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COPDPhase 2NCT03673670

Bronchodilator Effect of RPL554 Administered in Addition to Tiotropium/Olodaterol in Patients With COPD

A Phase 2 study testing RPL554 Suspension and Tiotropium/olodaterol (Respimat) in people with COPD, run by Verona Pharma, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA at 4 sites in 2 countries.

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 study investigates the effect of 3 days of twice daily treatment of two different doses of RPL554 (a phosphodiesterase [PDE]3/4 inhibitor) or placebo, each administered in addition to once daily tiotropium/olodaterol (Respimat) in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Read more about this study

Who is it for?
Ages 40 to 80 years
Conditions the study is for
COPD
What is being tested?
RPL554 Suspension and Tiotropium/olodaterol (Respimat)
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
79 participants
Where
4 sitesin 2 countries
Study dates
16 Jul 2018to 13 Nov 2018
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

  • Written informed consent
  • Male or female aged 40 and 80 years
  • For males, not to donate sperm and either be sexually abstinent or use contraception as specified by the protocol. For females, be of non-childbearing potential or use a highly effective form of contraception
  • 12-lead ECG with heart rate between 45 and 90 beats per minute, QTcF ≤450 msec for males, and ≤ 470 msec for females, QRS interval ≤120 msec and no clinically significant abnormality including morphology
  • Screening Holter report with a minimum of 18 hours recording that is able to be evaluated for rhythm analysis showing no abnormality which indicates a significant impairment of patient safety or which may significantly impair interpretation
  • Capable of complying with all study restrictions and procedures including ability to use the study nebulizer and Respimat® correctly.
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  • Body mass index (BMI) between 18 and 36 kg/m2 and minimum weight of 45 kg.
  • COPD diagnosis for at least 1 year and clinically stable COPD for 4 week
  • Post-bronchodilator (two puffs of salbutamol/albuterol followed by two puffs of ipratropium) spirometry at Screening:
  • Post-bronchodilator FEV1/forced vital capacity (FVC) ratio of ≤0.70
  • Post-bronchodilator FEV1 ≥30 % and ≤70% of predicted normal
  • Demonstrates ≥150 mL increase from pre-bronchodilator FEV1
  • A chest X-ray showing no abnormalities, which are both clinically significant and unrelated to COPD.
  • 12. Meet the concomitant medication restrictions and be expected to do so for the rest of the study.
  • 13. Current and former smokers with smoking history of ≥10 pack years. 14. Capable of withdrawing from long acting bronchodilators for the duration of the study, and short acting bronchodilators for 8 hours prior to dosing.

Who cannot join

  • A history of life-threatening COPD including Intensive Care Unit admission and/or requiring intubation.
  • COPD exacerbation requiring oral or parenteral steroids, or lower respiratory tract infection requiring antibiotics, in the last 3 months
  • A history of one or more hospitalizations for COPD in the last 12 months
  • Intolerance or hypersensitivity to tiotropium, olodaterol, atropine, ipratropium, or RPL554.
  • Evidence of cor pulmonale or clinically significant pulmonary hypertension.
  • Other respiratory disorders
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  • Previous lung resection or lung reduction surgery.
  • Use of oral COPD medications, except mucolytics, in the last 3 months
  • Pulmonary rehabilitation, unless such treatment has been stable in the last 4 weeks
  • History of, or reason to believe a patient has, drug or alcohol abuse within the past 5 years.
  • Inability to perform acceptable spirometry or whole body plethysmography
  • Received an experimental drug within 30 days or five half lives, whichever is longer.
  • Patients with uncontrolled disease that the Investigator believes are clinically significant. This includes any hepatic disease, or an alanine aminotransferase or aspartate aminotransferase>2 x upper limit of normal (ULN).
  • Documented cardiovascular disease: arrhythmias, angina, recent (<1 year) or suspected myocardial infarction, congestive heart failure, unstable or uncontrolled hypertension, or diagnosis of hypertension in the last 3 months
  • Use of non-selective oral β-blockers.
  • Major surgery (requiring general anesthesia) in the last 6 weeks or will not have fully recovered from surgery, or planned surgery through the end of the study.
  • A disclosed history or one known to the Investigator, of significant non compliance in previous investigational studies or with prescribed medications.
  • Required use of oxygen therapy, even on an occasional basis.
  • Symptomatic prostatic hyperplasia or bladder-neck obstruction or with narrow-angle glaucoma.
  • History of malignancy of any organ system within 5 years, with the exception of localized skin cancers (basal or squamous cell).
  • Clinically significant abnormal values for safety laboratory tests (hematology, biochemistry, virology or urinalysis) as determined by the Investigator
  • Any other reason that the Investigator considers makes the patient unsuitable to participate.

Trial locations and contacts

4 sites in 2 countries.

4 sites in 2 countries

United States2 sites
  • Allied Biomedical Research Holdings, d/b/a Vitalink Research

    Greenville, South Carolina, 29615

  • Clinical Site Partners, LLC

    Winter Park, Florida, 32789

Other trials in United States

United Kingdom2 sites
  • Respiratory Clinical Trials LTD,

    London, W1G8HU

  • Medicines Evaluation Unit

    Manchester, M23 9QZ

Other trials in United Kingdom

About this study

Official title: A Phase II, Randomized, Double Blind, Placebo Controlled, Three-way Crossover Study to Assess the Bronchodilator Effect of RPL554 Administered in Addition to Open Label Tiotropium/Olodaterol in Patients With COPD

The study investigates the effect of 3 days of twice daily treatment of two different doses of RPL554 (a phosphodiesterase [PDE]3/4 inhibitor) or placebo, each administered in addition to once daily tiotropium/olodaterol (Respimat) in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Patients will receive each of the three treatment combinations in a randomized sequence using a crossover design

Read the detailed description

RPL554 is a dual inhibitor of phosphodiesterase 3 (PDE3) and phosphodiesterase 4 (PDE4) which are known to have a role in modulating the inflammatory airway response in respiratory diseases, including COPD. PDE3 inhibitors act as bronchodilators whilst PDE4 inhibitors have anti-inflammatory properties and there is also evidence to suggest that combined inhibition of PDE3 and PDE4 can have additive or synergistic anti-inflammatory and bronchodilator. The two doses of RPL554 (1.5 mg and 6 mg)have been selected based on the results from prior studies investigating single and multiple ascending doses in healthy subjects, single doses in asthmatics, single/multiple ascending doses in COPD patients, and 3 days of dosing in COPD patients. These doses were demonstrated to be both effective as a bronchodilator and well tolerated.

The purpose of the study is to investigate if RPL554 has an additive bronchodilator effect when administered in combination with a commonly used anticholinergic/β-agonist combination medication, tiotropium/olodaterol (Respimat), in this patient population measured by the peak forced expiratory volume in one second (FEV1), and forced vital capacity (FVC).

Conditions
COPD
Being tested
RPL554 Suspension, Placebo, Tiotropium/olodaterol (Respimat)
Keywords
COPD, Bronchodilation, FEV1
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.

  • RPL554 SuspensionDrug

    A PDE3/4 inhibitor

  • PlaceboDrug

    A placebo solution

  • Tiotropium/olodaterol (Respimat)Drug

    An anticholinergic/β-agonist combination medication

Study groups in NCT03673670
Study groupRoleWhat they receive
1.5 mg RPL554 and tiotropium/olodaterolExperimental1.5 mg RPL554 suspension administered using a nebulizer twice daily plus 5 mcg/5 mcg tiotropium/olodaterol (Respimat) administered once daily
Receives: Drug: RPL554 Suspension; Drug: Tiotropium/olodaterol (Respimat)
6 mg RPL554 and tiotropium/olodaterolExperimental6 mg RPL554 suspension administered using a nebulizer twice daily plus 5 mcg/5 mcg tiotropium/olodaterol (Respimat) administered once daily
Receives: Drug: RPL554 Suspension; Drug: Tiotropium/olodaterol (Respimat)
Placebo and tiotropium/olodaterolExperimentalPlacebo administered using a nebulizer twice daily plus 5 mcg/5 mcg tiotropium/olodaterol (Respimat) administered once daily
Receives: Drug: Placebo; Drug: Tiotropium/olodaterol (Respimat)

What is being measured

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

  1. Change From Baseline in Peak FEV1 on Day 3

    Change from baseline FEV1 to peak FEV1 (measured as the greatest value in the 4 hours post-dose after the morning dose) on Day 3

    Measured: Change from pre-dose at 5, 15 and 30 minutes and 1, 1.5, 2 & 4 hours on Day 3

Secondary outcomes (13)
  1. Change From Baseline to Trough FEV1 on Day 4

    Change from baseline to morning trough FEV1 on Day 4

    Measured: Change from pre-dose on Day 1 to pre-dose on Day 4

  2. Change From Baseline in AUC0-4h FEV1 on Day 3

    Change from baseline FEV1 to AUC FEV1 over 4 hours post-dose after the morning dose on Day 3. The endpoint is measured as AUC/interval length (average) and measured in liters. (Note: Endpoint is AUC/interval length (average) so the units are in liters.)

    Measured: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4 hours on Day 3 (after the morning dose)

  3. Change From Baseline in AUC0-12h FEV1 on Day 3

    Change from baseline in AUC over 12 hours post-dose after the morning dose on Day 3. The endpoint is measured as AUC/interval length (average) and measured in liters (Note: Endpoint is AUC/interval length (average) so the units are in liters.)

    Measured: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4, 6, 8, 12 hours on Day 3 (after the morning dose)

  4. Change From Baseline in Peak FEV1 on Day 1

    Change from baseline FEV1 to peak FEV1 in the 4 hours post-dose after the morning dose on Day 1

    Measured: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4 hours on Day 1 (after the morning dose), with the maximum change reported

  5. Change From Baseline in Peak FEV1 After Evening Dose on Day 3

    Change from baseline FEV1 to peak FEV1 in the 4 hours post-dose after the evening dose on Day 3

    Measured: Change from pre-dose to each of the ollowing timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4 hours on Day 3 (after the evening dose), with the maximum change reported

  6. Change From Baseline in AUC0-12h FEV1 on Day 1

    Change from baseline FEV1 to AUC FEV1 over 12 hours post-dose after the morning dose on Day 1. The endpoint is measured as AUC/interval length (average) and measured in liters (Note: Endpoint is AUC/interval length (average) so the units are in liters.)

    Measured: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4, 6, 8, 12 hours on Day 1 (after the morning dose)

  7. Determination of Onset of Action on Day 1

    Time to >10% increase in FEV1 from pre-first dose, censored at 2 hours

    Measured: Change from pre-dose to the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2 hours on Day 1 (after the morning dose)

  8. Residual Volume on Day 1

    Change in residual volume during treatment

    Measured: Change from pre-dose to 1.25 hours on Day 1 (after the morning dose)

  9. Residual Volume on Day 3

    Change in residual volume during treatment

    Measured: Change from pre-dose on Day 1 to the following timepoints: pre-dose, 1.25, 8.25 and 12.25 hours on Day 3 (after the morning dose)

  10. Functional Residual Capacity on Day 1

    Change in functional residual capacity during treatment

    Measured: Change from pre-dose to 1.25 hours on Day 1 (after the morning dose)

  11. Functional Residual Capacity on Day 3

    Change in functional residual capacity during treatment

    Measured: Change from pre-dose on Day 1 to the following timepoints: pre-dose, 1.25, 8.25 and 12.25 hours on Day 3 (after the morning dose)

  12. Specific Airway Conductance on Day 1

    Change in specific airway conductance during treatment

    Measured: Change from pre-dose to 1.25 hours on Day 1 (after the morning dose)

  13. Specific Airway Conductance on Day 3

    Change in specific airway conductance during treatment

    Measured: Change from pre-dose on Day 1 to the following timepoints: pre-dose, 1.25, 8.25 and 12.25 hours on Day 3 (after the morning dose)

Timeline

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

  1. First posted17 Sep 2018
  2. Study start16 Jul 2018
  3. Primary completion13 Nov 2018
  4. Study completion13 Nov 2018

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
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
79 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03673670
Sponsor's protocol ID
RPL554-CO-204
Status last verified
Sep 2019
First submitted
7 Sep 2018
Last updated
10 Oct 2019
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing RPL554 Suspension and Tiotropium/olodaterol (Respimat) in people with COPD, run by Verona Pharma, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA at 4 sites in 2 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 15 inclusion and 22 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 10 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States, United Kingdom. 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 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 10 Oct 2019). 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?

Change From Baseline in Peak FEV1 on Day 3 (time frame: Change from pre-dose at 5, 15 and 30 minutes and 1, 1.5, 2 & 4 hours on Day 3). 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 10 Oct 2019.

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