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Pulmonary Disease, Chronic ObstructivePhase 2AC4115321NCT01372410

A Randomized, Double Blind, Placebo Controlled, Incomplete Block, Crossover, Dose Ranging Study to Evaluate the Dose Response of GSK573719 Administered Once or Twice Daily Over 7 Days in Patients With Chronic Obstructive Pulmonary Disease (COPD)

A Phase 2 study testing GSK573719 and Tiotropium in people with Pulmonary Disease, Chronic Obstructive, run by GlaxoSmithKline at 13 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to further characterize the dose response of GSK573719 at doses of 15.6 micrograms (mcg) to 125 mcg once daily in patients with chronic obstructive pulmonary disease (COPD). Treatment with doses of GSK573719 dosed twice daily will also be included to further evaluate dosing frequency. Read more about this study

Who is it for?
Ages 40 to 80 years
Conditions the study is for
Pulmonary Disease, Chronic Obstructive
What is being tested?
GSK573719 and Tiotropium
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
163 participants
Where
13 sitesUnited States
Study dates
1 Jul 2011to 27 Oct 2011
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Outpatient
  • A signed and dated written informed consent prior to study participation.
  • Male or female adults.
  • 40 to 80 years of age at Visit 1
  • Diagnosis of COPD
  • Current or former cigarette smokers with a history of cigarette smoking of greater than or equal to 10 pack-years
  • Post-albuterol forced expiratory volume in 1 second (FEV1)/ forced vital capacity (FVC)<0.70 and post albuterol FEV1 of greater than or equal to 35% and less than or equal to 70% of predicted normal values

Who cannot join

  • Women who are pregnant or lactating or are planning on becoming pregnant during the study.
  • A current diagnosis of asthma
  • Known alpha-1 antitrypsin deficiency, active lung infections (such as tuberculosis), and lung cancer
  • Other significant respiratory conditions in addition to COPD
  • Other diseases that are uncontrolled including cancer in remission for less than 5 years
  • Chest x-ray or CT scan with clinically significant abnormalities not believed to be due to the presence of COPD
Show all 34Show fewer
  • Hypersensitivity to any anticholinergic/muscarinic receptor antagonist, beta2-agonist, lactose/milk protein or magnesium stearate
  • A medical condition that contraindicates study participation or use of an inhaled anticholinergic
  • Hospitalization for COPD or pneumonia within 12 weeks of Visit 1
  • Any previous lung resection surgery
  • A body mass index (BMI) value of >35 kilogram (kg)/meter squared (m2)
  • An abnormal and significant electrocardiogram finding at Visit 1
  • Significantly abnormal finding from clinical chemistry or haematology tests at Visit 1.
  • A positive Hepatitis B surface antigen or positive Hepatitis C antibody
  • Medically unable to withhold albuterol (salbutamol) for the 6 hour period prior to study visits
  • Use of depot corticosteroids within 12 weeks of Visit 1
  • Use of oral or parenteral corticosteroids or antibiotics for lower respiratory tract infection within 6 weeks of Visit 1
  • Use of long-acting beta-agonist (LABA)/inhaled corticosteroid (ICS) product if LABA/ICS therapy is discontinued within 30 days of Visit 1
  • Use of ICS at a dose of >1000mcg/day of fluticasone propionate or equivalent within 30 days of Visit 1
  • Initiation or discontinuation of ICS within 30 days of Visit 1
  • Use of tiotropium or phosphodiesterase 4 inhibitors within 14 days of Visit 1
  • Use of theophyllines, oral leukotriene inhibitors, long-acting oral beta-agonists, or inhaled long-acting beta-agonists within 48 hours of Visit 1
  • Short-acting oral beta-agonists within 12 hours of Visit 1
  • Use of LABA/ICS combination products only if discontinuing LABA therapy and switching to ICS monotherapy within 48 hours of Visit 1 for the LABA component
  • Use of sodium cromoglycate or nedocromil sodium within 24 hours of Visit 1
  • Use of inhaled short-acting beta-agonists, inhaled short-acting anticholinergics, or inhaled short-acting anticholinergic/short-acting beta-agonist combination products within 6 hours of Visit 1
  • Use of any other investigational medication within 30 days or 5 drug half-lives (whichever is longer)
  • Oxygen therapy prescribed for greater than 12 hours a day
  • Regular use (prescribed for use every day, not for as-needed use) of short-acting bronchodilators
  • Use of continuous positive airway pressure (CPAP), nocturnal positive pressure or non-invasive positive pressure ventilation (NIPPV), including use for sleep apnea.
  • Acute phase of a pulmonary rehabilitation program within 4 weeks prior to Visit 1
  • A known or suspected history of alcohol or drug abuse within 2 years prior to Visit 1
  • Anyone affiliated with investigator site
  • Previous use of GSK573719 or GSK53719/GW642444

Trial locations and contacts

13 sites in 1 country.

13 sites in 1 country

United States13 sites
  • GSK Investigational Site

    Atlanta, Georgia, 30342

  • GSK Investigational Site

    Charlotte, North Carolina, 28207

  • GSK Investigational Site

    Costa Mesa, California, 92626

  • GSK Investigational Site

    Duluth, Georgia, 30096

  • GSK Investigational Site

    Easley, South Carolina, 29640

  • GSK Investigational Site

    Edina, Minnesota, 55438

  • GSK Investigational Site

    Gaffney, South Carolina, 29340

  • GSK Investigational Site

    Greenville, South Carolina, 29615

  • GSK Investigational Site

    Oklahoma City, Oklahoma, 73103

  • GSK Investigational Site

    Orangeburg, South Carolina, 29118

  • GSK Investigational Site

    Raleigh, North Carolina, 27607

  • GSK Investigational Site

    Spartanburg, South Carolina, 29303

  • GSK Investigational Site

    Union, South Carolina, 29379

Other trials in United States

About this study

The purpose of this study is to further characterize the dose response of GSK573719 at doses of 15.6 micrograms (mcg) to 125 mcg once daily in patients with chronic obstructive pulmonary disease (COPD). Treatment with doses of GSK573719 dosed twice daily will also be included to further evaluate dosing frequency. Treatment with tiotropium (18 mcg) once daily via the Handihaler will be included as an active control. A placebo treatment will be included in order to evaluate absolute treatment effect of the different doses of GSK573719.

Read the detailed description

Inhaled bronchodilators, such as beta 2 agonists and anticholinergics, and inhaled corticosteroids are the mainstays of therapy in patients diagnosed with COPD. Anticholinergic bronchodilators or long acting muscarinic receptor antagonists function by blocking endogenous airway smooth muscle cholinergic tone. Treatment with anticholinergics has been shown to significantly improve forced expiratory volume in 1 second (FEV1), resting and dynamic lung hyperinflation, symptoms, and exercise capacity in patients with COPD. Currently tiotropium is the only approved long acting muscarinic antagonist available for treatment of COPD.

This is a multicenter, randomized, double-blind, placebo controlled, three way crossover, incomplete block study to evaluate 4 doses of GSK573719 inhaled once daily and 2 doses of GSK573719 inhaled twice daily over 7 days in patients with COPD. Tiotropium will be included as an open label active comparator. A placebo treatment will be included to evaluate treatment effect of each GSK573719 dose. Pharmacokinetic profiles of GSK573719 will also be determined. Each eligible subject will receive a sequence of 3 of 8 potential treatments for a total of 3 treatment periods per subject. There will be 7 clinic visits, during three of which 24 hour serial spirometry will be performed. The total duration of subject participation is approximately 9 weeks.

Being tested
GSK573719, Tiotropium, Placebo
Keywords
Long acting muscarinic antagonist, Tiotropium, Chronic Bronchitis, Emphysema, Chronic Obstructive Pulmonary Disease
Medical subject headings
Pulmonary Disease, Chronic Obstructive, Bronchitis, Chronic, Emphysema

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • GSK573719Drug

    125 mcg once daily

  • GSK573719Drug

    62.5 mcg once daily

  • GSK573719Drug

    31.25 mcg once daily

  • GSK573719Drug

    15.6 mcg once daily

  • GSK573719Drug

    31.25 mcg twice daily

  • GSK573719Drug

    15.6 mcg twice daily

  • TiotropiumDrug

    18 mcg once daily

  • PlaceboDrug

    once or twice daily

Study groups in NCT01372410
Study groupRoleWhat they receive
TiotropiumActive comparator18 mcg, inhaled long acting muscarinic antagonist
Receives: Drug: Tiotropium
GSK573719Experimentalinhaled medication
Receives: Drug: GSK573719
PlaceboPlacebo comparatorinactive/excipients only
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Final Dose-response Model for Trough Forced Expiratory Volume in One Second (FEV1)

    The trough FEV1 data for both the once-daily (QD) and twice-daily (BID) UMEC doses were included in a parametric analysis in order to evaluate trough FEV1dose response. The Day 8 dataset and a pooled dataset for Day 7 and Day 8 were analyzed separately and reported. The rationale for pooling Day 7 and Day 8 (post-hoc analysis) was to ensure informative interpretation of FEV1 response as a function of dose given the repeated measures for trough FEV1 response within each participant on different days. The fixed-effects parameters of the dose response model include Emax (the maximum predicted FEV1 response), ED50 (potency), and S0 (estimated Baseline FEV1). FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. Data for Emax and S0 are reported in this table. mITT=Modified Intent-to-Treat; par.=participants; BL=Baseline.

    Measured: Day 7 and Day 8 of each treatment period (up to Study Day 50)

  2. Final Dose-response Model for Trough FEV1 for ED50 (Potency) Parameter

    The trough FEV1 data for both the once-daily (QD) and twice-daily (BID) UMEC doses were included in a parametric analysis in order to evaluate dose response. Both a Day 8 dataset and a pooled dataset for Day 7 and Day 8 were analyzed and reported. The rationale for pooling Day 7 and Day 8 (post-hoc analysis) was to ensure informative interpretation of FEV1 response as a function of dose given the repeated measures for trough FEV1 response within each participant on different days. ED50 is defined as the potency and is the dose that yields 50% of Emax (maximum predicted FEV1 response). FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second.

    Measured: Day 7 and Day 8 of each treatment period (up to Study Day 50)

  3. Final Dose-response Model Parameter β-FEV1MB-S0 for Trough FEV1

    The trough FEV1 data for both the once-daily (QD) and twice-daily (BID) UMEC doses were included in a parametric analysis in order to evaluate dose response. Both a Day 8 dataset and a pooled dataset for Day 7 and Day 8 were analyzed and reported. The rationale for pooling Day 7 and Day 8 (post-hoc analysis) was to ensure informative interpretation of FEV1 response as a function of dose given the repeated measures for trough FEV1 response within each participant on different days. β-FEV1MB-S0 is defined as the covariate (Baseline trough FEV1) effect on the mean Baseline trough FEV1 estimate (S0). FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second.

    Measured: Day 7 and Day 8 of each treatment period (up to Study Day 50)

  4. Change From Baseline in Trough Forced Expiratory Volume in One Second (FEV1) on Day 8 of Each Treatment Period

    FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. Trough FEV1 on Treatment Day 8 is defined as the value obtained 24 hours after the morning dose administered on Day 7. Analysis was performed using a mixed model with covariates of mean Baseline, period Baseline, treatment, and period as fixed effects and participant as a random effect. Baseline is the FEV1 value recorded pre-dose on Day 1 of each treatment period, mean Baseline is the mean of the Baselines for each participant, and period Baseline is the difference between the Baseline and the mean Baseline in each treatment period for each particiapant. Change from Baseline for each treatment period is the trough FEV1 at Day 8 minus the Baseline value for that treatment period.

    Measured: Baseline and Day 8 of each treatment period (up to Study Day 50)

Secondary outcomes (2)
  1. Change From Baseline (BL) in Serial FEV1 Over Time on Day 7 of Each Treatment Period

    Serial FEV1 for once daily dosing is recorded at the pre-AM dose (AMD; time 0 hour [h]) and at 1, 3, 6, 9, 12,13, 15, 23, and 24 hours after the AMD on Day 7. For twice daily dosing, the 12 h AMD corresponds to the pre-PM dose (PMD), the 13 h AMD corresponds to the 1 h PMD, the 15 h AMD corresponds to the 3 h PMD, the 23 h AMD corresponds to the 11 h PMD, and the 24 h AMD corresponds to the 12 h PMD in this table. Analysis was performed using a mixed model with covariates of mean BL, period BL, treatment, period, time, time by period BL interaction, time by mean BL interaction, and time by treatment interaction as fixed effects and participant as a random effect. BL is the value recorded pre-dose on Day 1 of each TP, mean BLis the mean of the BLs for each participant, and period BL is the difference between the BL and the mean BL in each TP for each participant. Change from BL for each timepoint within a TP is the serial FEV1 measure at that timepoint minus the BL value for that TP.

    Measured: Baseline and Day 7 of each treatment period (TP; up to Study Day 49)

  2. Change From Baseline (BL) in Weighted Mean FEV1 Over 0 to 24 Hours After the Morning Dosing on Day 7 of Each Treatment Period

    FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. The weighted mean FEV1 was derived by calculating the area under the FEV1/time curve (AUC) using the trapezoidal rule, and then dividing the value by the time interval over which the AUC was calculated. The weighted mean FEV1 was calculated using 0-24 hour post-dose measurements at Day 7 of each treatment period, which included pre-dose and post-dose 1, 3, 6, 9, 12, 13, 15, 23, and 24 hours. Analysis was performed using a mixed model with covariates of mean BL, period BL, treatment, and period as fixed effects and participant as a random effect. BL is the FEV1 value recorded pre-dose on Day 1 of each TP, mean BL is the mean of the BLs for each participant, and period BL is the difference between the BL and the mean BL in each TP for each participant. Change from BL for each TP is the weighted mean FEV1 at Day 7 minus the BL value for that TP.

    Measured: Baseline and Day 7 of each treatment period (TP; up to Study Day 49)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Jun 2011 (estimated)
  2. Study start1 Jul 2011
  3. Primary completion1 Oct 2011
  4. Study completion27 Oct 2011

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
163 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01372410
Sponsor's protocol ID
115321
Acronym
AC4115321
Status last verified
Oct 2017
First submitted
9 Jun 2011
Last updated
8 Nov 2017
Data monitoring committee
No
Individual data sharing
Yes: Patient-level data for this study will be made available through www.clinicalstudydatarequest.com following the timelines and process described on this site.

Publications

  • Church A, Beerahee M, Brooks J, Mehta R, Shah P. Dose response of umeclidinium administered once or twice daily in patients with COPD: a randomised cross-over study. BMC Pulm Med. 2014 Jan 6;14:2. doi: 10.1186/1471-2466-14-2.

    PubMed 24393134

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing GSK573719 and Tiotropium in people with Pulmonary Disease, Chronic Obstructive, run by GlaxoSmithKline at 13 sites in United States.

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 7 inclusion and 34 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 8 Nov 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 13 sites in United States. 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. Some participants in this study may receive a placebo. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Feb 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Final Dose-response Model for Trough Forced Expiratory Volume in One Second (FEV1) (time frame: Day 7 and Day 8 of each treatment period (up to Study Day 50)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01372410, which also lists 1 linked publication.

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 8 Nov 2017.

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