Clinical Trial of Efficacy and Safety of Rengalin in the Treatment of Cough in Patients With Chronic Obstructive Pulmonary Disease
Primary Purpose
Chronic Obstructive Pulmonary Disease
Status
Completed
Phase
Phase 4
Locations
Russian Federation
Study Type
Interventional
Intervention
Rengalin
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease
Eligibility Criteria
Inclusion Criteria:
- Patients of both sexes aged from 40 to 80 years old.
- COPD diagnosed (in accordance with the GOLD-2014 guidelines) ≥12 months before inclusion.
- Stable course of COPD (≥ 6 weeks free of disease progression).
- Mild, moderate or severe degree of bronchial obstruction (FEV1/FVC < 0.7; post-bronchodilator FEV1 ≥30% of predicted value).
- CSS score ≥2.
- Stable dose of standard therapy within the preceding 4 weeks.
- Use of and adherence to contraceptive methods by fertile-age patients of both sexes during the study.
- Availability of a signed patient information sheet (Informed Consent form) for participation in the trial.
Exclusion Criteria:
- Earlier diagnosis of intra- or extrathoracic causes of cough (e.g., asthma, malignant neoplasm of lung, tuberculosis, sarcoidosis, α1-antitrypsin deficiency, bronchiectasis, cystic fibrosis, interstitial pulmonary diseases, perennial allergic rhinitis, gastro-oesophageal reflux disease, use of ACE inhibitors, disease of upper respiratory tract, etc.).
- Cough associated with eating.
- An exacerbation of COPD, acute upper and/or lower respiratory infection at inclusion or in the previous 4 weeks.
- Modifications to standard drug therapy (dose escalation, replacement of medicines prescribed or addition of new medications) in the previous 4 weeks.
- Very severe degree of bronchial obstruction (post-bronchodilator FEV1 <30% pred or < 50% and chronic respiratory failure).
- Haemoptysis.
- Stroke in the preceding 3 months or stroke with long-term residual neurological deficit within 6 months before study entry.
- Acute coronary syndrome, myocardial infarction within 6 months before study enrollment.
- Unstable or life-threatening arrhythmia in the previous 3 months.
- Acute or chronic heart failure (NYHA (1964) Class III or IV).
- Presence or suspicion of oncological disease.
- Body Mass Index (BMI) ≤18 kg/m2 or ≥40 kg/m2.
- Chronic kidney disease (categories С3-5 А3).
- Hepatic failure (Child-Pugh class C)
- Exacerbation or decompensation of a chronic disease that would affect the patient's ability to participate in the clinical trial.
- For smokers - intention to quit smoking in the next 4 weeks.
- Allergy/intolerance to any of the components of medications used in the treatment.
- Course intake of medicines listed in the section 'Prohibited concomitant treatment' for 4 weeks prior to the enrollment in the trial.
- Participation in other clinical trials within 3 months prior to the enrollment in this study.
- Patients who, from investigator's point of view, will fail to comply with the observation requirements of the trial or with the dosing regimen of the investigational drug.
- Other conditions preventing the patient from normal participation (e.g., planned business or other trips).
- Drug addiction, alcohol use in the amount over 2 units of alcohol a day, mental diseases.
- Pregnancy, breast-feeding, unwillingness to use contraception during the study.
- Patient is related to the research staff of the clinical investigative site who are directly involved in the trial or is the immediate family member of the investigator. The immediate family members include husband/wife, parents, children or brothers (or sisters), regardless of whether they are natural or adopted.
- Patient works for MATERIA MEDICA HOLDING company (i.e., is the company's employee, temporary contract worker or appointed official responsible for carrying out the research or their immediate family).
Sites / Locations
- Regional state budgetary health care institution "Regional Clinical Hospital"
- Regional state budget health care institution "City Hospital No. 5, Barnaul"
- NUZ "Road Clinical Hospital at the station Chelyabinsk JSC" RZhD "
- The State Budget Health Institution "Regional Clinical Hospital No. 4"
- Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University"/Central City Clinical Hospital and Clinic #18
- Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University"/Professor's Clinic
- Pirogov Russian National Research Medical University
- State Budgetary Institution of Health Care of the Nizhny Novgorod Region "City Clinical Hospital No. 10"
- Ryazan State Medical University named after academician I.P. Pavlov
- North-Western State Medical University named after I.I. Mechnikov
- North-western State Medical University named after I.I.Mechnikov
- St. Petersburg State Budgetary Public Health Institution "Vvedensky City Clinical Hospital"
- The Federal State Institute of Public Health 'The Nikiforov Russian Center of Emergency and Radiation Medicine'
- The First Pavlov State Medical University of St. Petersburg
- St. Petersburg State Budgetary Institution of Health "City Polyclinic No. 106"
- Samara City Hospital №4
- St. Petersburg State Budgetary Institution "City Hospital No. 40 in the Kurortny District"
- Voronezh Regional Clinical Hospital №1
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
Rengalin
Placebo
Arm Description
Oral administration. Two tablets per intake. The tablet should be held in the mouth until complete dissolution. 2 tablets 3 times a day without food (i.e. 15-30 min prior to meal or 15-30 min after meal).
Oral administration. Two tablets per intake. The tablet should be held in the mouth until complete dissolution. 2 tablets 3 times a day without food (i.e. 15-30 min prior to meal or 15-30 min after meal).
Outcomes
Primary Outcome Measures
Percentage of Patients With a Positive Treatment Response
Cough Severity Scale (CSS) total score. Cough intensity according to the scale is assessed in daytime and at night in points where 0 - no cough, 5 - continuous exhausting cough in daytime and at night. Response criterion: ≥1 lower total CSS score compared to baseline.
Secondary Outcome Measures
Severity of Cough After 4 Weeks Compared to Baseline
Cough Severity Scale (CSS) total score. Cough intensity according to the scale is assessed in the daytime and at night in points, where 0 - no cough, 5 - continuous exhausting cough in the daytime, and at night.
Percentage of Patients With ≥50% Lesser Cough Severity at 4 Weeks
Number of Participants with a Decrease from Baseline of ≥50% in Cough Severity at 4 weeks. Based on the total Cough Severity Scale (CSS) score. Cough intensity according to the scale is assessed in the daytime and at night in points, where 0 - no cough, 5 - continuous exhausting cough in the daytime and at night.
Changes in Clinical Symptoms of Chronic Obstructive Pulmonary Disease (COPD)
Based on the total COPD Assessment Test (CAT) score. CAT consists of 8 items. Each item ranges from "0" to "5" balls. The total score ranges from minimum "0" to maximum "40" points. Higher values represent a worse outcome.
Percentage of Patients With no Exacerbation of COPD
COPD exacerbation is defined as an acute event characterized by aggravation of the event within 2-3 or more days. Exacerbation manifests in intensification of respiratory disorders beyond their regular daily fluctuations and require administration of products in addition to the previously prescribed basic therapy as well as a rescue drug for symptom relief (salbutamol). Additional products include antibacterial drugs, systemic corticosteroids and/or emergency therapy (ambulance call) or hospitalization for COPD exacerbation.
COPD exacerbation is recorded as an adverse event. If a COPD exacerbation develops within the first week of the subject participation in the study, it will not be considered as a secondary inefficacy criterion
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03159091
Brief Title
Clinical Trial of Efficacy and Safety of Rengalin in the Treatment of Cough in Patients With Chronic Obstructive Pulmonary Disease
Official Title
Multicenter Double-blind Placebo-controlled Parallel-group Randomized Clinical Trial of Efficacy and Safety of Rengalin in the Treatment of Cough in Patients With Chronic Obstructive Pulmonary Disease
Study Type
Interventional
2. Study Status
Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
June 16, 2017 (Actual)
Primary Completion Date
April 25, 2019 (Actual)
Study Completion Date
April 25, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Materia Medica Holding
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
The purpose of this study is to obtain additional data on efficacy and safety of Rengalin in the treatment of cough in patients with stable obstructive pulmonary disease
Detailed Description
Design: multicenter, double-blind, randomized, parallel group placebo-controlled study.
The study will enroll men and women (aged 40 to 80 years) with cough associated with stable chronic obstructive pulmonary disease (COPD). Subjects with COPD diagnosed more than 12 months earlier obtaining allowed basic therapy and retaining cough ≥2 points (according to cough severity scale [CSS]) despite their therapy should be considered as the study candidates.
After signing patient information leaflet (informed consent form) to participate in the clinical study, collection of medical history and objective examination are performed, cough severity is assessed (using CSS; at baseline evaluation of diurnal and nocturnal cough the number of episodes and cough severity in the preceding day is taken into account) as well as intensity of COPD effect on the subject (САТ test), concomitant therapy is recorded, computer spirometry with evaluation of baseline FEV1/FVC and post-bronchodilator FEV1 (where respiratory function cannot be assessed, the results of the previous examination dating no more than 3 months earlier may be used). Females of childbearing potential will undergo pregnancy test.
If a patient meets the inclusion criteria and does not demonstrate any of the exclusion criteria at Visit 1 (Day 1), he/she is randomized to one of 2 groups: group 1 patients will receive Rengalin at 2 tablets 3 times a day for 4 weeks; group 2 patients will receive placebo using Rengalin dosing regimen for 4 weeks.
The patient will be monitored for 4 weeks (screening, randomization - before day 1, treatment - 4 weeks). During follow-up period two visits are scheduled (Visit 1 (Day 1) and Visit 2 (Week 4) at which objective examination, recording cough severity (using CSS) will be carried out, COPD effect on the subjects (САТ test) and concomitant therapy will be evaluated. At Visit 2 (after 4-week treatment period) compliance will be additionally assessed.
At one of the clinical sites (Research Institute of Pulmonology, Russian FMBA), patients will be monitored for cough on a daily basis (using the WHolter™ monitor), with the data used as an additional measure to evaluate efficacy.
Subjects are allowed to take basic COPD therapy and medications for their co-morbidities in the course of the study, except for the medicines listed in "Prohibited concomitant treatment".
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
238 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Rengalin
Arm Type
Experimental
Arm Description
Oral administration. Two tablets per intake. The tablet should be held in the mouth until complete dissolution. 2 tablets 3 times a day without food (i.e. 15-30 min prior to meal or 15-30 min after meal).
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Oral administration. Two tablets per intake. The tablet should be held in the mouth until complete dissolution. 2 tablets 3 times a day without food (i.e. 15-30 min prior to meal or 15-30 min after meal).
Intervention Type
Drug
Intervention Name(s)
Rengalin
Intervention Description
Oral administration.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Oral administration.
Primary Outcome Measure Information:
Title
Percentage of Patients With a Positive Treatment Response
Description
Cough Severity Scale (CSS) total score. Cough intensity according to the scale is assessed in daytime and at night in points where 0 - no cough, 5 - continuous exhausting cough in daytime and at night. Response criterion: ≥1 lower total CSS score compared to baseline.
Time Frame
in 4 weeks of the treatment
Secondary Outcome Measure Information:
Title
Severity of Cough After 4 Weeks Compared to Baseline
Description
Cough Severity Scale (CSS) total score. Cough intensity according to the scale is assessed in the daytime and at night in points, where 0 - no cough, 5 - continuous exhausting cough in the daytime, and at night.
Time Frame
Baseline and 4 weeks after the treatment
Title
Percentage of Patients With ≥50% Lesser Cough Severity at 4 Weeks
Description
Number of Participants with a Decrease from Baseline of ≥50% in Cough Severity at 4 weeks. Based on the total Cough Severity Scale (CSS) score. Cough intensity according to the scale is assessed in the daytime and at night in points, where 0 - no cough, 5 - continuous exhausting cough in the daytime and at night.
Time Frame
in 4 weeks of the treatment
Title
Changes in Clinical Symptoms of Chronic Obstructive Pulmonary Disease (COPD)
Description
Based on the total COPD Assessment Test (CAT) score. CAT consists of 8 items. Each item ranges from "0" to "5" balls. The total score ranges from minimum "0" to maximum "40" points. Higher values represent a worse outcome.
Time Frame
in 4 weeks of the treatment
Title
Percentage of Patients With no Exacerbation of COPD
Description
COPD exacerbation is defined as an acute event characterized by aggravation of the event within 2-3 or more days. Exacerbation manifests in intensification of respiratory disorders beyond their regular daily fluctuations and require administration of products in addition to the previously prescribed basic therapy as well as a rescue drug for symptom relief (salbutamol). Additional products include antibacterial drugs, systemic corticosteroids and/or emergency therapy (ambulance call) or hospitalization for COPD exacerbation.
COPD exacerbation is recorded as an adverse event. If a COPD exacerbation develops within the first week of the subject participation in the study, it will not be considered as a secondary inefficacy criterion
Time Frame
in 4 weeks of the treatment
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients of both sexes aged from 40 to 80 years old.
COPD diagnosed (in accordance with the GOLD-2014 guidelines) ≥12 months before inclusion.
Stable course of COPD (≥ 6 weeks free of disease progression).
Mild, moderate or severe degree of bronchial obstruction (FEV1/FVC < 0.7; post-bronchodilator FEV1 ≥30% of predicted value).
CSS score ≥2.
Stable dose of standard therapy within the preceding 4 weeks.
Use of and adherence to contraceptive methods by fertile-age patients of both sexes during the study.
Availability of a signed patient information sheet (Informed Consent form) for participation in the trial.
Exclusion Criteria:
Earlier diagnosis of intra- or extrathoracic causes of cough (e.g., asthma, malignant neoplasm of lung, tuberculosis, sarcoidosis, α1-antitrypsin deficiency, bronchiectasis, cystic fibrosis, interstitial pulmonary diseases, perennial allergic rhinitis, gastro-oesophageal reflux disease, use of ACE inhibitors, disease of upper respiratory tract, etc.).
Cough associated with eating.
An exacerbation of COPD, acute upper and/or lower respiratory infection at inclusion or in the previous 4 weeks.
Modifications to standard drug therapy (dose escalation, replacement of medicines prescribed or addition of new medications) in the previous 4 weeks.
Very severe degree of bronchial obstruction (post-bronchodilator FEV1 <30% pred or < 50% and chronic respiratory failure).
Haemoptysis.
Stroke in the preceding 3 months or stroke with long-term residual neurological deficit within 6 months before study entry.
Acute coronary syndrome, myocardial infarction within 6 months before study enrollment.
Unstable or life-threatening arrhythmia in the previous 3 months.
Acute or chronic heart failure (NYHA (1964) Class III or IV).
Presence or suspicion of oncological disease.
Body Mass Index (BMI) ≤18 kg/m2 or ≥40 kg/m2.
Chronic kidney disease (categories С3-5 А3).
Hepatic failure (Child-Pugh class C)
Exacerbation or decompensation of a chronic disease that would affect the patient's ability to participate in the clinical trial.
For smokers - intention to quit smoking in the next 4 weeks.
Allergy/intolerance to any of the components of medications used in the treatment.
Course intake of medicines listed in the section 'Prohibited concomitant treatment' for 4 weeks prior to the enrollment in the trial.
Participation in other clinical trials within 3 months prior to the enrollment in this study.
Patients who, from investigator's point of view, will fail to comply with the observation requirements of the trial or with the dosing regimen of the investigational drug.
Other conditions preventing the patient from normal participation (e.g., planned business or other trips).
Drug addiction, alcohol use in the amount over 2 units of alcohol a day, mental diseases.
Pregnancy, breast-feeding, unwillingness to use contraception during the study.
Patient is related to the research staff of the clinical investigative site who are directly involved in the trial or is the immediate family member of the investigator. The immediate family members include husband/wife, parents, children or brothers (or sisters), regardless of whether they are natural or adopted.
Patient works for MATERIA MEDICA HOLDING company (i.e., is the company's employee, temporary contract worker or appointed official responsible for carrying out the research or their immediate family).
Facility Information:
Facility Name
Regional state budgetary health care institution "Regional Clinical Hospital"
City
Barnaul
ZIP/Postal Code
656024
Country
Russian Federation
Facility Name
Regional state budget health care institution "City Hospital No. 5, Barnaul"
City
Barnaul
ZIP/Postal Code
656045
Country
Russian Federation
Facility Name
NUZ "Road Clinical Hospital at the station Chelyabinsk JSC" RZhD "
City
Chelyabinsk
ZIP/Postal Code
454000
Country
Russian Federation
Facility Name
The State Budget Health Institution "Regional Clinical Hospital No. 4"
City
Chelyabinsk
ZIP/Postal Code
454021
Country
Russian Federation
Facility Name
Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University"/Central City Clinical Hospital and Clinic #18
City
Kazan
ZIP/Postal Code
420012
Country
Russian Federation
Facility Name
Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University"/Professor's Clinic
City
Kazan
ZIP/Postal Code
420012
Country
Russian Federation
Facility Name
Pirogov Russian National Research Medical University
City
Moscow
ZIP/Postal Code
117997
Country
Russian Federation
Facility Name
State Budgetary Institution of Health Care of the Nizhny Novgorod Region "City Clinical Hospital No. 10"
City
Nizhny Novgorod
ZIP/Postal Code
603011
Country
Russian Federation
Facility Name
Ryazan State Medical University named after academician I.P. Pavlov
City
Ryazan
ZIP/Postal Code
390026
Country
Russian Federation
Facility Name
North-Western State Medical University named after I.I. Mechnikov
City
Saint Petersburg
ZIP/Postal Code
191015
Country
Russian Federation
Facility Name
North-western State Medical University named after I.I.Mechnikov
City
Saint Petersburg
ZIP/Postal Code
191015
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Public Health Institution "Vvedensky City Clinical Hospital"
City
Saint Petersburg
ZIP/Postal Code
191180
Country
Russian Federation
Facility Name
The Federal State Institute of Public Health 'The Nikiforov Russian Center of Emergency and Radiation Medicine'
City
Saint Petersburg
ZIP/Postal Code
194044
Country
Russian Federation
Facility Name
The First Pavlov State Medical University of St. Petersburg
City
Saint Petersburg
ZIP/Postal Code
197022
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Institution of Health "City Polyclinic No. 106"
City
Saint Petersburg
ZIP/Postal Code
198328
Country
Russian Federation
Facility Name
Samara City Hospital №4
City
Samara
ZIP/Postal Code
443056
Country
Russian Federation
Facility Name
St. Petersburg State Budgetary Institution "City Hospital No. 40 in the Kurortny District"
City
Sestroretsk
ZIP/Postal Code
197706
Country
Russian Federation
Facility Name
Voronezh Regional Clinical Hospital №1
City
Voronezh
ZIP/Postal Code
394066
Country
Russian Federation
12. IPD Sharing Statement
Citations:
PubMed Identifier
33981141
Citation
Avdeev SN, Vizel AA, Abrosimov VN, Zaicev AA, Ignatova GL, Khamitov RF, Mikhaylusova MP, Shapovalova JS, Pavlysh EF, Trofimov BI, Emelyanov AV, Martynenko TI, Martynenko VA, Kostina NE, Chizhov DA, Chizhova OY, Kuzubova NA, Makova EV, Makarova EV. Management of Cough in Patients with Chronic Obstructive Pulmonary Disease: Results of the Multicenter Randomized Placebo-Controlled Clinical Trial. Int J Chron Obstruct Pulmon Dis. 2021 May 5;16:1243-1253. doi: 10.2147/COPD.S292109. eCollection 2021.
Results Reference
derived
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Clinical Trial of Efficacy and Safety of Rengalin in the Treatment of Cough in Patients With Chronic Obstructive Pulmonary Disease
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