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Sponsored by: |
Boehringer Ingelheim Pharmaceuticals |
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Information provided by: | Boehringer Ingelheim Pharmaceuticals |
ClinicalTrials.gov Identifier: | NCT00239499 |
The primary objective of this study is to estimate the comparative bronchodilator effect size and variability for tiotropium (Spiriva, 18 µg q.d.) with the free combination of salmeterol (Serevent, 50 µg b.i.d.) and fluticasone (Flixotide, 250 µg b.i.d.) in COPD patients.
International COPD guidelines preserve milder stages of the disease (GOLD stage I and IIa) to bronchodilators and recommend the addition of inhaled corticosteroids only in those patients who have a documented spirometric response to inhaled corticosteroids and in patients with a post-bronchodilator FEV1 of less than 50% predicted, who suffer from frequent exacerbations requiring oral courses of corticosteroids.
Recently published reports indicate that additional bronchodilator efficacy may be achieved when a long-acting beta agonist is combined with an inhaled corticosteroid. Steady state bronchodilation was achieved within one week with the drug combination. However, results of these studies are not consistent, and since the inclusion criteria employed were different from those utilised in the previously conducted tiotropium studies, it is difficult to generalise the observed effects to the general COPD population. In addition, no comparative data is available on the average response over the 12 daytime hours when COPD patients are active and in most need of bronchodilation. 12 hours corresponds to the dosing intervals for both salmeterol and fluticasone.
Condition | Intervention | Phase |
---|---|---|
Pulmonary Disease, Chronic Obstructive |
Drug: Tiotropium Drug: Salmeterol plus Fluticasone |
Phase IV |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double-Blind, Active Control, Parallel Assignment, Efficacy Study |
Official Title: | A Multiple Dose Pilot Comparison of Tiotropium Inhalation Capsules and Salmeterol Inhalation Aerosol Combined With Fluticasone Inhalation Aerosol in a Six-Week, Randomized, Double-Blind, Triple-Dummy Parallel Group Study in Patients With Chronic Obstructive Pulmonary Disease (COPD) |
Estimated Enrollment: | 107 |
Study Start Date: | September 2003 |
Estimated Study Completion Date: | August 2004 |
This is a six-week, multi-centre, randomised, double-blind, triple-dummy, parallel group pilot study to compare the bronchodilator efficacy and safety of the long-acting bronchodilator tiotropium (Spiriva, 18 µg q.d.) to the free combination of fluticasone (Flixotide, 250 µg b.i.d.) and salmeterol (Serevent, 50 µg b.i.d.) in patients with COPD. Following an initial screening at Visit 1, subjects will enter a two-week run-in period during which they will record daily rescue salbutamol use in the Patient Daily Diary Card. At Visit 1, pre-dose and post-bronchodilator pulmonary function tests (PFT) will be measured. Four inhalations of ipratropium (20 µg per puff) and four inhalations of salbutamol (100 µg per puff) will be administered 60 minutes prior to obtaining post-bronchodilator PFT measurement. At Visit 2, a pre-dose PFT will be performed prior to first administration of trial medication. Treatment with blinded study medication (tiotropium or fluticasone + salmeterol) will start in the morning of Visit 2 (Day 1). After three weeks of treatment, at Visit 3 (Day 22), pre-dose FEV1 and FVC will be measured, patient compliance checked and a re-supply of study medication dispensed. After six weeks of treatment, at Visit 4 (Day 43), a 12 hour profile of PFTs will be obtained.
Study Hypothesis:
As this is a pilot trial to investigate the efficacy and safety of tiotropium (18 µg q.d.) as compared to the free combination of fluticasone (250 µg b.i.d.) and salmeterol (50 µg b.i.d.), no formal hypothesis testing will be performed. However, the underlying hypothesis for this trial is that tiotropium is superior to the free combination with respect to the primary efficacy endpoint FEV1AUC0-12 (area under the curve for the time period 0 to 12 hours).
Comparison(s):
At least 100 male or female outpatients with clinical and spirometric evidence of chronic obstructive pulmonary disease (COPD) will be entered in this study. Patients will be randomly assigned to receive either tiotropium inhalation capsules 18 µg q.d., or salmeterol 50 µg oral inhalation b.i.d. in free combination with fluticasone 250 µg oral inhalation b.i.d. in a double-blind triple-dummy fashion.
Ages Eligible for Study: | 40 Years and older |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion criteria:
All patients must have a diagnosis of chronic obstructive pulmonary disease according to the GOLD criteria and must meet the following spirometric criteria:
Exclusion criteria:
South Africa | |
Boehringer Ingelheim Investigational Site | |
Pretoria, South Africa, 0001 | |
QdotPharma | |
George, South Africa, 6529 | |
Durban Lung Centre | |
Durban, South Africa, 4001 | |
Tijger Trial Centre | |
Bellville, South Africa, 7530 | |
Boehringer Ingelheim Investigational Site | |
Paarl, South Africa, 7646 | |
Vergelegen Medi-Clinic | |
Somerset West, South Africa, 7130 | |
St Augustine Hospital | |
Durban, South Africa, 4001 | |
Boehringer Ingelheim Investigational Site | |
Bloemfontein, South Africa, 9301 | |
Boehringer Ingelheim Investigational Site | |
Welkom, South Africa, 9460 | |
Centre for Chest Diseases Research Unit | |
Johannesburg, South Africa, 2193 | |
UCT Lung Institute | |
Cape Town, South Africa, 7700 | |
Boehringer Ingelheim Investigational Site | |
Cape Town, South Africa, 8001 |
Study Chair: | Boehringer Ingelheim Study Coordinator | B.I. South Africa (Pty.) Ltd. |
Study ID Numbers: | 205.273 |
Study First Received: | October 14, 2005 |
Last Updated: | November 26, 2008 |
ClinicalTrials.gov Identifier: | NCT00239499 History of Changes |
Health Authority: | South Africa: Medicines Control Council |
Anti-Inflammatory Agents Neurotransmitter Agents Salmeterol Cholinergic Antagonists Adrenergic Agents Adrenergic beta-Agonists Respiration Disorders Anti-Asthmatic Agents Anti-Allergic Agents Cholinergic Agents |
Adrenergic Agonists Lung Diseases, Obstructive Respiratory Tract Diseases Lung Diseases Fluticasone Chronic Disease Peripheral Nervous System Agents Tiotropium Bronchodilator Agents Pulmonary Disease, Chronic Obstructive |
Anti-Inflammatory Agents Parasympatholytics Respiratory System Agents Disease Attributes Neurotransmitter Agents Cholinergic Antagonists Adrenergic Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Cholinergic Agents Adrenergic Agonists Lung Diseases, Obstructive Pathologic Processes Respiratory Tract Diseases Therapeutic Uses |
Fluticasone Tiotropium Dermatologic Agents Salmeterol Adrenergic beta-Agonists Respiration Disorders Anti-Asthmatic Agents Anti-Allergic Agents Pharmacologic Actions Autonomic Agents Lung Diseases Chronic Disease Peripheral Nervous System Agents Bronchodilator Agents Pulmonary Disease, Chronic Obstructive |