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Formoterol Dose Ranging Study (ACHIEVE Duaklir USA Phase IIb)

Primary Purpose

Chronic Obstructive Pulmonary Disease - COPD

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Formoterol fumarate (6 μg)
Formoterol furmarate (20 μg)
Placebo for formoterol fumarate
Formoterol fumarate (12 μg)
Formoterol fumarate (40 μg)
Sponsored by
AstraZeneca
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 Perforomist, Pressair, COPD, Cigarette smoking, Formoterol fumarate, long-acting β2-adrenergic agonists (LABA), long-acting muscarinic antagonists (LAMA)

Eligibility Criteria

40 Years - 130 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult male or non-pregnant, non-lactating female patients aged ≥40.
  • Patients with a diagnosis of COPD (GOLD guidelines, 2016) for a period of at least 6 months prior to Visit 1.
  • Patients with moderate to severe stable COPD: post-bronchodilator FEV1 ≥ 30% and <80% of the predicted normal and post-bronchodilator FEV1/FVC < 70% at Visit 1.
  • Patients with reversible airway obstruction defined as an increase in FEV1 of at least 12% and 200 mL over the baseline value after four inhalations of albuterol sulfate 108 µg via a pMDI at Visit 1.
  • Current or former-smokers, with a smoking history of ≥ 10 pack-years.
  • Patients able to perform acceptable and repeatable pulmonary function testing for FEV1 according to the American Thoracic Society (ATS)/European Respiratory Society (ERS) 2005 criteria at Visit 1.
  • Patients eligible and able to participate in the study and who had signed an Informed Consent Form prior to initiation of any study-related procedures.

Exclusion Criteria:

  • Patients with asthma.
  • Any respiratory tract infection (including the upper respiratory tract) or COPD exacerbation (including the mild COPD exacerbation) within 6 weeks prior to Visit 1 or during the run-in period.
  • Patients hospitalized for a COPD exacerbation (an emergency room visit for longer than 24 hours is considered a hospitalization) within 3 months prior to Visit 1.
  • Clinically significant respiratory conditions other than COPD.
  • Patients who in the investigator's opinion may need to start a pulmonary rehabilitation program during the study and/or patients who started/finished it within 3 months prior to Visit 1.
  • Use of long-term oxygen therapy (≥ 15 hours/day).
  • Patients who do not maintain regular day/night, waking/sleeping cycles including night shift workers.
  • Clinically significant cardiovascular conditions.
  • Patients with uncontrolled Type I or Type II diabetes, uncontrolled hypo-or hyperthyroidism, hypokalaemia, or hyperadrenergic state, uncontrolled hypertension.
  • Patients with history of long QT syndrome or whose QTc (calculated according to Fridericia's Formula QTc=QT/RR1/3) > 470 ms as indicated in the centralized reading report assessed at Visit 1.
  • Patients with clinically significant abnormalities in the laboratory tests, ECG parameters (other than QTc) or in the physical examination at Visit 1 that might compromise patient safety.
  • Patients with a history of hypersensitivity reaction to an inhaled medication or any component thereof, including paradoxical bronchospasm.
  • Patients with known narrow-angle glaucoma, symptomatic bladder neck obstruction, acute urinary retention or symptomatic unstable prostate hypertrophy.
  • History of malignancy of any organ system (including lung cancer), treated or untreated, within the past 5 years other than basal or squamous cell skin cancer.
  • Patients with any other serious or uncontrolled physical or mental dysfunction.
  • Patients with a history (within 2 years prior to screening) of drug and/or alcohol abuse that may prevent study compliance based on the Investigator judgment.
  • Patients unlikely to be cooperative or who cannot comply with the study procedures.
  • Patients treated with any investigational drug within 30 days (or 6 half-lives, whichever is longer) prior to Visit 1.
  • Patients who intended to use any concomitant medication not permitted by this protocol or who had not undergone the required washout period for a particular prohibited medication.
  • Patients unable to give consent, or patients of consenting age but under guardianship, or vulnerable patients.
  • Any other conditions that, in the investigator's opinion, might render the patient to be unsuitable for the study.
  • Involvement in the planning and/or conduct of the study (applies to AstraZeneca staff and/or site staff), or patients employed by or relatives of the employees of the site or sponsor.
  • Previous randomization in the present study D6571C00002.

Sites / Locations

  • Research Site
  • Research Site
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  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
  • Research Site
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  • Research Site
  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

Formoterol 6 μg

Formoterol 12 μg

Formoterol 24 μg

Placebo

Formoterol 20 μg

Formoterol 40 μg

Arm Description

Participants received formoterol fumarate 6 μg administered via Pressair twice daily (BID).

Participants received formoterol fumarate 12 μg administered via Pressair BID.

Participants received formoterol fumarate 24 μg administered via Pressair BID.

Participants received placebo to formoterol fumarate administered via Pressair BID.

Participants received Perforomist inhalation solution and were instructed to take one puff from each of the two Pressair inhalers or to inhale one vial from the Perforomist 20 μg inhalation solution BID for 7 ± 1 consecutive days.

Participants received Perforomist 40 μg (2 vials of Performist 20 μg) as a single dose of administration.

Outcomes

Primary Outcome Measures

Change From Baseline in Normalized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) Over the 12 h Period Immediately After Morning Study Drug Administration, AUC0-12/12h at Day 7 on Treatment
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) twice daily (BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate(20 μg). Pre-dose spirometry was performed before the morning daily dose at Day 1 and Day 7 of each treatment period. Two sets of measurements were performed during the hour preceding the scheduled morning study drug administration, allowing approximately 30 minutes between them. Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation.

Secondary Outcome Measures

Change From Baseline in FEV1 AUC0-6/6h at Day 1 on Treatment
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg and 40 μg). 6-hour serial spirometry was performed at Day 1 of each treatment period: spirometry was performed post-dose at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours and 6 hours post-dose.
Change From Baseline in FEV1 AUC0-6/6h at Day 7 on Treatment
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg). 6-hour serial spirometry was performed at Day 7 of each treatment period: spirometry was performed post-dose at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours and 6 hours post-dose Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation
Change From Baseline in Morning Pre-dose (Trough) FEV1 at Day 7 on Treatment
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg). Trough value was defined as the mean of the 2 pre-dose measurements on Day 7. If 1 of the 2 measurements was missing, the non-missing measurement was used as the trough value. Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation.

Full Information

First Posted
June 7, 2016
Last Updated
January 11, 2018
Sponsor
AstraZeneca
Collaborators
Parexel
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1. Study Identification

Unique Protocol Identification Number
NCT02796651
Brief Title
Formoterol Dose Ranging Study (ACHIEVE Duaklir USA Phase IIb)
Official Title
A Randomized, Double-blind, Placebo-controlled, Incomplete Unbalanced, Crossover Study to Assess the Efficacy and Safety of Three Doses of Formoterol Fumarate in Pressair® Compared With Perforomist® Inhalation Solution (20 and 40 μg Open-label) in Moderate to Severe COPD Patients With Reversible Airway Disease.
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
June 30, 2016 (Actual)
Primary Completion Date
December 7, 2016 (Actual)
Study Completion Date
December 7, 2016 (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
To assess the bronchodilation of three doses of formoterol fumarate (6 μg, 12 μg and 24 μg) twice daily (BID) administered via Pressair® compared to placebo and to open-label nebulized formoterol fumarate (20 μg and 40 μg).
Detailed Description
This is a prospective, randomized, double-blind, 5-period incomplete unbalanced crossover, placebo and active comparator (open-label) controlled, multicenter clinical trial to assess the efficacy and safety of three doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label formoterol fumarate (20 μg BID and 40 μg single dose) administered as an inhalation solution via a standard jet nebulizer (with a mouthpiece) connected to an air compressor (Perforomist® Inhalation Solution). The drug product is an inhalation powder comprising of micronized aclidinium bromide and micronized formoterol fumarate with α-lactose monohydrate as the carrier, presented in a breathactuated device-metered dry-powder inhaler (DPI). It has been approved under the trademarks of Genuair® and/or Pressair® in some territories.

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
Perforomist, Pressair, COPD, Cigarette smoking, Formoterol fumarate, long-acting β2-adrenergic agonists (LABA), long-acting muscarinic antagonists (LAMA)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
132 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Formoterol 6 μg
Arm Type
Experimental
Arm Description
Participants received formoterol fumarate 6 μg administered via Pressair twice daily (BID).
Arm Title
Formoterol 12 μg
Arm Type
Experimental
Arm Description
Participants received formoterol fumarate 12 μg administered via Pressair BID.
Arm Title
Formoterol 24 μg
Arm Type
Experimental
Arm Description
Participants received formoterol fumarate 24 μg administered via Pressair BID.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants received placebo to formoterol fumarate administered via Pressair BID.
Arm Title
Formoterol 20 μg
Arm Type
Experimental
Arm Description
Participants received Perforomist inhalation solution and were instructed to take one puff from each of the two Pressair inhalers or to inhale one vial from the Perforomist 20 μg inhalation solution BID for 7 ± 1 consecutive days.
Arm Title
Formoterol 40 μg
Arm Type
Experimental
Arm Description
Participants received Perforomist 40 μg (2 vials of Performist 20 μg) as a single dose of administration.
Intervention Type
Drug
Intervention Name(s)
Formoterol fumarate (6 μg)
Other Intervention Name(s)
Formoterol (Pressair®)
Intervention Description
Oral Inhalation (by Pressair® Dry Powder Inhaler, DPI)
Intervention Type
Drug
Intervention Name(s)
Formoterol furmarate (20 μg)
Other Intervention Name(s)
Perforomist® Inhalation Solution
Intervention Description
Oral Inhalation (via a standard jet nebulizer connected to an air compressor.
Intervention Type
Drug
Intervention Name(s)
Placebo for formoterol fumarate
Other Intervention Name(s)
Placebo (Pressair®)
Intervention Description
Oral Inhalation (by Pressair® Dry Powder Inhaler, DPI)
Intervention Type
Drug
Intervention Name(s)
Formoterol fumarate (12 μg)
Other Intervention Name(s)
Formoterol (Pressair®)
Intervention Description
Oral Inhalation (by Pressair® Dry Powder Inhaler, DPI)
Intervention Type
Drug
Intervention Name(s)
Formoterol fumarate (40 μg)
Other Intervention Name(s)
Perforomist® Inhalation Solution
Intervention Description
Oral Inhalation (via a standard jet nebulizer connected to an air compressor.
Primary Outcome Measure Information:
Title
Change From Baseline in Normalized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) Over the 12 h Period Immediately After Morning Study Drug Administration, AUC0-12/12h at Day 7 on Treatment
Description
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) twice daily (BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate(20 μg). Pre-dose spirometry was performed before the morning daily dose at Day 1 and Day 7 of each treatment period. Two sets of measurements were performed during the hour preceding the scheduled morning study drug administration, allowing approximately 30 minutes between them. Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation.
Time Frame
Day 7: 30 min, 1 to 4 hours, 6 hours, 9 hours and 12 hours post-dose
Secondary Outcome Measure Information:
Title
Change From Baseline in FEV1 AUC0-6/6h at Day 1 on Treatment
Description
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg and 40 μg). 6-hour serial spirometry was performed at Day 1 of each treatment period: spirometry was performed post-dose at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours and 6 hours post-dose.
Time Frame
Day 1: zero time to 6 hours post-dose
Title
Change From Baseline in FEV1 AUC0-6/6h at Day 7 on Treatment
Description
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg). 6-hour serial spirometry was performed at Day 7 of each treatment period: spirometry was performed post-dose at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours and 6 hours post-dose Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation
Time Frame
Day 7: zero time to 6 hours post-dose
Title
Change From Baseline in Morning Pre-dose (Trough) FEV1 at Day 7 on Treatment
Description
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg). Trough value was defined as the mean of the 2 pre-dose measurements on Day 7. If 1 of the 2 measurements was missing, the non-missing measurement was used as the trough value. Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation.
Time Frame
At baseline and Day 7

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
130 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult male or non-pregnant, non-lactating female patients aged ≥40. Patients with a diagnosis of COPD (GOLD guidelines, 2016) for a period of at least 6 months prior to Visit 1. Patients with moderate to severe stable COPD: post-bronchodilator FEV1 ≥ 30% and <80% of the predicted normal and post-bronchodilator FEV1/FVC < 70% at Visit 1. Patients with reversible airway obstruction defined as an increase in FEV1 of at least 12% and 200 mL over the baseline value after four inhalations of albuterol sulfate 108 µg via a pMDI at Visit 1. Current or former-smokers, with a smoking history of ≥ 10 pack-years. Patients able to perform acceptable and repeatable pulmonary function testing for FEV1 according to the American Thoracic Society (ATS)/European Respiratory Society (ERS) 2005 criteria at Visit 1. Patients eligible and able to participate in the study and who had signed an Informed Consent Form prior to initiation of any study-related procedures. Exclusion Criteria: Patients with asthma. Any respiratory tract infection (including the upper respiratory tract) or COPD exacerbation (including the mild COPD exacerbation) within 6 weeks prior to Visit 1 or during the run-in period. Patients hospitalized for a COPD exacerbation (an emergency room visit for longer than 24 hours is considered a hospitalization) within 3 months prior to Visit 1. Clinically significant respiratory conditions other than COPD. Patients who in the investigator's opinion may need to start a pulmonary rehabilitation program during the study and/or patients who started/finished it within 3 months prior to Visit 1. Use of long-term oxygen therapy (≥ 15 hours/day). Patients who do not maintain regular day/night, waking/sleeping cycles including night shift workers. Clinically significant cardiovascular conditions. Patients with uncontrolled Type I or Type II diabetes, uncontrolled hypo-or hyperthyroidism, hypokalaemia, or hyperadrenergic state, uncontrolled hypertension. Patients with history of long QT syndrome or whose QTc (calculated according to Fridericia's Formula QTc=QT/RR1/3) > 470 ms as indicated in the centralized reading report assessed at Visit 1. Patients with clinically significant abnormalities in the laboratory tests, ECG parameters (other than QTc) or in the physical examination at Visit 1 that might compromise patient safety. Patients with a history of hypersensitivity reaction to an inhaled medication or any component thereof, including paradoxical bronchospasm. Patients with known narrow-angle glaucoma, symptomatic bladder neck obstruction, acute urinary retention or symptomatic unstable prostate hypertrophy. History of malignancy of any organ system (including lung cancer), treated or untreated, within the past 5 years other than basal or squamous cell skin cancer. Patients with any other serious or uncontrolled physical or mental dysfunction. Patients with a history (within 2 years prior to screening) of drug and/or alcohol abuse that may prevent study compliance based on the Investigator judgment. Patients unlikely to be cooperative or who cannot comply with the study procedures. Patients treated with any investigational drug within 30 days (or 6 half-lives, whichever is longer) prior to Visit 1. Patients who intended to use any concomitant medication not permitted by this protocol or who had not undergone the required washout period for a particular prohibited medication. Patients unable to give consent, or patients of consenting age but under guardianship, or vulnerable patients. Any other conditions that, in the investigator's opinion, might render the patient to be unsuitable for the study. Involvement in the planning and/or conduct of the study (applies to AstraZeneca staff and/or site staff), or patients employed by or relatives of the employees of the site or sponsor. Previous randomization in the present study D6571C00002.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark H. Gotfried, MD
Organizational Affiliation
1112 East McDowell Road, Phoenix, AZ 85006, United States.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Research Site
City
Glendale
State/Province
Arizona
ZIP/Postal Code
85306
Country
United States
Facility Name
Research Site
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85006
Country
United States
Facility Name
Research Site
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85283
Country
United States
Facility Name
Research Site
City
Celebration
State/Province
Florida
ZIP/Postal Code
34747
Country
United States
Facility Name
Research Site
City
Clearwater
State/Province
Florida
ZIP/Postal Code
33756
Country
United States
Facility Name
Research Site
City
DeLand
State/Province
Florida
ZIP/Postal Code
32720
Country
United States
Facility Name
Research Site
City
Orlando
State/Province
Florida
ZIP/Postal Code
32825
Country
United States
Facility Name
Research Site
City
Lawrenceville
State/Province
Georgia
ZIP/Postal Code
30046
Country
United States
Facility Name
Research Site
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63141
Country
United States
Facility Name
Research Site
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89102
Country
United States
Facility Name
Research Site
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
Facility Name
Research Site
City
Gastonia
State/Province
North Carolina
ZIP/Postal Code
28054
Country
United States
Facility Name
Research Site
City
Medford
State/Province
Oregon
ZIP/Postal Code
97504
Country
United States
Facility Name
Research Site
City
Portland
State/Province
Oregon
ZIP/Postal Code
97202
Country
United States
Facility Name
Research Site
City
Easley
State/Province
South Carolina
ZIP/Postal Code
29640
Country
United States
Facility Name
Research Site
City
Greenville
State/Province
South Carolina
ZIP/Postal Code
29615
Country
United States
Facility Name
Research Site
City
Rock Hill
State/Province
South Carolina
ZIP/Postal Code
29372
Country
United States
Facility Name
Research Site
City
Spartanburg
State/Province
South Carolina
ZIP/Postal Code
29303
Country
United States
Facility Name
Research Site
City
Boerne
State/Province
Texas
ZIP/Postal Code
78006
Country
United States
Facility Name
Research Site
City
Killeen
State/Province
Texas
ZIP/Postal Code
76543
Country
United States

12. IPD Sharing Statement

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Formoterol Dose Ranging Study (ACHIEVE Duaklir USA Phase IIb)

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