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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
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 - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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

    First Posted
    September 16, 2014
    Last Updated
    September 16, 2014
    Sponsor
    Boehringer Ingelheim
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    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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    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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