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Terbutaline Sulfate in Adults With Asthma (TBS02)

Primary Purpose

Asthma

Status
Not yet recruiting
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Terbutaline
Sponsored by
Kanecia Obie Zimmerman
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Asthma

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Participant has provided informed consent
  2. History of physician-diagnosed asthma
  3. Age ≥18 to <50 at time of consent
  4. Past evidence of airway reactivity (within 12 months of consent), defined as:

    • Documentation of ≥12% FEV1 improvement following bronchodilator OR
    • Positive methacholine challenge (20% or more FEV1 decrease at ≤ 16 mg/mL)
  5. Evidence of recent asthma symptoms measured at Screening, defined as either:

    • Self-reported use of short-acting beta-agonist (SABA) for asthma symptoms at least twice/week on average over the past month OR
    • Asthma Control Questionnaire, 5-item version (ACQ - 5) ≥ 1.25
  6. Willing and able to undergo study procedures and attend required study visits
  7. Adequate venous access for blood draws and drug administration, as determined by study investigator, or designee
  8. Weight ≥ 40kg
  9. FEV1 ≥ 60% predicted on day of terbutaline sulfate dosing
  10. Systolic blood pressure (BP) ≤ 150 millimeters of Mercury (mmHg) and diastolic BP ≤ 90 mmHg measured after 10 to 15 minutes of rest
  11. Heart rate > 45 and < 110 beats per minute (bpm) measured after 10 to 15 minutes of rest
  12. Female participants of child-bearing potential: negative pregnancy test ((uUrine hCG)) at Screening screening and agreement to use effective contraception (complete abstinence from vaginal intercourse, combination barrier and spermicide, partner vasectomy, bilateral tubal ligation, intrauterine device (IUD), progestin implants, or hormonal) during study participation

Exclusion Criteria:

  1. Self-reported pregnancy or lactating or breastfeeding
  2. Previous enrollment in the current study (any part)
  3. Any chronic respiratory condition besides asthma (including, but not limited to Chronic Obstructive Pulmonary Disease (COPD), emphysema, or interstitial lung disease) that in the opinion of the Principal Investigator (PI) or clinical site investigator, would make the participant unsuitable for the study
  4. Body Mass Index (BMI) > 35 kg/m2 (class II or III obesity)
  5. Moderate to severe renal impairment, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2
  6. Self-reported smoking (including any vaping/e-cigarettes/marijuana) in past 6 months
  7. Greater than 10 pack-year smoking history
  8. Any history of cardiac disease (e.g. coronary insufficiency, cardiac arrhythmias), non-skin cancer, clinically diagnosed hypertension, hyperthyroidism, diabetes mellitus or epilepsy
  9. History of ocular, brain, abdominal or thoracic surgery in the 12 months prior to screening
  10. Known hypersensitivity to terbutaline sulfate
  11. Use of any medications from the following classes within 30 days prior to Visit 1: monoamine oxidase inhibitors, tricyclic antidepressants, betablockers, antihypertensive diuretics
  12. Self-reported respiratory tract infection in the 14 days prior to Visit 1
  13. Any current chronic condition or past history of disease that, in the opinion of the PI would make the participant unsuitable for the study
  14. Baseline prolongation of QTc (QTc ≥ 460 ms by Fridericia's formula)
  15. Participation in another research study that includes use of any investigational drug treatment within the 30 days prior to Visit 1, or planned participation during the study period.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Terbutaline Arm A

    Terbutaline Arm B

    Terbutaline Arm C

    Terbutaline Arm D

    Terbutaline Arm E

    Arm Description

    • Arm A: (n=6) IV bolus (0.25 mg) over 5 minutes SQ administration (0.25 mg) Participants in Part 1 Arms A and B (n=12) will be randomized to one of two treatment arms.No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.

    • Arm B: (n=6) SQ administration (0.25 mg) IV bolus (0.25 mg) over 5 minutes Participants in Part 1 Arms A and B (n=12) will be randomized to one of two treatment arms.No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.

    • Arm C: (n=6) SQ (0.25 mg) IV low dose over 5 minutes IV medium dose over 5 minutes IV high dose over 5 minutes Participants in Part 2 (n=18) will be randomized to one of three treatment arms. To maintain masking the first treatment will be 0.25 mg of study drug SQ, followed by one of three IV dose regimes (low, medium, high) below, which are estimated to be 0.1 mg, 0.5 mg, 1.0 mg, but may be adjusted based on the interim analysis completed in Part 1. No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.

    • Arm D: (n=6)SQ (0.25 mg) IV medium dose over 5 minutes IV high dose over 5 minutes IV low dose over 5 minutes Participants in Part 2 (n=18) will be randomized to one of three treatment arms. To maintain masking the first treatment will be 0.25 mg of study drug SQ, followed by one of three IV dose regimes (low, medium, high) below, which are estimated to be 0.1 mg, 0.5 mg, 1.0 mg, but may be adjusted based on the interim analysis completed in Part 1. No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.

    • Arm E: (n=6) SQ (0.25 mg) IV high dose over 5 minutes IV low dose over 5 minutes IV medium dose over 5 minutes Participants in Part 2 (n=18) will be randomized to one of three treatment arms. To maintain masking the first treatment will be 0.25 mg of study drug SQ, followed by one of three IV dose regimes (low, medium, high) below, which are estimated to be 0.1 mg, 0.5 mg, 1.0 mg, but may be adjusted based on the interim analysis completed in Part 1. No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.

    Outcomes

    Primary Outcome Measures

    PK: Maximum concentration (CMAX)
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route.
    PK: Time to Research Maximum Concentration (Tmax)
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route.
    PK: Clearance (Cl)
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route
    PK: Volume of Distribution (Vd)
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route
    PK: Half Life (t1/2)
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route
    Concentration Achieving Maximum FEV1 Improvement (CeMax)
    Estimate a target plasma concentration and IV dose which achieves maximum FEV1 improvement from baseline and FEV1 AUC 0 to 6 hours.
    Area Under the Concentration Time Curve (AUC)
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route.
    Forced Expiratory Volume in 1 second (FEV1)
    Estimate a target plasma concentration and IV dose which achieves maximum FEV1 improvement from baseline and FEV1 AUC 0 to 6 hours.

    Secondary Outcome Measures

    Number of Adverse Events (AEs)
    Adverse events (AEs) in participants receiving terbutaline sulfate.
    Number of Serious Adverse Events (SAEs)
    Serious Adverse Events (SAEs) in participants receiving terbutaline sulfate.
    Number of Suspected Unexpected Serious Adverse Reactions (SUSARs)
    Suspected Unexpected Serious Adverse Reactions (SUSARs) in participants receiving terbutaline sulfate.

    Full Information

    First Posted
    July 14, 2021
    Last Updated
    December 16, 2022
    Sponsor
    Kanecia Obie Zimmerman
    Collaborators
    Duke Health, The Emmes Company, LLC
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04973345
    Brief Title
    Terbutaline Sulfate in Adults With Asthma
    Acronym
    TBS02
    Official Title
    A Prospective, Blinded, Cross-Over Trial of the Exposure-Response Relationship of Terbutaline Sulfate in Adults With Asthma
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    December 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    January 3, 2023 (Anticipated)
    Primary Completion Date
    December 2025 (Anticipated)
    Study Completion Date
    December 2025 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor-Investigator
    Name of the Sponsor
    Kanecia Obie Zimmerman
    Collaborators
    Duke Health, The Emmes Company, LLC

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    Yes
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The overall aim in Part 1 is to compare the pharmacokinetic (PK)/pharmacodynamics (PD) relationship in intravenous (IV) versus subcutaneous (SQ) terbutaline sulfate to identify the optimal IV dosing range for use in Part 2. The overall aim in Part 2 is to evaluate the optimal IV dosing of terbutaline sulfate based on PD response and safety data.
    Detailed Description
    Primary Objectives: Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route. Estimate a target plasma concentration and IV dose which achieves maximum FEV1 improvement from baseline and FEV1 AUC. Secondary Objective: Describe all adverse events (AEs) in participants receiving terbutaline sulfate.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Asthma

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2, Phase 3
    Interventional Study Model
    Crossover Assignment
    Model Description
    A Prospective, Blinded, Cross-over Trial of the Exposure-Response Relationship of Terbutaline Sulfate in Adults with Asthma (TBS02)
    Masking
    ParticipantCare ProviderInvestigator
    Allocation
    Randomized
    Enrollment
    30 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Terbutaline Arm A
    Arm Type
    Experimental
    Arm Description
    • Arm A: (n=6) IV bolus (0.25 mg) over 5 minutes SQ administration (0.25 mg) Participants in Part 1 Arms A and B (n=12) will be randomized to one of two treatment arms.No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.
    Arm Title
    Terbutaline Arm B
    Arm Type
    Experimental
    Arm Description
    • Arm B: (n=6) SQ administration (0.25 mg) IV bolus (0.25 mg) over 5 minutes Participants in Part 1 Arms A and B (n=12) will be randomized to one of two treatment arms.No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.
    Arm Title
    Terbutaline Arm C
    Arm Type
    Experimental
    Arm Description
    • Arm C: (n=6) SQ (0.25 mg) IV low dose over 5 minutes IV medium dose over 5 minutes IV high dose over 5 minutes Participants in Part 2 (n=18) will be randomized to one of three treatment arms. To maintain masking the first treatment will be 0.25 mg of study drug SQ, followed by one of three IV dose regimes (low, medium, high) below, which are estimated to be 0.1 mg, 0.5 mg, 1.0 mg, but may be adjusted based on the interim analysis completed in Part 1. No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.
    Arm Title
    Terbutaline Arm D
    Arm Type
    Experimental
    Arm Description
    • Arm D: (n=6)SQ (0.25 mg) IV medium dose over 5 minutes IV high dose over 5 minutes IV low dose over 5 minutes Participants in Part 2 (n=18) will be randomized to one of three treatment arms. To maintain masking the first treatment will be 0.25 mg of study drug SQ, followed by one of three IV dose regimes (low, medium, high) below, which are estimated to be 0.1 mg, 0.5 mg, 1.0 mg, but may be adjusted based on the interim analysis completed in Part 1. No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.
    Arm Title
    Terbutaline Arm E
    Arm Type
    Experimental
    Arm Description
    • Arm E: (n=6) SQ (0.25 mg) IV high dose over 5 minutes IV low dose over 5 minutes IV medium dose over 5 minutes Participants in Part 2 (n=18) will be randomized to one of three treatment arms. To maintain masking the first treatment will be 0.25 mg of study drug SQ, followed by one of three IV dose regimes (low, medium, high) below, which are estimated to be 0.1 mg, 0.5 mg, 1.0 mg, but may be adjusted based on the interim analysis completed in Part 1. No masking will be applied for Part 1 or for the SQ dosing in Part 2. All IV treatments in Part 2 will be masked, with exception to the unmasked study pharmacist, refer to the MOP for details.
    Intervention Type
    Drug
    Intervention Name(s)
    Terbutaline
    Intervention Description
    management of asthma symptoms
    Primary Outcome Measure Information:
    Title
    PK: Maximum concentration (CMAX)
    Description
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route.
    Time Frame
    5 minutes, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, and next calendar day after dose
    Title
    PK: Time to Research Maximum Concentration (Tmax)
    Description
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route.
    Time Frame
    5 minutes, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours after dose
    Title
    PK: Clearance (Cl)
    Description
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route
    Time Frame
    5 mins, 15 mins, 30 mins, 45 mins, 1 hr, 2 hrs, 3 hrs, 4 hrs, 6 hrs, after dose
    Title
    PK: Volume of Distribution (Vd)
    Description
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route
    Time Frame
    5 minutes, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours after dose
    Title
    PK: Half Life (t1/2)
    Description
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route
    Time Frame
    5 minutes, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours after dose
    Title
    Concentration Achieving Maximum FEV1 Improvement (CeMax)
    Description
    Estimate a target plasma concentration and IV dose which achieves maximum FEV1 improvement from baseline and FEV1 AUC 0 to 6 hours.
    Time Frame
    0-6 hours
    Title
    Area Under the Concentration Time Curve (AUC)
    Description
    Describe differences in the PK profiles of terbutaline sulfate administered via the SQ route versus the IV route.
    Time Frame
    5 minutes, 15 minutes, 30 minutes, 45 minutes, 1 hour, 2 hours, 3 hours, 4 hours, 6 hours, and next calendar day after dose
    Title
    Forced Expiratory Volume in 1 second (FEV1)
    Description
    Estimate a target plasma concentration and IV dose which achieves maximum FEV1 improvement from baseline and FEV1 AUC 0 to 6 hours.
    Time Frame
    0-6 hours
    Secondary Outcome Measure Information:
    Title
    Number of Adverse Events (AEs)
    Description
    Adverse events (AEs) in participants receiving terbutaline sulfate.
    Time Frame
    From baseline through the end of study (Part I up to 60 days, Part II up to 180 days)
    Title
    Number of Serious Adverse Events (SAEs)
    Description
    Serious Adverse Events (SAEs) in participants receiving terbutaline sulfate.
    Time Frame
    From baseline through the end of study (Part I up to 60 days, Part II up to 180 days)
    Title
    Number of Suspected Unexpected Serious Adverse Reactions (SUSARs)
    Description
    Suspected Unexpected Serious Adverse Reactions (SUSARs) in participants receiving terbutaline sulfate.
    Time Frame
    From baseline through the end of study (Part I up to 60 days, Part II up to 180 days)

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    50 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Participant has provided informed consent History of physician-diagnosed asthma Age ≥18 to <50 at time of consent Past evidence of airway reactivity (within 12 months of consent), defined as: Documentation of ≥12% FEV1 improvement following bronchodilator OR Positive methacholine challenge (20% or more FEV1 decrease at ≤ 16 mg/mL) Evidence of recent asthma symptoms measured at Screening, defined as either: Self-reported use of short-acting beta-agonist (SABA) for asthma symptoms at least twice/week on average over the past month OR Asthma Control Questionnaire, 5-item version (ACQ - 5) ≥ 1.25 Willing and able to undergo study procedures and attend required study visits Adequate venous access for blood draws and drug administration, as determined by study investigator, or designee Weight ≥ 40kg FEV1 ≥ 60% predicted on day of terbutaline sulfate dosing Systolic blood pressure (BP) ≤ 150 millimeters of Mercury (mmHg) and diastolic BP ≤ 90 mmHg measured after 10 to 15 minutes of rest Heart rate > 45 and < 110 beats per minute (bpm) measured after 10 to 15 minutes of rest Female participants of child-bearing potential: negative pregnancy test ((uUrine hCG)) at Screening screening and agreement to use effective contraception (complete abstinence from vaginal intercourse, combination barrier and spermicide, partner vasectomy, bilateral tubal ligation, intrauterine device (IUD), progestin implants, or hormonal) during study participation Exclusion Criteria: Self-reported pregnancy or lactating or breastfeeding Previous enrollment in the current study (any part) Any chronic respiratory condition besides asthma (including, but not limited to Chronic Obstructive Pulmonary Disease (COPD), emphysema, or interstitial lung disease) that in the opinion of the Principal Investigator (PI) or clinical site investigator, would make the participant unsuitable for the study Body Mass Index (BMI) > 35 kg/m2 (class II or III obesity) Moderate to severe renal impairment, defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2 Self-reported smoking (including any vaping/e-cigarettes/marijuana) in past 6 months Greater than 10 pack-year smoking history Any history of cardiac disease (e.g. coronary insufficiency, cardiac arrhythmias), non-skin cancer, clinically diagnosed hypertension, hyperthyroidism, diabetes mellitus or epilepsy History of ocular, brain, abdominal or thoracic surgery in the 12 months prior to screening Known hypersensitivity to terbutaline sulfate Use of any medications from the following classes within 30 days prior to Visit 1: monoamine oxidase inhibitors, tricyclic antidepressants, betablockers, antihypertensive diuretics Self-reported respiratory tract infection in the 14 days prior to Visit 1 Any current chronic condition or past history of disease that, in the opinion of the PI would make the participant unsuitable for the study Baseline prolongation of QTc (QTc ≥ 460 ms by Fridericia's formula) Participation in another research study that includes use of any investigational drug treatment within the 30 days prior to Visit 1, or planned participation during the study period.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Talaya McCright-Gill, MA
    Phone
    321-556-3091
    Email
    Talaya.McCright-Gill@duke.edu
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Jason Lang, MD
    Organizational Affiliation
    Duke University
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No

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    Terbutaline Sulfate in Adults With Asthma

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