Pharmacokinetics and Safety Comparison of Tiotropium Inhalation Powder Administered as the Bromide Salt From Hard Polyethylene Capsule Via the HandiHaler® 2 and Spiriva® HandiHaler® 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 low dose
Tiotropium medium dose
Spiriva® HandiHaler® high dose
Placebo via the blue HandiHaler®
Placebo via the grey HandiHaler®
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 randomization of patients with any respiratory infection or COPD exacerbation in the 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period should be postponed. Patients may be randomized 6 weeks following recovery from the infection or exacerbation
- At Visit 1, patients must demonstrate an improvement in FEV1 of >= 12% over the baseline FEV1 value 45 minutes after inhalation of 4 puffs of 20 µg ipratropium bromide (Atrovent® 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 had never smoked cigarettes had to 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 and the HandiHaler® devices
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 (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. A repeat eosinophil count will not be conducted in these patients
- 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. See exclusion criterion No 6
- Patients who are being treated with cromolyn sodium or nedocromil sodium
- 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, lactose or any other components of the inhalation capsule delivery system (Spiriva® HandiHaler®; tiotropium HandiHaler 2)
- 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 study23. 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
Experimental
Active Comparator
Placebo Comparator
Arm Label
Tiotropium low dose
Tiotropium medium dose
Spiriva® HandiHaler® high dose
Placebo
Arm Description
oral inhalation via the blue HandiHaler®
oral inhalation via the blue HandiHaler®
oral inhalation via the grey HandiHaler®
Outcomes
Primary Outcome Measures
Area under the curve for the time period 0 to 12 hours of forced expiratory volume in one second (FEV1 AUC0-12)
Secondary Outcome Measures
Peak FEV1 on each test-day
Peak FEV1 is defined as the maximum FEV1 obtained within the first three hours post dosing
Peak forced vital capacity (FVC)
FVC AUC0-12
FEV1 AUC12-24
FEV1 AUC0-24
FVC AUC12-24
FVC AUC0-24
Individual FEV1 measurements at each time point
Individual FVC measurements at each time point
AUCt1-t2 (area under the concentration-time curve of the analyte in plasma over the time interval t1 to t2)
Cmax (maximum measured concentration of the analyte in plasma)
tmax (time from dosing to the maximum concentration of the analyte in plasma)
Aet1-t2 (amount of analyte that is eliminated in urine from the time point t1 to time point t2)
fet1-t2 (fraction of analyte eliminated in urine from time point t1 to time point t2)
CLR,t1-t2 (renal clearance of the analyte from the time point t1 until the time point t2)
%AUCtz-∞ (percentage of the extrapolated part of the total AUC0-∞)
Number of patients with adverse events
Full Information
NCT ID
NCT02242266
First Posted
September 16, 2014
Last Updated
September 16, 2014
Sponsor
Boehringer Ingelheim
1. Study Identification
Unique Protocol Identification Number
NCT02242266
Brief Title
Pharmacokinetics and Safety Comparison of Tiotropium Inhalation Powder Administered as the Bromide Salt From Hard Polyethylene Capsule Via the HandiHaler® 2 and Spiriva® HandiHaler® 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 Tiotropium Inhalation Powder (5 μg and 10 μg), Administered as the Bromide Salt From Hard Polyethylene Capsule Via the HandiHaler® 2 and Spiriva® HandiHaler® (18 μg Tiotropium) 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
July 2005 (undefined)
Primary Completion Date
June 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 tiotropium 10 μg, formulated as inhalation powder in the polyethylene hard capsule and delivered via the HandiHaler® 2, compared to tiotropium 18 μg, formulated as inhalation powder in the hard gelatine capsule and delivered via the HandiHaler® (Spiriva®) following single dose inhalation in patients with COPD. A hard polyethylene (PE) capsule with half the strength (tiotropium 5 μg) was included to investigate a dose ordering effect.
The secondary objectives were to characterize the pharmacokinetics of tiotropium inhalation powder hard PE capsule (delivered via HandiHaler® 2) and tiotropium inhalation powder hard gelatine capsule (delivered via HandiHaler®) and to compare the safety of the two pharmaceutical formulations.
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
121 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Tiotropium low dose
Arm Type
Experimental
Arm Description
oral inhalation via the blue HandiHaler®
Arm Title
Tiotropium medium dose
Arm Type
Experimental
Arm Description
oral inhalation via the blue HandiHaler®
Arm Title
Spiriva® HandiHaler® high dose
Arm Type
Active Comparator
Arm Description
oral inhalation via the grey HandiHaler®
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Tiotropium low dose
Intervention Description
inhalation powder, hard PE capsule
Intervention Type
Drug
Intervention Name(s)
Tiotropium medium dose
Intervention Description
inhalation powder, hard PE capsule
Intervention Type
Drug
Intervention Name(s)
Spiriva® HandiHaler® high dose
Intervention Description
Tiotropium inhalation powder, hard gelatine capsule
Intervention Type
Drug
Intervention Name(s)
Placebo via the blue HandiHaler®
Intervention Description
oral inhalation via the blue HandiHaler®
Intervention Type
Drug
Intervention Name(s)
Placebo via the grey HandiHaler®
Intervention Description
oral inhalation via the grey HandiHaler®
Primary Outcome Measure Information:
Title
Area under the curve for the time period 0 to 12 hours of forced expiratory volume in one second (FEV1 AUC0-12)
Time Frame
pre-dose and 30, 60 minutes, 2, 3, 4, 6, 8, 10 and 12 hours post-dosing
Secondary Outcome Measure Information:
Title
Peak FEV1 on each test-day
Description
Peak FEV1 is defined as the maximum FEV1 obtained within the first three hours post dosing
Time Frame
pre-dose and 30, 60 minutes, 2 and 3 hours post-dosing
Title
Peak forced vital capacity (FVC)
Time Frame
pre-dose and 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
FVC AUC0-12
Time Frame
pre-dose and 30, 60 minutes, 2, 3, 4, 6, 8, 10 and 12 hours post-dosing
Title
FEV1 AUC12-24
Time Frame
12, 14, 22, 23 and 24 hours post-dosing
Title
FEV1 AUC0-24
Time Frame
pre-dose and 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
FVC AUC12-24
Time Frame
12, 14, 22, 23 and 24 hours post-dosing
Title
FVC AUC0-24
Time Frame
pre-dose and 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 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 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing
Title
AUCt1-t2 (area under the concentration-time curve of the analyte in plasma over the time interval t1 to t2)
Time Frame
5, 15, 30 minutes, 1 and 2 hours following drug administration
Title
Cmax (maximum measured concentration of the analyte in plasma)
Time Frame
5, 15, 30 minutes, 1 and 2 hours following drug administration
Title
tmax (time from dosing to the maximum concentration of the analyte in plasma)
Time Frame
5, 15, 30 minutes, 1 and 2 hours following drug administration
Title
Aet1-t2 (amount of analyte that is eliminated in urine from the time point t1 to time point t2)
Time Frame
0 to 2, 2 to 12 hours after administration
Title
fet1-t2 (fraction of analyte eliminated in urine from time point t1 to time point t2)
Time Frame
0 to 2, 2 to 12 hours after administration
Title
CLR,t1-t2 (renal clearance of the analyte from the time point t1 until the time point t2)
Time Frame
0 to 2, 2 to 12 hours after administration
Title
%AUCtz-∞ (percentage of the extrapolated part of the total AUC0-∞)
Time Frame
5, 15, 30 minutes, 1 and 2 hours following drug administration
Title
Number of patients with adverse events
Time Frame
up to 13 weeks
10. Eligibility
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 randomization of patients with any respiratory infection or COPD exacerbation in the 6 weeks prior to the Screening Visit (Visit 1) or during the baseline period should be postponed. Patients may be randomized 6 weeks following recovery from the infection or exacerbation
At Visit 1, patients must demonstrate an improvement in FEV1 of >= 12% over the baseline FEV1 value 45 minutes after inhalation of 4 puffs of 20 µg ipratropium bromide (Atrovent® 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 had never smoked cigarettes had to 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 and the HandiHaler® devices
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 (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. A repeat eosinophil count will not be conducted in these patients
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. See exclusion criterion No 6
Patients who are being treated with cromolyn sodium or nedocromil sodium
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, lactose or any other components of the inhalation capsule delivery system (Spiriva® HandiHaler®; tiotropium HandiHaler 2)
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 study23. 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
Related Info
Learn more about this trial
Pharmacokinetics and Safety Comparison of Tiotropium Inhalation Powder Administered as the Bromide Salt From Hard Polyethylene Capsule Via the HandiHaler® 2 and Spiriva® HandiHaler® in Patients With Chronic Obstructive Pulmonary Disease (COPD)
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