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Effect on Exercise Endurance and Lung Hyperinflation of Tiotropium + Olodaterol in COPD Patients.

Primary Purpose

Pulmonary Disease, Chronic Obstructive

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Placebo
Tiotropium + Olodaterol
tiotropium + Olodaterol
Tiotropium
Olodaterol
Respimat
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  1. All patients must sign an informed consent consistent with ICH-GCP guidelines prior to participation in the trial, which includes medication washout and restrictions.
  2. All patients must have a diagnosis of chronic obstructive pulmonary disease and must meet the following spirometric criteria:

    Patients must have relatively stable airway obstruction with a post-bronchodilator FEV1 <80% of predicted normal and a post-bronchodilator FEV1/FVC <70% at Visit 1.

  3. Male or female patients, between 40 and 75 years of age (inclusive) on day of signing informed consent.
  4. Patients must be current or ex-smokers with a smoking history of more than 10 pack years.

Exclusion criteria:

  1. Patients with a significant disease other than COPD; a significant disease is defined as a disease which, in the opinion of the investigator, may (i) put the patient at risk because of participation in the study, (ii) influence the results of the study, or (iii) cause concern regarding the patient's ability to participate in the study
  2. Patients with clinically relevant abnormal baseline haematology, blood chemistry, or urinalysis; all patients with an SGOT >x2 ULN, SGPT >x2 ULN, bilirubin >x2 ULN or creatinine >x2 ULN will be excluded regardless of clinical condition
  3. Patients with a history of asthma. For patients with allergic rhinitis or atopy, source documentation is required to verify that the patient does not have asthma.

    Patients with any of the following conditions:

  4. A diagnosis of thyrotoxicosis (due to the known class side effect profile of ß2-agonists)
  5. A diagnosis of paroxysmal tachycardia (>100 beats per minute) (due to the known class side effect profile of ß2-agonists)
  6. A history of myocardial infarction within 1 year of screening visit (Visit 1)
  7. Unstable or life-threatening cardiac arrhythmia
  8. Hospitalized for heart failure within the past year
  9. Known active tuberculosis
  10. A malignancy for which patient has undergone resection, radiation therapy or chemotherapy within last five years (patients with treated basal cell carcinoma are allowed)
  11. A history of life-threatening pulmonary obstruction
  12. A history of cystic fibrosis
  13. Clinically evident bronchiectasis
  14. A history of significant alcohol or drug abuse
  15. Any contraindications for exercise testing.
  16. 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)
  17. Patients being treated with any oral ß-adrenergics
  18. Patients being treated with oral corticosteroid medication at unstable doses
  19. Patients who regularly use daytime oxygen therapy for more than one hour per day and in the investigator's opinion will be unable to abstain from the use of oxygen therapy during clinic visits
  20. Patients who have completed a pulmonary rehabilitation program in the six weeks prior to the screening visit or patients who are currently in a pulmonary rehabilitation program
  21. Patients who have a limitation of exercise performance as a result of factors other than fatigue or exertional dyspnoea, such as arthritis in the leg, angina pectoris or claudication or morbid obesity.
  22. Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to screening visit
  23. Patients with known hypersensitivity to ß-adrenergics drugs, anticholinergic drugs, BAC, EDTA or any other component of the Respimat® inhalation solution delivery system
  24. Pregnant or nursing women
  25. Women of childbearing potential not using highly effective methods of birth control.

Sites / Locations

  • 1237.14.01404 Boehringer Ingelheim Investigational Site
  • 1237.14.01414 Boehringer Ingelheim Investigational Site
  • 1237.14.01417 Boehringer Ingelheim Investigational Site
  • 1237.14.01418 Boehringer Ingelheim Investigational Site
  • 1237.14.01408 Boehringer Ingelheim Investigational Site
  • 1237.14.01409 Boehringer Ingelheim Investigational Site
  • 1237.14.01407 Boehringer Ingelheim Investigational Site
  • 1237.14.01403 Boehringer Ingelheim Investigational Site
  • 1237.14.01401 Boehringer Ingelheim Investigational Site
  • 1237.14.01412 Boehringer Ingelheim Investigational Site
  • 1237.14.01410 Boehringer Ingelheim Investigational Site
  • 1237.14.54402 Boehringer Ingelheim Investigational Site
  • 1237.14.54401 Boehringer Ingelheim Investigational Site
  • 1237.14.43402 Boehringer Ingelheim Investigational Site
  • 1237.14.43401 Boehringer Ingelheim Investigational Site
  • 1237.14.11404 Boehringer Ingelheim Investigational Site
  • 1237.14.11403 Boehringer Ingelheim Investigational Site
  • 1237.14.11402 Boehringer Ingelheim Investigational Site
  • 1237.14.11401 Boehringer Ingelheim Investigational Site
  • 1237.14.49406 Boehringer Ingelheim Investigational Site
  • 1237.14.49404 Boehringer Ingelheim Investigational Site
  • 1237.14.49401 Boehringer Ingelheim Investigational Site
  • 1237.14.49405 Boehringer Ingelheim Investigational Site
  • 1237.14.49403 Boehringer Ingelheim Investigational Site
  • 1237.14.49402 Boehringer Ingelheim Investigational Site
  • 1237.14.31001 Boehringer Ingelheim Investigational Site
  • 1237.14.31005 Boehringer Ingelheim Investigational Site
  • 1237.14.31004 Boehringer Ingelheim Investigational Site
  • 1237.14.31006 Medisch Centrum Leeuwarden
  • 1237.14.31007 Boehringer Ingelheim Investigational Site
  • 1237.14.70401 Boehringer Ingelheim Investigational Site
  • 1237.14.70402 Boehringer Ingelheim Investigational Site
  • 1237.14.46001 Boehringer Ingelheim Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Active Comparator

Placebo Comparator

Active Comparator

Experimental

Experimental

Arm Label

Olodaterol 5 mcg QD

Placebo QD

Tiotropium 5 mcg QD

Tiotropium + olodaterol low dose QD

Tiotropium + olodaterol high dose

Arm Description

patient will receive olodaterol 5 mcg once daily

placebo comparator for tiotropium + olodaterol

patient will receive tiotropium 5 mcg once daily

patient will receive tiotropium 2.5 mcg + olodaterol 5 mcg in fixed dose combination once daily

patient will receive tiotropium 5 mcg + olodaterol 5 mcg in fixed dose combination once daily

Outcomes

Primary Outcome Measures

Inspiratory Capacity at Rest Before Constant Work Rate Cycle Ergometry to Symptom Limitation at 75% Work Capacity
Inspiratory capacity (IC) at rest before constant work rate cycle ergometry to symptom limitation at 75% maximal work capacity (Wcap). Wcap was defined as the maximum work rate achieved for at least 30 seconds during the incremental cycle ergometry performed at Visit 1. The presented means are adjusted means from the MMRM (Mixed Effects Model Repeated Measures) model.
Endurance Time During Constant Work Rate Cycle Ergometry to Symptom Limitation at 75% Wcap
Endurance time during constant work rate cycle ergometry (CWRCE) to symptom limitation at 75% Wcap Wcap was defined as the maximum work rate achieved for at least 30 seconds during the incremental cycle ergometry performed at Visit 1. The presented means are adjusted mean from the MMRM model.

Secondary Outcome Measures

Slope of the Intensity of Breathing Discomfort (Borg Scale) During Constant Work Rate Cycle Ergometry to Symptom Limitation at 75% Wcap
Slope of the intensity of breathing discomfort (Borg Scale) during CWRCE to symptom limitation at 75% Wcap. The intensity of breathing discomfort was rated using the modified Borg scale with ratings from 0 (nothing at all) to 10 (maximal). Slope is defined as : (intensity of breathing discomfort at the end of exercise minus intensity of breathing discomfort at rest) / endurance time. A decrease in slope indicates improvement. The presented means are adjusted means from MMRM model.
FEV1 (1 Hour Post-dose)
Forced Expiratory Volume in 1 Second (FEV1) (one hour post-dose). The presented means are adjusted means from MMRM model.

Full Information

First Posted
February 13, 2012
Last Updated
August 12, 2015
Sponsor
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT01533935
Brief Title
Effect on Exercise Endurance and Lung Hyperinflation of Tiotropium + Olodaterol in COPD Patients.
Official Title
A Randomised, Double-blind, 5 Treatment Arms, 4-period, Incomplete Cross-over Study to Determine the Effect of 6 Weeks Treatment of Orally Inhaled Tiotropium + Olodaterol Fixed Dose Combination (FDC) (2.5 / 5 µg; and 5 / 5 µg) (Delivered by the Respimat® Inhaler) Compared With Tiotropium (5 µg), Olodaterol (5 µg ) and Placebo (Delivered by the Respimat® Inhaler) on Lung Hyperinflation and Exercise Endurance Time During Constant Work Rate Cycle Ergometry in Patients With Chronic Obstructive Pulmonary Disease (COPD) [MORACTO TM 2]
Study Type
Interventional

2. Study Status

Record Verification Date
August 2015
Overall Recruitment Status
Completed
Study Start Date
February 2012 (undefined)
Primary Completion Date
November 2013 (Actual)
Study Completion Date
November 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
The primary objective of this trial is to investigate the effect of 6 weeks treatment with tiotropium + olodaterol fixed dose combination inhalation solution on lung hyperinflation and exercise tolerance in patients with COPD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Disease, Chronic Obstructive

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Crossover Assignment
Masking
Double
Allocation
Randomized
Enrollment
291 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Olodaterol 5 mcg QD
Arm Type
Active Comparator
Arm Description
patient will receive olodaterol 5 mcg once daily
Arm Title
Placebo QD
Arm Type
Placebo Comparator
Arm Description
placebo comparator for tiotropium + olodaterol
Arm Title
Tiotropium 5 mcg QD
Arm Type
Active Comparator
Arm Description
patient will receive tiotropium 5 mcg once daily
Arm Title
Tiotropium + olodaterol low dose QD
Arm Type
Experimental
Arm Description
patient will receive tiotropium 2.5 mcg + olodaterol 5 mcg in fixed dose combination once daily
Arm Title
Tiotropium + olodaterol high dose
Arm Type
Experimental
Arm Description
patient will receive tiotropium 5 mcg + olodaterol 5 mcg in fixed dose combination once daily
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
placebo matching tiotropium + olodaterol
Intervention Type
Drug
Intervention Name(s)
Tiotropium + Olodaterol
Intervention Description
Tiotropium 2.5 mcg + olodaterol 5 mcg once daily
Intervention Type
Drug
Intervention Name(s)
tiotropium + Olodaterol
Intervention Description
tiotropium 5 mcg + olodaterol 5 mcg once daily
Intervention Type
Drug
Intervention Name(s)
Tiotropium
Intervention Description
tiotropium
Intervention Type
Drug
Intervention Name(s)
Olodaterol
Intervention Description
Olodaterol 5 mcg once daily
Intervention Type
Device
Intervention Name(s)
Respimat
Intervention Description
Respimat inhaler
Primary Outcome Measure Information:
Title
Inspiratory Capacity at Rest Before Constant Work Rate Cycle Ergometry to Symptom Limitation at 75% Work Capacity
Description
Inspiratory capacity (IC) at rest before constant work rate cycle ergometry to symptom limitation at 75% maximal work capacity (Wcap). Wcap was defined as the maximum work rate achieved for at least 30 seconds during the incremental cycle ergometry performed at Visit 1. The presented means are adjusted means from the MMRM (Mixed Effects Model Repeated Measures) model.
Time Frame
6 weeks
Title
Endurance Time During Constant Work Rate Cycle Ergometry to Symptom Limitation at 75% Wcap
Description
Endurance time during constant work rate cycle ergometry (CWRCE) to symptom limitation at 75% Wcap Wcap was defined as the maximum work rate achieved for at least 30 seconds during the incremental cycle ergometry performed at Visit 1. The presented means are adjusted mean from the MMRM model.
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Slope of the Intensity of Breathing Discomfort (Borg Scale) During Constant Work Rate Cycle Ergometry to Symptom Limitation at 75% Wcap
Description
Slope of the intensity of breathing discomfort (Borg Scale) during CWRCE to symptom limitation at 75% Wcap. The intensity of breathing discomfort was rated using the modified Borg scale with ratings from 0 (nothing at all) to 10 (maximal). Slope is defined as : (intensity of breathing discomfort at the end of exercise minus intensity of breathing discomfort at rest) / endurance time. A decrease in slope indicates improvement. The presented means are adjusted means from MMRM model.
Time Frame
6 weeks
Title
FEV1 (1 Hour Post-dose)
Description
Forced Expiratory Volume in 1 Second (FEV1) (one hour post-dose). The presented means are adjusted means from MMRM model.
Time Frame
6 weeks

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: All patients must sign an informed consent consistent with ICH-GCP guidelines prior to participation in the trial, which includes medication washout and restrictions. All patients must have a diagnosis of chronic obstructive pulmonary disease and must meet the following spirometric criteria: Patients must have relatively stable airway obstruction with a post-bronchodilator FEV1 <80% of predicted normal and a post-bronchodilator FEV1/FVC <70% at Visit 1. Male or female patients, between 40 and 75 years of age (inclusive) on day of signing informed consent. Patients must be current or ex-smokers with a smoking history of more than 10 pack years. Exclusion criteria: Patients with a significant disease other than COPD; a significant disease is defined as a disease which, in the opinion of the investigator, may (i) put the patient at risk because of participation in the study, (ii) influence the results of the study, or (iii) cause concern regarding the patient's ability to participate in the study Patients with clinically relevant abnormal baseline haematology, blood chemistry, or urinalysis; all patients with an SGOT >x2 ULN, SGPT >x2 ULN, bilirubin >x2 ULN or creatinine >x2 ULN will be excluded regardless of clinical condition Patients with a history of asthma. For patients with allergic rhinitis or atopy, source documentation is required to verify that the patient does not have asthma. Patients with any of the following conditions: A diagnosis of thyrotoxicosis (due to the known class side effect profile of ß2-agonists) A diagnosis of paroxysmal tachycardia (>100 beats per minute) (due to the known class side effect profile of ß2-agonists) A history of myocardial infarction within 1 year of screening visit (Visit 1) Unstable or life-threatening cardiac arrhythmia Hospitalized for heart failure within the past year Known active tuberculosis A malignancy for which patient has undergone resection, radiation therapy or chemotherapy within last five years (patients with treated basal cell carcinoma are allowed) A history of life-threatening pulmonary obstruction A history of cystic fibrosis Clinically evident bronchiectasis A history of significant alcohol or drug abuse Any contraindications for exercise testing. 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 being treated with any oral ß-adrenergics Patients being treated with oral corticosteroid medication at unstable doses Patients who regularly use daytime oxygen therapy for more than one hour per day and in the investigator's opinion will be unable to abstain from the use of oxygen therapy during clinic visits Patients who have completed a pulmonary rehabilitation program in the six weeks prior to the screening visit or patients who are currently in a pulmonary rehabilitation program Patients who have a limitation of exercise performance as a result of factors other than fatigue or exertional dyspnoea, such as arthritis in the leg, angina pectoris or claudication or morbid obesity. Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to screening visit Patients with known hypersensitivity to ß-adrenergics drugs, anticholinergic drugs, BAC, EDTA or any other component of the Respimat® inhalation solution delivery system Pregnant or nursing women Women of childbearing potential not using highly effective methods of birth control.
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
1237.14.01404 Boehringer Ingelheim Investigational Site
City
Phoenix
State/Province
Arizona
Country
United States
Facility Name
1237.14.01414 Boehringer Ingelheim Investigational Site
City
Austell
State/Province
Georgia
Country
United States
Facility Name
1237.14.01417 Boehringer Ingelheim Investigational Site
City
Baltimore
State/Province
Maryland
Country
United States
Facility Name
1237.14.01418 Boehringer Ingelheim Investigational Site
City
Rochester
State/Province
Minnesota
Country
United States
Facility Name
1237.14.01408 Boehringer Ingelheim Investigational Site
City
St. Charles
State/Province
Missouri
Country
United States
Facility Name
1237.14.01409 Boehringer Ingelheim Investigational Site
City
Charlotte
State/Province
North Carolina
Country
United States
Facility Name
1237.14.01407 Boehringer Ingelheim Investigational Site
City
Greenville
State/Province
South Carolina
Country
United States
Facility Name
1237.14.01403 Boehringer Ingelheim Investigational Site
City
Spartanburg
State/Province
South Carolina
Country
United States
Facility Name
1237.14.01401 Boehringer Ingelheim Investigational Site
City
Union
State/Province
South Carolina
Country
United States
Facility Name
1237.14.01412 Boehringer Ingelheim Investigational Site
City
Dallas
State/Province
Texas
Country
United States
Facility Name
1237.14.01410 Boehringer Ingelheim Investigational Site
City
Seattle
State/Province
Washington
Country
United States
Facility Name
1237.14.54402 Boehringer Ingelheim Investigational Site
City
Buenos Aires
Country
Argentina
Facility Name
1237.14.54401 Boehringer Ingelheim Investigational Site
City
Mendoza
Country
Argentina
Facility Name
1237.14.43402 Boehringer Ingelheim Investigational Site
City
Grieskirchen
Country
Austria
Facility Name
1237.14.43401 Boehringer Ingelheim Investigational Site
City
Neumarkt am Wallersee
Country
Austria
Facility Name
1237.14.11404 Boehringer Ingelheim Investigational Site
City
Vancouver
State/Province
British Columbia
Country
Canada
Facility Name
1237.14.11403 Boehringer Ingelheim Investigational Site
City
Toronto
State/Province
Ontario
Country
Canada
Facility Name
1237.14.11402 Boehringer Ingelheim Investigational Site
City
Montreal
State/Province
Quebec
Country
Canada
Facility Name
1237.14.11401 Boehringer Ingelheim Investigational Site
City
Ste-Foy
State/Province
Quebec
Country
Canada
Facility Name
1237.14.49406 Boehringer Ingelheim Investigational Site
City
Bamberg
Country
Germany
Facility Name
1237.14.49404 Boehringer Ingelheim Investigational Site
City
Bochum
Country
Germany
Facility Name
1237.14.49401 Boehringer Ingelheim Investigational Site
City
Großhansdorf
Country
Germany
Facility Name
1237.14.49405 Boehringer Ingelheim Investigational Site
City
Hamburg
Country
Germany
Facility Name
1237.14.49403 Boehringer Ingelheim Investigational Site
City
Hannover
Country
Germany
Facility Name
1237.14.49402 Boehringer Ingelheim Investigational Site
City
Kiel
Country
Germany
Facility Name
1237.14.31001 Boehringer Ingelheim Investigational Site
City
Heerlen
Country
Netherlands
Facility Name
1237.14.31005 Boehringer Ingelheim Investigational Site
City
Hoofddorp
Country
Netherlands
Facility Name
1237.14.31004 Boehringer Ingelheim Investigational Site
City
Hoorn
Country
Netherlands
Facility Name
1237.14.31006 Medisch Centrum Leeuwarden
City
Leeuwarden
Country
Netherlands
Facility Name
1237.14.31007 Boehringer Ingelheim Investigational Site
City
Leiden
Country
Netherlands
Facility Name
1237.14.70401 Boehringer Ingelheim Investigational Site
City
Moscow
Country
Russian Federation
Facility Name
1237.14.70402 Boehringer Ingelheim Investigational Site
City
St. Petersburg
Country
Russian Federation
Facility Name
1237.14.46001 Boehringer Ingelheim Investigational Site
City
Lund
Country
Sweden

12. IPD Sharing Statement

Citations:
PubMed Identifier
28424359
Citation
O'Donnell DE, Casaburi R, Frith P, Kirsten A, De Sousa D, Hamilton A, Xue W, Maltais F. Effects of combined tiotropium/olodaterol on inspiratory capacity and exercise endurance in COPD. Eur Respir J. 2017 Apr 19;49(4):1601348. doi: 10.1183/13993003.01348-2016. Print 2017 Apr.
Results Reference
derived
Links:
URL
http://trials.boehringer-ingelheim.com/
Description
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Effect on Exercise Endurance and Lung Hyperinflation of Tiotropium + Olodaterol in COPD Patients.

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