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Free Combinations of Tiotropium Inhalation Powder Capsule + Salmeterol Metered Dose Inhaler, Tiotropium Inhalation Powder Capsule and Salmeterol Metered Dose Inhaler in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Primary Purpose

Pulmonary Disease, Chronic Obstructive

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Tiotropium
Salmeterol
Placebo-MDI
Placebo HandiHaler®
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:

  1. All patients must sign an informed consent consistent with International Conference on Harmonization Good Clinical Practice (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, moderate to severe airway obstruction with an FEV1 ≤ 60% of predicted normal and FEV1 ≤ 70% of FVC (Visits 1 and 2)

  3. Male or female patients 40 years of age or older
  4. Patients must be current or ex-smokers with a smoking history of more than 10 pack-years (Patients who had never smoked cigarettes have to be excluded)
  5. Patients must be able to perform technically acceptable pulmonary function tests and must be able to maintain records (Patient Daily Diary Card) during the study period as required in the protocol
  6. Patients must be able to inhale medication in a competent manner from the HandiHaler® device and from a metered dose inhaler (MDI)

Exclusion Criteria:

  1. 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
  2. Patients with clinically relevant abnormal baseline haematology, blood chemistry, or urinalysis, if the abnormality defines a significant disease as defined in exclusion criterion No. 1
  3. Patients with a recent history (i.e. six months or less) of myocardial infarction
  4. Patients with any unstable or life-threatening cardiac arrhythmia or patients who have been hospitalised for such an event 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. Patients with treated basal cell carcinoma are allowed
  6. Patients with known narrow-angle glaucoma
  7. Patients with a history of asthma, allergic rhinitis or who have a total blood eosinophil count ≥600 mm3
  8. Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
  9. Patients with known active tuberculosis
  10. Patients with a history of and/or active significant alcohol or drug abuse. See exclusion criterion No. 1
  11. 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
  12. Patients who have completed a pulmonary rehabilitation program in the six weeks prior to the Screening Visit (Visit 1)
  13. Patients who regularly use daytime oxygen therapy
  14. Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Screening Visit (Visit 1)
  15. Patients who are being treated with oral beta-adrenergics
  16. Patients who are being treated with cromolyn sodium or nedocromil sodium
  17. Patients who are being treated with antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions. See exclusion criterion No. 7
  18. 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
  19. Patients with known hypersensitivity to anticholinergic drugs, beta-adrenergics, lactose or any other components of the medication delivery systems
  20. Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous 3 months (i.e. oral contraceptives, intrauterine devices, diaphragm or subdermal implants eg: Norplant®)
  21. Patients with previous participation (receipt of randomised treatment) in this study
  22. Patients who are currently participating in another study
  23. The randomisation of patients with any respiratory infection or COPD exacerbation in the six weeks prior to the Screening Visit (Visit 1) or during the baseline period should be postponed. Patients may be randomised six weeks following recovery from the infection or exacerbation

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Active Comparator

    Active Comparator

    Active Comparator

    Arm Label

    Tiotropium+salmeterol QD

    Tiotropium+salmeterol BID

    Tiotropium QD

    Salmeterol BID

    Arm Description

    free combination of tiotropium and salmeterol

    free combination of tiotropium and salmeterol

    Outcomes

    Primary Outcome Measures

    Area under the curve of forced expiratory volume in one second (FEV1 AUC0-24h)
    FEV1 AUC0-12h

    Secondary Outcome Measures

    FEV1 AUC12-24h
    AUC of forced vital capacity (FVC AUC0-12h)
    FVC AUC0-24h
    FVC AUC12-24h
    Peak FEV1
    Trough FEV1
    Trough FEV1 was defined as the pre-dose FEV1 measured just prior to the last administration of the morning dose of randomised treatment.
    Peak FVC
    Trough FVC
    Trough FVC was defined as the pre-dose FVC measured just prior to the last administration of the morning dose of randomised treatment
    Individual FEV measurements at each time point
    Individual FVC measurements at each time point
    Peak expiratory flow rate (PEFR) measured twice daily
    Number of inhalations of rescue salbutamol therapy used per day
    Change in focal score of the Mahler Transition Dyspnea Index (TDI)
    The TDI focal score is the sum of the three components of the TDI: Functional Impairment, Magnitude of Task and Magnitude of Effort
    Number of patients with adverse events

    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
    NCT02242253
    Brief Title
    Free Combinations of Tiotropium Inhalation Powder Capsule + Salmeterol Metered Dose Inhaler, Tiotropium Inhalation Powder Capsule and Salmeterol Metered Dose Inhaler in Patients With Chronic Obstructive Pulmonary Disease (COPD)
    Official Title
    A Randomised, Double-blind, Double-dummy, Crossover Efficacy and Safety Comparison of 6-week Treatment Periods of the Free Combinations of Tiotropium Inhalation Powder Capsule (18 μg) QD + Salmeterol Metered Dose Inhaler (2 Puffs of 25 μg) QD or BID, Tiotropium Inhalation Powder Capsule (18 μg) QD and Salmeterol Metered Dose Inhaler (2 Puffs of 25 μg) BID in Patients With (COPD)
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    September 2003 (undefined)
    Primary Completion Date
    July 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
    Main Study: To evaluate and to compare the lung function response to the free combinations of tiotropium 18 μg (QD) + salmeterol 50 μg (QD or BID), salmeterol 50 μg BID and tiotropium 18 μg QD at the end of 6-week treatment periods in patients with COPD. Sub-Study: Was performed in subset of patients participating in the Main Study to assess the effect of the four randomised treatments on dynamic hyperinflation. Extension Study: To establish whether the FEV1 time profile following combination bronchodilator therapy of tiotropium plus salmeterol is affected by the pharmaceutical formulation of salmeterol, i.e. the MDI or the Diskus®.

    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
    97 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Tiotropium+salmeterol QD
    Arm Type
    Experimental
    Arm Description
    free combination of tiotropium and salmeterol
    Arm Title
    Tiotropium+salmeterol BID
    Arm Type
    Active Comparator
    Arm Description
    free combination of tiotropium and salmeterol
    Arm Title
    Tiotropium QD
    Arm Type
    Active Comparator
    Arm Title
    Salmeterol BID
    Arm Type
    Active Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Tiotropium
    Intervention Description
    administered via HandiHaler®
    Intervention Type
    Drug
    Intervention Name(s)
    Salmeterol
    Intervention Description
    administered via metered dose inhaler (MDI)
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo-MDI
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo HandiHaler®
    Primary Outcome Measure Information:
    Title
    Area under the curve of forced expiratory volume in one second (FEV1 AUC0-24h)
    Time Frame
    up to 12 hours after morning and evening dose
    Title
    FEV1 AUC0-12h
    Time Frame
    up to 12 hours after morning and evening dose
    Secondary Outcome Measure Information:
    Title
    FEV1 AUC12-24h
    Time Frame
    after 6 weeks of each treatment
    Title
    AUC of forced vital capacity (FVC AUC0-12h)
    Time Frame
    after 6 weeks of each treatment
    Title
    FVC AUC0-24h
    Time Frame
    after 6 weeks of each treatment
    Title
    FVC AUC12-24h
    Time Frame
    after 6 weeks of each treatment
    Title
    Peak FEV1
    Time Frame
    after 6 weeks of each treatment
    Title
    Trough FEV1
    Description
    Trough FEV1 was defined as the pre-dose FEV1 measured just prior to the last administration of the morning dose of randomised treatment.
    Time Frame
    after 6 weeks of each treatment
    Title
    Peak FVC
    Time Frame
    after 6 weeks of each treatment
    Title
    Trough FVC
    Description
    Trough FVC was defined as the pre-dose FVC measured just prior to the last administration of the morning dose of randomised treatment
    Time Frame
    after 6 weeks of each treatment
    Title
    Individual FEV measurements at each time point
    Time Frame
    up to 6 weeks
    Title
    Individual FVC measurements at each time point
    Time Frame
    up to 6 weeks
    Title
    Peak expiratory flow rate (PEFR) measured twice daily
    Time Frame
    weeks 4 to 6 of each treatment period
    Title
    Number of inhalations of rescue salbutamol therapy used per day
    Time Frame
    weeks 4 to 6 of each treatment period
    Title
    Change in focal score of the Mahler Transition Dyspnea Index (TDI)
    Description
    The TDI focal score is the sum of the three components of the TDI: Functional Impairment, Magnitude of Task and Magnitude of Effort
    Time Frame
    after 6 weeks of each treatment
    Title
    Number of patients with adverse events
    Time Frame
    up to 33 weeks

    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 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, moderate to severe airway obstruction with an FEV1 ≤ 60% of predicted normal and FEV1 ≤ 70% of FVC (Visits 1 and 2) 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 had never smoked cigarettes have to be excluded) Patients must be able to perform technically acceptable pulmonary function tests and must be able to maintain records (Patient Daily Diary Card) during the study period as required in the protocol Patients must be able to inhale medication in a competent manner from the HandiHaler® device and from a metered dose inhaler (MDI) 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 haematology, blood chemistry, or urinalysis, if the abnormality defines a significant disease as defined in exclusion criterion No. 1 Patients with a recent history (i.e. six months or less) of myocardial infarction Patients with any unstable or life-threatening cardiac arrhythmia or patients who have been hospitalised for such an event 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 treated basal cell carcinoma are allowed Patients with known narrow-angle glaucoma Patients with a history of asthma, allergic rhinitis 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 a history of and/or active significant alcohol or drug abuse. See exclusion criterion No. 1 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) Patients who regularly use daytime oxygen therapy Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Screening Visit (Visit 1) Patients who are being treated with oral beta-adrenergics Patients who are being treated with cromolyn sodium or nedocromil sodium Patients who are being treated with antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions. See exclusion criterion No. 7 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 anticholinergic drugs, beta-adrenergics, lactose or any other components of the medication delivery systems Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous 3 months (i.e. oral contraceptives, intrauterine devices, diaphragm or subdermal implants eg: Norplant®) Patients with previous participation (receipt of randomised treatment) in this study Patients who are currently participating in another study The randomisation of patients with any respiratory infection or COPD exacerbation in the six weeks prior to the Screening Visit (Visit 1) or during the baseline period should be postponed. Patients may be randomised six weeks following recovery from the infection or exacerbation

    12. IPD Sharing Statement

    Links:
    URL
    http://trials.boehringer-ingelheim.com
    Description
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    Free Combinations of Tiotropium Inhalation Powder Capsule + Salmeterol Metered Dose Inhaler, Tiotropium Inhalation Powder Capsule and Salmeterol Metered Dose Inhaler in Patients With Chronic Obstructive Pulmonary Disease (COPD)

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