Pulmonary Disease, Chronic ObstructivePhase 4NCT00239499
Pilot Study Comparing Tiotropium (Spiriva) to Salmeterol (Serevent) Plus Fluticasone (Flixotide) in Chronic Obstructive Pulmonary Disease (COPD)
A Phase 4 study testing Tiotropium and Salmeterol plus Fluticasone in people with Pulmonary Disease, Chronic Obstructive, run by Boehringer Ingelheim at 12 sites in South Africa.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 40 years and older
- Conditions the study is for
- Pulmonary Disease, Chronic Obstructive
- What is being tested?
- Tiotropium and Salmeterol plus Fluticasone
- How many people
- 107 participants
- Where
- 12 sitesSouth Africa
- Study dates
- Sep 2003to Aug 2004
- Phase
- Phase 4
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- All patients must have a diagnosis of chronic obstructive pulmonary disease according to the GOLD criteria and must meet the following spirometric criteria:
- Patients must have relatively stable airway obstruction with a post-bronchodilator FEV1 < 80% of predicted normal and FEV1/FVC < 70% at Visit 1, and a pre-dose FEV1 < 65% predicted at Visit 2.
- Male or female patients 40 years of age or older. There is no upper age limit.
- Patients must be current or ex-smokers with a smoking history of more than 10 pack-years.
Who cannot join
- Patients with significant diseases other than COPD.
- Patients with a history of asthma, allergic rhinitis or atopy or who have a total blood eosinophil count more than or equal to 600/mm3.
- Patients who have been treated with commercially available tiotropium (Spiriva®).
Trial locations and contacts
12 sites in 1 country.
12 sites in 1 country
South Africa12 sites
Tijger Trial Centre
Bellville, 7530
Boehringer Ingelheim Investigational Site
Bloemfontein, 9301
UCT Lung Institute
Cape Town, 7700
Boehringer Ingelheim Investigational Site
Cape Town, 8001
Durban Lung Centre
Durban, 4001
St Augustine Hospital
Durban, 4001
QdotPharma
George, 6529
Centre for Chest Diseases Research Unit
Johannesburg, 2193
Boehringer Ingelheim Investigational Site
Paarl, 7646
Boehringer Ingelheim Investigational Site
Pretoria, 0001
Vergelegen Medi-Clinic
Somerset West, 7130
Boehringer Ingelheim Investigational Site
Welkom, 9460
About this study
Official title: A Six-Week, Randomised, Double-Blind, Triple-Dummy, Parallel Group, Multiple Dose, Pilot Study Comparing Tiotropium Inhalation Capsules to Salmeterol Inhalation Aerosol Combined With Fluticasone Inhalation Aerosol in Patients With Chronic Obstructive Pulmonary Disease (COPD).
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.
Read more
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.
Read the detailed description
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.
- Conditions
- Pulmonary Disease, Chronic Obstructive
- Being tested
- Tiotropium, Salmeterol plus Fluticasone
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
TiotropiumDrug
Salmeterol plus FluticasoneDrug
What is being measured
The primary outcome is the main question the study is designed to answer.
The primary efficacy endpoint will be FEV1 area under the curve for the time period 0 to 12 hours (FEV1 AUC0-12) measured after 6 weeks of treatment, at the final study visit (Visit 4).
Secondary outcomes (1)
Trough and peak FEV1. Trough FVC at Visits 3 and 4 and peak FVC and FVC AUC0-12 at Visit 4. Individual FEV1 and FVC measurements at each time point. Weekly mean number of puffs of rescue therapy used per day and night.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Oct 2005 (estimated)
- Study startSep 2003
- Primary completionAug 2004
- Study completionAug 2004
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Pulmonary Disease, Chronic ObstructiveStudies of the same condition, open and under way.
- More trials run by Boehringer IngelheimThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Enrolment
- 107 participants
Sponsor and investigators
- Lead sponsor
- Boehringer Ingelheim
- Sponsor type
- Industry (pharma, biotech, devices)
- Investigators
- Boehringer Ingelheim Study Coordinator, Study chair, B.I. South Africa (Pty.) Ltd.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00239499
- Sponsor's protocol ID
- 205.273
- Status last verified
- Nov 2013
- First submitted
- 14 Oct 2005
- Last updated
- 11 Nov 2013
- Results posted
- No
Study at a glance
From the registry record, last updated by the sponsor on 11 Nov 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Six-Week, Randomised, Double-Blind, Triple-Dummy, Parallel Group, Multiple Dose, Pilot Study Comparing Tiotropium Inhalation Capsules to Salmeterol Inhalation Aerosol Combined With Fluticasone Inhalation Aerosol in Patients With Chronic Obstructive Pulmonary Disease (COPD).
- ClinicalTrials.gov ID
- NCT00239499
- Acronym / sponsor ID
- 205.273
- Conditions
- Pulmonary Disease, Chronic Obstructive
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 107 participants
- Lead sponsor
- Boehringer IngelheimIndustry (pharma, biotech, devices)
- Study start
- Sep 2003
- Primary completion
- Aug 2004 (actual)
- Study completion
- Aug 2004
- First posted
- 17 Oct 2005 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
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.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
Who may qualify
- Ages
- 40 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- All patients must have a diagnosis of chronic obstructive pulmonary disease according to the GOLD criteria and must meet the following spirometric criteria:
- Male or female patients 40 years of age or older. There is no upper age limit.
- Patients must be current or ex-smokers with a smoking history of more than 10 pack-years.
Key exclusion criteria (3 listed)
- Patients with significant diseases other than COPD.
- Patients with a history of asthma, allergic rhinitis or atopy or who have a total blood eosinophil count more than or equal to 600/mm3.
- Patients who have been treated with commercially available tiotropium (Spiriva®).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Tiotropium | Drug | – |
| Salmeterol plus Fluticasone | Drug | – |
Primary outcome
The primary efficacy endpoint will be FEV1 area under the curve for the time period 0 to 12 hours (FEV1 AUC0-12) measured after 6 weeks of treatment, at the final study visit (Visit 4).
1 secondary outcome
Trough and peak FEV1. Trough FVC at Visits 3 and 4 and peak FVC and FVC AUC0-12 at Visit 4. Individual FEV1 and FVC measurements at each time point. Weekly mean number of puffs of rescue therapy used per day and night.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Nov 2013.
- Related InfoLink provided by the sponsor.
- Related InfoLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Boehringer Ingelheim Study Coordinator study chair
B.I. South Africa (Pty.) Ltd.
12 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Tiotropium and Salmeterol plus Fluticasone in people with Pulmonary Disease, Chronic Obstructive, run by Boehringer Ingelheim at 12 sites in South Africa.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Nov 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 12 sites in South Africa. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The primary efficacy endpoint will be FEV1 area under the curve for the time period 0 to 12 hours (FEV1 AUC0-12) measured after 6 weeks of treatment, at the final study visit (Visit 4).. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Nov 2013.