Free Combinations of Tiotropium Inhalation Powder Capsule + Salmeterol Metered Dose Inhaler, Tiotropium Inhalation Powder Capsule and Salmeterol Metered Dose Inhaler in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Primary Purpose
Pulmonary Disease, Chronic Obstructive
Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Tiotropium
Salmeterol
Placebo-MDI
Placebo HandiHaler®
Sponsored by
About this trial
This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive
Eligibility Criteria
Inclusion Criteria:
- All patients must sign an informed consent consistent with International Conference on Harmonization Good Clinical Practice (ICH-GCP) guidelines prior to participation in the trial, which includes medication washout and restrictions
All patients must have a diagnosis of chronic obstructive pulmonary disease and must meet the following spirometric criteria:
Patients must have relatively stable, moderate to severe airway obstruction with an FEV1 ≤ 60% of predicted normal and FEV1 ≤ 70% of FVC (Visits 1 and 2)
- Male or female patients 40 years of age or older
- Patients must be current or ex-smokers with a smoking history of more than 10 pack-years (Patients who had never smoked cigarettes have to be excluded)
- Patients must be able to perform technically acceptable pulmonary function tests and must be able to maintain records (Patient Daily Diary Card) during the study period as required in the protocol
- Patients must be able to inhale medication in a competent manner from the HandiHaler® device and from a metered dose inhaler (MDI)
Exclusion Criteria:
- Patients with significant diseases other than COPD will be excluded. A significant disease is defined as a disease which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study
- Patients with clinically relevant abnormal baseline haematology, blood chemistry, or urinalysis, if the abnormality defines a significant disease as defined in exclusion criterion No. 1
- Patients with a recent history (i.e. six months or less) of myocardial infarction
- Patients with any unstable or life-threatening cardiac arrhythmia or patients who have been hospitalised for such an event within the past year
- Patients with a malignancy for which the patient has undergone resection, Radiation therapy or chemotherapy within the last five years. Patients with treated basal cell carcinoma are allowed
- Patients with known narrow-angle glaucoma
- Patients with a history of asthma, allergic rhinitis or who have a total blood eosinophil count ≥600 mm3
- Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
- Patients with known active tuberculosis
- Patients with a history of and/or active significant alcohol or drug abuse. See exclusion criterion No. 1
- Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1
- Patients who have completed a pulmonary rehabilitation program in the six weeks prior to the Screening Visit (Visit 1)
- Patients who regularly use daytime oxygen therapy
- Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Screening Visit (Visit 1)
- Patients who are being treated with oral beta-adrenergics
- Patients who are being treated with cromolyn sodium or nedocromil sodium
- Patients who are being treated with antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions. See exclusion criterion No. 7
- Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at doses in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
- Patients with known hypersensitivity to anticholinergic drugs, beta-adrenergics, lactose or any other components of the medication delivery systems
- Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous 3 months (i.e. oral contraceptives, intrauterine devices, diaphragm or subdermal implants eg: Norplant®)
- Patients with previous participation (receipt of randomised treatment) in this study
- Patients who are currently participating in another study
- The randomisation of patients with any respiratory infection or COPD exacerbation in the six weeks prior to the Screening Visit (Visit 1) or during the baseline period should be postponed. Patients may be randomised six weeks following recovery from the infection or exacerbation
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Experimental
Active Comparator
Active Comparator
Active Comparator
Arm Label
Tiotropium+salmeterol QD
Tiotropium+salmeterol BID
Tiotropium QD
Salmeterol BID
Arm Description
free combination of tiotropium and salmeterol
free combination of tiotropium and salmeterol
Outcomes
Primary Outcome Measures
Area under the curve of forced expiratory volume in one second (FEV1 AUC0-24h)
FEV1 AUC0-12h
Secondary Outcome Measures
FEV1 AUC12-24h
AUC of forced vital capacity (FVC AUC0-12h)
FVC AUC0-24h
FVC AUC12-24h
Peak FEV1
Trough FEV1
Trough FEV1 was defined as the pre-dose FEV1 measured just prior to the last administration of the morning dose of randomised treatment.
Peak FVC
Trough FVC
Trough FVC was defined as the pre-dose FVC measured just prior to the last administration of the morning dose of randomised treatment
Individual FEV measurements at each time point
Individual FVC measurements at each time point
Peak expiratory flow rate (PEFR) measured twice daily
Number of inhalations of rescue salbutamol therapy used per day
Change in focal score of the Mahler Transition Dyspnea Index (TDI)
The TDI focal score is the sum of the three components of the TDI: Functional Impairment, Magnitude of Task and Magnitude of Effort
Number of patients with adverse events
Full Information
NCT ID
NCT02242253
First Posted
September 16, 2014
Last Updated
September 16, 2014
Sponsor
Boehringer Ingelheim
1. Study Identification
Unique Protocol Identification Number
NCT02242253
Brief Title
Free Combinations of Tiotropium Inhalation Powder Capsule + Salmeterol Metered Dose Inhaler, Tiotropium Inhalation Powder Capsule and Salmeterol Metered Dose Inhaler in Patients With Chronic Obstructive Pulmonary Disease (COPD)
Official Title
A Randomised, Double-blind, Double-dummy, Crossover Efficacy and Safety Comparison of 6-week Treatment Periods of the Free Combinations of Tiotropium Inhalation Powder Capsule (18 μg) QD + Salmeterol Metered Dose Inhaler (2 Puffs of 25 μg) QD or BID, Tiotropium Inhalation Powder Capsule (18 μg) QD and Salmeterol Metered Dose Inhaler (2 Puffs of 25 μg) BID in Patients With (COPD)
Study Type
Interventional
2. Study Status
Record Verification Date
September 2014
Overall Recruitment Status
Completed
Study Start Date
September 2003 (undefined)
Primary Completion Date
July 2004 (Actual)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim
4. Oversight
5. Study Description
Brief Summary
Main Study: To evaluate and to compare the lung function response to the free combinations of tiotropium 18 μg (QD) + salmeterol 50 μg (QD or BID), salmeterol 50 μg BID and tiotropium 18 μg QD at the end of 6-week treatment periods in patients with COPD.
Sub-Study: Was performed in subset of patients participating in the Main Study to assess the effect of the four randomised treatments on dynamic hyperinflation.
Extension Study: To establish whether the FEV1 time profile following combination bronchodilator therapy of tiotropium plus salmeterol is affected by the pharmaceutical formulation of salmeterol, i.e. the MDI or the Diskus®.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Disease, Chronic Obstructive
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
Double
Allocation
Randomized
Enrollment
97 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Tiotropium+salmeterol QD
Arm Type
Experimental
Arm Description
free combination of tiotropium and salmeterol
Arm Title
Tiotropium+salmeterol BID
Arm Type
Active Comparator
Arm Description
free combination of tiotropium and salmeterol
Arm Title
Tiotropium QD
Arm Type
Active Comparator
Arm Title
Salmeterol BID
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Tiotropium
Intervention Description
administered via HandiHaler®
Intervention Type
Drug
Intervention Name(s)
Salmeterol
Intervention Description
administered via metered dose inhaler (MDI)
Intervention Type
Drug
Intervention Name(s)
Placebo-MDI
Intervention Type
Drug
Intervention Name(s)
Placebo HandiHaler®
Primary Outcome Measure Information:
Title
Area under the curve of forced expiratory volume in one second (FEV1 AUC0-24h)
Time Frame
up to 12 hours after morning and evening dose
Title
FEV1 AUC0-12h
Time Frame
up to 12 hours after morning and evening dose
Secondary Outcome Measure Information:
Title
FEV1 AUC12-24h
Time Frame
after 6 weeks of each treatment
Title
AUC of forced vital capacity (FVC AUC0-12h)
Time Frame
after 6 weeks of each treatment
Title
FVC AUC0-24h
Time Frame
after 6 weeks of each treatment
Title
FVC AUC12-24h
Time Frame
after 6 weeks of each treatment
Title
Peak FEV1
Time Frame
after 6 weeks of each treatment
Title
Trough FEV1
Description
Trough FEV1 was defined as the pre-dose FEV1 measured just prior to the last administration of the morning dose of randomised treatment.
Time Frame
after 6 weeks of each treatment
Title
Peak FVC
Time Frame
after 6 weeks of each treatment
Title
Trough FVC
Description
Trough FVC was defined as the pre-dose FVC measured just prior to the last administration of the morning dose of randomised treatment
Time Frame
after 6 weeks of each treatment
Title
Individual FEV measurements at each time point
Time Frame
up to 6 weeks
Title
Individual FVC measurements at each time point
Time Frame
up to 6 weeks
Title
Peak expiratory flow rate (PEFR) measured twice daily
Time Frame
weeks 4 to 6 of each treatment period
Title
Number of inhalations of rescue salbutamol therapy used per day
Time Frame
weeks 4 to 6 of each treatment period
Title
Change in focal score of the Mahler Transition Dyspnea Index (TDI)
Description
The TDI focal score is the sum of the three components of the TDI: Functional Impairment, Magnitude of Task and Magnitude of Effort
Time Frame
after 6 weeks of each treatment
Title
Number of patients with adverse events
Time Frame
up to 33 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
All patients must sign an informed consent consistent with International Conference on Harmonization Good Clinical Practice (ICH-GCP) guidelines prior to participation in the trial, which includes medication washout and restrictions
All patients must have a diagnosis of chronic obstructive pulmonary disease and must meet the following spirometric criteria:
Patients must have relatively stable, moderate to severe airway obstruction with an FEV1 ≤ 60% of predicted normal and FEV1 ≤ 70% of FVC (Visits 1 and 2)
Male or female patients 40 years of age or older
Patients must be current or ex-smokers with a smoking history of more than 10 pack-years (Patients who had never smoked cigarettes have to be excluded)
Patients must be able to perform technically acceptable pulmonary function tests and must be able to maintain records (Patient Daily Diary Card) during the study period as required in the protocol
Patients must be able to inhale medication in a competent manner from the HandiHaler® device and from a metered dose inhaler (MDI)
Exclusion Criteria:
Patients with significant diseases other than COPD will be excluded. A significant disease is defined as a disease which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study
Patients with clinically relevant abnormal baseline haematology, blood chemistry, or urinalysis, if the abnormality defines a significant disease as defined in exclusion criterion No. 1
Patients with a recent history (i.e. six months or less) of myocardial infarction
Patients with any unstable or life-threatening cardiac arrhythmia or patients who have been hospitalised for such an event within the past year
Patients with a malignancy for which the patient has undergone resection, Radiation therapy or chemotherapy within the last five years. Patients with treated basal cell carcinoma are allowed
Patients with known narrow-angle glaucoma
Patients with a history of asthma, allergic rhinitis or who have a total blood eosinophil count ≥600 mm3
Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis
Patients with known active tuberculosis
Patients with a history of and/or active significant alcohol or drug abuse. See exclusion criterion No. 1
Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1
Patients who have completed a pulmonary rehabilitation program in the six weeks prior to the Screening Visit (Visit 1)
Patients who regularly use daytime oxygen therapy
Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Screening Visit (Visit 1)
Patients who are being treated with oral beta-adrenergics
Patients who are being treated with cromolyn sodium or nedocromil sodium
Patients who are being treated with antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions. See exclusion criterion No. 7
Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at doses in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
Patients with known hypersensitivity to anticholinergic drugs, beta-adrenergics, lactose or any other components of the medication delivery systems
Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous 3 months (i.e. oral contraceptives, intrauterine devices, diaphragm or subdermal implants eg: Norplant®)
Patients with previous participation (receipt of randomised treatment) in this study
Patients who are currently participating in another study
The randomisation of patients with any respiratory infection or COPD exacerbation in the six weeks prior to the Screening Visit (Visit 1) or during the baseline period should be postponed. Patients may be randomised six weeks following recovery from the infection or exacerbation
12. IPD Sharing Statement
Links:
URL
http://trials.boehringer-ingelheim.com
Description
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Learn more about this trial
Free Combinations of Tiotropium Inhalation Powder Capsule + Salmeterol Metered Dose Inhaler, Tiotropium Inhalation Powder Capsule and Salmeterol Metered Dose Inhaler in Patients With Chronic Obstructive Pulmonary Disease (COPD)
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