Effects of Mometasone Furoate/Formoterol Combination Versus Formoterol and Mometasone Furoate Alone in Chronic Obstructive Pulmonary Disease (COPD) (Study P04230AM4)(COMPLETED)
Primary Purpose
Chronic Obstructive Pulmonary Disease (COPD)
Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Mometasone furoate/formoterol (MF/F) combination
Mometasone furoate/formoterol (MF/F) combination
Mometasone furoate MDI (MF MDI)
Formoterol MDI
Placebo
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease (COPD)
Eligibility Criteria
Inclusion Criteria:
- Moderate to severe COPD based on prebronchodilator FEV1/forced vital capacity (FVC) ratio of <=70%.
- At Screening & Baseline, postbronchodilator FEV1 must be >= 60% predicted normal & >=25% predicted normal.
- COPD symptoms for >=24 months.
- >=2 COPD exacerbations requiring course of oral corticosteroid &/or antibiotics within 2-12 months before screening.
- Ex- or current smoker with smoking history >=10 pack years.
- Only albuterol/salbutamol for relief for at least 2 weeks prior to randomization.
- Withdraw from parenteral & oral steroids, anticholinergics, & antibiotics 4 weeks prior to Screening.
- No harm in changing current COPD therapy, willing to discontinue his/her anticholinergics, inhaled corticosteroids (ICS) or ICS/long-acting beta agonists (LABA) at Screening, & transferred to albuterol/salbutamol for relief for 2 weeks prior to Randomization.
- Lab tests conducted at Screening must be acceptable to investigator. Electrocardiogram (ECG) performed at Screening or within 30 days prior to Screening must be acceptable to investigator. Chest X-ray or computerized tomography (CT) scan is acceptable within 12 months prior to Screening must be acceptable to investigator.
- Female of childbearing potential must use birth control. Includes: hormonal contraceptives, intra-uterine device (IUD), condom in combination with spermicide, monogamous relationship with male partner who had vasectomy. Started birth control at least 3 months prior to Screening (exception condom), & must agree to continue. Female who is not currently sexually active must agree/consent to using a method should she become sexually active. Women who have been surgically sterilized or are at least 1 year postmenopausal are not considered to be of childbearing potential. Female must have negative serum pregnancy test at Screening.
Exclusion Criteria:
- Evidence (upon visual inspection) of oropharyngeal candidiasis at Baseline with or without treatment. If there is evidence at Screening, may be treated as appropriate & visit can be scheduled upon resolution. If there is evidence at Baseline, may be treated as appropriate & visit can be rescheduled upon resolution.
- History of renal, hepatic, cardiovascular, metabolic, neurologic, hematologic, ophthalmological, respiratory, gastrointestinal, cerebrovascular, or other which could interfere with study or require treatment which might interfere with study. Examples include (but are not limited to) hypertension treated with beta-blockers), active hepatitis, coronary artery disease, arrhythmia, significant QTc prolongation (ie QTcF or QTcB [Fridericia or Bazett corrections, respectively >500 milliseconds (msecs)]) stroke, severe rheumatoid arthritis, chronic open-angle glaucoma or posterior subcapsular cataracts, acquired immune deficiency syndrome (AIDS), or conditions that may interfere with respiratory function such as asthma, bronchiectasis, cystic fibrosis. Others which are well-controlled & stable (eg hypertension not requiring beta-blockers) will not prohibit participation if appropriate to investigator.
- Allergy/sensitivity to glucocorticosteroids, beta-2 agonists, study drug/excipients.
- Female who is breast-feeding, pregnant, or intends to become pregnant.
- Illicit drug user.
- Human immunodeficiency virus (HIV) positive (testing not conducted).
- Unable to correctly use oral MDI.
- Taking any restricted medications prior to Screening without meeting washout.
- Cannot adhere to permitted concomitant & prohibited medications.
- May not participate in this same study at another investigational site. Cannot participate in different investigational study at any site, during same time.
- Not be randomized into study more than once.
- No person directly associated with administration of study may participate.
- Previously participated in MF/F trial.
- Increase in absolute volume of >=400 milliliters (mL) at Screening or prior to Baseline within 30 minutes after administration of 4 inhalations of albuterol/salbutamol (total dose of 360 to 400 mcg), or nebulized 2.5 mg albuterol/salbutamol.
- Asthma.
- Lobectomy, pneumonectomy or lung volume reduction surgery.
- Lung cancer.
- Requires long-term administration of oxygen (>15 hours/day).
- Alpha-1-antitrypsin deficiency.
A history and/or presence of intraocular pressure in either eye >=22 millimeters of mercury (mm Hg), glaucoma, and/or posterior subcapsular cataracts. A subject who has undergone incisional or intraocular surgery in which the natural lens is still present in the eye. A subject with a history of penetrating trauma to both eyes. A subject with one or more of the following Lens Opacities Classification System (LOCS) III grades at screening:
- nuclear opalescence (NO): >=3.0,
- nuclear color (NC): >=3.0,
- cortical cataract (C): >=2.0,
- posterior subcapsular (P): >=0.5.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm Type
Experimental
Experimental
Experimental
Active Comparator
Placebo Comparator
Arm Label
MF/F MDI 400/10 mcg BID
MF/F MDI 200/10 mcg BID
MF MDI 400 mcg BID
Formoterol MDI 10 mcg BID
Placebo MDI BID
Arm Description
Outcomes
Primary Outcome Measures
Mean Area Under the Time Curve From 0 to 12 Hours (AUC(0-12 Hours)) of Change From Baseline to Week 13 in Forced Expiratory Volume (Liters) in 1 Second (FEV1)
FEV1 AUC was standardized to liters. Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
Mean Change From Baseline to Week 13 Endpoint in AM Predose FEV1
Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
Secondary Outcome Measures
Change From Baseline to Endpoint in St George's Respiratory Questionaire (SGRQ) Total Score
SGRQ consisted of 76 items aggregated into 3 component scores: symptoms
(frequency/severity), activity (cause or limited by breathlessness), impact (social functioning, psychological disturbances from airway disease), & total score. Best health scores have a low numeric value. All component scores & total score ranged from 0-100, with a higher score indicating greater disease burden. A 4-point increase over placebo (and Baseline) was considered the minimum clinically important difference. Endpoint was the last post-baseline non-missing result through the 26 week evaluation carried forward.
Change From Baseline in Proportion of Chronic Obstructive Pulmonary Disease (COPD) Symptom-Free Nights (AM Diary Symptoms)
Prior to the use of study drug rescue medication (in the morning upon awakening) the participant evaluated the COPD symptoms of wheezing, cough, and difficulty breathing. A symptom-free night was defined as a combined score of 0 (no symptoms) across all three COPD symptoms evaluated the following morning. Proportion for Baseline included data from the last week before the first dose. Proportion for Endpoint included data across the entire 26-week treatment period.
Number of Participants With Partly Stable COPD
Partly stable COPD was a composite measure that included the following COPD
outcomes: (1) No oral steroid rescue medication; (2) No AM or PM COPD weekly
average symptom score greater than 2 during at least 7 of 8 weeks; (3) No moderate or severe exacerbations; (4) No unscheduled visits due to COPD worsenings; (5) No study discontinuation due to treatment failure or treatment-related adverse event as determined by the investigator.
Number of Participants With Mild, Moderate, or Severe COPD Exacerbations
Mild = 12 or more inhalations/day of inhaled rescue medication or 2 or more
nebulized treatments/day of inhaled rescue medication. Moderate = treatment with
antibiotics or oral steroids. Severe = emergency room treatment or hospitalizations of survival curves. If an event was composed of multiple criteria, the most severe criteria was assigned to the event.
Full Information
NCT ID
NCT00383721
First Posted
September 29, 2006
Last Updated
February 7, 2022
Sponsor
Organon and Co
Collaborators
Novartis
1. Study Identification
Unique Protocol Identification Number
NCT00383721
Brief Title
Effects of Mometasone Furoate/Formoterol Combination Versus Formoterol and Mometasone Furoate Alone in Chronic Obstructive Pulmonary Disease (COPD) (Study P04230AM4)(COMPLETED)
Official Title
A Randomized, 26-Week, Placebo-Controlled Efficacy and Safety Study With a 26-Week Long-Term Safety Extension, of High- and Medium-Dose Inhaled Mometasone Furoate/Formoterol Fixed-Dose Combination Formulation Compared With Formoterol and High-Dose Inhaled Mometasone Furoate Monotherapy in Subjects With Moderate to Severe COPD
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Completed
Study Start Date
September 2006 (undefined)
Primary Completion Date
July 2010 (Actual)
Study Completion Date
July 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Organon and Co
Collaborators
Novartis
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This is a randomized, placebo-controlled, parallel-group, multi-site, double-blind study evaluating the efficacy of mometasone furoate/formoterol fumarate (MF/F) metered dose inhaler (MDI) 400/10 mcg twice daily (BID) and MF/F MDI 200/10 mcg BID compared with MF 400 mcg BID and F 10 mcg BID in adults at least 40 years of age, with moderate to severe chronic obstructive pulmonary disease (COPD). All placebo-treated subjects and active-treated subjects who will not participate in the safety extension will be discontinued and will have their Final Visit at Week 26. Subjects who continue into the 26-week safety extension will have their Final Visit at Week 52. Efficacy will be measured by the mean change from Baseline to Week 13 in area under the forced expiratory volume in one second concentration time curve from 0 to 12 hours (FEV1 AUC[0-12hr]) and change from Baseline to Week 13 in AM predose FEV1.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease (COPD)
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
1196 (Actual)
8. Arms, Groups, and Interventions
Arm Title
MF/F MDI 400/10 mcg BID
Arm Type
Experimental
Arm Title
MF/F MDI 200/10 mcg BID
Arm Type
Experimental
Arm Title
MF MDI 400 mcg BID
Arm Type
Experimental
Arm Title
Formoterol MDI 10 mcg BID
Arm Type
Active Comparator
Arm Title
Placebo MDI BID
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Mometasone furoate/formoterol (MF/F) combination
Other Intervention Name(s)
SCH 418131
Intervention Description
MF/F 400/10 mcg via a metered dose inhaler (MDI) twice daily for 52 weeks
Intervention Type
Drug
Intervention Name(s)
Mometasone furoate/formoterol (MF/F) combination
Other Intervention Name(s)
SCH 418131
Intervention Description
MF/F 200/10 mcg via a metered dose inhaler (MDI) twice daily for 52 weeks
Intervention Type
Drug
Intervention Name(s)
Mometasone furoate MDI (MF MDI)
Other Intervention Name(s)
SCH 32088
Intervention Description
MF 400 mcg via metered dose inhaler twice daily for 52 weeks
Intervention Type
Drug
Intervention Name(s)
Formoterol MDI
Other Intervention Name(s)
Foradil
Intervention Description
Formoterol 10 mcg via metered dose inhaler twice a day for 52 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo MDI twice a day for 26 weeks
Primary Outcome Measure Information:
Title
Mean Area Under the Time Curve From 0 to 12 Hours (AUC(0-12 Hours)) of Change From Baseline to Week 13 in Forced Expiratory Volume (Liters) in 1 Second (FEV1)
Description
FEV1 AUC was standardized to liters. Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
Time Frame
Baseline to Endpoint (13 weeks)
Title
Mean Change From Baseline to Week 13 Endpoint in AM Predose FEV1
Description
Endpoint was the last post-baseline non-missing result through Week 13 carried forward.
Time Frame
Baseline to Endpoint (13 weeks)
Secondary Outcome Measure Information:
Title
Change From Baseline to Endpoint in St George's Respiratory Questionaire (SGRQ) Total Score
Description
SGRQ consisted of 76 items aggregated into 3 component scores: symptoms
(frequency/severity), activity (cause or limited by breathlessness), impact (social functioning, psychological disturbances from airway disease), & total score. Best health scores have a low numeric value. All component scores & total score ranged from 0-100, with a higher score indicating greater disease burden. A 4-point increase over placebo (and Baseline) was considered the minimum clinically important difference. Endpoint was the last post-baseline non-missing result through the 26 week evaluation carried forward.
Time Frame
Baseline to Endpoint (26 weeks)
Title
Change From Baseline in Proportion of Chronic Obstructive Pulmonary Disease (COPD) Symptom-Free Nights (AM Diary Symptoms)
Description
Prior to the use of study drug rescue medication (in the morning upon awakening) the participant evaluated the COPD symptoms of wheezing, cough, and difficulty breathing. A symptom-free night was defined as a combined score of 0 (no symptoms) across all three COPD symptoms evaluated the following morning. Proportion for Baseline included data from the last week before the first dose. Proportion for Endpoint included data across the entire 26-week treatment period.
Time Frame
Baseline to Endpoint (26 weeks)
Title
Number of Participants With Partly Stable COPD
Description
Partly stable COPD was a composite measure that included the following COPD
outcomes: (1) No oral steroid rescue medication; (2) No AM or PM COPD weekly
average symptom score greater than 2 during at least 7 of 8 weeks; (3) No moderate or severe exacerbations; (4) No unscheduled visits due to COPD worsenings; (5) No study discontinuation due to treatment failure or treatment-related adverse event as determined by the investigator.
Time Frame
Endpoint (26 weeks)
Title
Number of Participants With Mild, Moderate, or Severe COPD Exacerbations
Description
Mild = 12 or more inhalations/day of inhaled rescue medication or 2 or more
nebulized treatments/day of inhaled rescue medication. Moderate = treatment with
antibiotics or oral steroids. Severe = emergency room treatment or hospitalizations of survival curves. If an event was composed of multiple criteria, the most severe criteria was assigned to the event.
Time Frame
Endpoint (26 weeks)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Moderate to severe COPD based on prebronchodilator FEV1/forced vital capacity (FVC) ratio of <=70%.
At Screening & Baseline, postbronchodilator FEV1 must be >= 60% predicted normal & >=25% predicted normal.
COPD symptoms for >=24 months.
>=2 COPD exacerbations requiring course of oral corticosteroid &/or antibiotics within 2-12 months before screening.
Ex- or current smoker with smoking history >=10 pack years.
Only albuterol/salbutamol for relief for at least 2 weeks prior to randomization.
Withdraw from parenteral & oral steroids, anticholinergics, & antibiotics 4 weeks prior to Screening.
No harm in changing current COPD therapy, willing to discontinue his/her anticholinergics, inhaled corticosteroids (ICS) or ICS/long-acting beta agonists (LABA) at Screening, & transferred to albuterol/salbutamol for relief for 2 weeks prior to Randomization.
Lab tests conducted at Screening must be acceptable to investigator. Electrocardiogram (ECG) performed at Screening or within 30 days prior to Screening must be acceptable to investigator. Chest X-ray or computerized tomography (CT) scan is acceptable within 12 months prior to Screening must be acceptable to investigator.
Female of childbearing potential must use birth control. Includes: hormonal contraceptives, intra-uterine device (IUD), condom in combination with spermicide, monogamous relationship with male partner who had vasectomy. Started birth control at least 3 months prior to Screening (exception condom), & must agree to continue. Female who is not currently sexually active must agree/consent to using a method should she become sexually active. Women who have been surgically sterilized or are at least 1 year postmenopausal are not considered to be of childbearing potential. Female must have negative serum pregnancy test at Screening.
Exclusion Criteria:
Evidence (upon visual inspection) of oropharyngeal candidiasis at Baseline with or without treatment. If there is evidence at Screening, may be treated as appropriate & visit can be scheduled upon resolution. If there is evidence at Baseline, may be treated as appropriate & visit can be rescheduled upon resolution.
History of renal, hepatic, cardiovascular, metabolic, neurologic, hematologic, ophthalmological, respiratory, gastrointestinal, cerebrovascular, or other which could interfere with study or require treatment which might interfere with study. Examples include (but are not limited to) hypertension treated with beta-blockers), active hepatitis, coronary artery disease, arrhythmia, significant QTc prolongation (ie QTcF or QTcB [Fridericia or Bazett corrections, respectively >500 milliseconds (msecs)]) stroke, severe rheumatoid arthritis, chronic open-angle glaucoma or posterior subcapsular cataracts, acquired immune deficiency syndrome (AIDS), or conditions that may interfere with respiratory function such as asthma, bronchiectasis, cystic fibrosis. Others which are well-controlled & stable (eg hypertension not requiring beta-blockers) will not prohibit participation if appropriate to investigator.
Allergy/sensitivity to glucocorticosteroids, beta-2 agonists, study drug/excipients.
Female who is breast-feeding, pregnant, or intends to become pregnant.
Illicit drug user.
Human immunodeficiency virus (HIV) positive (testing not conducted).
Unable to correctly use oral MDI.
Taking any restricted medications prior to Screening without meeting washout.
Cannot adhere to permitted concomitant & prohibited medications.
May not participate in this same study at another investigational site. Cannot participate in different investigational study at any site, during same time.
Not be randomized into study more than once.
No person directly associated with administration of study may participate.
Previously participated in MF/F trial.
Increase in absolute volume of >=400 milliliters (mL) at Screening or prior to Baseline within 30 minutes after administration of 4 inhalations of albuterol/salbutamol (total dose of 360 to 400 mcg), or nebulized 2.5 mg albuterol/salbutamol.
Asthma.
Lobectomy, pneumonectomy or lung volume reduction surgery.
Lung cancer.
Requires long-term administration of oxygen (>15 hours/day).
Alpha-1-antitrypsin deficiency.
A history and/or presence of intraocular pressure in either eye >=22 millimeters of mercury (mm Hg), glaucoma, and/or posterior subcapsular cataracts. A subject who has undergone incisional or intraocular surgery in which the natural lens is still present in the eye. A subject with a history of penetrating trauma to both eyes. A subject with one or more of the following Lens Opacities Classification System (LOCS) III grades at screening:
nuclear opalescence (NO): >=3.0,
nuclear color (NC): >=3.0,
cortical cataract (C): >=2.0,
posterior subcapsular (P): >=0.5.
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
http://www.merck.com/clinical-trials/pdf/Merck%20Procedure%20on%20Clinical%20Trial%20Data%20Access%20Final_Updated%20July_9_2014.pdf
http://engagezone.msd.com/ds_documentation.php
Citations:
PubMed Identifier
25044280
Citation
Maspero J, Cherrez I, Doherty DE, Tashkin DP, Kuna P, Kuo WL, Gates D, Nolte H, Chylack LT Jr. Appraisal of lens opacity with mometasone furoate/formoterol fumarate combination in patients with COPD or asthma. Respir Med. 2014 Sep;108(9):1355-62. doi: 10.1016/j.rmed.2014.04.015. Epub 2014 May 2.
Results Reference
derived
PubMed Identifier
22334770
Citation
Tashkin DP, Doherty DE, Kerwin E, Matiz-Bueno CE, Knorr B, Shekar T, Gates D, Staudinger H. Efficacy and safety characteristics of mometasone furoate/formoterol fumarate fixed-dose combination in subjects with moderate to very severe COPD: findings from pooled analysis of two randomized, 52-week placebo-controlled trials. Int J Chron Obstruct Pulmon Dis. 2012;7:73-86. doi: 10.2147/COPD.S29444. Epub 2012 Feb 3.
Results Reference
derived
PubMed Identifier
22334769
Citation
Doherty DE, Tashkin DP, Kerwin E, Knorr BA, Shekar T, Banerjee S, Staudinger H. Effects of mometasone furoate/formoterol fumarate fixed-dose combination formulation on chronic obstructive pulmonary disease (COPD): results from a 52-week Phase III trial in subjects with moderate-to-very severe COPD. Int J Chron Obstruct Pulmon Dis. 2012;7:57-71. doi: 10.2147/COPD.S27320. Epub 2012 Feb 3.
Results Reference
derived
Learn more about this trial
Effects of Mometasone Furoate/Formoterol Combination Versus Formoterol and Mometasone Furoate Alone in Chronic Obstructive Pulmonary Disease (COPD) (Study P04230AM4)(COMPLETED)
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