Safety, Tolerability and Pharmacokinetics of Tiotropium in Cystic Fibrosis Patients
Primary Purpose
Cystic Fibrosis
Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Tiotropium bromide low
Tiotropium bromide medium
Tiotropium bromide high
Placebo
Sponsored by

About this trial
This is an interventional treatment trial for Cystic Fibrosis
Eligibility Criteria
Inclusion Criteria:
- Male or female patients (pediatric ≤11 years; adolescent / adult ≥12 years)
- Documented diagnosis of CF (positive sweat chloride ≥60 mEq/liter, by pilocarpine iontophoresis) and/or a genotype with two identifiable mutations consistent with CF accompanied by one or more clinical features with the CF phenotype
- Able to perform acceptable spirometric maneuvers, according to ATS (American Thoracic Society) standards
- FEV1 >25% of predicted values
- Patients must be able to inhale medication in a reproducible manner from the Respimat® inhaler and from a metered dose inhaler (MDI)
Clinical stability:
- no evidence of acute upper or lower respiratory tract infection within 4 weeks of screening
- no pulmonary exacerbation requiring use of i.v./oral/inhaled antibiotics, or oral corticosteroids within 4 weeks of screening
- FEV1 at Visit 2 must be within 10% of FEV1 at Visit 1. If FEV1 at Visit 2 is not within 10% of FEV1 at Visit 1, Visit 2 may be re-scheduled once within 7 days
- The patient or the patient's legally acceptable representative must be able to give informed consent in accordance with International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines and local regulation
- Patients taking a chronic medication must be willing to continue this therapy for the entire duration of the study
Exclusion Criteria:
- Patients with a significant history of allergy / hypersensitivity (including medication allergy) which is deemed relevant to the trial as judged by the Investigator. "Relevance" in this context refers to any increased risk of hypersensitivity reaction to trial medication
- Patients with a known hypersensitivity to study drug or its components
- Patients who have participated in another study with an Investigational drug within one month or six half-lives (whichever is greater) preceding the screening visit
- Patients who are currently participating in another trial. Observational studies are allowed. Permission should be obtained from the sponsor of the study
- Patients with known relevant substance abuse, including alcohol or drug abuse. The intention of this criterion was to exclude patients who are considered to be at risk of not complying with or abusing the trial medication administration directives.
- Female patients who are pregnant or lactating, including females who have a positive urine pregnancy test at screening (pregnancy tests were performed for all females of child bearing potential)
- Female patients of child bearing potential who are not using a medically approved form of contraception.
- Patients with documented persistent colonization with B. cepacia (defined as more than one positive culture within the past year). The intention of this exclusion criterion is to be consistent with the current policy within the CF community for reducing the risk of B. cepacia cross infection.
- Patients who have started a new chronic medication for CF within four (4) weeks of screening. Patients who are on a cycling TOBI® (Tobramycin treatment) regimen must have completed at least three (3) cycles of every other month TOBI® administration prior to the screening visit. As there are other cycles used with TOBI®, the clinical monitor should be consulted before the patient was enrolled.
- Clinically significant disease or medical condition other than CF or CF-related conditions that, in the opinion of the Investigator, would compromise the safety of the patient or the quality of the data. This included significant hematological, hepatic, renal, cardiovascular, and neurologic disease. Patients with diabetes could participate if their disease is under good control prior to screening. This criterion provides an opportunity for the investigator to exclude patients based on clinical judgment, even if other eligibility criteria are satisfied.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm Type
Experimental
Experimental
Experimental
Experimental
Experimental
Placebo Comparator
Arm Label
Tiotropium bromide low
Tiotropium bromide medium
Tiotropium bromide high
Tiotropium bromide low (28 days)
Tiotropium bromide medium (28 days)
Placebo
Arm Description
Single dose: 2.5 µg Tiotropium
Single dose: 5 µg Tiotropium
Single dose: 10 µg Tiotropium
multiple dose: 2.5 µg Tiotropium
Multiple dose: 5 µg Tiotropium
single or multiple dose of Placebo
Outcomes
Primary Outcome Measures
Changes from baseline in physical examination
Changes from baseline in blood pressure
Changes from baseline in pulse rate
Changes from baseline in laboratory evaluation
Occurrence of Adverse Events
Change in FEV1 (Forced expiratory volume in one second)
Change in FVC (Forced vital capacity)
Change in FEF25-75% (Forced Expiratory Flow)
Secondary Outcome Measures
Cmax (maximum concentration of the analyte in plasma) after the first dose of 2.5 μg tiotropium bromide
tmax (time from dosing to maximum concentration) after the first dose of 2.5 μg tiotropium bromide
AUC0-tz (area under the concentration-time curve of the analyte in plasma over the time interval from 0 to the last quantifiable data point within the first dosing of 2.5 μg tiotropium bromide interval)
Aet1-t2 (amount of analyte that is eliminated in urine from the time point t1 to time point t2) after the first dose of 2.5 μg tiotropium bromide
fet1-t2 (fraction of analyte excreted in urine from time point t1 to t2) after the first dose of 2.5 μg tiotropium bromide
AUCt1-t2 (area under the concentration-time curve of the analyte in plasma over the time interval t1 to t2) after the first dose of 5 μg and 10 μg tiotropium bromide
AUC0-∞ (area under the concentration-time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity) after the first dose of 5 μg and 10 μg tiotropium bromide
%AUCtz-∞ (the percentage of the AUC 0-∞ that is obtained by extrapolation) after the first dose of 5 μg and 10 μg tiotropium bromide
λz (terminal rate constant of the analyte in plasma) after the first dose of 5 μg and 10 μg tiotropium bromide
t½ (terminal half-life of the analyte in plasma) after the first dose of 5 μg and 10 μg tiotropium bromide
MRTih (mean residence time of the analyte in the body after inhalation) after the first dose of 5 μg and 10 μg tiotropium bromide
CL/F (apparent clearance of the analyte in the plasma after extravascular administration) after the first dose of 5 μg and 10 μg tiotropium bromide
Vz/F (apparent volume of distribution of the analyte during the terminal phase λz following an extravascular dose) after the first dose of 5 μg and 10 μg tiotropium bromide
CLR,t1- t2 (renal clearance of the analyte in plasma from the time point t1 to time point t2) after the first dose of 5 μg and 10 μg tiotropium bromide
Cmax,ss (maximum measured concentration of the analyte in plasma at steady state over a uniform dosing interval τ)
tmax,ss (time from last dosing to maximum concentration of the analyte in plasma at steady state)
Cmin,ss (minimum measured concentration of the analyte in plasma at steady state over a uniform dosing interval τ)
Cpre,ss(predose concentration of the analyte in plasma at steady state immediately before administration of the next dose)
AUCτ,ss (area under the concentration-time curve of the analyte in plasma at steady state over a uniform dosing interval τ)
λz,ss (terminal rate constant in plasma at steady state)
t1/2,ss (terminal half-life of the analyte in plasma at steady state)
MRTih,ss (mean residence time of the analyte in the body after 14 administrations at steady state)
CL/F,ss (apparent clearance of the analyte in the plasma at steady state following extravascular multiple dose administration)
Vz/F,ss (apparent volume of distribution during the terminal phase λz at steady state following extravascular administration)
Aet1-t2,ss (amount of analyte that is eliminated in urine at steady state from the time point t1 to time point t2)
fet1-t2,ss (fraction of analyte eliminated in urine at steady state from time point t1 to time point t2)
CLR,t1-t2,ss (renal clearance of the analyte in plasma from the time point t1 until the time point t2 at steady state)
Accumulation Ratio (R)A,Cmax,28 based on Cmax
Accumulation Ratio (R)A,AUC,28 based on AUC0-τ
Linearity index (LI)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02172534
Brief Title
Safety, Tolerability and Pharmacokinetics of Tiotropium in Cystic Fibrosis Patients
Official Title
A Randomized, Double-blind Within Dose, Placebo-controlled Study to Investigate the Safety, Tolerability and Pharmacokinetics of Increasing Single and Multiple Doses (28-day Dosing) of Tiotropium Bromide Administered Once Daily Via the Respimat® Device in Cystic Fibrosis Patients
Study Type
Interventional
2. Study Status
Record Verification Date
June 2014
Overall Recruitment Status
Completed
Study Start Date
September 2006 (undefined)
Primary Completion Date
September 2008 (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
Study to obtain information about the safety and tolerability of tiotropium bromide administered via the Respimat® inhalation device in pediatric (≤11 y.o.) and adolescent/adult (≥12 y.o.) cystic fibrosis (CF) patients after single and multiple doses as well as to obtain pharmacokinetic data for tiotropium in CF patients after single and multiple doses
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
113 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Tiotropium bromide low
Arm Type
Experimental
Arm Description
Single dose: 2.5 µg Tiotropium
Arm Title
Tiotropium bromide medium
Arm Type
Experimental
Arm Description
Single dose: 5 µg Tiotropium
Arm Title
Tiotropium bromide high
Arm Type
Experimental
Arm Description
Single dose: 10 µg Tiotropium
Arm Title
Tiotropium bromide low (28 days)
Arm Type
Experimental
Arm Description
multiple dose: 2.5 µg Tiotropium
Arm Title
Tiotropium bromide medium (28 days)
Arm Type
Experimental
Arm Description
Multiple dose: 5 µg Tiotropium
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
single or multiple dose of Placebo
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide low
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide medium
Intervention Type
Drug
Intervention Name(s)
Tiotropium bromide high
Intervention Type
Drug
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Changes from baseline in physical examination
Time Frame
Baseline, Day 1 and 28
Title
Changes from baseline in blood pressure
Time Frame
Baseline, Day 1 and 28
Title
Changes from baseline in pulse rate
Time Frame
Baseline, Day 1 and 28
Title
Changes from baseline in laboratory evaluation
Time Frame
Baseline, Day 28
Title
Occurrence of Adverse Events
Time Frame
up to 59 days
Title
Change in FEV1 (Forced expiratory volume in one second)
Time Frame
Pre-dose and 0.5, 1 and 2 hours after treatment on Day1 and 28
Title
Change in FVC (Forced vital capacity)
Time Frame
Pre-dose and 0.5, 1 and 2 hours after treatment on Day1 and 28
Title
Change in FEF25-75% (Forced Expiratory Flow)
Time Frame
Pre-dose and 0.5, 1 and 2 hours after treatment on Day1 and 28
Secondary Outcome Measure Information:
Title
Cmax (maximum concentration of the analyte in plasma) after the first dose of 2.5 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
tmax (time from dosing to maximum concentration) after the first dose of 2.5 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
AUC0-tz (area under the concentration-time curve of the analyte in plasma over the time interval from 0 to the last quantifiable data point within the first dosing of 2.5 μg tiotropium bromide interval)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
Aet1-t2 (amount of analyte that is eliminated in urine from the time point t1 to time point t2) after the first dose of 2.5 μg tiotropium bromide
Time Frame
Pre-dose and 0-2, 2-4 and 4-8 hours after treatment on Day1
Title
fet1-t2 (fraction of analyte excreted in urine from time point t1 to t2) after the first dose of 2.5 μg tiotropium bromide
Time Frame
Pre-dose and 0-2, 2-4 and 4-8 hours after treatment on Day1
Title
AUCt1-t2 (area under the concentration-time curve of the analyte in plasma over the time interval t1 to t2) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
AUC0-∞ (area under the concentration-time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
%AUCtz-∞ (the percentage of the AUC 0-∞ that is obtained by extrapolation) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
λz (terminal rate constant of the analyte in plasma) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
t½ (terminal half-life of the analyte in plasma) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
MRTih (mean residence time of the analyte in the body after inhalation) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
CL/F (apparent clearance of the analyte in the plasma after extravascular administration) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
Vz/F (apparent volume of distribution of the analyte during the terminal phase λz following an extravascular dose) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
CLR,t1- t2 (renal clearance of the analyte in plasma from the time point t1 to time point t2) after the first dose of 5 μg and 10 μg tiotropium bromide
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day1
Title
Cmax,ss (maximum measured concentration of the analyte in plasma at steady state over a uniform dosing interval τ)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
tmax,ss (time from last dosing to maximum concentration of the analyte in plasma at steady state)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
Cmin,ss (minimum measured concentration of the analyte in plasma at steady state over a uniform dosing interval τ)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
Cpre,ss(predose concentration of the analyte in plasma at steady state immediately before administration of the next dose)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
AUCτ,ss (area under the concentration-time curve of the analyte in plasma at steady state over a uniform dosing interval τ)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
λz,ss (terminal rate constant in plasma at steady state)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
t1/2,ss (terminal half-life of the analyte in plasma at steady state)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
MRTih,ss (mean residence time of the analyte in the body after 14 administrations at steady state)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
CL/F,ss (apparent clearance of the analyte in the plasma at steady state following extravascular multiple dose administration)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
Vz/F,ss (apparent volume of distribution during the terminal phase λz at steady state following extravascular administration)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
Aet1-t2,ss (amount of analyte that is eliminated in urine at steady state from the time point t1 to time point t2)
Time Frame
Pre-dose and 0-2, 2-4 and 4-8 hours after treatment on Day 28
Title
fet1-t2,ss (fraction of analyte eliminated in urine at steady state from time point t1 to time point t2)
Time Frame
Pre-dose and 0-2, 2-4 and 4-8 hours after treatment on Day 28
Title
CLR,t1-t2,ss (renal clearance of the analyte in plasma from the time point t1 until the time point t2 at steady state)
Time Frame
Pre-dose and 5, 15, 30 min and 1, 2, 4, 6 hours after treatment on Day 28
Title
Accumulation Ratio (R)A,Cmax,28 based on Cmax
Time Frame
28 days
Title
Accumulation Ratio (R)A,AUC,28 based on AUC0-τ
Time Frame
28 days
Title
Linearity index (LI)
Time Frame
28 days
10. Eligibility
Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Male or female patients (pediatric ≤11 years; adolescent / adult ≥12 years)
Documented diagnosis of CF (positive sweat chloride ≥60 mEq/liter, by pilocarpine iontophoresis) and/or a genotype with two identifiable mutations consistent with CF accompanied by one or more clinical features with the CF phenotype
Able to perform acceptable spirometric maneuvers, according to ATS (American Thoracic Society) standards
FEV1 >25% of predicted values
Patients must be able to inhale medication in a reproducible manner from the Respimat® inhaler and from a metered dose inhaler (MDI)
Clinical stability:
no evidence of acute upper or lower respiratory tract infection within 4 weeks of screening
no pulmonary exacerbation requiring use of i.v./oral/inhaled antibiotics, or oral corticosteroids within 4 weeks of screening
FEV1 at Visit 2 must be within 10% of FEV1 at Visit 1. If FEV1 at Visit 2 is not within 10% of FEV1 at Visit 1, Visit 2 may be re-scheduled once within 7 days
The patient or the patient's legally acceptable representative must be able to give informed consent in accordance with International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines and local regulation
Patients taking a chronic medication must be willing to continue this therapy for the entire duration of the study
Exclusion Criteria:
Patients with a significant history of allergy / hypersensitivity (including medication allergy) which is deemed relevant to the trial as judged by the Investigator. "Relevance" in this context refers to any increased risk of hypersensitivity reaction to trial medication
Patients with a known hypersensitivity to study drug or its components
Patients who have participated in another study with an Investigational drug within one month or six half-lives (whichever is greater) preceding the screening visit
Patients who are currently participating in another trial. Observational studies are allowed. Permission should be obtained from the sponsor of the study
Patients with known relevant substance abuse, including alcohol or drug abuse. The intention of this criterion was to exclude patients who are considered to be at risk of not complying with or abusing the trial medication administration directives.
Female patients who are pregnant or lactating, including females who have a positive urine pregnancy test at screening (pregnancy tests were performed for all females of child bearing potential)
Female patients of child bearing potential who are not using a medically approved form of contraception.
Patients with documented persistent colonization with B. cepacia (defined as more than one positive culture within the past year). The intention of this exclusion criterion is to be consistent with the current policy within the CF community for reducing the risk of B. cepacia cross infection.
Patients who have started a new chronic medication for CF within four (4) weeks of screening. Patients who are on a cycling TOBI® (Tobramycin treatment) regimen must have completed at least three (3) cycles of every other month TOBI® administration prior to the screening visit. As there are other cycles used with TOBI®, the clinical monitor should be consulted before the patient was enrolled.
Clinically significant disease or medical condition other than CF or CF-related conditions that, in the opinion of the Investigator, would compromise the safety of the patient or the quality of the data. This included significant hematological, hepatic, renal, cardiovascular, and neurologic disease. Patients with diabetes could participate if their disease is under good control prior to screening. This criterion provides an opportunity for the investigator to exclude patients based on clinical judgment, even if other eligibility criteria are satisfied.
12. IPD Sharing Statement
Links:
URL
http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/205/205.338_U09-3457.pdf
Description
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Safety, Tolerability and Pharmacokinetics of Tiotropium in Cystic Fibrosis Patients
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