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Study to Assess the Lung Exposure Bioequivalence of Budesonide, Glycopyrronium, and Formoterol Delivered by BGF MDI HFO Compared With BGF MDI HFA

Primary Purpose

Chronic Obstructive Pulmonary Disease

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Treatment A (BGF MDI HFO with oral activated charcoal)
Treatment B (BGF MDI HFA with oral activated charcoal)
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease focused on measuring Corticosteroid, Long acting muscarine agonist (LAMA), Long acting beta agonist, Propellant, Bioequivalence, Lung exposure, Healthy subjects, Inhaled corticosteroid (ICS), Long-acting β2 agonist (LABA), Next generation propellant (NGP)

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy non-smoking male and/or female subjects aged 18 - 60 years with suitable veins for cannulation or repeated venipuncture.
  • Females must have a negative pregnancy test at screening and on admission to the unit, must not be lactating, confirmed at screening.
  • Have a Body Mass Index (BMI) between 18 and 35 kg/m2 inclusive and weigh at least 50 kg and no more than 120 kg inclusive.
  • Subjects must have a Forced expiratory volume in the first second (FEV1) ≥ 80% of the predicted normal value and an FEV1/FVC (Forced vital capacity) > 70% regarding age, height, and ethnicity at the screening visit.
  • Subjects must demonstrate proper inhalation technique and have the ability to properly use an MDI device after training.
  • Provision of signed and dated, written informed consent prior to any study specific procedures.

Exclusion Criteria:

  • History of any clinically significant disease or disorder which, in the opinion of the investigator, may either put the volunteer at risk because of participation in the study, or influence the results or the volunteer's ability to participate.
  • History or presence of gastrointestinal, hepatic or renal disease, or any other condition known to interfere with absorption, distribution, metabolism, or excretion of drugs.
  • Any clinically significant illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of Investigational Medicinal Product (IMP).
  • History of narrow angle glaucoma not adequately treated and/or change in vision that may be relevant.
  • History of symptomatic prostatic hypertrophy or bladder neck obstruction/urinary retention.
  • Unresectable cancer that has not been in complete remission for at least 5 years.
  • Any clinically significant abnormalities in clinical chemistry, hematology, or urinalysis results.
  • Any clinically significant abnormal findings in physical examination, or vital signs at screening.
  • Any clinically significant abnormalities on 12-lead electrocardiogram (ECG) at screening.
  • Any positive result on screening for serum hepatitis B surface antigen, hepatitis C antibody, and HIV antibody.
  • Subject has a positive RT-PCR test for SARS-CoV-2 prior to randomization.
  • Subject has clinical signs and symptoms consistent with SARS-CoV-2 infection, eg, fever, dry cough, dyspnea, sore throat, fatigue, or laboratory confirmed acute infection with SARS-CoV-2.
  • Subject who had severe course of COVID-19 (extracorporeal membrane oxygenation, mechanically ventilated, Intensive Care Unit stay).
  • Recent (within 14 days prior to admission to the Clinical Unit) exposure to someone who has COVID-19 symptoms or tested positive for SARS-CoV-2.
  • Has a current occupation that involves routine exposure to potential COVID-19 patients or sources of SARS-CoV-2 infection (eg, healthcare worker).
  • History of any respiratory disorders such as asthma, COPD, or idiopathic pulmonary fibrosis.
  • Known or suspected history of drug abuse.
  • Receipt of any investigational drug within 30 days or 5 half-lives (whichever is longer) prior to randomization
  • Plasma donation within 1 month of screening or any blood donation/loss more than 500 mL during the 3 months prior to screening.
  • History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity or history of hypersensitivity to drugs with a similar chemical structure or class to BGF.
  • Current smokers or those who have smoked or used nicotine products (including e cigarettes) within 3 months prior to screening.
  • Positive screen for drugs of abuse or cotinine at screening or on admission to the Clinical Unit or positive screen for alcohol on admission to the Clinical Unit.
  • Use of drugs with enzyme-inducing properties such as St John's Wort within 3 weeks prior to the first administration of IMP.
  • Use of any prescribed or non prescribed medication including antacids, analgesics (other than paracetamol/acetaminophen), herbal remedies, megadose vitamins and minerals during the 2 weeks prior to the first administration of IMP.
  • Known or suspected history of alcohol or drug abuse or excessive intake of alcohol.
  • Excessive intake of caffeine-containing drinks or food. Excessive intake of caffeine defined as the regular consumption of more than 600 mg of caffeine per day or would likely be unable to refrain from the use of caffeine-containing beverages during confinement.
  • Subjects who have previously received BGF MDI HFO.

Sites / Locations

  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Treatment A: BGF MDI HFO 160/7.2/4.8 μg ex-actuator with oral activated charcoal

Treatment B: BGF MDI HFA 160/7.2/4.8 μg ex-actuator with oral activated charcoal

Arm Description

Subjects will receive Test formulation in 1 of 3 possible treatment sequences: ABB, BAB, or BBA. The reference formulation will be administered during 2 of the 3 treatment periods in order to estimate intra-subject variability.

Subjects will receive Reference formulation in 1 of 3 possible treatment sequences: ABB, BAB, or BBA. The reference formulation will be administered during 2 of the 3 treatment periods in order to estimate intra-subject variability.

Outcomes

Primary Outcome Measures

Maximum observed plasma (peak) drug concentration (Cmax )
To assess the bioequivalence (Cmax) of the lung exposure of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO compared with BGF MDI HFA.
Area under plasma concentration time curve from zero to infinity (AUCinf)
To assess the bioequivalence (AUCinf) of the lung exposure of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO compared with BGF MDI HFA.
Area under the plasma concentration curve from zero to the last quantifiable concentration (AUClast)
To assess the bioequivalence (AUClast) of the lung exposure of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO compared with BGF MDI HFA.

Secondary Outcome Measures

Time to reach peak or maximum observed concentration or response following drug administration (tmax)
To characterize the PK profiles (tmax) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Half life associated with terminal slope (λz) of a semi logarithmic concentration time curve (t½λz)
To characterize the PK profiles (t½λz) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Terminal rate constant, estimated by log linear least squares regression of the terminal part of the concentration time curve (λz)
To characterize the PK profiles (λz) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Mean residence time of the unchanged drug in the systemic circulation from zero to infinity (MRTinf)
To characterize the PK profiles (MRTinf) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Apparent total body clearance of drug from plasma after extravascular administration (CL/F)
To characterize the PK profiles (CL/F) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Volume of distribution (apparent) at steady state following extravascular administration (based on terminal phase) (Vz/F)
To characterize the PK profiles (Vz/F) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Number of subjects with serious adverse events (SAE) and non-serious adverse events
To assess the safety and tolerability of single doses of BGF MDI HFO and BGF MDI HFA with oral activated charcoal in healthy subjects.
Percentage of subjects with potentially clinically significant changes in laboratory values
To evaluate the percentage of subjects with clinically significant changes in Laboratory assessments (hematology, clinical chemistry, urinalysis).
Percentage of subjects with abnormality in Physical examination
To assess the percentage of subjects with abnormality in full physical exams.
Percentage of subjects with potentially clinically significant changes in ECGs
To evaluate the percentage of subjects with potentially clinically significant changes in 12-lead ECG recordings.
Percentage of subjects with potentially clinically significant changes in Blood pressure
To evaluate the percentage of subjects with potentially clinically significant changes in systolic, diastolic Blood pressure.
Percentage of subjects with potentially clinically significant changes in pulse rate
To evaluate the percentage of subjects with potentially clinically significant changes in pulse rate.
Percentage of subjects with potentially clinically significant changes in body temperature
To evaluate the percentage of subjects with potentially clinically significant changes in body temperature.
Percentage of subjects with potentially clinically significant changes in respiratory rate
To evaluate the percentage of subjects with potentially clinically significant changes in respiratory rate

Full Information

First Posted
July 26, 2022
Last Updated
May 9, 2023
Sponsor
AstraZeneca
Collaborators
Parexel
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1. Study Identification

Unique Protocol Identification Number
NCT05477108
Brief Title
Study to Assess the Lung Exposure Bioequivalence of Budesonide, Glycopyrronium, and Formoterol Delivered by BGF MDI HFO Compared With BGF MDI HFA
Official Title
A Phase I, Randomized, Double-blind, Single-dose, Partial Replicate, 3-way Cross-over Study to Assess the Lung Exposure Bioequivalence of Budesonide, Glycopyrronium, and Formoterol Delivered by BGF MDI HFO Compared With BGF MDI HFA
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
July 29, 2022 (Actual)
Primary Completion Date
April 11, 2023 (Actual)
Study Completion Date
April 11, 2023 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The study will assess the Pharmacokinetic (PK) and safety of BGF MDI [Budesonide/glycopyrronium/formoterol (BGF) metered dose inhaler (MDI)] formulated with 2 different propellants :Hydrofluoroolefin (HFO) and Hydrofluoroalkane (HFA) with oral activated charcoal in healthy subjects (male or female).
Detailed Description
This is a Phase I, randomized, double-blind, single-dose, single-center, partial-replicate, 3 way cross-over study. The study will comprise: Screening period: up to 28 days prior to first dosing; Three treatment periods : Subject will be resident in the Clinical Unit from the morning on the day before dosing with BGF MDI (Day 1 of Treatment Period 1), until 24 hours following the final dose (Day 2 of Treatment Period 3 a washout period of 3 to 7 days between each dose; Follow-up: Within 3 to 7 days after the last administration of BGF MDI. Subjects will receive 3 single-dose treatments of BGF MDI [Test formulation Treatment A (BGF MDI HFO); Reference formulation Treatment B (BGF MDI HFA)] on Day 1 of each Treatment Period (1, 2, and 3) following an overnight fast of at least 8 hours. There will be a washout period of 3 to 7 days between each dose. Each subjects will be involved in the study for up to 55 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease
Keywords
Corticosteroid, Long acting muscarine agonist (LAMA), Long acting beta agonist, Propellant, Bioequivalence, Lung exposure, Healthy subjects, Inhaled corticosteroid (ICS), Long-acting β2 agonist (LABA), Next generation propellant (NGP)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
108 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment A: BGF MDI HFO 160/7.2/4.8 μg ex-actuator with oral activated charcoal
Arm Type
Experimental
Arm Description
Subjects will receive Test formulation in 1 of 3 possible treatment sequences: ABB, BAB, or BBA. The reference formulation will be administered during 2 of the 3 treatment periods in order to estimate intra-subject variability.
Arm Title
Treatment B: BGF MDI HFA 160/7.2/4.8 μg ex-actuator with oral activated charcoal
Arm Type
Experimental
Arm Description
Subjects will receive Reference formulation in 1 of 3 possible treatment sequences: ABB, BAB, or BBA. The reference formulation will be administered during 2 of the 3 treatment periods in order to estimate intra-subject variability.
Intervention Type
Drug
Intervention Name(s)
Treatment A (BGF MDI HFO with oral activated charcoal)
Other Intervention Name(s)
Budesonide / Glycopyronium / Formoterol fumarate pressurized inhalation suspension, HFO
Intervention Description
Subject will receive 4 inhalations as a single dose with oral activated charcoal - test formulation; administered during 1 Treatment Period.
Intervention Type
Drug
Intervention Name(s)
Treatment B (BGF MDI HFA with oral activated charcoal)
Other Intervention Name(s)
Budesonide / Glycopyronium / Formoterol fumarate pressurized inhalation suspension, HFA
Intervention Description
Subject will received 4 inhalations as a single dose with oral activated charcoal - reference formulation; administered during 2 Treatment Periods.
Primary Outcome Measure Information:
Title
Maximum observed plasma (peak) drug concentration (Cmax )
Description
To assess the bioequivalence (Cmax) of the lung exposure of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO compared with BGF MDI HFA.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Area under plasma concentration time curve from zero to infinity (AUCinf)
Description
To assess the bioequivalence (AUCinf) of the lung exposure of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO compared with BGF MDI HFA.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Area under the plasma concentration curve from zero to the last quantifiable concentration (AUClast)
Description
To assess the bioequivalence (AUClast) of the lung exposure of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO compared with BGF MDI HFA.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Secondary Outcome Measure Information:
Title
Time to reach peak or maximum observed concentration or response following drug administration (tmax)
Description
To characterize the PK profiles (tmax) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Half life associated with terminal slope (λz) of a semi logarithmic concentration time curve (t½λz)
Description
To characterize the PK profiles (t½λz) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Terminal rate constant, estimated by log linear least squares regression of the terminal part of the concentration time curve (λz)
Description
To characterize the PK profiles (λz) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Mean residence time of the unchanged drug in the systemic circulation from zero to infinity (MRTinf)
Description
To characterize the PK profiles (MRTinf) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Apparent total body clearance of drug from plasma after extravascular administration (CL/F)
Description
To characterize the PK profiles (CL/F) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Volume of distribution (apparent) at steady state following extravascular administration (based on terminal phase) (Vz/F)
Description
To characterize the PK profiles (Vz/F) of budesonide, glycopyrronium, and formoterol administered as BGF MDI HFO and BGF MDI HFA with oral activated charcoal.
Time Frame
Day 1 and Day 2 of each treatment period (each treatment period is of 2 days)
Title
Number of subjects with serious adverse events (SAE) and non-serious adverse events
Description
To assess the safety and tolerability of single doses of BGF MDI HFO and BGF MDI HFA with oral activated charcoal in healthy subjects.
Time Frame
SAE: Screening (up to 28 days); AE: Screening, Day 1 and Day 2 until Follow-up visit (approximately 3 to 7 days post final dose) [approximately 55 days]
Title
Percentage of subjects with potentially clinically significant changes in laboratory values
Description
To evaluate the percentage of subjects with clinically significant changes in Laboratory assessments (hematology, clinical chemistry, urinalysis).
Time Frame
Up to 55 days
Title
Percentage of subjects with abnormality in Physical examination
Description
To assess the percentage of subjects with abnormality in full physical exams.
Time Frame
Up to 55 days
Title
Percentage of subjects with potentially clinically significant changes in ECGs
Description
To evaluate the percentage of subjects with potentially clinically significant changes in 12-lead ECG recordings.
Time Frame
Up to 55 days
Title
Percentage of subjects with potentially clinically significant changes in Blood pressure
Description
To evaluate the percentage of subjects with potentially clinically significant changes in systolic, diastolic Blood pressure.
Time Frame
Up to 55 days
Title
Percentage of subjects with potentially clinically significant changes in pulse rate
Description
To evaluate the percentage of subjects with potentially clinically significant changes in pulse rate.
Time Frame
Up to 55 days
Title
Percentage of subjects with potentially clinically significant changes in body temperature
Description
To evaluate the percentage of subjects with potentially clinically significant changes in body temperature.
Time Frame
Up to 55 days
Title
Percentage of subjects with potentially clinically significant changes in respiratory rate
Description
To evaluate the percentage of subjects with potentially clinically significant changes in respiratory rate
Time Frame
Up to 55 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy non-smoking male and/or female subjects aged 18 - 60 years with suitable veins for cannulation or repeated venipuncture. Females must have a negative pregnancy test at screening and on admission to the unit, must not be lactating, confirmed at screening. Have a Body Mass Index (BMI) between 18 and 35 kg/m2 inclusive and weigh at least 50 kg and no more than 120 kg inclusive. Subjects must have a Forced expiratory volume in the first second (FEV1) ≥ 80% of the predicted normal value and an FEV1/FVC (Forced vital capacity) > 70% regarding age, height, and ethnicity at the screening visit. Subjects must demonstrate proper inhalation technique and have the ability to properly use an MDI device after training. Provision of signed and dated, written informed consent prior to any study specific procedures. Exclusion Criteria: History of any clinically significant disease or disorder which, in the opinion of the investigator, may either put the volunteer at risk because of participation in the study, or influence the results or the volunteer's ability to participate. History or presence of gastrointestinal, hepatic or renal disease, or any other condition known to interfere with absorption, distribution, metabolism, or excretion of drugs. Any clinically significant illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of Investigational Medicinal Product (IMP). History of narrow angle glaucoma not adequately treated and/or change in vision that may be relevant. History of symptomatic prostatic hypertrophy or bladder neck obstruction/urinary retention. Unresectable cancer that has not been in complete remission for at least 5 years. Any clinically significant abnormalities in clinical chemistry, hematology, or urinalysis results. Any clinically significant abnormal findings in physical examination, or vital signs at screening. Any clinically significant abnormalities on 12-lead electrocardiogram (ECG) at screening. Any positive result on screening for serum hepatitis B surface antigen, hepatitis C antibody, and HIV antibody. Subject has a positive RT-PCR test for SARS-CoV-2 prior to randomization. Subject has clinical signs and symptoms consistent with SARS-CoV-2 infection, eg, fever, dry cough, dyspnea, sore throat, fatigue, or laboratory confirmed acute infection with SARS-CoV-2. Subject who had severe course of COVID-19 (extracorporeal membrane oxygenation, mechanically ventilated, Intensive Care Unit stay). Recent (within 14 days prior to admission to the Clinical Unit) exposure to someone who has COVID-19 symptoms or tested positive for SARS-CoV-2. Has a current occupation that involves routine exposure to potential COVID-19 patients or sources of SARS-CoV-2 infection (eg, healthcare worker). History of any respiratory disorders such as asthma, COPD, or idiopathic pulmonary fibrosis. Known or suspected history of drug abuse. Receipt of any investigational drug within 30 days or 5 half-lives (whichever is longer) prior to randomization Plasma donation within 1 month of screening or any blood donation/loss more than 500 mL during the 3 months prior to screening. History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity or history of hypersensitivity to drugs with a similar chemical structure or class to BGF. Current smokers or those who have smoked or used nicotine products (including e cigarettes) within 3 months prior to screening. Positive screen for drugs of abuse or cotinine at screening or on admission to the Clinical Unit or positive screen for alcohol on admission to the Clinical Unit. Use of drugs with enzyme-inducing properties such as St John's Wort within 3 weeks prior to the first administration of IMP. Use of any prescribed or non prescribed medication including antacids, analgesics (other than paracetamol/acetaminophen), herbal remedies, megadose vitamins and minerals during the 2 weeks prior to the first administration of IMP. Known or suspected history of alcohol or drug abuse or excessive intake of alcohol. Excessive intake of caffeine-containing drinks or food. Excessive intake of caffeine defined as the regular consumption of more than 600 mg of caffeine per day or would likely be unable to refrain from the use of caffeine-containing beverages during confinement. Subjects who have previously received BGF MDI HFO.
Facility Information:
Facility Name
Research Site
City
Brooklyn
State/Province
Maryland
ZIP/Postal Code
21225
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Qualified researchers can request access to anonymized individual patient-level data from AstraZeneca group of companies sponsored clinical trials via the request portal. All request will be evaluated as per the AZ disclosure commitment: https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Yes, indicates that AZ are accepting requests for IPD, but this does not mean all requests will be shared.
IPD Sharing Time Frame
AstraZeneca will meet or exceed data availability as per the commitments made to the EFPIA Pharma Data Sharing Principles. For details of our timelines, please rerefer to our disclosure commitment at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing Access Criteria
When a request has been approved AstraZeneca will provide access to the deidentified individual patient-level data in an approved sponsored tool . Signed Data Sharing Agreement (non-negotiable contract for data accessors) must be in place before accessing requested information. Additionally, all users will need to accept the terms and conditions of the SAS MSE to gain access. For additional details, please review the Disclosure Statements at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure.
IPD Sharing URL
https://astrazenecagroup-dt.pharmacm.com/DT/Home

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Study to Assess the Lung Exposure Bioequivalence of Budesonide, Glycopyrronium, and Formoterol Delivered by BGF MDI HFO Compared With BGF MDI HFA

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