Ipratropium Bromide/Salbutamol Delivered by the Respimat® Inhaler Compared to Ipratropium Bromide Respimat®, COMBIVENT® Inhalation Aerosol and Placebo in Adults With Chronic Obstructive Pulmonary Disease
Primary Purpose
Pulmonary Disease, Chronic Obstructive
Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Ipratropium bromide / Salbutamol
Placebo Inhalation solution
Ipratropium bromide
COMBIVENT Inhalation Aerosol
Placebo Inhalation Aerosol
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive
Eligibility Criteria
Inclusion Criteria:
All patients must have a diagnosis of COPD and the following spirometric criteria:
- Visit 1 (Screening) and Visit 2: Patients must have relatively stable, moderate to severe airway obstruction with an FEV1 ≤65% of predicted normal and FEV1 ≤70% of FVC
- Male or female patients 40 years of age or older
- Patients must have a smoking history of more than ten pack-years. A pack-year is defined as the equivalent of smoking one pack of 20 cigarettes per day for a year
- Patients must be able to perform pulmonary function tests and maintain records during the study period as required in the protocol
- Patients must be able to be trained in the proper use of an MDI (metered dose inhaler) and the Respimat® inhaler
- All patients must sign an Informed Consent Form prior to participation in the trial
Exclusion Criteria:
- Patients with significant diseases other than COPD will be excluded. A significant disease is defined as a disease which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study
- Patients with clinically relevant abnormal baseline hematology, blood chemistry or urinalysis. If the abnormality defines a disease listed as an exclusion criterion, the patient is excluded
- All patients with a SGOT (serum glutamic oxaloacetic transaminase) >80 IU/L, SGPT (serum glutamic pyruvic transaminase) >80 IU/L, bilirubin >2.0 mg/dL or creatinine >2.0 mg/dL will be excluded regardless of the clinical condition
- Patients who have a total blood eosinophil count ≥600/mm3
- Patients with a recent history (i.e., one year or less) of myocardial infarction
- Patients with a recent history (i.e., three years or less) of heart failure or patients with any cardiac arrhythmia requiring drug therapy
- Patients with a history of cancer, other than treated basal cell carcinoma, within the last 5 years
- Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
- Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of a thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1
- Patients with a history of asthma or allergic rhinitis
- Patients with a history of and/or active alcohol or drug abuse
- Patients with known active tuberculosis
- Patients with an upper or lower respiratory tract infection or COPD exacerbation in the 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period
- Patients with known symptomatic prostatic hypertrophy or bladder neck obstruction
- Patients with known narrow-angle glaucoma
- Patients with current significant psychiatric disorders
- 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
- Patients who are being treated with cromolyn sodium or nedocromil sodium
- Patients who are being treated with antihistamines for any excluded allergic conditions
- Patients using oral corticosteroid medication at unstable doses (i.e., less than 6 weeks on a stable dose) or at a dose in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
- Patients who initiated use of an inhaled steroid or changed doses less than 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period
- Patients who are being treated with beta-blocker medications, MAO (monoamine oxidase) inhibitors or tricyclic antidepressants. Beta blocker eye medications (e.g., Betoptic) for treatment of non-narrow angle glaucoma are allowed
- Patients who have had changes in their therapeutic plan within the last 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period
- Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception
- Patients with known hypersensitivity to anticholinergic drugs or any component of the ipratropium bromide/salbutamol Respimat® solution (including BAC (Benzalkonium chloride) and EDTA (Ethylenediaminetetraacetic acid)) or the ipratropium bromide/salbutamol MDI components
- Previous participation in this study
- Patients who are currently participating in another study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Experimental
Placebo Comparator
Experimental
Active Comparator
Placebo Comparator
Arm Label
Ipratropium bromide / Salbutamol Inhalation solution
Placebo Inhalation solution
Ipratropium bromide Inhalation solution
COMBIVENT Inhalation Aerosol (ipratropium bromide/salbutamol)
Placebo Inhalation Aerosol
Arm Description
Outcomes
Primary Outcome Measures
FEV1 TAUC0-6 (Total area under the FEV1 (forced expiratory volume in one second) curve from 0 to 6 hours divided by six)
Secondary Outcome Measures
FEV1 TAUC0-6
FEV1 TAUC0-8
Peak FEV1 post treatment over two hours
Change from baseline in Peak FEV1 response
Area under the FEV1 curve from 0 to 6 hours above test-day baseline divided by six for normalization (AUC0-6)
Onset of therapeutic FEV1 response
Duration of therapeutic FEV1 response
Time to peak FEV1 response
TAUC0-6, TAUC0-8 and peak FVC (Forced vital capacity)
Amount of beta agonist therapy used as rescue medication during the treatment period
Number of patients using concomitant medication including corticosteroids during the treatment period
Weekly means of daily symptom scores over the treatment period
Number of patients with at least one COPD exacerbation
Number of COPD exacerbations during the treatment period
Physician's Global Evaluation
Trough PEFR (peak expiratory flow rate) measured by the patient at home once daily
Number of patients with adverse events
Incidence of paradoxical bronchoconstriction on the test day
Number of COPD exacerbation days
Number of patients with clinically significant changes in vital signs
Number of patients with abnormal changes in laboratory parameters
Number of patients with abnormal changes in 12-lead electrocardiogram (ECG) parameters
Plasma ipratropium and salbutamol concentrations
Renal excretion amounts of ipratropium and salbutamol
Length of COPD exacerbations during the treatment period
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02177253
Brief Title
Ipratropium Bromide/Salbutamol Delivered by the Respimat® Inhaler Compared to Ipratropium Bromide Respimat®, COMBIVENT® Inhalation Aerosol and Placebo in Adults With Chronic Obstructive Pulmonary Disease
Official Title
A Comparison of Ipratropium Bromide/Salbutamol (40 mcg / 200 mcg, One Inhalation) Delivered by the Respimat ® Inhaler to COMBIVENT Inhalation Aerosol (Two Inhalations), Ipratropium Bromide Respimat ® and Placebo of Each Formulation in a 12-week, Double-blind, Safety and Efficacy Study in Adults With Chronic Obstructive Pulmonary Disease
Study Type
Interventional
2. Study Status
Record Verification Date
June 2014
Overall Recruitment Status
Completed
Study Start Date
October 2002 (undefined)
Primary Completion Date
March 2004 (Actual)
Study Completion Date
undefined (undefined)
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 study was to compare the long-term (12-week) bronchodilator efficacy and safety of ipratropium bromide / salbutamol combination administered by the Respimat® 40 mcg / 200 mcg (one inhalation q.i.d.) to COMBIVENT Inhalation Aerosol (two inhalations q.i.d.), ipratropium bromide Respimat® (one inhalation q.i.d.) and Placebo formulations of each in patients with Chronic Obstructive Pulmonary Disease (COPD). An additional objective was to show the superiority of Combivent Respimat as compared to ipratropium bromide (40 mcg) Respimat. Steady state pharmacokinetics over one dosing interval following four weeks of therapy were also characterized.
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
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
1118 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Ipratropium bromide / Salbutamol Inhalation solution
Arm Type
Experimental
Arm Title
Placebo Inhalation solution
Arm Type
Placebo Comparator
Arm Title
Ipratropium bromide Inhalation solution
Arm Type
Experimental
Arm Title
COMBIVENT Inhalation Aerosol (ipratropium bromide/salbutamol)
Arm Type
Active Comparator
Arm Title
Placebo Inhalation Aerosol
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Ipratropium bromide / Salbutamol
Intervention Type
Drug
Intervention Name(s)
Placebo Inhalation solution
Intervention Type
Drug
Intervention Name(s)
Ipratropium bromide
Intervention Type
Drug
Intervention Name(s)
COMBIVENT Inhalation Aerosol
Intervention Type
Drug
Intervention Name(s)
Placebo Inhalation Aerosol
Primary Outcome Measure Information:
Title
FEV1 TAUC0-6 (Total area under the FEV1 (forced expiratory volume in one second) curve from 0 to 6 hours divided by six)
Time Frame
Day 85
Secondary Outcome Measure Information:
Title
FEV1 TAUC0-6
Time Frame
Days 1, 29 and 57
Title
FEV1 TAUC0-8
Time Frame
Days 1, 29, 57 and 85
Title
Peak FEV1 post treatment over two hours
Time Frame
Days 1, 29, 57 and 85
Title
Change from baseline in Peak FEV1 response
Time Frame
Days 1, 29, 57 and 85
Title
Area under the FEV1 curve from 0 to 6 hours above test-day baseline divided by six for normalization (AUC0-6)
Time Frame
Days 1, 29, 57 and 85
Title
Onset of therapeutic FEV1 response
Time Frame
Days 1, 29, 57 and 85
Title
Duration of therapeutic FEV1 response
Time Frame
Days 1, 29, 57 and 85
Title
Time to peak FEV1 response
Time Frame
Days 1, 29, 57 and 85
Title
TAUC0-6, TAUC0-8 and peak FVC (Forced vital capacity)
Time Frame
Days 1, 29, 57 and 85
Title
Amount of beta agonist therapy used as rescue medication during the treatment period
Time Frame
up to day 85
Title
Number of patients using concomitant medication including corticosteroids during the treatment period
Time Frame
up to day 85
Title
Weekly means of daily symptom scores over the treatment period
Time Frame
up to day 85
Title
Number of patients with at least one COPD exacerbation
Time Frame
up to day 85
Title
Number of COPD exacerbations during the treatment period
Time Frame
up to day 85
Title
Physician's Global Evaluation
Time Frame
Days 1, 29, 57 and 85
Title
Trough PEFR (peak expiratory flow rate) measured by the patient at home once daily
Time Frame
up to day 85
Title
Number of patients with adverse events
Time Frame
up to day 85
Title
Incidence of paradoxical bronchoconstriction on the test day
Time Frame
up to day 85
Title
Number of COPD exacerbation days
Time Frame
up to day 85
Title
Number of patients with clinically significant changes in vital signs
Time Frame
Baseline, days 1, 29, 57 and 85
Title
Number of patients with abnormal changes in laboratory parameters
Time Frame
Days 29 and 85
Title
Number of patients with abnormal changes in 12-lead electrocardiogram (ECG) parameters
Time Frame
pre-treatment and 1 hour post-treatment on days 1, 29 and 85
Title
Plasma ipratropium and salbutamol concentrations
Time Frame
pre-treatment, 5, 15, 30 and 60 minutes and 2, 4 and 8 hours after inhalation of test drug on day 29
Title
Renal excretion amounts of ipratropium and salbutamol
Time Frame
0-2 hours, 2-8 hours at day 29
Title
Length of COPD exacerbations during the treatment period
Time Frame
up to day 85
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
All patients must have a diagnosis of COPD and the following spirometric criteria:
Visit 1 (Screening) and Visit 2: Patients must have relatively stable, moderate to severe airway obstruction with an FEV1 ≤65% of predicted normal and FEV1 ≤70% of FVC
Male or female patients 40 years of age or older
Patients must have a smoking history of more than ten pack-years. A pack-year is defined as the equivalent of smoking one pack of 20 cigarettes per day for a year
Patients must be able to perform pulmonary function tests and maintain records during the study period as required in the protocol
Patients must be able to be trained in the proper use of an MDI (metered dose inhaler) and the Respimat® inhaler
All patients must sign an Informed Consent Form prior to participation in the trial
Exclusion Criteria:
Patients with significant diseases other than COPD will be excluded. A significant disease is defined as a disease which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study
Patients with clinically relevant abnormal baseline hematology, blood chemistry or urinalysis. If the abnormality defines a disease listed as an exclusion criterion, the patient is excluded
All patients with a SGOT (serum glutamic oxaloacetic transaminase) >80 IU/L, SGPT (serum glutamic pyruvic transaminase) >80 IU/L, bilirubin >2.0 mg/dL or creatinine >2.0 mg/dL will be excluded regardless of the clinical condition
Patients who have a total blood eosinophil count ≥600/mm3
Patients with a recent history (i.e., one year or less) of myocardial infarction
Patients with a recent history (i.e., three years or less) of heart failure or patients with any cardiac arrhythmia requiring drug therapy
Patients with a history of cancer, other than treated basal cell carcinoma, within the last 5 years
Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of a thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1
Patients with a history of asthma or allergic rhinitis
Patients with a history of and/or active alcohol or drug abuse
Patients with known active tuberculosis
Patients with an upper or lower respiratory tract infection or COPD exacerbation in the 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period
Patients with known symptomatic prostatic hypertrophy or bladder neck obstruction
Patients with known narrow-angle glaucoma
Patients with current significant psychiatric disorders
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
Patients who are being treated with cromolyn sodium or nedocromil sodium
Patients who are being treated with antihistamines for any excluded allergic conditions
Patients using oral corticosteroid medication at unstable doses (i.e., less than 6 weeks on a stable dose) or at a dose in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
Patients who initiated use of an inhaled steroid or changed doses less than 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period
Patients who are being treated with beta-blocker medications, MAO (monoamine oxidase) inhibitors or tricyclic antidepressants. Beta blocker eye medications (e.g., Betoptic) for treatment of non-narrow angle glaucoma are allowed
Patients who have had changes in their therapeutic plan within the last 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period
Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception
Patients with known hypersensitivity to anticholinergic drugs or any component of the ipratropium bromide/salbutamol Respimat® solution (including BAC (Benzalkonium chloride) and EDTA (Ethylenediaminetetraacetic acid)) or the ipratropium bromide/salbutamol MDI components
Previous participation in this study
Patients who are currently participating in another study
12. IPD Sharing Statement
Links:
URL
http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/1012/1012.46_U08-3586-01.pdf
Description
Related Info
URL
http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/1012/1012.46_literature.pdf
Description
Related Info
Learn more about this trial
Ipratropium Bromide/Salbutamol Delivered by the Respimat® Inhaler Compared to Ipratropium Bromide Respimat®, COMBIVENT® Inhalation Aerosol and Placebo in Adults With Chronic Obstructive Pulmonary Disease
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