province
Nebraska
Country
United States
Facility Name
205.424.01001 Boehringer Ingelheim Investigational Site
City
Canton
State/Province
Ohio
Country
United States
Facility Name
205.424.49007 Boehringer Ingelheim Investigational Site
City
Koblenz
Country
Germany
Facility Name
205.424.49004 Boehringer Ingelheim Investigational Site
City
Rosenheim
Country
Germany
Facility Name
205.424.49002 Boehringer Ingelheim Investigational Site
City
Wesel
Country
Germany
Facility Name
205.424.37104 Boehringer Ingelheim Investigational Site
City
Balvi
Country
Latvia
Facility Name
205.424.37103 Boehringer Ingelheim Investigational Site
City
Daugavpils
Country
Latvia
Facility Name
205.424.37105 Boehringer Ingelheim Investigational Site
City
Rezekne
Country
Latvia
Facility Name
205.424.37101 Boehringer Ingelheim Investigational Site
City
Riga
Country
Latvia
Facility Name
205.424.37102 Boehringer Ingelheim Investigational Site
City
Riga
Country
Latvia
Facility Name
205.424.37001 Boehringer Ingelheim Investigational Site
City
Vilnius
Country
Lithuania
Facility Name
205.424.37003 Boehringer Ingelheim Investigational Site
City
Vilnius
Country
Lithuania
Facility Name
205.424.37004 Boehringer Ingelheim Investigational Site
City
Vilnius
Country
Lithuania
Facility Name
205.424.38604 Boehringer Ingelheim Investigational Site
City
Kamnik
Country
Slovenia
Facility Name
205.424.38605 Boehringer Ingelheim Investigational Site
City
Ljubljana
Country
Slovenia
Facility Name
205.424.38602 Boehringer Ingelheim Investigational Site
City
Maribor
Country
Slovenia
12. IPD Sharing Statement
Citations:
PubMed Identifier
25081651
Citation
Vogelberg C, Engel M, Moroni-Zentgraf P, Leonaviciute-Klimantaviciene M, Sigmund R, Downie J, Nething K, Vevere V, Vandewalker M. Tiotropium in asthmatic adolescents symptomatic despite inhaled corticosteroids: a randomised dose-ranging study. Respir Med. 2014 Sep;108(9):1268-76. doi: 10.1016/j.rmed.2014.06.011. Epub 2014 Jul 17.
Results Reference
derived
Links:
URL
http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/205/205.424_U11-2586-02-DS.pdf
Description
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Efficacy and Safety of 3 Doses of Tiotropium Compared to Placebo in Adolescents (12 to 17 Yrs) With Moderate Asthma
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