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A Study to Evaluate Efficacy and Safety of Tiotropium in Children 6 to 11 Years Old With Moderate Asthma

Primary Purpose

Asthma

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Tiotropium bromide
Tiotropium bromide
Tiotropium bromide
Tiotropium bromide
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asthma

Eligibility Criteria

6 Years - 11 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion criteria:

Patients must meet all of the following inclusion criteria to be eligible for enrollment into this study:

  1. All patients' parents (or legally accepted caregivers) must sign and date an informed consent prior to any study procedures including medication washout and restrictions. In addition, an informed assent suitable for this age group has to be obtained from patients.
  2. Male or female patients between 6 and 11 years of age (up to 1 day prior to their 12th birthday at Visit 1).
  3. All patients must have at least a 6-month history of asthma at the time of enrolment into the trial.
  4. All patients must have been on maintenance treatment with inhaled corticosteroids at a stable medium dose - a patient is eligible on =200 µg to =400 µg Budesonide DPI or equivalent.
  5. All patients must be symptomatic (partly controlled) at Visit 1 (screening) and prior to randomisation at Visit 2 as defined by an ACQ mean score of =1.5.
  6. All patients must have a pre-bronchodilator FEV1 =60% and =90% of predicted normal at Visit 1. Variation of absolute FEV1 values of Visit 2 (pre-dose) as compared to values at Visit 2 (pre-bronchodilator) must be within ± 30%.
  7. All patients must demonstrate an increase in FEV1 of =12% 15 to 30 min. after 200 µg salbutamol (albuterol) at Visit 1.
  8. Patients must be able to inhale from the Respimat® inhaler correctly.
  9. Patients must be able to perform all trial related procedures including technically acceptable spirometric manoeuvres according to current ATS/ERS standards and the use of the electronic diary/peak flow meter.

Exclusion criteria:

Patients with any of the following characteristics will not be eligible for entry into this study:

  1. Patients with a significant disease other than asthma.
  2. Patients with clinically relevant abnormal screening haematology or blood chemistry will be excluded if the abnormality defines a significant disease as defined in exclusion criterion 1. For participation in PK sampling, a haemoglobin of less than 11.3 g/dL will be regarded as exclusion criterion.
  3. Patients with a history of congenital or acquired heart disease, or patients who have been hospitalised for cardiac syncope or failure during the past year.
  4. Patients with any unstable or life-threatening cardiac arrhythmia, including cardiac arrhythmia requiring intervention (e.g. pacemaker implantation, catheter ablation etc.) or a change in drug therapy within the past year.
  5. Patients with a malignancy for which the patient has undergone resection, radiation therapy or chemotherapy within the last five years.
  6. Patients with clinically significant lung diseases other than asthma, such as CF, or bronchopulmonary dysplasia.
  7. Patients with known active tuberculosis.
  8. Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1.
  9. Patients who are currently in a pulmonary rehabilitation program or have completed a pulmonary rehabilitation program in the 6 weeks prior to the screening visit (Visit 1).
  10. Patients with known hypersensitivity to anticholinergic drugs, BAC, EDTA or any other components of the tiotropium inhalation solution.
  11. Patients with known narrow-angle glaucoma, or any other disease where anticholinergic treatment is contraindicated.
  12. Patients with moderate to severe renal impairment, as defined by a creatinine clearance <50 mL/min./1.73 m2 BSA, as tiotropium is a predominantly renally excreted drug.

Sites / Locations

  • 205.425.49005 Boehringer Ingelheim Investigational Site
  • 205.425.49004 Boehringer Ingelheim Investigational Site
  • 205.425.49002 Boehringer Ingelheim Investigational Site
  • 205.425.36001 Boehringer Ingelheim Investigational Site
  • 205.425.36003 Boehringer Ingelheim Investigational Site
  • 205.425.36002 Boehringer Ingelheim Investigational Site
  • 205.425.36004 Boehringer Ingelheim Investigational Site
  • 205.425.37101 Boehringer Ingelheim Investigational Site
  • 205.425.37105 Boehringer Ingelheim Investigational Site
  • 205.425.37104 Boehringer Ingelheim Investigational Site
  • 205.425.37106 Boehringer Ingelheim Investigational Site
  • 205.425.37102 Boehringer Ingelheim Investigational Site
  • 205.425.37103 Boehringer Ingelheim Investigational Site
  • 205.425.37004 Boehringer Ingelheim Investigational Site
  • 205.425.37003 Boehringer Ingelheim Investigational Site
  • 205.425.37001 Boehringer Ingelheim Investigational Site
  • 205.425.37002 Boehringer Ingelheim Investigational Site
  • 205.425.07003 Boehringer Ingelheim Investigational Site
  • 205.425.07004 Boehringer Ingelheim Investigational Site
  • 205.425.07001 Boehringer Ingelheim Investigational Site
  • 205.425.07002 Boehringer Ingelheim Investigational Site
  • 205.425.38002 Boehringer Ingelheim Investigational Site
  • 205.425.38004 Boehringer Ingelheim Investigational Site
  • 205.425.38003 Boehringer Ingelheim Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

Treatment A

Treatment B

Treatment C

Treatment D

Arm Description

patients inhale 2 puffs (low dose) once daily in the evening via Respimat inhaler

patients inhale 2 puffs (medium dose) once daily in the evening via Respimat inhaler

patients inhale 2 puffs (high dose) once daily in the evening via Respimat inhaler

patients inhale 2 puffs of placebo inhalation solution matching tiotropium 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.
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.
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 3 hours 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 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 3 hours 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.
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 Period (24 h, Daytime and Night-time Use)
Mean number of inhalations (puffs) of unscheduled rescue salbutamol therapy during whole day (24 h, daytime and night-time use). 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 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. The scores for this question used the following scale where: 1='Did not wake up', 2='Woke up once', 3='Woke up 2-5 times', 4='Woke up more than 5 times' and 5='Was awake all night'.

Full Information

First Posted
June 20, 2011
Last Updated
March 26, 2015
Sponsor
Boehringer Ingelheim
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT01383499
Brief Title
A Study to Evaluate Efficacy and Safety of Tiotropium in Children 6 to 11 Years Old 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 Children 6 to 11 Yrs Old With Moderate Persistent Asthma
Study Type
Interventional

2. Study Status

Record Verification Date
March 2015
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
September 2012 (Actual)
Study Completion Date
September 2012 (Actual)

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 aim of this trial is to select an optimum dose may be selected based on bronchodilator efficacy, safety evaluations and pharmacokinetics of tiotropium bromide.

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
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
101 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment A
Arm Type
Experimental
Arm Description
patients inhale 2 puffs (low dose) once daily in the evening via Respimat inhaler
Arm Title
Treatment B
Arm Type
Experimental
Arm Description
patients inhale 2 puffs (medium dose) once daily in the evening via Respimat inhaler
Arm Title
Treatment C
Arm Type
Experimental
Arm Description
patients inhale 2 puffs (high dose) once daily in the evening via Respimat inhaler
Arm Title
Treatment D
Arm Type
Placebo Comparator
Arm Description
patients inhale 2 puffs of placebo inhalation solution matching tiotropium once daily in the evening via Respimat inhaler
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide
Intervention Description
inhalation solution administered via Respimat in 3 different doses
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide
Intervention Description
inhalation solution administered via Respimat in 3 different doses
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide
Intervention Description
inhalation solution administered via Respimat in 3 different doses
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide
Intervention Description
inhalation solution administered via Respimat in 3 different doses
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
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
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 3 hours 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 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 3 hours 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
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 Period (24 h, Daytime and Night-time Use)
Description
Mean number of inhalations (puffs) of unscheduled rescue salbutamol therapy during whole day (24 h, daytime and night-time use). 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 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. The scores for this question used the following scale where: 1='Did not wake up', 2='Woke up once', 3='Woke up 2-5 times', 4='Woke up more than 5 times' and 5='Was awake all night'.
Time Frame
Baseline and last week of treatment (week 4)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
11 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Patients must meet all of the following inclusion criteria to be eligible for enrollment into this study: All patients' parents (or legally accepted caregivers) must sign and date an informed consent prior to any study procedures including medication washout and restrictions. In addition, an informed assent suitable for this age group has to be obtained from patients. Male or female patients between 6 and 11 years of age (up to 1 day prior to their 12th birthday at Visit 1). All patients must have at least a 6-month history of asthma at the time of enrolment into the trial. All patients must have been on maintenance treatment with inhaled corticosteroids at a stable medium dose - a patient is eligible on =200 µg to =400 µg Budesonide DPI or equivalent. All patients must be symptomatic (partly controlled) at Visit 1 (screening) and prior to randomisation at Visit 2 as defined by an ACQ mean score of =1.5. All patients must have a pre-bronchodilator FEV1 =60% and =90% of predicted normal at Visit 1. Variation of absolute FEV1 values of Visit 2 (pre-dose) as compared to values at Visit 2 (pre-bronchodilator) must be within ± 30%. All patients must demonstrate an increase in FEV1 of =12% 15 to 30 min. after 200 µg salbutamol (albuterol) at Visit 1. Patients must be able to inhale from the Respimat® inhaler correctly. Patients must be able to perform all trial related procedures including technically acceptable spirometric manoeuvres according to current ATS/ERS standards and the use of the electronic diary/peak flow meter. Exclusion criteria: Patients with any of the following characteristics will not be eligible for entry into this study: Patients with a significant disease other than asthma. Patients with clinically relevant abnormal screening haematology or blood chemistry will be excluded if the abnormality defines a significant disease as defined in exclusion criterion 1. For participation in PK sampling, a haemoglobin of less than 11.3 g/dL will be regarded as exclusion criterion. Patients with a history of congenital or acquired heart disease, or patients who have been hospitalised for cardiac syncope or failure during the past year. Patients with any unstable or life-threatening cardiac arrhythmia, including cardiac arrhythmia requiring intervention (e.g. pacemaker implantation, catheter ablation etc.) or a change in drug therapy within the past year. Patients with a malignancy for which the patient has undergone resection, radiation therapy or chemotherapy within the last five years. Patients with clinically significant lung diseases other than asthma, such as CF, or bronchopulmonary dysplasia. Patients with known active tuberculosis. Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1. Patients who are currently in a pulmonary rehabilitation program or have completed a pulmonary rehabilitation program in the 6 weeks prior to the screening visit (Visit 1). Patients with known hypersensitivity to anticholinergic drugs, BAC, EDTA or any other components of the tiotropium inhalation solution. Patients with known narrow-angle glaucoma, or any other disease where anticholinergic treatment is contraindicated. Patients with moderate to severe renal impairment, as defined by a creatinine clearance <50 mL/min./1.73 m2 BSA, as tiotropium is a predominantly renally excreted drug.
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
205.425.49005 Boehringer Ingelheim Investigational Site
City
Bochum
Country
Germany
Facility Name
205.425.49004 Boehringer Ingelheim Investigational Site
City
Dresden
Country
Germany
Facility Name
205.425.49002 Boehringer Ingelheim Investigational Site
City
Koblenz
Country
Germany
Facility Name
205.425.36001 Boehringer Ingelheim Investigational Site
City
Budapest
Country
Hungary
Facility Name
205.425.36003 Boehringer Ingelheim Investigational Site
City
Budapest
Country
Hungary
Facility Name
205.425.36002 Boehringer Ingelheim Investigational Site
City
Mosdos
Country
Hungary
Facility Name
205.425.36004 Boehringer Ingelheim Investigational Site
City
Szeged
Country
Hungary
Facility Name
205.425.37101 Boehringer Ingelheim Investigational Site
City
Baldone
Country
Latvia
Facility Name
205.425.37105 Boehringer Ingelheim Investigational Site
City
Balvi
Country
Latvia
Facility Name
205.425.37104 Boehringer Ingelheim Investigational Site
City
Daugavpils
Country
Latvia
Facility Name
205.425.37106 Boehringer Ingelheim Investigational Site
City
Dubulti
Country
Latvia
Facility Name
205.425.37102 Boehringer Ingelheim Investigational Site
City
Riga
Country
Latvia
Facility Name
205.425.37103 Boehringer Ingelheim Investigational Site
City
Riga
Country
Latvia
Facility Name
205.425.37004 Boehringer Ingelheim Investigational Site
City
Kaunas
Country
Lithuania
Facility Name
205.425.37003 Boehringer Ingelheim Investigational Site
City
Taurage
Country
Lithuania
Facility Name
205.425.37001 Boehringer Ingelheim Investigational Site
City
Vilnius
Country
Lithuania
Facility Name
205.425.37002 Boehringer Ingelheim Investigational Site
City
Vilnius
Country
Lithuania
Facility Name
205.425.07003 Boehringer Ingelheim Investigational Site
City
Moscow
Country
Russian Federation
Facility Name
205.425.07004 Boehringer Ingelheim Investigational Site
City
Moscow
Country
Russian Federation
Facility Name
205.425.07001 Boehringer Ingelheim Investigational Site
City
St. Petersburg
Country
Russian Federation
Facility Name
205.425.07002 Boehringer Ingelheim Investigational Site
City
St. Petersburg
Country
Russian Federation
Facility Name
205.425.38002 Boehringer Ingelheim Investigational Site
City
Donetsk
Country
Ukraine
Facility Name
205.425.38004 Boehringer Ingelheim Investigational Site
City
Kiev
Country
Ukraine
Facility Name
205.425.38003 Boehringer Ingelheim Investigational Site
City
Zaporizhya
Country
Ukraine

12. IPD Sharing Statement

Citations:
PubMed Identifier
25851298
Citation
Vogelberg C, Moroni-Zentgraf P, Leonaviciute-Klimantaviciene M, Sigmund R, Hamelmann E, Engel M, Szefler S. A randomised dose-ranging study of tiotropium Respimat(R) in children with symptomatic asthma despite inhaled corticosteroids. Respir Res. 2015 Feb 7;16(1):20. doi: 10.1186/s12931-015-0175-9. Erratum In: Respir Res. 2015;16:128.
Results Reference
derived
Links:
URL
http://trials.boehringer-ingelheim.com/
Description
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A Study to Evaluate Efficacy and Safety of Tiotropium in Children 6 to 11 Years Old With Moderate Asthma

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