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The Effects of RPL554 on Top of Standard COPD Reliever Medications

Primary Purpose

Chronic Obstructive Pulmonary Disease

Status
Completed
Phase
Phase 2
Locations
United Kingdom
Study Type
Interventional
Intervention
Salbutamol
Ipratropium
RPL554
Salbutamol matched placebo
Ipratropium matched placebo
RPL554 matched placebo
Sponsored by
Verona Pharma plc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease

Eligibility Criteria

40 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Provide informed consent
  • Males not donating sperm and using adequate contraception or females who are surgically sterile or postmenopausal
  • 12-lead ECG showing:Heart rate 45 to 90 bpm, QTcF≤450 msec, QRS ≤120 msec, PR interval ≤220 msec, no clinically significant abnormality
  • Capable of complying with all study restrictions and procedures including ability to use the study nebuliser correctly.
  • BMI 18 to 33 kg/m2 with a minimum weight of 45 kg.
  • COPD diagnosis for at least 1 year and clinically stable COPD in previous 4 weeks
  • Demonstrates reversibility to bronchodilator (two puffs of salbutamol followed by two puffs of ipratropium) via spirometry:

    • Post-bronchodilator FEV1/forced vital capacity (FVC) ratio of ≤0.70
    • Post-bronchodilator FEV1 ≥40 % and ≤80% of predicted normal
    • ≥150 mL increase from pre-bronchodilator FEV1
  • Chest X-ray showing no abnormalities
  • Meet the concomitant medication restrictions and be expected to do so for the rest of the study.
  • Smoking history of ≥10 pack years.
  • Capable of withdrawing from long acting bronchodilators throughout the study and short acting bronchodilators for 8 hours prior to study treatment.

Exclusion Criteria:

  • History of life-threatening COPD including Intensive Care Unit admission and/or requiring intubation.
  • COPD exacerbation requiring oral steroids in the previous 3 months
  • History of one or more hospitalisations for COPD in the previous 12 months
  • Respiratory tract infection (both upper and lower) treated with antibiotics in previous 12 weeks
  • Evidence of cor pulmonale or clinically significant pulmonary hypertension.
  • Other respiratory disorders
  • Previous lung resection or lung reduction surgery.
  • Oral therapies for COPD in the previous 3 months and throughout the study.
  • Drug or alcohol abuse in the past 3 years
  • Received an experimental drug within 3 months or five half lives, whichever is longer.
  • Prior exposure to RPL554
  • Patients with a history of chronic uncontrolled disease that the Investigator believes are clinically significant.
  • Documented cardiovascular disease in last 3 months
  • Major surgery, (requiring general anaesthesia) in the previous 6 weeks, or will not have fully recovered from surgery, or planned surgery through the end of the study.
  • History of malignancy of any organ system within 5 years with the exception of localised skin cancers (basal or squamous cell)
  • Clinically significant abnormal values for safety laboratory tests
  • A disclosed history, or one known to the Investigator, of significant non compliance in previous investigational studies or with prescribed medications.
  • Requires oxygen therapy, even on an occasional basis.
  • Inability to adequately perform whole body plethysmography.
  • Any other reason that the Investigator considers makes the subject unsuitable to participate.
  • Patients with known hypersensitivity to atropine or its derivatives, or to ipratropium bromide, salbutamol or RPL554 or their excipients/components.

Sites / Locations

  • Medicines Evaluation Unit

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Active Comparator

Experimental

Active Comparator

Experimental

Experimental

Placebo Comparator

Arm Label

Salbutamol alone

Salbutamol and RPL554

Ipratropium

Ipratropium and RPL554

RPL554

Placebo

Arm Description

200 micrograms salbutamol, ipratropium matched placebo and RPL554 matched placebo

200 micrograms salbutamol, ipratropium matched placebo and 6 mg RPL554

Salbutamol matched placebo, 40 micrograms ipratropium and RPL554 matched placebo

Salbutamol matched placebo, 40 micrograms ipratropium and 6 mg RPL554

Salbutamol matched placebo, ipratropium matched placebo and 6 mg RPL554

Salbutamol matched placebo, ipratropium matched placebo and RPL554 matched placebo

Outcomes

Primary Outcome Measures

8 hour spirometry
Forced expired volume in one second (FEV1) over 8 hours post-dose

Secondary Outcome Measures

12 hour spirometry
FEV1 over 4, 6 and 12 hours post-dose
Whole body plethysmography
Functional residual capacity, residual volume, total lung capacity, specific airway conductance, specific airway resistance at 1 and 4 hours post-dose
Area under the curve (AUC)
AUC for RPL554 plasma concentration
Maximum plasma concentration (Cmax)
Cmax for RPL554 plasma concentration
Time to maximum plasma concentration (Tmax)
Tmax for RPL554 plasma concentration
Adverse events
Continuous measurement of adverse events throughout the study
Safety laboratory tests
Laboratory safety tests at screening, before each treatment and end of study
ECG
12 lead ECG at screening, before and up to 12 hours after each treatment and end of study
Vital signs
Blood pressure and pulse rate at screening, before and up to 12 hours after each treatment and end of study

Full Information

First Posted
August 30, 2015
Last Updated
September 8, 2016
Sponsor
Verona Pharma plc
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1. Study Identification

Unique Protocol Identification Number
NCT02542254
Brief Title
The Effects of RPL554 on Top of Standard COPD Reliever Medications
Official Title
A Phase II, Randomised, Double Blind, Placebo Controlled, Six Way Crossover Study to Assess the Bronchodilator Effect of RPL554 Administered on Top of Salbutamol and Ipratropium in Patients With COPD.
Study Type
Interventional

2. Study Status

Record Verification Date
September 2016
Overall Recruitment Status
Completed
Study Start Date
October 2015 (undefined)
Primary Completion Date
December 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Verona Pharma plc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study evaluates the addition of RPL554 to standard reliever medications for chronic obstructive pulmonary disorder (COPD). All patients will receive the same six treatments in a randomised sequence: salbutamol, ipratropium, salbutamol + RPL554, ipratropium + RPL554, RPL554 Placebo
Detailed Description
The purpose of this study is to investigate if RPL554 has an additive bronchodilator effect when administered in combination with standard of care bronchodilators in patients with COPD.This study investigates the pharmacodynamic effect of RPL554 using spirometry and whole body plethysmography compared to placebo, when administered in addition to a beta2 agonist (salbutamol), a muscarinic antagonist (ipratropium) or placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Obstructive Pulmonary Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Salbutamol alone
Arm Type
Active Comparator
Arm Description
200 micrograms salbutamol, ipratropium matched placebo and RPL554 matched placebo
Arm Title
Salbutamol and RPL554
Arm Type
Experimental
Arm Description
200 micrograms salbutamol, ipratropium matched placebo and 6 mg RPL554
Arm Title
Ipratropium
Arm Type
Active Comparator
Arm Description
Salbutamol matched placebo, 40 micrograms ipratropium and RPL554 matched placebo
Arm Title
Ipratropium and RPL554
Arm Type
Experimental
Arm Description
Salbutamol matched placebo, 40 micrograms ipratropium and 6 mg RPL554
Arm Title
RPL554
Arm Type
Experimental
Arm Description
Salbutamol matched placebo, ipratropium matched placebo and 6 mg RPL554
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Salbutamol matched placebo, ipratropium matched placebo and RPL554 matched placebo
Intervention Type
Drug
Intervention Name(s)
Salbutamol
Intervention Description
200 micrograms salbutamol administered using a pressurised metered dose inhaler (pMDI)
Intervention Type
Drug
Intervention Name(s)
Ipratropium
Intervention Description
40 micrograms ipratropium administered using a pMDI
Intervention Type
Drug
Intervention Name(s)
RPL554
Intervention Description
6 mg RPL554 administered using a nebuliser
Intervention Type
Drug
Intervention Name(s)
Salbutamol matched placebo
Intervention Description
Placebo pMDI
Intervention Type
Drug
Intervention Name(s)
Ipratropium matched placebo
Intervention Description
Placebo pMDI
Intervention Type
Drug
Intervention Name(s)
RPL554 matched placebo
Intervention Description
Nebulised placebo
Primary Outcome Measure Information:
Title
8 hour spirometry
Description
Forced expired volume in one second (FEV1) over 8 hours post-dose
Time Frame
8 hours
Secondary Outcome Measure Information:
Title
12 hour spirometry
Description
FEV1 over 4, 6 and 12 hours post-dose
Time Frame
12 hours
Title
Whole body plethysmography
Description
Functional residual capacity, residual volume, total lung capacity, specific airway conductance, specific airway resistance at 1 and 4 hours post-dose
Time Frame
4 hours
Title
Area under the curve (AUC)
Description
AUC for RPL554 plasma concentration
Time Frame
12 hours
Title
Maximum plasma concentration (Cmax)
Description
Cmax for RPL554 plasma concentration
Time Frame
12 hours
Title
Time to maximum plasma concentration (Tmax)
Description
Tmax for RPL554 plasma concentration
Time Frame
12 hours
Title
Adverse events
Description
Continuous measurement of adverse events throughout the study
Time Frame
Up to 94 days
Title
Safety laboratory tests
Description
Laboratory safety tests at screening, before each treatment and end of study
Time Frame
Up to 94 days
Title
ECG
Description
12 lead ECG at screening, before and up to 12 hours after each treatment and end of study
Time Frame
Up to 94 days
Title
Vital signs
Description
Blood pressure and pulse rate at screening, before and up to 12 hours after each treatment and end of study
Time Frame
Up to 94 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide informed consent Males not donating sperm and using adequate contraception or females who are surgically sterile or postmenopausal 12-lead ECG showing:Heart rate 45 to 90 bpm, QTcF≤450 msec, QRS ≤120 msec, PR interval ≤220 msec, no clinically significant abnormality Capable of complying with all study restrictions and procedures including ability to use the study nebuliser correctly. BMI 18 to 33 kg/m2 with a minimum weight of 45 kg. COPD diagnosis for at least 1 year and clinically stable COPD in previous 4 weeks Demonstrates reversibility to bronchodilator (two puffs of salbutamol followed by two puffs of ipratropium) via spirometry: Post-bronchodilator FEV1/forced vital capacity (FVC) ratio of ≤0.70 Post-bronchodilator FEV1 ≥40 % and ≤80% of predicted normal ≥150 mL increase from pre-bronchodilator FEV1 Chest X-ray showing no abnormalities Meet the concomitant medication restrictions and be expected to do so for the rest of the study. Smoking history of ≥10 pack years. Capable of withdrawing from long acting bronchodilators throughout the study and short acting bronchodilators for 8 hours prior to study treatment. Exclusion Criteria: History of life-threatening COPD including Intensive Care Unit admission and/or requiring intubation. COPD exacerbation requiring oral steroids in the previous 3 months History of one or more hospitalisations for COPD in the previous 12 months Respiratory tract infection (both upper and lower) treated with antibiotics in previous 12 weeks Evidence of cor pulmonale or clinically significant pulmonary hypertension. Other respiratory disorders Previous lung resection or lung reduction surgery. Oral therapies for COPD in the previous 3 months and throughout the study. Drug or alcohol abuse in the past 3 years Received an experimental drug within 3 months or five half lives, whichever is longer. Prior exposure to RPL554 Patients with a history of chronic uncontrolled disease that the Investigator believes are clinically significant. Documented cardiovascular disease in last 3 months Major surgery, (requiring general anaesthesia) in the previous 6 weeks, or will not have fully recovered from surgery, or planned surgery through the end of the study. History of malignancy of any organ system within 5 years with the exception of localised skin cancers (basal or squamous cell) Clinically significant abnormal values for safety laboratory tests A disclosed history, or one known to the Investigator, of significant non compliance in previous investigational studies or with prescribed medications. Requires oxygen therapy, even on an occasional basis. Inability to adequately perform whole body plethysmography. Any other reason that the Investigator considers makes the subject unsuitable to participate. Patients with known hypersensitivity to atropine or its derivatives, or to ipratropium bromide, salbutamol or RPL554 or their excipients/components.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dave Singh
Organizational Affiliation
Medicines Evaluation Unit
Official's Role
Principal Investigator
Facility Information:
Facility Name
Medicines Evaluation Unit
City
Manchester
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
30166326
Citation
Singh D, Abbott-Banner K, Bengtsson T, Newman K. The short-term bronchodilator effects of the dual phosphodiesterase 3 and 4 inhibitor RPL554 in COPD. Eur Respir J. 2018 Nov 1;52(5):1801074. doi: 10.1183/13993003.01074-2018. Print 2018 Nov.
Results Reference
derived

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The Effects of RPL554 on Top of Standard COPD Reliever Medications

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