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Assessment of the Safety and Ability of a Once-a-day Dose of an Orally Inhaled Medicine [i.e., Glycopyrrolate Inhalation Solution = GIS] to Improve Airflow in the Lungs When Delivered Using an eFlow Nebulizer in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Primary Purpose

Chronic Obstructive Pulmonary Disease

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Glycopyrrolate Inhalation Solution12.5μg
Glycopyrrolate Inhalation Solution 50μg
Glycopyrrolate Inhalation Solution 100μg
Glycopyrrolate Inhalation Solution 200μg
Glycopyrrolate Inhalation Solution 400μg
Placebo 0.5mL
Sponsored by
Sunovion Respiratory Development Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

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

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)Does not accept healthy volunteers

Inclusion Criteria:

  1. Male and female patients aged 40 through 75 years, inclusive
  2. A clinical diagnosis of COPD according to the GOLD guidelines
  3. Current smokers or ex-smokers with at least 10 pack-year smoking history (e.g., at least 1 pack/day for 10
  4. Post-bronchodilator FEV1 30-70% of predicted normal at the Screening Visit
  5. Post-bronchodilator FEV1/FVC ratio < 0.70 at the Screening Visit
  6. Improvement in FEV1 >12% and 150 mL following inhalation of ipratropium bromide at the Screening Visit
  7. Ability to perform reproducible spirometry according to the ATS/ERS guidelines
  8. Willing to stay at the study site for approximately 30 hours on each treatment visit
  9. Willing and able to provide written informed consent

Exclusion Criteria:

  1. Females who are pregnant or lactating at the Screening Visit, or if of childbearing potential not using one of the following acceptable means of birth control throughout the study:

    • Abstinence
    • Post-menopausal for at least two years
    • Surgically sterile (i.e., tubal ligation, hysterectomy)
    • Oral contraceptives (taken for at least one month prior to the Screening Visit)
    • Approved implantable or injectable contraceptives (e.g., Norplant®, Depo-Provera® or equivalent)
    • Barrier methods (e.g., condoms with spermicide)
    • Intrauterine device (i.e., IUD)
    • Vasectomy of male partner
    • Non-heterosexual life style
  2. Current evidence or recent history of any clinically significant disease (other than COPD) or abnormality in the opinion of the Investigator that would put the subject at risk or which would compromise the quality of the study data; including but not limited to cardiovascular disease, myocardial infarction, cardiac failure, uncontrolled hypertension, life-threatening arrhythmias, uncontrolled diabetes, neurologic or neuromuscular disease, liver disease, gastrointestinal disease or electrolyte abnormalities
  3. Recent history of hospitalization due to an exacerbation of airway disease within 3 months or need for increased treatments for COPD within 6 weeks prior to the Screening Visit
  4. Primary diagnosis of asthma
  5. Prior lung volume reduction surgery or history of chest/lung irradiation
  6. Regular use of daily oxygen therapy
  7. Use of systemic (eg, intramuscular or intravenous) steroids within 3 months prior to the Screening Visit
  8. Respiratory tract infection within 6 weeks prior to the Screening Visit
  9. History of tuberculosis, bronchiectasis or other non- specific pulmonary disease
  10. History of urinary retention or bladder neck obstruction type symptoms
  11. History of narrow-angle glaucoma
  12. Clinically significant abnormal ECG
  13. Positive Hepatitis B surface antigen or positive Hepatitis C antibody
  14. Positive screening test for HIV antibodies
  15. Current or recent history (previous 12 months) of excessive use or abuse of alcohol
  16. Current evidence or history of abusing legal drugs or use of illegal drugs or substances
  17. Donation of 450 mL of blood within 8 weeks of the Screening Visit
  18. History of hypersensitivity or intolerance to aerosol medications
  19. Participation in another investigational drug study was received within 30 days prior to the Screening Visit

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Placebo Comparator

    Arm Label

    Glycopyrrolate Inhalation Solution12.5μg

    Glycopyrrolate Inhalation Solution 50μg

    Glycopyrrolate Inhalation Solution 100μg

    Glycopyrrolate Inhalation Solution 200μg

    Glycopyrrolate Inhalation Solution 400μg

    Placebo 0.5mL

    Arm Description

    Glycopyrrolate Inhalation Solution12.5μg via e-flow nebulizer, once daily

    Glycopyrrolate Inhalation Solution 50mg via e-flow nebulizer, once daily

    Glycopyrrolate Inhalation Solution 100μg via e-flow nebulizer, once daily

    Glycopyrrolate Inhalation Solution 200μg via e-flow nebulizer, once daily

    Glycopyrrolate Inhalation Solution 400μg via e-flow nebulizer, once daily

    Placebo 0.5mL via e-flow nebulizer, once daily

    Outcomes

    Primary Outcome Measures

    Trough FEV1 (Change From Baseline)
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. Trough FEV1 was defined as the mean of FEV1 values obtained at 23 hours 30 minutes and 24 hours post-dose of each Treatment Visit.
    Standardized FEV1AUC0-12 Area Under the FEV1 Curve From 0 to 12 Hours Post-dose ( Actual and Change From Baseline).
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines.. The standardized actual FEV1 AUC(0-12) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(0-12) was also calculated similarly, using the change from pre-dose FEV1.
    Standardized FEV1AUC12-24 Area Under the FEV1 Curve From 12 to 24 Hours Post- Dose (Actual and Change From Baseline).
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. The standardized actual FEV1 AUC(12-24) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(12-24) was also calculated similarly, using the change from pre-dose FEV1.
    Standardized FEV1 AUC0-24 Area Under the FEV1 Curve From 0 to 24 Hours Post-dose (Actual and Change Baseline)
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. . The standardized actual FEV1 AUC(0-24) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(0-24) was also calculated similarly, using the change from pre-dose FEV1.
    Peak FEV1 (Change From Baseline and Percent Change)
    spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. . The peak FEV1 was defined as the highest post-dose FEV1 value within 4 hrs after the dose. Percent change from baseline was calculated as 100 times the difference of peak FEV1 minus baseline FEV1 divided by baseline FEV1.

    Secondary Outcome Measures

    Cmax; Maximum Observed Plasma Concentration
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Tmax; Time to Maximum Observed Plasma Concentration
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    t1/2; Plasma Half-life
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    AUC0-t; Area Under the Plasma Concentration-time Curve From Time Zero to Time of Last Measurable Drug Concentration.
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    AUC0-inf Area Under the Plasma Concentration-time Curve From Time Zero to Infinity
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Number of Subjects Who Died, Number of Subjects With Treatment Emergent SAEs, Number of Subjects Who Discontinued Due to AE
    AE's are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment
    Number of Subjects With Clinically Significant Abnormal Vital Signs Reported During the Study
    Vital signs were measured at screening and at each Treatment Visit pre-dose (within 30 minutes prior to dose); post-dose at 30 minutes and 1, 2, 4, 8, 12 and 24 hours; and then at the post study assessment.
    Number of Clinically Significant Abnormal Laboratory Results Reported During the Study
    Clinical safety lab parameters were collected at screening and at the post study assessment. Any laboratory values that were out of range of normal reference values were evaluated by the Investigators.
    Number of Subjects With Clinically Significant ECG Parameters Reported During the Study
    ECGs were recorded at screening and at each study treatment visit pre-dose (within 30 minutes prior to dose); post-dose at 30 minutes and 1, 2, 4, 8, 12 and 24 hours; and then at the post study assessment.
    Percentage of Subjects With Treatment Emergent AEs
    AE's are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment

    Full Information

    First Posted
    October 26, 2016
    Last Updated
    March 7, 2018
    Sponsor
    Sunovion Respiratory Development Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02948582
    Brief Title
    Assessment of the Safety and Ability of a Once-a-day Dose of an Orally Inhaled Medicine [i.e., Glycopyrrolate Inhalation Solution = GIS] to Improve Airflow in the Lungs When Delivered Using an eFlow Nebulizer in Patients With Chronic Obstructive Pulmonary Disease (COPD)
    Official Title
    Randomized, Placebo-Controlled, Double-Blind, Dose Ranging, Single-Dose, 6-Way Crossover Study to Assess Safety, Efficacy and Pharmacokinetics of EP-101 Using eFlow Nebuliser in Patients With COPD
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2018
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2010 (undefined)
    Primary Completion Date
    November 2010 (Actual)
    Study Completion Date
    November 2010 (Actual)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Sunovion Respiratory Development Inc.

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The study assessed the safety and ability of an orally inhaled medicine [i.e., Glycopyrrolate Inhalation Solution = GIS] to improve airflow in the lungs when delivered using an eFlow nebulizer in 42 patients with Chronic Obstructive Pulmonary Disease (COPD). Each patient randomly received several, single doses of GIS, or placebo, separated by approximately 1 to 2 weeks. After the dose was given, lung airflow was measured over 24 hours and blood was collected to measure how much GIS was in the bloodstream. The study was conducted to find the once-a- day GIS dose that produced the highest improvement in lung airflow using the eFlow nebulizer.

    6. Conditions and Keywords

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

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Crossover Assignment
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    42 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Glycopyrrolate Inhalation Solution12.5μg
    Arm Type
    Experimental
    Arm Description
    Glycopyrrolate Inhalation Solution12.5μg via e-flow nebulizer, once daily
    Arm Title
    Glycopyrrolate Inhalation Solution 50μg
    Arm Type
    Experimental
    Arm Description
    Glycopyrrolate Inhalation Solution 50mg via e-flow nebulizer, once daily
    Arm Title
    Glycopyrrolate Inhalation Solution 100μg
    Arm Type
    Experimental
    Arm Description
    Glycopyrrolate Inhalation Solution 100μg via e-flow nebulizer, once daily
    Arm Title
    Glycopyrrolate Inhalation Solution 200μg
    Arm Type
    Experimental
    Arm Description
    Glycopyrrolate Inhalation Solution 200μg via e-flow nebulizer, once daily
    Arm Title
    Glycopyrrolate Inhalation Solution 400μg
    Arm Type
    Experimental
    Arm Description
    Glycopyrrolate Inhalation Solution 400μg via e-flow nebulizer, once daily
    Arm Title
    Placebo 0.5mL
    Arm Type
    Placebo Comparator
    Arm Description
    Placebo 0.5mL via e-flow nebulizer, once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Glycopyrrolate Inhalation Solution12.5μg
    Other Intervention Name(s)
    GIS
    Intervention Description
    Glycopyrrolate Inhalation Solution12.5μg via eFlow, once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Glycopyrrolate Inhalation Solution 50μg
    Other Intervention Name(s)
    GIS
    Intervention Description
    Glycopyrrolate Inhalation Solution 50μg via eFlow, once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Glycopyrrolate Inhalation Solution 100μg
    Other Intervention Name(s)
    GIS
    Intervention Description
    Glycopyrrolate Inhalation Solution 100μg via eFlow, once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Glycopyrrolate Inhalation Solution 200μg
    Other Intervention Name(s)
    GIS
    Intervention Description
    Glycopyrrolate Inhalation Solution 200μg via eFlow, once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Glycopyrrolate Inhalation Solution 400μg
    Other Intervention Name(s)
    GIS
    Intervention Description
    Glycopyrrolate Inhalation Solution 400μg via eFlow, once daily
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo 0.5mL
    Other Intervention Name(s)
    Placebo
    Intervention Description
    Placebo 0.5mL via eFlow, once daily
    Primary Outcome Measure Information:
    Title
    Trough FEV1 (Change From Baseline)
    Description
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. Trough FEV1 was defined as the mean of FEV1 values obtained at 23 hours 30 minutes and 24 hours post-dose of each Treatment Visit.
    Time Frame
    24hr post dose
    Title
    Standardized FEV1AUC0-12 Area Under the FEV1 Curve From 0 to 12 Hours Post-dose ( Actual and Change From Baseline).
    Description
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines.. The standardized actual FEV1 AUC(0-12) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(0-12) was also calculated similarly, using the change from pre-dose FEV1.
    Time Frame
    0-12h post dose
    Title
    Standardized FEV1AUC12-24 Area Under the FEV1 Curve From 12 to 24 Hours Post- Dose (Actual and Change From Baseline).
    Description
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. The standardized actual FEV1 AUC(12-24) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(12-24) was also calculated similarly, using the change from pre-dose FEV1.
    Time Frame
    12-24h post dose
    Title
    Standardized FEV1 AUC0-24 Area Under the FEV1 Curve From 0 to 24 Hours Post-dose (Actual and Change Baseline)
    Description
    Spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. . The standardized actual FEV1 AUC(0-24) was calculated using the trapezoidal rule divided by the actual hours from the first FEV1 to the last FEV1 in the interval. Standardized change from baseline FEV1 AUC(0-24) was also calculated similarly, using the change from pre-dose FEV1.
    Time Frame
    0 to 24h
    Title
    Peak FEV1 (Change From Baseline and Percent Change)
    Description
    spirometry measurements were conducted in accordance with the current ATS/ERS 2005 guidelines. . The peak FEV1 was defined as the highest post-dose FEV1 value within 4 hrs after the dose. Percent change from baseline was calculated as 100 times the difference of peak FEV1 minus baseline FEV1 divided by baseline FEV1.
    Time Frame
    0-4h post dose
    Secondary Outcome Measure Information:
    Title
    Cmax; Maximum Observed Plasma Concentration
    Description
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Time Frame
    0 to 12 hour
    Title
    Tmax; Time to Maximum Observed Plasma Concentration
    Description
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Time Frame
    0 to 12 hours
    Title
    t1/2; Plasma Half-life
    Description
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Time Frame
    0 to 12 hour
    Title
    AUC0-t; Area Under the Plasma Concentration-time Curve From Time Zero to Time of Last Measurable Drug Concentration.
    Description
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Time Frame
    0 to 12 hour
    Title
    AUC0-inf Area Under the Plasma Concentration-time Curve From Time Zero to Infinity
    Description
    Pk parameters are calculated from glycopyrrolate plasma concentration analysed from serial blood samples collected between 0 and 12 hr
    Time Frame
    0 to 12 hour
    Title
    Number of Subjects Who Died, Number of Subjects With Treatment Emergent SAEs, Number of Subjects Who Discontinued Due to AE
    Description
    AE's are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment
    Time Frame
    Day 69 (includes dosing Day 1, washout Day 12, safety follow up Day 69)
    Title
    Number of Subjects With Clinically Significant Abnormal Vital Signs Reported During the Study
    Description
    Vital signs were measured at screening and at each Treatment Visit pre-dose (within 30 minutes prior to dose); post-dose at 30 minutes and 1, 2, 4, 8, 12 and 24 hours; and then at the post study assessment.
    Time Frame
    0-24 h
    Title
    Number of Clinically Significant Abnormal Laboratory Results Reported During the Study
    Description
    Clinical safety lab parameters were collected at screening and at the post study assessment. Any laboratory values that were out of range of normal reference values were evaluated by the Investigators.
    Time Frame
    Day -14, Day 69
    Title
    Number of Subjects With Clinically Significant ECG Parameters Reported During the Study
    Description
    ECGs were recorded at screening and at each study treatment visit pre-dose (within 30 minutes prior to dose); post-dose at 30 minutes and 1, 2, 4, 8, 12 and 24 hours; and then at the post study assessment.
    Time Frame
    0 to 24h
    Title
    Percentage of Subjects With Treatment Emergent AEs
    Description
    AE's are defined as existing conditions which worsen or events which occur during the course of the clinical trial after treatment
    Time Frame
    Day 69 (includes dosing Day 1, washout Day 12, safety follow up Day 69)

    10. Eligibility

    Minimum Age & Unit of Time
    40 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Male and female patients aged 40 through 75 years, inclusive A clinical diagnosis of COPD according to the GOLD guidelines Current smokers or ex-smokers with at least 10 pack-year smoking history (e.g., at least 1 pack/day for 10 Post-bronchodilator FEV1 30-70% of predicted normal at the Screening Visit Post-bronchodilator FEV1/FVC ratio < 0.70 at the Screening Visit Improvement in FEV1 >12% and 150 mL following inhalation of ipratropium bromide at the Screening Visit Ability to perform reproducible spirometry according to the ATS/ERS guidelines Willing to stay at the study site for approximately 30 hours on each treatment visit Willing and able to provide written informed consent Exclusion Criteria: Females who are pregnant or lactating at the Screening Visit, or if of childbearing potential not using one of the following acceptable means of birth control throughout the study: Abstinence Post-menopausal for at least two years Surgically sterile (i.e., tubal ligation, hysterectomy) Oral contraceptives (taken for at least one month prior to the Screening Visit) Approved implantable or injectable contraceptives (e.g., Norplant®, Depo-Provera® or equivalent) Barrier methods (e.g., condoms with spermicide) Intrauterine device (i.e., IUD) Vasectomy of male partner Non-heterosexual life style Current evidence or recent history of any clinically significant disease (other than COPD) or abnormality in the opinion of the Investigator that would put the subject at risk or which would compromise the quality of the study data; including but not limited to cardiovascular disease, myocardial infarction, cardiac failure, uncontrolled hypertension, life-threatening arrhythmias, uncontrolled diabetes, neurologic or neuromuscular disease, liver disease, gastrointestinal disease or electrolyte abnormalities Recent history of hospitalization due to an exacerbation of airway disease within 3 months or need for increased treatments for COPD within 6 weeks prior to the Screening Visit Primary diagnosis of asthma Prior lung volume reduction surgery or history of chest/lung irradiation Regular use of daily oxygen therapy Use of systemic (eg, intramuscular or intravenous) steroids within 3 months prior to the Screening Visit Respiratory tract infection within 6 weeks prior to the Screening Visit History of tuberculosis, bronchiectasis or other non- specific pulmonary disease History of urinary retention or bladder neck obstruction type symptoms History of narrow-angle glaucoma Clinically significant abnormal ECG Positive Hepatitis B surface antigen or positive Hepatitis C antibody Positive screening test for HIV antibodies Current or recent history (previous 12 months) of excessive use or abuse of alcohol Current evidence or history of abusing legal drugs or use of illegal drugs or substances Donation of 450 mL of blood within 8 weeks of the Screening Visit History of hypersensitivity or intolerance to aerosol medications Participation in another investigational drug study was received within 30 days prior to the Screening Visit
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Ahmet Tutuncu, MD, PhD
    Organizational Affiliation
    Elevation Pharmaceuticals, Inc., (now known as Sunovion Respriatory Developement Inc.)
    Official's Role
    Study Chair

    12. IPD Sharing Statement

    Citations:
    PubMed Identifier
    25243340
    Citation
    Leaker BR, Barnes PJ, Jones CR, Tutuncu A, Singh D. Efficacy and safety of nebulized glycopyrrolate for administration using a high efficiency nebulizer in patients with chronic obstructive pulmonary disease. Br J Clin Pharmacol. 2015 Mar;79(3):492-500. doi: 10.1111/bcp.12517.
    Results Reference
    result

    Learn more about this trial

    Assessment of the Safety and Ability of a Once-a-day Dose of an Orally Inhaled Medicine [i.e., Glycopyrrolate Inhalation Solution = GIS] to Improve Airflow in the Lungs When Delivered Using an eFlow Nebulizer in Patients With Chronic Obstructive Pulmonary Disease (COPD)

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