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Chronic Obstructive Pulmonary Disease (COPD)Phase 4SECURE 1NCT01397890

Efficacy and Tolerability of Symbicort as an add-on Treatment to Spiriva Compare With Spiriva Alone in Patients With Severe Chronic Obstructive Pulmonary Disease (COPD)

A Phase 4 study testing Budesonide/formoterol (Symbicort® Turbuhaler®) and Tiotropium (SpirivaTM) in people with Chronic Obstructive Pulmonary Disease (COPD), run by AstraZeneca at 31 sites in 5 countries.

Completed

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

Official record
Search all trials

Trial summary

This is a multicentre study with a randomised, parallel group, open-label, 3-month phase IV design to assess the efficacy and tolerability of Symbicort as an add-on treatment to Spiriva compare with Spiriva alone in patients with severe chronic obstructive pulmonary disease (COPD). Read more about this study

Who is it for?
Ages 40 years and older
What is being tested?
Budesonide/formoterol (Symbicort® Turbuhaler®) and Tiotropium (SpirivaTM)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
793 participants
Where
31 sitesin 5 countries
Study dates
Jul 2011to Jun 2013
Phase
Phase 4
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Signed and dated informed consent
  • Men or women patients ≥40 years of age
  • Diagnosis of COPD with symptoms for more than 2 years and there is a history of at least one COPD exacerbation requiring a course of oral steroids and/or antibiotics within 1-12 months before Visit 2
  • Forced Expiratory Volume in 1 second (FEV1) ≤50% of predicted normal value, pre-bronchodilator and Forced Expiratory Volume in 1 second (FEV1) / Forced Vital Capacity (FVC) < 70%, pre-bronchodilator
  • Total symptom score of 2 or more per day for at least half of run-in period (breathing, cough and sputum scores from the diary card) and complete morning recordings of Digital Peak Flow Meter data at least 7 out of the last 10 days of the run-in period

Who cannot join

  • A history of asthma and seasonal allergic rhinitis before 40 years of age
  • Patients who have experienced exacerbation of COPD requiring hospitalisation and /or emergency room treatment and/or a course of oral steroids and/or intravenous corticosteroids and/or antibiotics within 4 weeks prior to Visit 2 and/or during run-in period and also the patients who use of systemic glucocorticosteroids (GCS) within 4 weeks and/or inhaled GCS within 2 weeks prior to Visit 2 and/or during run-in period
  • Patients with relevant cardiovascular disorder judged by the investigator
  • Patients with glaucoma, prostatic hyperplasia or bladder-neck obstruction judged by the investigator
  • Women who are pregnant, breast-feeding or of child-bearing potential judged by the investigator

Trial locations and contacts

31 sites in 5 countries.

31 sites in 5 countries

Thailand9 sites
  • Research Site

    Bangkok

  • Research Site

    Chiang Mai, Thailand

  • Research Site

    Chon Buri

  • Research Site

    Khon Kaen

  • Research Site

    Muang, Changwat Nan

  • Research Site

    Nonthaburi, Changwat Nonthaburi

  • Research Site

    Phitsanulok

  • Research Site

    Songkhla

  • Research Site

    Udon Thani

Other trials in Thailand

China8 sites
  • Research Site

    Beijing, Beijing Municipality

  • Research Site

    Changchun, Jilin

  • Research Site

    Changsha, Hunan

  • Research Site

    Guangzhou, Guangdong

  • Research Site

    Guangzhou

  • Research Site

    Shanghai, Shanghai Municipality

  • Research Site

    Shenyang, Liaoning

  • Research Site

    Taiyuan, Shanxi

Other trials in China

South Korea8 sites
  • Research Site

    Busan

  • Research Site

    Daegu

  • Research Site

    Gwangju

  • Research Site

    Incheon

  • Research Site

    Jinju, Gyeongsangnam-do

  • Research Site

    Seoul

  • Research Site

    Suwon, Gyeonggi-do

  • Research Site

    Wŏnju, Gangwon-do

Other trials in South Korea

Hong Kong3 sites
  • Research Site

    Hong Kong, Hong Kong

  • Research Site

    Hong Kong

  • Research Site

    Kowloon, HK

Other trials in Hong Kong

Indonesia3 sites
  • Research Site

    Jakarta

  • Research Site

    Solo

  • Research Site

    Surabaya

Other trials in Indonesia

About this study

Official title: A Randomised, Parallel-group, Open-label, Multicentre, 3-month Phase IV, Efficacy and Tolerability Study of Budesonide/Formoterol (Symbicort® Turbuhaler® 160/4.5μg/Inhalation, 2 Inhalations Twice Daily) Added to Tiotropium (SpirivaTM 18 μg/Inhalation, 1 Inhalation Once Daily) Compared With Tiotropium (SpirivaTM18 μg/Inhalation, 1 Inhalation Once Daily) Alone in Severe Chronic Obstructive Pulmonary Disease (COPD) Patients

This is a multicentre study with a randomised, parallel group, open-label, 3-month phase IV design to assess the efficacy and tolerability of Symbicort as an add-on treatment to Spiriva compare with Spiriva alone in patients with severe chronic obstructive pulmonary disease (COPD).

Being tested
Budesonide/formoterol (Symbicort® Turbuhaler®), Tiotropium (SpirivaTM)
Keywords
Severe chronic obstructive pulmonary disease (COPD) patients
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.

  • Budesonide/formoterol (Symbicort® Turbuhaler®)Drug

    Budesonide/formoterol (Symbicort® Turbuhaler®) 160/4.5μg/inhalation, 2 inhalations twice daily

  • Tiotropium (SpirivaTM)Drug

    Tiotropium (SpirivaTM) 18 μg/inhalation, 1 inhalation once daily

Study groups in NCT01397890
Study groupRoleWhat they receive
1OtherAdd-on treatment
Receives: Drug: Budesonide/formoterol (Symbicort® Turbuhaler®); Drug: Tiotropium (SpirivaTM)
2OtherAdd-on treatment
Receives: Drug: Tiotropium (SpirivaTM)

What is being measured

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

  1. Pre-dose FEV1

    Ratio of pre-dose FEV1 (Forced Expiratory Volume in 1 second) in treatment period to baseline value

    Measured: Baseline (week 0) and mean in treatment period (weeks 1, 6, 12) measured before inhalation of study drug

Secondary outcomes (23)
  1. Post-dose FEV1 at 5 Minutes

    Ratio of post-dose FEV1 at 5 minutes to baseline value

    Measured: Baseline (-2 weeks) and mean in treatment period (1, 6, 12 weeks) measured at 5 minutes after inhalation of study drug

  2. Post-dose FEV1 at 60 Minutes

    Ratio of post-dose FEV1 at 60 minutes to baseline value

    Measured: Baseline (measured before inhalation of study drug at week 0) and mean in treatment period (measured at 1 hour after inhalation of study drug at weeks 0, 1, 6, 12)

  3. Pre-dose FVC

    Ratio of pre-dose FVC (Forced Vital Capacity) in treatment period to baseline value

    Measured: Baseline (measured before inhalation of study drug at week 0) and mean in treatment period (measured at 1 hour after inhalation of study drug at weeks 0, 1, 6, 12)

  4. Post-dose FVC at 5 Minutes

    Ratio of post-dose FVC at 5 minutes to baseline value

    Measured: Baseline (measured before inhalation of study drug at week 0) and mean in treatment period (measured at 5 minutes after inhalation of study drug at weeks 0, 1, 6, 12)

  5. Post-dose FVC at 60 Minutes

    Ratio of post-dose FVC at 60 minutes to baseline value

    Measured: Baseline (measured before inhalation of study drug at week 0) and mean in treatment period (measured at 1 hour after inhalation of study drug at weeks 0, 1, 6, 12)

  6. Pre-dose IC

    Ratio of pre-dose IC (Inspiratory Capacity) in treatment period to baseline value

    Measured: Baseline (week 0) and mean in treatment period (weeks 1, 6, 12) measured before inhalation of study drug

  7. Post-dose IC at 60 Minutes

    Ratio of post-dose IC at 60 minutes to baseline value

    Measured: Baseline (measured before inhalation of study drug at week 0) and mean in treatment period (measured at 1 hour after inhalation of study drug at weeks 0, 1, 6, 12)

  8. Pre-dose PEF in Last Week of Treatment

    Change in pre-dose morning PEF (Peak Expiratory Flow) from run-in period to last week of treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured before inhalation of study drug in the last week of treatment, up to 12 weeks

  9. Pre-dose PEF in First Week of Treatment

    Change in pre-dose morning PEF (Peak Expiratory Flow) from run-in period to first week of treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured before inhalation of study drug in the first week of treatment

  10. Pre-dose PEF in Whole Treatment Period

    Change in pre-dose morning PEF from run-in period to whole treatment period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured before inhalation of study drug in whole treatment period of 12 weeks

  11. Post-dose PEF in Last Week of Treatment

    Change in post-dose morning PEF at 5 minutes from run-period to last week of treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured at 5 minutes after inhalation of study drug in the last week of treatment, up to 12 weeks

  12. Post-dose PEF in First Week of Treatment

    Change in post-dose morning PEF at 5 minutes from run-in period to first week of treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured at 5 minutes after inhalation of study drug in the first week of treatment

  13. Post-dose PEF in Whole Treatment Period

    Change in post-dose morning PEF at 5 minutes from run-period to whole treatment period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured at 5 minutes after inhalation of study drug in whole treatment period of 12 weeks

  14. Use of Reliever Medication During Day in the Last Week on Treatment

    Change in the number of inhalations of reliever medication during day from run-in period to the last week on treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured during day in the last week on treatment, up to 12 weeks

  15. Use of Reliever Medication During Day in the First Week on Treatment

    Change in the number of inhalations of reliever medication during day from run-in period to the first week on treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured during day in the first week on treatment

  16. Use of Reliever Medication During Day in the Whole Treatment Period

    Change in the number of inhalations of reliever medication during day from run-in period to the whole treatment period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured during day in the whole treatment period of 12 weeks

  17. Use of Reliever Medication During Night in the Last Week on Treatment

    Change in the number of inhalations of reliever medication during night from run-in period to the last week on treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured during day in the last week on treatment, up to 12 weeks

  18. Use of Reliever Medication During Night in the First Week on Treatment

    Change in the number of inhalations of reliever medication during day from run-in period to the first week on treatment

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured during night in the first week on treatment

  19. Use of Reliever Medication During Night in the Whole Treatment Period

    Change in the number of inhalations of reliever medication during night from run-in period to the whole treatment period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements measured during day in the whole treatment period of 12 weeks

  20. Change in COPD Symptoms - Breathing

    Change in breathing symptom score (from 0:none to 4:severe) from run-in period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements in the whole treatment period of 12 weeks

  21. Change in COPD Symptoms - Cough

    Change in Cough symptom score (from 0:none to 4:severe) from run-in period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements in the whole treatment period of 12 weeks

  22. Change in COPD Symptoms - Sputum

    Change in Sputum symptom score (from 0:none to 4:severe) from run-in period

    Measured: Mean of daily measurements in run-in period (the last 10 days before randomization) and mean of daily measurements in the whole treatment period of 12 weeks

  23. COPD Exacerbations

    Severe exacerbations requiring systemic steroids (oral ≥3 days or parenteral) or hospitalisation or emergency room treatment due to worsening of COPD symptoms

    Measured: Whole treatment period of 12 weeks

Timeline

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

  1. First posted20 Jul 2011 (estimated)
  2. Study startJul 2011
  3. Primary completionJun 2013
  4. Study completionJun 2013

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
793 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01397890
Sponsor's protocol ID
D589BL00023
Acronym
SECURE 1
Status last verified
Mar 2015
First submitted
27 Jun 2011
Last updated
27 Mar 2015

Publications

  • Lee SD, Xie CM, Yunus F, Itoh Y, Ling X, Yu WC, Kiatboonsri S. Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: A randomized, multicentre study in East Asia. Respirology. 2016 Jan;21(1):119-27. doi: 10.1111/resp.12646. Epub 2015 Sep 23.

    PubMed 26394882

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Budesonide/formoterol (Symbicort® Turbuhaler®) and Tiotropium (SpirivaTM) in people with Chronic Obstructive Pulmonary Disease (COPD), run by AstraZeneca at 31 sites in 5 countries.

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 5 inclusion and 5 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 27 Mar 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 31 sites in Thailand, China, South Korea, Hong Kong, Indonesia. 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?

Yes. Results are posted in the registry (first posted 27 Aug 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?

Pre-dose FEV1 (time frame: Baseline (week 0) and mean in treatment period (weeks 1, 6, 12) measured before inhalation of study drug). 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 NCT01397890, 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 27 Mar 2015.

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