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Effect of Aclidinium/Formoterol on Lung Hyperinflation, Exercise Capacity and Physical Activity in Moderate to Severe COPD Patients (ACTIVATE)

Primary Purpose

Pulmonary Disease, Chronic Obstructive

Status
Completed
Phase
Phase 4
Locations
International
Study Type
Interventional
Intervention
Aclidinium/Formoterol
Placebo
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive focused on measuring COPD

Eligibility Criteria

40 Years - 130 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males and non-pregnant, non-lactating females aged ≥ 40.
  2. Patients with a clinical diagnosis of COPD according to GOLD guidelines 2014, with a post bronchodilator FEV1 ≥ 40% and < 80% of the predicted value and FEV1/FVC < 70% at Visit 1.
  3. Functional residual capacity (FRC) measured by body plethysmography at Visit 1 ≥ 120% of predicted value.
  4. Patients with modified Medical Research Council dyspnea scale (mMRC) ≥ 2 at Visit 1.
  5. Current or former cigarette smokers with a smoking history of at least 10 pack-years at Visit 1
  6. Patients willing to participate in the telecoaching program during the four last weeks and to enhance their physical activity
  7. Patients who understand and are able to follow the study procedures, are cooperative and are willing to participate in the study as indicated by signing the informed consent.

Exclusion Criteria:

  1. History or current diagnosis of asthma.
  2. Any respiratory tract infection (including upper respiratory tract) or COPD exacerbation in the 6 weeks prior to Visit 1 or during the run-in period.
  3. Patients who have been hospitalised for an acute COPD exacerbation within 3 months prior to Visit 1 or during the run-in period.
  4. Clinically significant respiratory conditions other than COPD.
  5. Use of long-term oxygen therapy (≥ 15 hours/day).
  6. Oxygen saturation ≤ 85% as measured by pulse oximetry during exercise testing at Visit 1, Visit 2 or Visit 3 prior to randomisation.
  7. Patients with a Body Mass Index (BMI) ≥ 40kg/m2.
  8. Patient who may need to start a pulmonary rehabilitation program during the study and/or who started/finished it within 3 months prior to Visit 1 or during the run-in period.
  9. Patients with clinically significant cardiovascular conditions.
  10. Patients with Type I or uncontrolled Type II diabetes, uncontrolled hypo-or hyperthyroidism, hypokalaemia, or hyperadrenergic state, uncontrolled or untreated hypertension.
  11. Patient with known non-controlled history of infection with human immunodeficiency virus (HIV) and/or active hepatitis.
  12. Patients with clinically relevant abnormalities in the results of the blood pressure, ECG, or physical examination at Visit 1.
  13. Patients with any serious or uncontrolled physical or mental dysfunction that could place the patient at higher risk derived from his/her participation in the study or could confound the results
  14. Patients with conditions other than COPD that may contribute to dyspnoea and exercise limitation or with contraindications to clinical exercise testing according to ATS recommendations for CPET
  15. Patients with other relevant comorbidities that make the patient nor suitable to follow-up study procedures and/or could affect physical activity
  16. Patients who cycled < 2 minutes or > 15 minutes during the constant work-rate exercise tests conducted at Visit 2 (Run-in Visit) or at Visit 3 even after adjustment of the work load.
  17. Patients with history of hypersensitivity reaction to inhaled anticholinergics, sympathomimetic amines or inhaled medication or any component thereof (including report of paradoxical bronchospasm)
  18. Patients for whom the use of anticholinergic drugs is contraindicated (acute urinary retention, symptomatic prostatic hypertrophy, bladder neck obstruction or narrow-angle glaucoma)
  19. Patients unable to properly use a multidose dry powder inhaler or a pressurized metered-dose inhaler (pMDI).
  20. Patients using any prohibited medication (including IMP within 30 days (or 6 half-lives, whichever is longer) before Visit 1) or who have not undergone the required washout period.
  21. History of malignancy of any organ system (including lung cancer), treated or untreated, within the past 5 years other than basal or squamous cell skin cancer).
  22. Patients who do not maintain regular day/night, waking/sleeping cycles (e.g., night shift workers, sleep apnea).
  23. Patients unable to give their consent, or patients of consenting age but under guardianship, or vulnerable patients

Sites / Locations

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Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Aclidinium Bromide/Formoterol Fumarate FDC 400/12μg

Placebo to Aclidinium/Formoterol

Arm Description

8 weeks, double blind treatment period

8 weeks, double blind treatment period

Outcomes

Primary Outcome Measures

Change From Baseline in Trough Functional Residual Capacity (FRC) After 4 Weeks of Treatment
Baseline values in FRC were defined as the corresponding values just before randomization on Day 1 of treatment (Week 0). Trough values were obtained prior to study drug administration.

Secondary Outcome Measures

Change From Baseline in Endurance Time (ET) During Constant Work Rate Cycle Ergometry at Week 8
The ET was the time from the increase in work rate to 75% Wmax to the point of symptom limitation. Baseline measurements were taken prior to the IP dose on Day 1. Measurements at Week 8 were taken at 3 hours post-dose. Participants underwent a behavioural intervention (consisting of a telecoaching programme to enhance physical activity) between Week 4 and Week 8.
Percentage of Inactive Patients (Mean of <6000 Steps Per Day) at Week 8
Physical activity was assessed by means of measurement of activity parameters (e.g. number of steps) through a Dynaport MoveMonitor and completion of the Daily ProActive Physical Activity in chronic obstructive pulmonary disease (COPD) questionnaire. Compliant criterion based on at least 8 hours per day, and at least 3 days per week. Participants underwent a behavioural intervention (consisting of a telecoaching programme to enhance physical activity) between Week 4 and Week 8. Baseline was defined as mean of steps/day assessed during the week before the randomisation visit.

Full Information

First Posted
April 20, 2015
Last Updated
December 21, 2017
Sponsor
AstraZeneca
Collaborators
Menarini Group
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1. Study Identification

Unique Protocol Identification Number
NCT02424344
Brief Title
Effect of Aclidinium/Formoterol on Lung Hyperinflation, Exercise Capacity and Physical Activity in Moderate to Severe COPD Patients
Acronym
ACTIVATE
Official Title
A Multiple Dose, Randomized, Double-blind, Placebo Controlled, Parallel Clinical Trial to Assess the Effect of Aclidinium Bromide/Formoterol Fumarate Fixed-dose Combination on Lung Hyperinflation, Exercise Capacity and Physical Activity in Moderate to Severe Chronic Obstructive Pulmonary Disease (COPD)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2017
Overall Recruitment Status
Completed
Study Start Date
April 27, 2015 (Actual)
Primary Completion Date
July 25, 2016 (Actual)
Study Completion Date
July 25, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca
Collaborators
Menarini Group

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The present study is planned to evaluate the effect of the aclidinium bromide/formoterol fumarate 400/12 μg FDC BID on the hyperinflation, exercise endurance and physical activity in patients with moderate to severe COPD. Additionally, the effect of the behavioural intervention on top of aclidinium bromide/formoterol fumarate 400/12 μg will be assessed both on the exercise endurance and the physical activity.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Disease, Chronic Obstructive
Keywords
COPD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
267 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Aclidinium Bromide/Formoterol Fumarate FDC 400/12μg
Arm Type
Experimental
Arm Description
8 weeks, double blind treatment period
Arm Title
Placebo to Aclidinium/Formoterol
Arm Type
Placebo Comparator
Arm Description
8 weeks, double blind treatment period
Intervention Type
Drug
Intervention Name(s)
Aclidinium/Formoterol
Intervention Description
Aclidinium bromide/Formoterol fumarate FDC 400/12μg dry powder for oral inhalation twice daily via Genuair inhaler
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Dose-matched placebo dry powder for oral inhalation twice daily via Genuair inhaler
Primary Outcome Measure Information:
Title
Change From Baseline in Trough Functional Residual Capacity (FRC) After 4 Weeks of Treatment
Description
Baseline values in FRC were defined as the corresponding values just before randomization on Day 1 of treatment (Week 0). Trough values were obtained prior to study drug administration.
Time Frame
Baseline and Week 4
Secondary Outcome Measure Information:
Title
Change From Baseline in Endurance Time (ET) During Constant Work Rate Cycle Ergometry at Week 8
Description
The ET was the time from the increase in work rate to 75% Wmax to the point of symptom limitation. Baseline measurements were taken prior to the IP dose on Day 1. Measurements at Week 8 were taken at 3 hours post-dose. Participants underwent a behavioural intervention (consisting of a telecoaching programme to enhance physical activity) between Week 4 and Week 8.
Time Frame
Baseline to Week 8
Title
Percentage of Inactive Patients (Mean of <6000 Steps Per Day) at Week 8
Description
Physical activity was assessed by means of measurement of activity parameters (e.g. number of steps) through a Dynaport MoveMonitor and completion of the Daily ProActive Physical Activity in chronic obstructive pulmonary disease (COPD) questionnaire. Compliant criterion based on at least 8 hours per day, and at least 3 days per week. Participants underwent a behavioural intervention (consisting of a telecoaching programme to enhance physical activity) between Week 4 and Week 8. Baseline was defined as mean of steps/day assessed during the week before the randomisation visit.
Time Frame
Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
130 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and non-pregnant, non-lactating females aged ≥ 40. Patients with a clinical diagnosis of COPD according to GOLD guidelines 2014, with a post bronchodilator FEV1 ≥ 40% and < 80% of the predicted value and FEV1/FVC < 70% at Visit 1. Functional residual capacity (FRC) measured by body plethysmography at Visit 1 ≥ 120% of predicted value. Patients with modified Medical Research Council dyspnea scale (mMRC) ≥ 2 at Visit 1. Current or former cigarette smokers with a smoking history of at least 10 pack-years at Visit 1 Patients willing to participate in the telecoaching program during the four last weeks and to enhance their physical activity Patients who understand and are able to follow the study procedures, are cooperative and are willing to participate in the study as indicated by signing the informed consent. Exclusion Criteria: History or current diagnosis of asthma. Any respiratory tract infection (including upper respiratory tract) or COPD exacerbation in the 6 weeks prior to Visit 1 or during the run-in period. Patients who have been hospitalised for an acute COPD exacerbation within 3 months prior to Visit 1 or during the run-in period. Clinically significant respiratory conditions other than COPD. Use of long-term oxygen therapy (≥ 15 hours/day). Oxygen saturation ≤ 85% as measured by pulse oximetry during exercise testing at Visit 1, Visit 2 or Visit 3 prior to randomisation. Patients with a Body Mass Index (BMI) ≥ 40kg/m2. Patient who may need to start a pulmonary rehabilitation program during the study and/or who started/finished it within 3 months prior to Visit 1 or during the run-in period. Patients with clinically significant cardiovascular conditions. Patients with Type I or uncontrolled Type II diabetes, uncontrolled hypo-or hyperthyroidism, hypokalaemia, or hyperadrenergic state, uncontrolled or untreated hypertension. Patient with known non-controlled history of infection with human immunodeficiency virus (HIV) and/or active hepatitis. Patients with clinically relevant abnormalities in the results of the blood pressure, ECG, or physical examination at Visit 1. Patients with any serious or uncontrolled physical or mental dysfunction that could place the patient at higher risk derived from his/her participation in the study or could confound the results Patients with conditions other than COPD that may contribute to dyspnoea and exercise limitation or with contraindications to clinical exercise testing according to ATS recommendations for CPET Patients with other relevant comorbidities that make the patient nor suitable to follow-up study procedures and/or could affect physical activity Patients who cycled < 2 minutes or > 15 minutes during the constant work-rate exercise tests conducted at Visit 2 (Run-in Visit) or at Visit 3 even after adjustment of the work load. Patients with history of hypersensitivity reaction to inhaled anticholinergics, sympathomimetic amines or inhaled medication or any component thereof (including report of paradoxical bronchospasm) Patients for whom the use of anticholinergic drugs is contraindicated (acute urinary retention, symptomatic prostatic hypertrophy, bladder neck obstruction or narrow-angle glaucoma) Patients unable to properly use a multidose dry powder inhaler or a pressurized metered-dose inhaler (pMDI). Patients using any prohibited medication (including IMP within 30 days (or 6 half-lives, whichever is longer) before Visit 1) or who have not undergone the required washout period. History of malignancy of any organ system (including lung cancer), treated or untreated, within the past 5 years other than basal or squamous cell skin cancer). Patients who do not maintain regular day/night, waking/sleeping cycles (e.g., night shift workers, sleep apnea). Patients unable to give their consent, or patients of consenting age but under guardianship, or vulnerable patients
Facility Information:
Facility Name
Research Site
City
Hamilton
State/Province
Ontario
ZIP/Postal Code
L8N 3Z5
Country
Canada
Facility Name
Research Site
City
Kingston
State/Province
Ontario
ZIP/Postal Code
K7L 2V7
Country
Canada
Facility Name
Research Site
City
Sainte Foy
State/Province
Quebec
ZIP/Postal Code
G1V 4G5
Country
Canada
Facility Name
Research Site
City
Saskatoon
State/Province
Saskatchewan
ZIP/Postal Code
S7N 0W8
Country
Canada
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
10717
Country
Germany
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
10787
Country
Germany
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
10969
Country
Germany
Facility Name
Research Site
City
Berlin
ZIP/Postal Code
13086
Country
Germany
Facility Name
Research Site
City
Dortmund
ZIP/Postal Code
44263
Country
Germany
Facility Name
Research Site
City
Frankfurt
ZIP/Postal Code
60596
Country
Germany
Facility Name
Research Site
City
Großhansdorf
ZIP/Postal Code
22927
Country
Germany
Facility Name
Research Site
City
Hamburg
ZIP/Postal Code
20253
Country
Germany
Facility Name
Research Site
City
Hamburg
ZIP/Postal Code
20354
Country
Germany
Facility Name
Research Site
City
Hannover
ZIP/Postal Code
30173
Country
Germany
Facility Name
Research Site
City
Jena
ZIP/Postal Code
7740
Country
Germany
Facility Name
Research Site
City
Lübeck
ZIP/Postal Code
23552
Country
Germany
Facility Name
Research Site
City
München
ZIP/Postal Code
80331
Country
Germany
Facility Name
Research Site
City
Wiesbaden
ZIP/Postal Code
65187
Country
Germany
Facility Name
Research Site
City
Budapest
ZIP/Postal Code
1125
Country
Hungary
Facility Name
Research Site
City
Deszk
ZIP/Postal Code
6772
Country
Hungary
Facility Name
Research Site
City
Nyíregyháza
ZIP/Postal Code
4400
Country
Hungary
Facility Name
Research Site
City
Törökbálint
ZIP/Postal Code
2045
Country
Hungary
Facility Name
Research Site
City
Alicante
ZIP/Postal Code
03004
Country
Spain
Facility Name
Research Site
City
Cáceres
ZIP/Postal Code
10003
Country
Spain
Facility Name
Research Site
City
Madrid
ZIP/Postal Code
28046
Country
Spain

12. IPD Sharing Statement

Citations:
PubMed Identifier
35342289
Citation
Koopman M, Franssen FME, Gaffron S, Watz H, Troosters T, Garcia-Aymerich J, Paggiaro P, Molins E, Moya M, van Burk L, Maier D, Garcia Gil E, Wouters EFM, Vanfleteren LEGW, Spruit MA. Differential Outcomes Following 4 Weeks of Aclidinium/Formoterol in Patients with COPD: A Reanalysis of the ACTIVATE Study. Int J Chron Obstruct Pulmon Dis. 2022 Mar 8;17:517-533. doi: 10.2147/COPD.S308600. eCollection 2022.
Results Reference
derived

Learn more about this trial

Effect of Aclidinium/Formoterol on Lung Hyperinflation, Exercise Capacity and Physical Activity in Moderate to Severe COPD Patients

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