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2-arm Parallel Group Study of Fixed Combination of CHF 5993 vs Ultibro® in COPD Patients (TRIBUTE)

Primary Purpose

Chronic Obstructive Pulmonary Disease (COPD)

Status
Completed
Phase
Phase 3
Locations
Italy
Study Type
Interventional
Intervention
CHF 5993 + Ultibro matched placebo
Ultibro + CHF 5993 matched placebo
Central spirometry
COPD assessment test
Local laboratory Assessments
Saint George's Respiratory Questionnaire
EXACT-pro questionnaire
Sponsored by
Chiesi Farmaceutici S.p.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease (COPD) focused on measuring COPD, COPD Exacerbation, EXACT-PRO

Eligibility Criteria

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

Inclusion :

  1. Male and female ≥ 40 years
  2. Severe or very severe COPD diagnosed for at least 12 months
  3. Current smokers or ex-smokers who quit smoking at least 6 months prior to screening visit, with a smoking history of at least 10 pack years
  4. Post-bronchodilator FEV1 < 50% of the predicted normal value and a post-bronchodilator FEV1/FVC ratio < 0.7
  5. Documented history of at least one exacerbation in the 12 months
  6. Patient under double therapy for at least 2 months prior to screening. Double therapy will be defined by treatment with any of the following:

    Orally inhaled corticosteroid (ICS) and (long-acting beta2-agonist) LABA ICS and long-acting muscarinic antagonist (LAMA) Orally LABA and LAMA Monotherapy with LAMA for at least 2 months prior to screening

  7. Symptomatic patient at screening with a CAT score ≥ 10.
  8. Cooperative attitude and ability to use correctly the inhalers, the spacer AeroChamber Plus (only to patients who are using a spacer), the electronic devices with COPD questionnaire.

Exclusion :

  1. Pregnant or lactating women and all women physiologically capable of becoming pregnant UNLESS are willing to use one or more of the reliable methods of contraception
  2. Patient with a current clinical diagnosis of asthma with a physician-judged need for inhaled or oral corticosteroid therapy
  3. Patient requiring use of the following medications:

    Course of systemic steroids > 3 days for COPD exacerbation in the 4 weeks prior to screening Course of antibiotics for COPD exacerbation > 7 days in the 4 weeks prior to screening Phosphodiesterase-4 inhibitor in the 4 weeks prior to screening Use of antibiotics for a lower respiratory tract infection in the 4 weeks prior to screening

  4. COPD exacerbation requiring prescription of systemic corticosteroids and/or antibiotics or hospitalization during the run-in period
  5. Patient treated with non-cardioselective β-blockers in the month preceding the screening or during the run-in period.
  6. Patient treated with long-acting antihistamines unless taken at stable regimen at least 2 months prior to screening and to be maintained constant during the study or if taken as needed
  7. Patient requiring long term (at least 12 hours daily) oxygen therapy for chronic hypoxemia
  8. Known respiratory disorders other than COPD which may impact the efficacy of the study drug
  9. Patient who have clinically significant cardiovascular condition
  10. Patient with atrial fibrillation (AF): Paroxysmal atrial fibrillation, Persistent, Long standing or Permanent
  11. Abnormal and clinically significant 12-lead ECG that results in active medical problem which may impact the safety of the patient
  12. Patient whose ECG shows QTcF >450 ms for males or QTcF >470 ms for females at screening visit are not eligible (not applicable for patient with pacemaker)
  13. Medical diagnosis of narrow-angle glaucoma, clinically relevant prostatic hypertrophy or bladder neck obstruction would prevent use of anticholinergic agents
  14. History of hypersensitivity to M3 Antagonists, β2-agonist, corticosteroids or any of the excipients contained in any of the formulations used in the trial which may raise contra-indications or impact the efficacy of the study drug
  15. Clinically significant laboratory abnormalities indicating a significant or unstable concomitant disease which may impact the efficacy or the safety of the study drug
  16. Patients with hypokalaemia (serum potassium <3.5 mEq/L or 3.5 mmol/L) or uncontrolled hyperkalaemia
  17. Unstable concurrent disease which may impact the results of the study
  18. Patients with any history of malignancy likely to result in significant disability or likely to require significant medical or surgical intervention within the next six months (after V1) or with malignancy for which they are currently undergoing radiation therapy or chemotherapy
  19. History of alcohol abuse or substance/drug abuse within 12 months prior to screening visit
  20. Participation in another clinical trial if investigational drug was received less than 8 weeks prior to screening visit

Sites / Locations

  • Chiesi Farmaceutici S.p.A.

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CHF 5993 + Ultibro matched placebo

Ultibro + CHF 5993 matched placebo

Arm Description

Fixed triple therapy with BDP/FF/GB 100/6/12.5 mcg (CHF 5993) administered 2 puffs twice daily via pMDI + Fixed combination of indacaterol and of glycopyrronium (Ultibro® Breezhaler®) matched placebo administered once daily via DPI for 52-week treatment. Patient used to take pMDI medication using a spacer will be provided with a new spacer for the study. 7 study visits including : central spirometry tests, Local laboratory, COPD assessment test (visit 1 only), Local laboratory Assessments Saint George's Respiratory Questionnaire EXACT-pro questionnaire

Fixed combination of indacaterol 85 mcg and of glycopyrronium 43 mcg (Ultibro® Breezhaler®) administered once daily via DPI + Fixed triple therapy with BDP/FF/GB (CHF 5993) matched placebo administered 2 puffs twice daily via pMDI for 52-week treatment. Patient used to take pMDI medication using a spacer will be provided with a new spacer for the study. 7 study visits including : central spirometry tests, Local laboratory, COPD assessment test (visit 1 only), Local laboratory Assessments, Saint George's Respiratory Questionnaire, EXACT-pro questionnaire

Outcomes

Primary Outcome Measures

Moderate and severe COPD exacerbation rate over 52 weeks of treatment
Exacerbations will be evaluated at each study visit and collected using EXACT-PRO filled-in by patient every day throughout the study

Secondary Outcome Measures

Time to first moderate to severe COPD exacerbation
Rate of severe COPD exacerbation over 52 weeks of treatment
Rate of moderate COPD exacerbation over 52 weeks of treatment
Change from Baseline at each visit and over the entire treatment period in pre-dose morning FEV1

Full Information

First Posted
May 12, 2015
Last Updated
October 28, 2021
Sponsor
Chiesi Farmaceutici S.p.A.
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1. Study Identification

Unique Protocol Identification Number
NCT02579850
Brief Title
2-arm Parallel Group Study of Fixed Combination of CHF 5993 vs Ultibro® in COPD Patients
Acronym
TRIBUTE
Official Title
52-week, Double Blind, Randomized, 2 Active Parallel Arms Study of Fixed Combination CHF 5993 Administered vs Ultibro® in COPD Patients
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
May 29, 2015 (Actual)
Primary Completion Date
July 10, 2017 (Actual)
Study Completion Date
July 10, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chiesi Farmaceutici S.p.A.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The aim of the present study is to evaluate the superiority of the fixed triple therapy with BDP/FF/GB at a daily dose of 400/24/50 mcg respectively with that of Ultibro® Breezhaler® (DPI), fixed combination of indacaterol 85 mcg and of glycopyrronium 43 mcg in COPD patients.
Detailed Description
Outpatients attending the hospital clinics/study centres will be recruited. Patients with severe and very severe COPD airflow obstruction according to GOLD 2014 criteria. A total of approximately 2192 patients will need to be screened in order to obtain 1534 (767 per arm) randomized and evaluable patients. Approximately 200 sites will be involved worldwide. Each patient will perform a total of 8 clinic visits (V0 to V7) during the study. The Primary objective is to demonstrate the superiority of CHF 5993 pMDI over Ultibro® in terms of moderate and severe COPD exacerbation rate over 52 weeks of treatment. The Secondary objectives are: To evaluate the effect of CHF 5993 pMDI on other lung function parameters, patient's health status and clinical outcome measures; To assess the safety and the tolerability of the study treatments. A 2-week open-label run-in period under Ultibro® followed by a 52-week randomised treatment period. The trial design will be optimised to measure exacerbation rates by using the Exacerbations of Chronic Pulmonary Disease Tool (EXACT), developed means of collecting patient-reported outcome (PRO) data, which helps to capture the frequency of exacerbations.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease (COPD)
Keywords
COPD, COPD Exacerbation, EXACT-PRO

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
1532 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CHF 5993 + Ultibro matched placebo
Arm Type
Experimental
Arm Description
Fixed triple therapy with BDP/FF/GB 100/6/12.5 mcg (CHF 5993) administered 2 puffs twice daily via pMDI + Fixed combination of indacaterol and of glycopyrronium (Ultibro® Breezhaler®) matched placebo administered once daily via DPI for 52-week treatment. Patient used to take pMDI medication using a spacer will be provided with a new spacer for the study. 7 study visits including : central spirometry tests, Local laboratory, COPD assessment test (visit 1 only), Local laboratory Assessments Saint George's Respiratory Questionnaire EXACT-pro questionnaire
Arm Title
Ultibro + CHF 5993 matched placebo
Arm Type
Active Comparator
Arm Description
Fixed combination of indacaterol 85 mcg and of glycopyrronium 43 mcg (Ultibro® Breezhaler®) administered once daily via DPI + Fixed triple therapy with BDP/FF/GB (CHF 5993) matched placebo administered 2 puffs twice daily via pMDI for 52-week treatment. Patient used to take pMDI medication using a spacer will be provided with a new spacer for the study. 7 study visits including : central spirometry tests, Local laboratory, COPD assessment test (visit 1 only), Local laboratory Assessments, Saint George's Respiratory Questionnaire, EXACT-pro questionnaire
Intervention Type
Drug
Intervention Name(s)
CHF 5993 + Ultibro matched placebo
Other Intervention Name(s)
CHF 5993
Intervention Description
Active medication treatment CHF 5993 and Ultibro matched placebo administered twice a day
Intervention Type
Drug
Intervention Name(s)
Ultibro + CHF 5993 matched placebo
Other Intervention Name(s)
Ultibro Breezhaler
Intervention Description
Active medication treatment Ultibro and CHF 5993 matched placebo administered twice a day
Intervention Type
Procedure
Intervention Name(s)
Central spirometry
Intervention Description
Central spirometry to assess forced expiratory volume at one second and forced vital capacity
Intervention Type
Other
Intervention Name(s)
COPD assessment test
Intervention Description
COPD assessment test (CAT) at visit 1
Intervention Type
Procedure
Intervention Name(s)
Local laboratory Assessments
Intervention Description
ECG + Standard Haematology and Biochemistry
Intervention Type
Other
Intervention Name(s)
Saint George's Respiratory Questionnaire
Intervention Description
Saint George's Respiratory Questionnaire
Intervention Type
Other
Intervention Name(s)
EXACT-pro questionnaire
Intervention Description
daily from randomization (Visit 2) to end of study (Visit 7)
Primary Outcome Measure Information:
Title
Moderate and severe COPD exacerbation rate over 52 weeks of treatment
Description
Exacerbations will be evaluated at each study visit and collected using EXACT-PRO filled-in by patient every day throughout the study
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Time to first moderate to severe COPD exacerbation
Time Frame
1 year
Title
Rate of severe COPD exacerbation over 52 weeks of treatment
Time Frame
1 year
Title
Rate of moderate COPD exacerbation over 52 weeks of treatment
Time Frame
1 year
Title
Change from Baseline at each visit and over the entire treatment period in pre-dose morning FEV1
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion : Male and female ≥ 40 years Severe or very severe COPD diagnosed for at least 12 months Current smokers or ex-smokers who quit smoking at least 6 months prior to screening visit, with a smoking history of at least 10 pack years Post-bronchodilator FEV1 < 50% of the predicted normal value and a post-bronchodilator FEV1/FVC ratio < 0.7 Documented history of at least one exacerbation in the 12 months Patient under double therapy for at least 2 months prior to screening. Double therapy will be defined by treatment with any of the following: Orally inhaled corticosteroid (ICS) and (long-acting beta2-agonist) LABA ICS and long-acting muscarinic antagonist (LAMA) Orally LABA and LAMA Monotherapy with LAMA for at least 2 months prior to screening Symptomatic patient at screening with a CAT score ≥ 10. Cooperative attitude and ability to use correctly the inhalers, the spacer AeroChamber Plus (only to patients who are using a spacer), the electronic devices with COPD questionnaire. Exclusion : Pregnant or lactating women and all women physiologically capable of becoming pregnant UNLESS are willing to use one or more of the reliable methods of contraception Patient with a current clinical diagnosis of asthma with a physician-judged need for inhaled or oral corticosteroid therapy Patient requiring use of the following medications: Course of systemic steroids > 3 days for COPD exacerbation in the 4 weeks prior to screening Course of antibiotics for COPD exacerbation > 7 days in the 4 weeks prior to screening Phosphodiesterase-4 inhibitor in the 4 weeks prior to screening Use of antibiotics for a lower respiratory tract infection in the 4 weeks prior to screening COPD exacerbation requiring prescription of systemic corticosteroids and/or antibiotics or hospitalization during the run-in period Patient treated with non-cardioselective β-blockers in the month preceding the screening or during the run-in period. Patient treated with long-acting antihistamines unless taken at stable regimen at least 2 months prior to screening and to be maintained constant during the study or if taken as needed Patient requiring long term (at least 12 hours daily) oxygen therapy for chronic hypoxemia Known respiratory disorders other than COPD which may impact the efficacy of the study drug Patient who have clinically significant cardiovascular condition Patient with atrial fibrillation (AF): Paroxysmal atrial fibrillation, Persistent, Long standing or Permanent Abnormal and clinically significant 12-lead ECG that results in active medical problem which may impact the safety of the patient Patient whose ECG shows QTcF >450 ms for males or QTcF >470 ms for females at screening visit are not eligible (not applicable for patient with pacemaker) Medical diagnosis of narrow-angle glaucoma, clinically relevant prostatic hypertrophy or bladder neck obstruction would prevent use of anticholinergic agents History of hypersensitivity to M3 Antagonists, β2-agonist, corticosteroids or any of the excipients contained in any of the formulations used in the trial which may raise contra-indications or impact the efficacy of the study drug Clinically significant laboratory abnormalities indicating a significant or unstable concomitant disease which may impact the efficacy or the safety of the study drug Patients with hypokalaemia (serum potassium <3.5 mEq/L or 3.5 mmol/L) or uncontrolled hyperkalaemia Unstable concurrent disease which may impact the results of the study Patients with any history of malignancy likely to result in significant disability or likely to require significant medical or surgical intervention within the next six months (after V1) or with malignancy for which they are currently undergoing radiation therapy or chemotherapy History of alcohol abuse or substance/drug abuse within 12 months prior to screening visit Participation in another clinical trial if investigational drug was received less than 8 weeks prior to screening visit
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mario Scuri, MD
Organizational Affiliation
Chiesi Farmaceutici S.p.A.
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Nicolas Roche, Pr
Organizational Affiliation
Hopitaux Universitaires Paris Centre - Groupe Hospitalier Cochin
Official's Role
Principal Investigator
Facility Information:
Facility Name
Chiesi Farmaceutici S.p.A.
City
Parma
ZIP/Postal Code
43123
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Chiesi commits to sharing with qualified scientific and medical Researchers, conducting legitimate research, Patient-level Data, Study-level Data, the Clinical Protocol and the full CSR, providing access to clinical trial information consistently with the principle of safeguarding commercially confidential information and patient privacy. Any shared Patient-level Data is anonymized to protect personally identifiable information. Chiesi access criteria and complete process for clinical data sharing is available on the Chiesi Group website.
IPD Sharing Access Criteria
Chiesi access criteria and complete process for clinical data sharing is available on the Chiesi Group website.
IPD Sharing URL
https://www.chiesi.com/en/chiesi-clinical-trial-data-request-portal/
Citations:
PubMed Identifier
30587953
Citation
Vanfleteren L, Fabbri LM, Papi A, Petruzzelli S, Celli B. Triple therapy (ICS/LABA/LAMA) in COPD: time for a reappraisal. Int J Chron Obstruct Pulmon Dis. 2018 Dec 12;13:3971-3981. doi: 10.2147/COPD.S185975. eCollection 2018.
Results Reference
background
PubMed Identifier
30880943
Citation
Singh D, Fabbri LM, Vezzoli S, Petruzzelli S, Papi A. Extrafine triple therapy delays COPD clinically important deterioration vs ICS/LABA, LAMA, or LABA/LAMA. Int J Chron Obstruct Pulmon Dis. 2019 Feb 28;14:531-546. doi: 10.2147/COPD.S196383. eCollection 2019.
Results Reference
background
PubMed Identifier
30792343
Citation
Singh D, Fabbri LM, Corradi M, Georges G, Guasconi A, Vezzoli S, Petruzzelli S, Papi A. Extrafine triple therapy in patients with symptomatic COPD and history of one moderate exacerbation. Eur Respir J. 2019 May 18;53(5):1900235. doi: 10.1183/13993003.00235-2019. Print 2019 May.
Results Reference
background
PubMed Identifier
31000665
Citation
Papi A, Petruzzelli S, Vezzoli S, Georges G, Fabbri LM. Triple therapy for all patients with severe symptomatic COPD at risk of exacerbations. Eur Respir J. 2019 Apr 18;53(4):1900147. doi: 10.1183/13993003.00147-2019. Print 2019 Apr. No abstract available.
Results Reference
background
PubMed Identifier
29429593
Citation
Papi A, Vestbo J, Fabbri L, Corradi M, Prunier H, Cohuet G, Guasconi A, Montagna I, Vezzoli S, Petruzzelli S, Scuri M, Roche N, Singh D. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet. 2018 Mar 17;391(10125):1076-1084. doi: 10.1016/S0140-6736(18)30206-X. Epub 2018 Feb 9. Erratum In: Lancet. 2018 Feb 26;:
Results Reference
result
Links:
URL
https://www.clinicaltrialsregister.eu/ctr-search/trial/2014-001704-22/results
Description
Study Record on EU Clinical Trials Register including results
URL
https://www.chiesi.com/clinic/33_CSR_Synopsis_CCD-05993AA1-08.pdf
Description
CSR Synopsis available in the CHIESI Clinical Study Register

Learn more about this trial

2-arm Parallel Group Study of Fixed Combination of CHF 5993 vs Ultibro® in COPD Patients

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