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Safety and Efficacy of Two Different Doses of Ipratropium Bromide Versus ATROVENT® Inhalation Aerosol in Adults With Chronic Obstructive Pulmonary Disease

Primary Purpose

Pulmonary Disease, Chronic Obstructive

Status
Completed
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Low dose of Ipratropium bromide
High dose of Ipratropium bromide
Atrovent
Placebo
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pulmonary Disease, Chronic Obstructive

Eligibility Criteria

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

Inclusion Criteria:

  1. All patients must have a diagnosis of COPD and must meet the following spirometric criteria:

    • Patients must have relatively stable, moderate to severe airway obstruction with a FEV1 =< 65% of predicted normal and FEV1 =< 70% of FVC
  2. Male or female patients 40 years of age or older
  3. Patients must have a smoking history of more than ten packs-years. A pack-year is defined as the equivalent of smoking one pack of 20 cigarettes per day for a year
  4. Patients must be able to perform pulmonary function tests and maintain records during the study period, as required in the protocol
  5. Patients must be able to be trained in the proper use of an inhalation aerosol and the Respimat device
  6. All patients must sign an Informed Consent Form prior to participation in the trial i.e., at least 24 hours prior to screening (Visit 1)

Exclusion Criteria:

  1. 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
  2. Patients with clinically relevant abnormal baseline haematology, blood chemistry or urinalysis. If the abnormality defines a disease listed as an exclusion criterion, the patient is excluded
  3. All patients with a serum glutamate oxaloacetate transaminase > 80 U/L, serum glutamate pyruvate transaminase > 80 U/L, bilirubin > 34.2 µmol/L or creatinine > 176.8 µmol/L will be excluded regardless of the clinical condition. Repeat laboratory evaluation will not be conducted in these subjects
  4. Patients who have a blood eosinophil count >= 0.6 GI/L. A repeat eosinophil count will not be conducted in these patients
  5. Patients with a recent history (i.e., one year or less) of myocardial infarction
  6. Patients with a recent history (i.e., three years or less) of heart failure or patients with any cardiac arrhythmia requiring drug therapy
  7. Patients with a history of cancer, other than treated basal cell carcinoma, within the last five years
  8. Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or bronchiectasis
  9. Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of a thoracotomy for other reasons should be evaluated as per exclusion criterion #1
  10. Patients with a history of asthma, allergic rhinitis or atopy
  11. Patients with a history of and/or active alcohol or drug abuse
  12. Patients with known active tuberculosis
  13. Patients with an upper respiratory tract infection or COPD exacerbation in the past six weeks prior to the Screening Visit (Visit 1) or during the baseline period
  14. Patients with known symptomatic prostatic hypertrophy, bladder neck obstruction, or urinary retention
  15. Patients with known narrow-angle glaucoma, or raised intra-ocular pressure
  16. Patients with current significant psychiatric disorders
  17. Patients with regular use of daytime oxygen therapy
  18. Patients who are being treated with cromolyn sodium or nedocromil sodium
  19. Patients who are being treated with antihistamines
  20. Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at a dose in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day
  21. Patients who are being treated with beta-blocker medication
  22. Patients who have had changes in their therapeutic plan within the last six weeks prior to the Screening Visit (Visit 1)
  23. Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception (i.e., oral contraceptives, intrauterine devices or diaphragm with spermicide, or Norplant®)
  24. Patients with known hypersensitivity to anticholinergic drugs or any other components of the ATROVENT® Solution including Benzalkonium chloride and Edetic acid
  25. Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Screening Visit (Visit 1)
  26. Previous participation in this study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Active Comparator

    Placebo Comparator

    Arm Label

    Low dose of ipratropium bromide

    High dose of Ipratopium bromide

    Atrovent

    Placebo

    Arm Description

    Outcomes

    Primary Outcome Measures

    Area under the curve from 0 to 6 hours (AUC0-6) for average of forced expiratory volume in 1 second (FEV1)

    Secondary Outcome Measures

    Peak FEV1 post treatment
    Onset of therapeutic FEV1 response
    Duration of therapeutic FEV1 response
    Time to peak FEV1 response
    Total area under the curve from 0 to 6 hours (TAUC0-6) for average FEV1 response
    Average change in forced vital capacity (FVC) from zero to six hours
    Peak FVC post treatment
    Peak expiratory flow rate (PEFR) measured by the patient at home two times daily
    Amount of inhaled rescue medication used during the treatment period
    Concomitant medication usage during the treatment period including steroids
    Change in patient daily symptom assessments
    Number of patients with adverse events
    Changes in vital signs (pulse rate, blood pressure)
    Changes in laboratory tests
    Number of patients with significant changes in ECG (electrocardiogram)
    Changes in physical examination

    Full Information

    First Posted
    June 24, 2014
    Last Updated
    July 16, 2014
    Sponsor
    Boehringer Ingelheim
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02177344
    Brief Title
    Safety and Efficacy of Two Different Doses of Ipratropium Bromide Versus ATROVENT® Inhalation Aerosol in Adults With Chronic Obstructive Pulmonary Disease
    Official Title
    A Six Month, Randomized, Double-blind (Within Formulation), Multiple Dose Trial to Compare the Safety and Efficacy of 20 mcg and 40 mcg of Ipratropium Bromide, as Delivered by the RESPIMAT Device, to 18 mcg ATROVENT® Inhalation Aerosol (x 2 Puffs) and Respective Placebos in Adults, With Chronic Obstructive Pulmonary Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    August 1998 (undefined)
    Primary Completion Date
    October 1999 (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
    The objective of this study is to confirm that chronic dosing of 20 mcg and 40 mcg of ipratropium bromide, administered via the RESPIMAT device, demonstrates clinical comparability and similar safety profiles to the 36 mcg dose of ATROVENT® Inhalation Aerosol (containing chlorinated fluorocarbons (CFC)) in patients with chronic obstructive pulmonary disease (COPD). The efficacy and safety profiles of the two doses administered via the RESPIMAT device will also be compared to their respective placebo groups

    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 3
    Interventional Study Model
    Parallel Assignment
    Masking
    Double
    Allocation
    Randomized
    Enrollment
    646 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Low dose of ipratropium bromide
    Arm Type
    Experimental
    Arm Title
    High dose of Ipratopium bromide
    Arm Type
    Experimental
    Arm Title
    Atrovent
    Arm Type
    Active Comparator
    Arm Title
    Placebo
    Arm Type
    Placebo Comparator
    Intervention Type
    Drug
    Intervention Name(s)
    Low dose of Ipratropium bromide
    Intervention Description
    One puff, 4 times daily by oral inhalation
    Intervention Type
    Drug
    Intervention Name(s)
    High dose of Ipratropium bromide
    Intervention Description
    One puff, 4 times daily by oral inhalation
    Intervention Type
    Drug
    Intervention Name(s)
    Atrovent
    Intervention Description
    Two puffs, 4 times daily by oral inhalation
    Intervention Type
    Drug
    Intervention Name(s)
    Placebo
    Primary Outcome Measure Information:
    Title
    Area under the curve from 0 to 6 hours (AUC0-6) for average of forced expiratory volume in 1 second (FEV1)
    Time Frame
    up to day 169
    Secondary Outcome Measure Information:
    Title
    Peak FEV1 post treatment
    Time Frame
    up to day 169
    Title
    Onset of therapeutic FEV1 response
    Time Frame
    up to day 169
    Title
    Duration of therapeutic FEV1 response
    Time Frame
    up to day 169
    Title
    Time to peak FEV1 response
    Time Frame
    up to day 169
    Title
    Total area under the curve from 0 to 6 hours (TAUC0-6) for average FEV1 response
    Time Frame
    up to day 169
    Title
    Average change in forced vital capacity (FVC) from zero to six hours
    Time Frame
    up to day 169
    Title
    Peak FVC post treatment
    Time Frame
    up to day 169
    Title
    Peak expiratory flow rate (PEFR) measured by the patient at home two times daily
    Time Frame
    up to day 169
    Title
    Amount of inhaled rescue medication used during the treatment period
    Time Frame
    up to day 169
    Title
    Concomitant medication usage during the treatment period including steroids
    Time Frame
    up to day 169
    Title
    Change in patient daily symptom assessments
    Time Frame
    Baseline, up to day 169
    Title
    Number of patients with adverse events
    Time Frame
    Up to day 169
    Title
    Changes in vital signs (pulse rate, blood pressure)
    Time Frame
    Baseline, up to day 169
    Title
    Changes in laboratory tests
    Time Frame
    Baseline, day 169
    Title
    Number of patients with significant changes in ECG (electrocardiogram)
    Time Frame
    Baseline, day 169
    Title
    Changes in physical examination
    Time Frame
    Baseline, day 169

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: All patients must have a diagnosis of COPD and must meet the following spirometric criteria: Patients must have relatively stable, moderate to severe airway obstruction with a FEV1 =< 65% of predicted normal and FEV1 =< 70% of FVC Male or female patients 40 years of age or older Patients must have a smoking history of more than ten packs-years. A pack-year is defined as the equivalent of smoking one pack of 20 cigarettes per day for a year Patients must be able to perform pulmonary function tests and maintain records during the study period, as required in the protocol Patients must be able to be trained in the proper use of an inhalation aerosol and the Respimat device All patients must sign an Informed Consent Form prior to participation in the trial i.e., at least 24 hours prior to screening (Visit 1) 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 disease listed as an exclusion criterion, the patient is excluded All patients with a serum glutamate oxaloacetate transaminase > 80 U/L, serum glutamate pyruvate transaminase > 80 U/L, bilirubin > 34.2 µmol/L or creatinine > 176.8 µmol/L will be excluded regardless of the clinical condition. Repeat laboratory evaluation will not be conducted in these subjects Patients who have a blood eosinophil count >= 0.6 GI/L. A repeat eosinophil count will not be conducted in these patients Patients with a recent history (i.e., one year or less) of myocardial infarction Patients with a recent history (i.e., three years or less) of heart failure or patients with any cardiac arrhythmia requiring drug therapy Patients with a history of cancer, other than treated basal cell carcinoma, within the last five years Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or bronchiectasis Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of a thoracotomy for other reasons should be evaluated as per exclusion criterion #1 Patients with a history of asthma, allergic rhinitis or atopy Patients with a history of and/or active alcohol or drug abuse Patients with known active tuberculosis Patients with an upper respiratory tract infection or COPD exacerbation in the past six weeks prior to the Screening Visit (Visit 1) or during the baseline period Patients with known symptomatic prostatic hypertrophy, bladder neck obstruction, or urinary retention Patients with known narrow-angle glaucoma, or raised intra-ocular pressure Patients with current significant psychiatric disorders Patients with regular use of daytime oxygen therapy Patients who are being treated with cromolyn sodium or nedocromil sodium Patients who are being treated with antihistamines Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at a dose in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day Patients who are being treated with beta-blocker medication Patients who have had changes in their therapeutic plan within the last six weeks prior to the Screening Visit (Visit 1) Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception (i.e., oral contraceptives, intrauterine devices or diaphragm with spermicide, or Norplant®) Patients with known hypersensitivity to anticholinergic drugs or any other components of the ATROVENT® Solution including Benzalkonium chloride and Edetic acid Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Screening Visit (Visit 1) Previous participation in this study

    12. IPD Sharing Statement

    Links:
    URL
    http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/244/244.2484_U00-3278.pdf
    Description
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    Safety and Efficacy of Two Different Doses of Ipratropium Bromide Versus ATROVENT® Inhalation Aerosol in Adults With Chronic Obstructive Pulmonary Disease

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