Efficacy, Pharmacokinetics and Safety Comparison of Salmeterol Inhalation Powder Administered Via the HandiHaler® 2 and Serevent® Diskus® in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Primary Purpose
Pulmonary Disease, Chronic Obstructive
Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Salmeterol xinafoate
Serevent® Diskus®
Placebo (HandiHaler®)
Placebo (Diskus®)
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive
Eligibility Criteria
Inclusion Criteria:
- All patients must sign an informed consent consistent with International Conference on Harmonization Good Clinical Practice (ICH-GCP) guidelines and local legislations prior to any study-related procedures, 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 pre-dose FEV1 ≤ 60% of predicted normal and FEV1 ≤ 70% of FVC at Visits 1 and 2.
- *The enrolment of patients who have had an exacerbation within six weeks prior to planned study entry should be postponed
- At Visit 1, patients must demonstrate an improvement in FEV1 of ≥ 12% over the pre-bronchodilator value 45 minutes after inhalation of 4 puffs of 100 μg salbutamol (Sultanol® MDI)
- Male or female patients 40 years of age or older
- Patients must be current or ex-smokers with a smoking history of more than 10 pack-years ((Patients who have never smoked cigarettes must be excluded)
- Patients must be able to perform technically acceptable pulmonary function tests during the study period as required in the protocol
- Patients must be able to inhale medication in a competent manner from the HandiHaler® 2 device and the Diskus® device
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 a recent history (i.e., six months or less) of myocardial infarction
- Patients who have been hospitalized for heart failure (New York Heart Association (NYHA) class III or IV) within the past year
- Patients with any unstable or life threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention 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 treated basal cell carcinoma are allowed
- Patients with a history of asthma, allergic rhinitis or atopy or who have a total blood eosinophil count ≥600/mm3
- Patients with a history of life threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
- Patients with known active tuberculosis
- Patients with significant alcohol or drug abuse within the past two years
- 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 have completed a pulmonary rehabilitation program in the six weeks prior to the Screening Visit (Visit 1) or patients who are currently in a pulmonary rehabilitation program that will not be maintained throughout the duration of the study
- 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 antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions
- Patients who have been treated with cromolyn sodium or nedocromil sodium within one month prior to Visit 1 or during the run-in period
- Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at doses in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
- Patients with known hypersensitivity to beta-adrenergics, lactose or any other components of the inhalation capsule delivery system or the Diskus®
- Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous three months (i.e. oral contraceptives, intrauterine devices, diaphragm or subdermal implants, e.g.: Norplant®)
- Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Visit 1
- Patients who have been treated with oral beta-adrenergics within one month prior to Visit 1 or during the run-in period
- Patients who have been treated with theophylline preparations within one month prior to Visit 1 or during the run-in period
- Patients who have been treated with the long-acting anticholinergic tiotropium (Spiriva®) within one month prior to Visit 1 or during the run-in period
- Patients with any respiratory infections in the six weeks prior to the Screening Visit (Visit 1) or during the run-in period. In the case of a respiratory infection during the run-in period the latter may be extended up to six weeks
- Patients who are currently participating in another study
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Active Comparator
Placebo Comparator
Arm Label
Salmeterol xinafoate
Serevent® Diskus®
Placebo
Arm Description
25 μg Salmeterol inhalation powder administered via HandiHaler®
50 μg Salmeterol (dry powder inhaler) administered via Diskus®
Outcomes
Primary Outcome Measures
Change in area under the curve for the time period 0 to 12 hours (AUC0-12h) of the forced expiratory volume in one second (FEV1)
Secondary Outcome Measures
Change in peak FEV1
Peak FEV1 is defined as the maximum FEV1 obtained within the first three hours post dosing
Change in FEV1 AUC12-24h
Change in FEV1 AUC0-24h
Individual FEV1 measurements at each time point
Change in forced vital capacity (FVC) AUC0-12h
Change in peak FVC
Change in FVC AUC12-24h
Change in FVC AUC0-24h
Individual FVC measurements at each time point
Number of patients with adverse events
AUC0-tz (area under the concentration-time curve of the analyte in plasma over the time interval from 0 to the time of the last quantifiable data point)
AUCt1-t2 (area under the concentration-time curve of the analyte in plasma over the time interval t1 to t2; a time interval from 0 - 8 h is appropriate)
AUC0-∞ (area under the concentration-time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity)
Cmax (maximum measured concentration of the analyte in plasma)
tmax (time from dosing to the maximum concentration of the analyte in plasma)
λz (terminal rate constant in plasma)
t½ (terminal half-life of the analyte in plasma)
MRTih (mean residence time of the analyte in the body after inhalational administration)
CL/F (apparent clearance of the analyte in the plasma after extravascular administration)
Vz/F (apparent volume of distribution during the terminal phase λz following an extravascular dose)
Aet1-t2 (amount of analyte that is eliminated in urine from the time interval t1 to t2)
fet1-t2 (fraction of administered drug excreted unchanged in urine from time point t1 to t2)
CLR,t1-t2 (renal clearance of the analyte in plasma from the time point t1 to t2)
Full Information
NCT ID
NCT02242227
First Posted
September 16, 2014
Last Updated
September 16, 2014
Sponsor
Boehringer Ingelheim
1. Study Identification
Unique Protocol Identification Number
NCT02242227
Brief Title
Efficacy, Pharmacokinetics and Safety Comparison of Salmeterol Inhalation Powder Administered Via the HandiHaler® 2 and Serevent® Diskus® in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Official Title
A Single Dose, Placebo-controlled, Randomized, Double-blind, Double-dummy, Crossover Efficacy, Pharmacokinetics and Safety Comparison of Salmeterol Inhalation Powder (25 μg Salmeterol), Administered as the Xinafoate Salt From a Hard Polyethylene Capsule Via the HandiHaler® 2, and Serevent® Diskus® (50 μg Salmeterol) in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Study Type
Interventional
2. Study Status
Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
September 2005 (undefined)
Primary Completion Date
February 2006 (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 trial was to establish non-inferiority of lung function response to 25 μg salmeterol, administered as the xinafoate salt, in an inhalation powder delivered from hard polyethylene (PE) capsules via the HandiHaler® 2 compared to Serevent® Diskus® (salmeterol 50 μg, administered as the xinafoate salt) following single dose inhalation in patients with COPD.
The secondary objectives were to characterize the pharmacokinetics of salmeterol inhalation powder delivered by HandiHaler® 2 from the PE hard capsule and salmeterol xinafoate delivered by Serevent® Diskus®, and to compare the safety of the two pharmaceutical forms.
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 2
Interventional Study Model
Crossover Assignment
Masking
Double
Allocation
Randomized
Enrollment
111 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Salmeterol xinafoate
Arm Type
Experimental
Arm Description
25 μg Salmeterol inhalation powder administered via HandiHaler®
Arm Title
Serevent® Diskus®
Arm Type
Active Comparator
Arm Description
50 μg Salmeterol (dry powder inhaler) administered via Diskus®
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Salmeterol xinafoate
Intervention Type
Drug
Intervention Name(s)
Serevent® Diskus®
Intervention Type
Drug
Intervention Name(s)
Placebo (HandiHaler®)
Intervention Type
Drug
Intervention Name(s)
Placebo (Diskus®)
Primary Outcome Measure Information:
Title
Change in area under the curve for the time period 0 to 12 hours (AUC0-12h) of the forced expiratory volume in one second (FEV1)
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, and 12 hours post-dosing
Secondary Outcome Measure Information:
Title
Change in peak FEV1
Description
Peak FEV1 is defined as the maximum FEV1 obtained within the first three hours post dosing
Time Frame
within 3 hours post-dosing
Title
Change in FEV1 AUC12-24h
Time Frame
12, 14, 22, 23 and 24 hours post-dosing
Title
Change in FEV1 AUC0-24h
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
Individual FEV1 measurements at each time point
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
Change in forced vital capacity (FVC) AUC0-12h
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, and 12 hours post-dosing
Title
Change in peak FVC
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
Change in FVC AUC12-24h
Time Frame
12, 14, 22, 23 and 24 hours post-dosing
Title
Change in FVC AUC0-24h
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
Individual FVC measurements at each time point
Time Frame
Pre-dose and 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
Number of patients with adverse events
Time Frame
up to 23 days
Title
AUC0-tz (area under the concentration-time curve of the analyte in plasma over the time interval from 0 to the time of the last quantifiable data point)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
AUCt1-t2 (area under the concentration-time curve of the analyte in plasma over the time interval t1 to t2; a time interval from 0 - 8 h is appropriate)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
AUC0-∞ (area under the concentration-time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
Cmax (maximum measured concentration of the analyte in plasma)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
tmax (time from dosing to the maximum concentration of the analyte in plasma)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
λz (terminal rate constant in plasma)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
t½ (terminal half-life of the analyte in plasma)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
MRTih (mean residence time of the analyte in the body after inhalational administration)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
CL/F (apparent clearance of the analyte in the plasma after extravascular administration)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
Vz/F (apparent volume of distribution during the terminal phase λz following an extravascular dose)
Time Frame
pre-dose and 2, 5, 10, 17, 25, 40 minutes, and 1h 5min, 1h 35 min, 3h 5min, 6h 5min, and 8h 5 min following drug administration
Title
Aet1-t2 (amount of analyte that is eliminated in urine from the time interval t1 to t2)
Time Frame
0 to 3h 5min, from 3h 5min to 6h 5min, and from 6h 5min to 8h 5min after administration
Title
fet1-t2 (fraction of administered drug excreted unchanged in urine from time point t1 to t2)
Time Frame
0 to 3h 5min, from 3h 5min to 6h 5min, and from 6h 5min to 8h 5min after administration
Title
CLR,t1-t2 (renal clearance of the analyte in plasma from the time point t1 to t2)
Time Frame
0 to 3h 5min, from 3h 5min to 6h 5min, and from 6h 5min to 8h 5min after administration
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
All patients must sign an informed consent consistent with International Conference on Harmonization Good Clinical Practice (ICH-GCP) guidelines and local legislations prior to any study-related procedures, 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 pre-dose FEV1 ≤ 60% of predicted normal and FEV1 ≤ 70% of FVC at Visits 1 and 2.
*The enrolment of patients who have had an exacerbation within six weeks prior to planned study entry should be postponed
At Visit 1, patients must demonstrate an improvement in FEV1 of ≥ 12% over the pre-bronchodilator value 45 minutes after inhalation of 4 puffs of 100 μg salbutamol (Sultanol® MDI)
Male or female patients 40 years of age or older
Patients must be current or ex-smokers with a smoking history of more than 10 pack-years ((Patients who have never smoked cigarettes must be excluded)
Patients must be able to perform technically acceptable pulmonary function tests during the study period as required in the protocol
Patients must be able to inhale medication in a competent manner from the HandiHaler® 2 device and the Diskus® device
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 a recent history (i.e., six months or less) of myocardial infarction
Patients who have been hospitalized for heart failure (New York Heart Association (NYHA) class III or IV) within the past year
Patients with any unstable or life threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention 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 treated basal cell carcinoma are allowed
Patients with a history of asthma, allergic rhinitis or atopy or who have a total blood eosinophil count ≥600/mm3
Patients with a history of life threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
Patients with known active tuberculosis
Patients with significant alcohol or drug abuse within the past two years
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 have completed a pulmonary rehabilitation program in the six weeks prior to the Screening Visit (Visit 1) or patients who are currently in a pulmonary rehabilitation program that will not be maintained throughout the duration of the study
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 antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions
Patients who have been treated with cromolyn sodium or nedocromil sodium within one month prior to Visit 1 or during the run-in period
Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at doses in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
Patients with known hypersensitivity to beta-adrenergics, lactose or any other components of the inhalation capsule delivery system or the Diskus®
Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous three months (i.e. oral contraceptives, intrauterine devices, diaphragm or subdermal implants, e.g.: Norplant®)
Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Visit 1
Patients who have been treated with oral beta-adrenergics within one month prior to Visit 1 or during the run-in period
Patients who have been treated with theophylline preparations within one month prior to Visit 1 or during the run-in period
Patients who have been treated with the long-acting anticholinergic tiotropium (Spiriva®) within one month prior to Visit 1 or during the run-in period
Patients with any respiratory infections in the six weeks prior to the Screening Visit (Visit 1) or during the run-in period. In the case of a respiratory infection during the run-in period the latter may be extended up to six weeks
Patients who are currently participating in another study
12. IPD Sharing Statement
Links:
URL
http://trials.boehringer-ingelheim.com
Description
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Learn more about this trial
Efficacy, Pharmacokinetics and Safety Comparison of Salmeterol Inhalation Powder Administered Via the HandiHaler® 2 and Serevent® Diskus® in Patients With Chronic Obstructive Pulmonary Disease (COPD)
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