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