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To Evaluate Effectiveness of Aclidinium Bromide/Formoterol Fumarate Dihydrate in Chronic Obstructive Pulmonary Disease (ASTUTE)

Primary Purpose

Chronic Obstructive Pulmonary Disease

Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Aclidinium bromide/formoterol fumarate combination
Standard of Care
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease focused on measuring ASTUTE, Chronic Obstructive Pulmonary Disease, Randomised, Pragmatic, Standard of Care, Aclidinium bromide/formoterol fumarate fixed-dose combination, Duaklir, Genuair

Eligibility Criteria

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

Inclusion Criteria:

Patient is aged 40 years or older;

  • Confirmed diagnosis of COPD;
  • Spirometry performed at study entry or within the last 3 months preceding study entry with a post-bronchodilator Forced Expiratory Volume in 1 Second/Forced Vital Capacity quotient less than 0.7;
  • Patient is a current smoker or an ex-smoker with a smoking history of ≥10 pack-years;
  • Patient belongs to any of these treatment groups:

    • Patient is treated by a monotherapy long-acting bronchodilator (Long-Acting Muscarinic Antagonist or Long-Acting Beta Agonist), or
    • Naïve COPD patient, defined as:
  • Patient is newly diagnosed, or
  • Patient is naïve to maintenance therapy, or
  • Patient is treated with short acting bronchodilators as rescue medication, or
  • Patient has not been treated with long acting bronchodilators in the last 3 months.

Exclusion Criteria:

-

Patients should not be included in the study if any of the following exclusion criteria applies:

  • Patient changed COPD treatment regimen over the preceding 3 months;
  • Patient treated or intended to be treated at the time of randomisation with a maintenance regimen of inhaled corticosteroids or inhaled corticosteroids-containing medications;
  • Patient treated or intended to be treated at the time of randomisation with aclidinium bromide/formoterol fumarate dihydrate inhalation powder;
  • Patient had a previous diagnosis of asthma or is suspected of having asthma, asthma-COPD overlap or any other chronic respiratory disease other than COPD (including severe ones, such as cystic fibrosis, pulmonary fibrosis, active neoplasm except adequately treated [no evidence of recurrence within 5 years], active tuberculosis);
  • Patient developed a respiratory tract infection or COPD exacerbation within 6 weeks (or 3 months if an exacerbation-related hospitalisation was required) before the randomisation visit;
  • Patient with a history of hypersensitivity reaction to inhaled anticholinergics, sympathomimetic amines, lactose monohydrate, inhaled medication, or any component thereof (including report of paradoxical bronchospasm);
  • Patient has been previously enrolled in the current study.
  • Any condition that in the Investigator's opinion, would limit a patient's ability to participate in the study.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Active Comparator

    Arm Label

    Aclidinium/formoterol

    Bronchodilators

    Arm Description

    Patients will be randomized to receive either Aclidinium bromide/formoterol fumarate fixed-dose combination

    The comparator arm consists of SOC.

    Outcomes

    Primary Outcome Measures

    Change from baseline in overall early morning COPD symptom severity score of aclidinium bromide/formoterol fumarate dihydrate inhalation powder vs. Standard of Care bronchodilators as measured by the Early Morning Symptoms of COPD Instrument over 12 wks.
    Changes from baseline compared between aclidinium bromide/formoterol fumarate dihydrate inhalation powder and Standard of Care bronchodilators. Baseline values for EMSCI will be averaged over the study entry and previous day. For longitudinal analyses, each daily measure will be aggregated on a weekly (7 days) basis during the weeks of measurement (weeks 4, 8, and/or 12) by taking the mean value of all available measurements during the week.
    Change from baseline in overall night time COPD symptom severity score of aclidinium bromide/formoterol fumarate dihydrate inhalation powder vs. Standard of Care bronchodilators as measured by the Nighttime Symptoms of COPD Instrument over 12 weeks.
    Changes from baseline compared between aclidinium bromide/formoterol fumarate dihydrate inhalation powder and Standard of Care bronchodilators. Baseline values for NiSCI will be averaged over the study entry and previous day. For longitudinal analyses, each daily measure will be aggregated on a weekly (7 days) basis during the weeks of measurement (weeks 4, 8, and/or 12) by taking the mean value of all available measurements during the week.

    Secondary Outcome Measures

    Change from baseline in daily RS total Score of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the E-RS™COPD scale over 12 weeks.
    Baseline values of the RS-Total Score will be collected and averaged at the study entry visit and previous day. The secondary effectiveness variable will be estimated by the change from baseline in daily RS-Total Score over 12 weeks of treatment.
    Change from baseline in health status of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilatorsmeasured by the COPD assessment Test (CAT) over 12 weeks.
    The CAT measures the health status of patients with COPD. If the response to 1 of the 8 items is missing, the score will be considered missing. Change from baseline in health status over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12) will be calculated. These change scores will be the CAT endpoint.
    Change from baseline in total time index of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the Yale Physical Activity Survey (YPAS) over 12 weeks.
    The Total Time Index will be calculated at baseline and over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12). Change from baseline will be calculated. These change scores will be the Total Time Index analysed.
    Change from baseline in Energy Expenditure Index of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the Yale Physical Activity Survey (YPAS) over 12 weeks.
    The Energy Expenditure Index will be calculated at baseline and over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12). Change from baseline will be calculated. These change scores will be the Energy Expenditure Index analysed.
    Change from baseline in Activity Dimensions Summary Index of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the Yale Physical Activity Survey (YPAS) over 12 weeks.
    The Activity Dimensions Summary Index will be calculated at baseline and over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12). Change from baseline will be calculated. These change scores will be the Activity Dimensions Summary Index analysed.

    Full Information

    First Posted
    April 26, 2017
    Last Updated
    June 30, 2017
    Sponsor
    AstraZeneca
    Collaborators
    QuintilesIMS, Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03181880
    Brief Title
    To Evaluate Effectiveness of Aclidinium Bromide/Formoterol Fumarate Dihydrate in Chronic Obstructive Pulmonary Disease
    Acronym
    ASTUTE
    Official Title
    To Evaluate Effectiveness of Aclidinium Bromide/Formoterol Fumarate Dihydrate in Chronic Obstructive Pulmonary Disease
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2017
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study stopped early as AZ have re-prioritised to focus on research to help bring existing and innovative medicines to more patients with asthma and COPD.
    Study Start Date
    December 4, 2017 (Anticipated)
    Primary Completion Date
    December 3, 2018 (Anticipated)
    Study Completion Date
    December 3, 2018 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    AstraZeneca
    Collaborators
    QuintilesIMS, Inc.

    4. Oversight

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

    5. Study Description

    Brief Summary
    ASTUTE is a pragmatic open randomised 12-week multinational trial to evaluate the effectiveness of aclidinium bromide/formoterol fumarate dihydrate fixed-dose combination compared to standard of care bronchodilators in chronic obstructive pulmonary disease.
    Detailed Description
    ASTUTE is a longitudinal, randomised, multicentre, and multinational pragmatic study of patients with Chronic Obstructive Pulmonary Disease to evaluate the comparative effectiveness of Aclidinium bromide/formoterol fumarate fixed-dose combination (Duaklir™ Genuair®) and Standard of Care bronchodilators in patients treated with long acting bronchodilator monotherapies OR patients who abide to the following treatment category: patient is newly diagnosed, or naïve to maintenance therapy, or treated with short-acting bronchodilators as rescue medication, or has not been treated with long-acting bronchodilators in the last 3 months.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Chronic Obstructive Pulmonary Disease
    Keywords
    ASTUTE, Chronic Obstructive Pulmonary Disease, Randomised, Pragmatic, Standard of Care, Aclidinium bromide/formoterol fumarate fixed-dose combination, Duaklir, Genuair

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Aclidinium/formoterol
    Arm Type
    Active Comparator
    Arm Description
    Patients will be randomized to receive either Aclidinium bromide/formoterol fumarate fixed-dose combination
    Arm Title
    Bronchodilators
    Arm Type
    Active Comparator
    Arm Description
    The comparator arm consists of SOC.
    Intervention Type
    Drug
    Intervention Name(s)
    Aclidinium bromide/formoterol fumarate combination
    Other Intervention Name(s)
    Duaklir™ Genuair®
    Intervention Description
    Patients will be randomized to receive either Aclidinium bromide/formoterol fumarate fixed-dose combination (Duaklir™ Genuair®), or Standard Of Care (SOC) Bronchodilators. The product in study is Aclidinium bromide/formoterol fumarate fixed-dose combination (Duaklir™ Genuair®). Each inhaler will contain at least 60 doses (and a maximum of 68 doses) of aclidinium bromide/formoterol fixed-dose combination 400μg /12μg. Patients will be instructed to take 1 puff in the morning (09:00 ± 1 h) and 1 puff in the evening (21:00 ± 1 h) during the 12 weeks of treatment.
    Intervention Type
    Drug
    Intervention Name(s)
    Standard of Care
    Intervention Description
    Brochodilators
    Primary Outcome Measure Information:
    Title
    Change from baseline in overall early morning COPD symptom severity score of aclidinium bromide/formoterol fumarate dihydrate inhalation powder vs. Standard of Care bronchodilators as measured by the Early Morning Symptoms of COPD Instrument over 12 wks.
    Description
    Changes from baseline compared between aclidinium bromide/formoterol fumarate dihydrate inhalation powder and Standard of Care bronchodilators. Baseline values for EMSCI will be averaged over the study entry and previous day. For longitudinal analyses, each daily measure will be aggregated on a weekly (7 days) basis during the weeks of measurement (weeks 4, 8, and/or 12) by taking the mean value of all available measurements during the week.
    Time Frame
    study entry and previous day (retrospectively), days 22-28, days 50-56, days 78-84
    Title
    Change from baseline in overall night time COPD symptom severity score of aclidinium bromide/formoterol fumarate dihydrate inhalation powder vs. Standard of Care bronchodilators as measured by the Nighttime Symptoms of COPD Instrument over 12 weeks.
    Description
    Changes from baseline compared between aclidinium bromide/formoterol fumarate dihydrate inhalation powder and Standard of Care bronchodilators. Baseline values for NiSCI will be averaged over the study entry and previous day. For longitudinal analyses, each daily measure will be aggregated on a weekly (7 days) basis during the weeks of measurement (weeks 4, 8, and/or 12) by taking the mean value of all available measurements during the week.
    Time Frame
    study entry and previous day (retrospectively), days 22-28, days 50-56, days 78-84
    Secondary Outcome Measure Information:
    Title
    Change from baseline in daily RS total Score of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the E-RS™COPD scale over 12 weeks.
    Description
    Baseline values of the RS-Total Score will be collected and averaged at the study entry visit and previous day. The secondary effectiveness variable will be estimated by the change from baseline in daily RS-Total Score over 12 weeks of treatment.
    Time Frame
    study entry and previous day (retrospectively), days 22-28, days 50-56, days 78-84
    Title
    Change from baseline in health status of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilatorsmeasured by the COPD assessment Test (CAT) over 12 weeks.
    Description
    The CAT measures the health status of patients with COPD. If the response to 1 of the 8 items is missing, the score will be considered missing. Change from baseline in health status over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12) will be calculated. These change scores will be the CAT endpoint.
    Time Frame
    study entry, days 28, 56 and 84
    Title
    Change from baseline in total time index of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the Yale Physical Activity Survey (YPAS) over 12 weeks.
    Description
    The Total Time Index will be calculated at baseline and over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12). Change from baseline will be calculated. These change scores will be the Total Time Index analysed.
    Time Frame
    study entry, days 28, 56 and 84
    Title
    Change from baseline in Energy Expenditure Index of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the Yale Physical Activity Survey (YPAS) over 12 weeks.
    Description
    The Energy Expenditure Index will be calculated at baseline and over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12). Change from baseline will be calculated. These change scores will be the Energy Expenditure Index analysed.
    Time Frame
    study entry, days 28, 56 and 84
    Title
    Change from baseline in Activity Dimensions Summary Index of aclidinium bromide/formoterol fumarate dihydrate inhalation powder versus Standard of Care bronchodilators measured by the Yale Physical Activity Survey (YPAS) over 12 weeks.
    Description
    The Activity Dimensions Summary Index will be calculated at baseline and over 12 weeks of follow-up (on the last day of weeks 4, 8, and 12). Change from baseline will be calculated. These change scores will be the Activity Dimensions Summary Index analysed.
    Time Frame
    study entry, days 28, 56 and 84

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Patient is aged 40 years or older; Confirmed diagnosis of COPD; Spirometry performed at study entry or within the last 3 months preceding study entry with a post-bronchodilator Forced Expiratory Volume in 1 Second/Forced Vital Capacity quotient less than 0.7; Patient is a current smoker or an ex-smoker with a smoking history of ≥10 pack-years; Patient belongs to any of these treatment groups: Patient is treated by a monotherapy long-acting bronchodilator (Long-Acting Muscarinic Antagonist or Long-Acting Beta Agonist), or Naïve COPD patient, defined as: Patient is newly diagnosed, or Patient is naïve to maintenance therapy, or Patient is treated with short acting bronchodilators as rescue medication, or Patient has not been treated with long acting bronchodilators in the last 3 months. Exclusion Criteria: - Patients should not be included in the study if any of the following exclusion criteria applies: Patient changed COPD treatment regimen over the preceding 3 months; Patient treated or intended to be treated at the time of randomisation with a maintenance regimen of inhaled corticosteroids or inhaled corticosteroids-containing medications; Patient treated or intended to be treated at the time of randomisation with aclidinium bromide/formoterol fumarate dihydrate inhalation powder; Patient had a previous diagnosis of asthma or is suspected of having asthma, asthma-COPD overlap or any other chronic respiratory disease other than COPD (including severe ones, such as cystic fibrosis, pulmonary fibrosis, active neoplasm except adequately treated [no evidence of recurrence within 5 years], active tuberculosis); Patient developed a respiratory tract infection or COPD exacerbation within 6 weeks (or 3 months if an exacerbation-related hospitalisation was required) before the randomisation visit; Patient with a history of hypersensitivity reaction to inhaled anticholinergics, sympathomimetic amines, lactose monohydrate, inhaled medication, or any component thereof (including report of paradoxical bronchospasm); Patient has been previously enrolled in the current study. Any condition that in the Investigator's opinion, would limit a patient's ability to participate in the study.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Anna Ribera
    Organizational Affiliation
    AstraZeneca
    Official's Role
    Study Director

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    To Evaluate Effectiveness of Aclidinium Bromide/Formoterol Fumarate Dihydrate in Chronic Obstructive Pulmonary Disease

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