Bronchial ObstructionPhase 4PRETIONCT07827859
PREterm Infants With Bronchial Obstruction - Prospective Study of Efficacy and Safety of Inhaled Tiotropium
A Phase 4 study testing tiotropium bromide (Spiriva Respimat) in people with Bronchial Obstruction and Premature Birth, run by General University Hospital, Prague at 1 site in Czechia.
Trial summary
The purpose of this clinical trial is to evaluate the efficacy and safety of inhaled tiotropium bromide (Spiriva Respimat) in preterm-born children and adolescents suffering from chronic bronchial obstruction. Read more about this study
- Who is it for?
- Ages 6 to 18 years
- Conditions the study is for
- Bronchial Obstruction, Premature Birth
- What is being tested?
- tiotropium bromide (Spiriva Respimat)
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteCzechia
- Study dates
- 1 Nov 2026to 1 Aug 2029
- Phase
- Phase 4
- Are there results?
- Not yet: the study is under way
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 6 to 18 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Age between 6 and 18 years.
- History of preterm birth (defined as delivery at < 37 gestational weeks).
- Spirometrically proven bronchial obstruction, defined as a z-score of FEV1 and/or >= 2 other parameters - Forced Vital Capacity (FVC; liters [L]), Peak Expiratory Flow (PEF; liters per second [L/s]), and Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity (FEF25-75; liters per second [L/s]).) below -1.65 SD.
- Positive bronchodilatation test, defined as an increase in FEV₁ or FVC of more than 10% of the corresponding GLI-predicted value following administration of ipratropium bromide. Bronchodilator responsiveness will be calculated separately for FEV₁ and FVC as:
- [(post-bronchodilator value - pre-bronchodilator value) / predicted value] × 100.
- FEV₁ and FVC will be measured in litres (L) after ipratropium administration.
- Acceptable spirometry performance in accordance with American Thoracic Society/European Respiratory Society (ATS/ERS) 2019 standards.
- No long-term inhalation therapy (such as a long-acting beta₂-agonist (LABA) or a combination of an inhaled corticosteroid and a long-acting beta₂-agonist (ICS/LABA)) within the last month prior to study enrollment.
Who cannot join
- Other chronic respiratory diseases (e.g., asthma, cystic fibrosis).
- Anatomical abnormalities of the respiratory tract or presence of glaucoma.
- Congenital malformations of the uropoetic tract or cardiac arrhythmias/congenital heart defects.
- Concomitant use of anticholinergic medications for enuresis nocturna.
- Pregnancy (mandatory urine screening required for all female participants aged 13 years and older).
- Insufficient cooperation or inability to properly perform spirometry maneuvers.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Czechia1 site
General University Hospital in Prague, Department of Paediatrics and Inherited Metabolic Disorders (KPDPM)
Prague, 128 08
About this study
Official title: A Prospective, Randomized, Controlled, Crossover Phase IV Study to Evaluate the Efficacy and Safety of Inhaled Tiotropium in Preterm Infants With Bronchial Obstruction Compared to Standard Treatment
The purpose of this clinical trial is to evaluate the efficacy and safety of inhaled tiotropium bromide (Spiriva Respimat) in preterm-born children and adolescents suffering from chronic bronchial obstruction.
Preterm infants often experience persistent narrowing of the airways, which leads to shortness of breath, chronic respiratory symptoms, and reduced exercise tolerance.
Read more
Tiotropium is a long-acting muscarinic antagonist (LAMA) that helps dilate the airways and facilitate breathing. While this medication is already approved for pediatric patients aged 6 years and older with severe asthma, its efficacy and safety have not yet been validated in the specific population of preterm infants with bronchial obstruction. This study aims to fill this clinical knowledge gap.
This is a non-commercial, monocentric, prospective, randomized, open-label, phase IV study utilizing a 2x2 crossover design. The trial will enroll 50 participants aged 6 to 18 years. Each participant will undergo two distinct 3-month phases: a treatment period with daily inhaled tiotropium (5 µg once daily) and a control observation period without long-term anticholinergic therapy. The sequence of these periods will be randomly assigned to each participant. The primary objective is to demonstrate lung function improvement by evaluating the change in forced expiratory volume in 1 second (FEV1) expressed in liters and Forced Vital Capacity (FVC) expressed in liters between the treatment and control periods. No blood samples or invasive procedures are required for this study.
Read the detailed description
This clinical trial is designed as an investigator-initiated, academic, phase IV, randomized, open-label, 2x2 crossover study to evaluate the response to inhaled tiotropium bromide in children and adolescents born prematurely who suffer from chronic bronchial obstruction.
The study consists of two different sequences:
- Sequence A (Treatment first): Participants receive inhaled tiotropium (5 µg once daily via Spiriva Respimat) for 3 months, followed by a 4-week washout period, and subsequently undergo a 3-month control observation period under standard treatment.
- Sequence B (Control first): Participants start with a 3-month control observation period under standard treatment, followed immediately (without a washout period) by a 3-month treatment period with daily inhaled tiotropium.
Clinical and spirometric assessments (including Forced Expiratory Volume in 1 second in liters - FEV₁, Forced Vital Capacity in liters - FVC, Peak Expiratory Flow in liters per second - PEF, Forced Expiratory Flow between 25% and 75% of FVC in liters per second - FEF₂₅-₇₅ parameters) will be performed at baseline, at the crossover point (end of the first period), and at the end of the study (end of the second period). Participants or their parents will maintain daily diaries to log respiratory symptoms, rescue medication - short-acting beta₂-agonist (SABA) use, and potential acute exacerbations throughout the trial.
- Conditions
- Bronchial Obstruction, Premature Birth
- Being tested
- tiotropium bromide (Spiriva Respimat)
- Keywords
- Tiotropium, LAMA, Preterm Infants, Spirometry
- Medical subject headings
- Premature Birth
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
tiotropium bromide (Spiriva Respimat)Drug
Inhaled tiotropium bromide administered via Spiriva Respimat inhaler. Dose: 5 µg (2 actuations of 2.5 µg) once daily for a total duration of 12 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Sequence A: Tiotropium first | Experimental | Participants in this sequence receive inhaled tiotropium bromide (5 µg once daily via Spiriva Respimat) for 3 months, followed by a 4-week washout period, and then undergo a 3-month control observation period with standard treatment. Receives: Drug: tiotropium bromide (Spiriva Respimat) |
| Sequence B: Control first | Experimental | Participants in this sequence begin with a 3-month control observation period under standard treatment (no long-term anticholinergic therapy), immediately followed by a 3-month treatment period with daily inhaled tiotropium (5 µg once daily). Receives: Drug: tiotropium bromide (Spiriva Respimat) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Absolute change from Baseline in Forced Expiratory Volume in 1 Second (FEV1) expressed in liters (L)
The outcome will be the within-participant difference in forced expiratory volume in 1 second (FEV₁), expressed in litres (L) and Forced Vital Capacity in liters - FVC, between the end of the 3-month tiotropium treatment period and the end of the 3-month control observation period. FEV₁ and FVC will also be expressed as a z-score and percentage of the predicted value calculated using the applicable Global Lung Function Initiative (GLI) reference equations. The treatment effect will be calculated as:
FEV₁ after the tiotropium treatment period (L) - FEV₁ after the control observation period (L).
Measured: At the end of the 3-month treatment period and at the end of the 3-month control period (specifically at Week 12 and Week 28 for Sequence A, or at Week 12 and Week 24 for Sequence B)
Secondary outcomes (2)
Change from Baseline in Secondary Spirometric Parameters (FVC expressed in liters [L], PEF in liters per second [L/s], and MEF25-75 in liters per second [L/s])
The absolute changes in Forced Vital Capacity (FVC, expressed in liters [L]), Peak Expiratory Flow (PEF, expressed in liters per second [L/s],), and Forced Expiratory Flow at 25%, 50%, and 75% of FVC (FEF25-75, expressed in liters per second [L/s],) evaluated between the end of the 3-month tiotropium treatment period and the end of the 3-month control observation period.
Measured: At the end of the 3-month treatment period and at the end of the 3-month control period (specifically at Week 12 and Week 28 for Sequence A, or at Week 12 and Week 24 for Sequence B)
Frequency of Acute Respiratory Exacerbations and Rescue Medication Use
The total number of acute respiratory exacerbations and the frequency of rescue medication (Short-acting Beta-2 Agonist - SABA) usage tracked via daily patient/parent diaries during the 3-month tiotropium treatment period compared to the 3-month control observation period.
Measured: Continuously throughout both 3-month periods (treatment and control) and the 4-week washout phase, evaluated over a total span of up to 7 months per participant.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Sep 2026
- Study start1 Nov 2026 (estimated)
- Primary completion1 May 2029 (estimated)
- Study completion1 Aug 2029 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Bronchial ObstructionStudies of the same condition, open and under way.
- 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
- Crossover
- Model description
- This is a prospective, randomized, 2x2 crossover study consisting of two treatment sequences. Sequence A involves a 3-month period of inhaled tiotropium treatment, followed by a 4-week washout period, and then a 3-month control observation period. Sequence B involves a 3-month control observation period, followed directly by a 3-month period of inhaled tiotropium treatment without an intermediate washout period.
- Masking
- None (open label)
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- General University Hospital, Prague
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Jana Tuková, General University Hospital, Prague
- Investigators
- Jana Tuková, MUDr., Ph.D., Principal investigator, General University Hospital, Prague
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07827859
- Sponsor's protocol ID
- PRETIO-2026
- Other IDs
- 2026-525773-39-00
- Acronym
- PRETIO
- Status last verified
- Sep 2026
- First submitted
- 20 Jul 2026
- Last updated
- 18 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Individual participant data (IPD) will not be shared to protect patient privacy, as this study evaluates a vulnerable pediatric population and is subject to strict GDPR and institutional data protection regulations.
Study at a glance
From the registry record, last updated by the sponsor on 18 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective, Randomized, Controlled, Crossover Phase IV Study to Evaluate the Efficacy and Safety of Inhaled Tiotropium in Preterm Infants With Bronchial Obstruction Compared to Standard Treatment
- ClinicalTrials.gov ID
- NCT07827859
- Acronym / sponsor ID
- PRETIO / PRETIO-2026
- Conditions
- Bronchial Obstruction, Premature Birth
- Keywords
- Tiotropium, LAMA, Preterm Infants, Spirometry
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- General University Hospital, PragueUniversity, hospital or other
- Study start
- 1 Nov 2026 (estimated)
- Primary completion
- 1 May 2029 (estimated)
- Study completion
- 1 Aug 2029 (estimated)
- First posted
- 18 Sep 2026 (actual)
- 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 purpose of this clinical trial is to evaluate the efficacy and safety of inhaled tiotropium bromide (Spiriva Respimat) in preterm-born children and adolescents suffering from chronic bronchial obstruction.
Preterm infants often experience persistent narrowing of the airways, which leads to shortness of breath, chronic respiratory symptoms, and reduced exercise tolerance.
Tiotropium is a long-acting muscarinic antagonist (LAMA) that helps dilate the airways and facilitate breathing. While this medication is already approved for pediatric patients aged 6 years and older with severe asthma, its efficacy and safety have not yet been validated in the specific population of preterm infants with bronchial obstruction. This study aims to fill this clinical knowledge gap.
This is a non-commercial, monocentric, prospective, randomized, open-label, phase IV study utilizing a 2x2 crossover design. The trial will enroll 50 participants aged 6 to 18 years. Each participant will undergo two distinct 3-month phases: a treatment period with daily inhaled tiotropium (5 µg once daily) and a control observation period without long-term anticholinergic therapy. The sequence of these periods will be randomly assigned to each participant. The primary objective is to demonstrate lung function improvement by evaluating the change in forced expiratory volume in 1 second (FEV1) expressed in liters and Forced Vital Capacity (FVC) expressed in liters between the treatment and control periods. No blood samples or invasive procedures are required for this study.
Detailed description
This clinical trial is designed as an investigator-initiated, academic, phase IV, randomized, open-label, 2x2 crossover study to evaluate the response to inhaled tiotropium bromide in children and adolescents born prematurely who suffer from chronic bronchial obstruction.
The study consists of two different sequences:
- Sequence A (Treatment first): Participants receive inhaled tiotropium (5 µg once daily via Spiriva Respimat) for 3 months, followed by a 4-week washout period, and subsequently undergo a 3-month control observation period under standard treatment.
- Sequence B (Control first): Participants start with a 3-month control observation period under standard treatment, followed immediately (without a washout period) by a 3-month treatment period with daily inhaled tiotropium.
Clinical and spirometric assessments (including Forced Expiratory Volume in 1 second in liters - FEV₁, Forced Vital Capacity in liters - FVC, Peak Expiratory Flow in liters per second - PEF, Forced Expiratory Flow between 25% and 75% of FVC in liters per second - FEF₂₅-₇₅ parameters) will be performed at baseline, at the crossover point (end of the first period), and at the end of the study (end of the second period). Participants or their parents will maintain daily diaries to log respiratory symptoms, rescue medication - short-acting beta₂-agonist (SABA) use, and potential acute exacerbations throughout the trial.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- This is a prospective, randomized, 2x2 crossover study consisting of two treatment sequences. Sequence A involves a 3-month period of inhaled tiotropium treatment, followed by a 4-week washout period, and then a 3-month control observation period. Sequence B involves a 3-month control observation period, followed directly by a 3-month period of inhaled tiotropium treatment without an intermediate washout period.
| Arm | Type | Receives |
|---|---|---|
| Sequence A: Tiotropium first | Experimental | Drug: tiotropium bromide (Spiriva Respimat)Participants in this sequence receive inhaled tiotropium bromide (5 µg once daily via Spiriva Respimat) for 3 months, followed by a 4-week washout period, and then undergo a 3-month control observation period with standard treatment. |
| Sequence B: Control first | Experimental | Drug: tiotropium bromide (Spiriva Respimat)Participants in this sequence begin with a 3-month control observation period under standard treatment (no long-term anticholinergic therapy), immediately followed by a 3-month treatment period with daily inhaled tiotropium (5 µg once daily). |
Who may qualify
- Ages
- 6 to 18 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (8 listed)
- Age between 6 and 18 years.
- History of preterm birth (defined as delivery at < 37 gestational weeks).
- Spirometrically proven bronchial obstruction, defined as a z-score of FEV1 and/or >= 2 other parameters - Forced Vital Capacity (FVC; liters [L]), Peak Expiratory Flow (PEF; liters per second [L/s]), and Forced Expiratory Flow between 25% and 75% of Forced Vital Capacity (FEF25-75; liters per second [L/s]).) below -1.65 SD.
- Positive bronchodilatation test, defined as an increase in FEV₁ or FVC of more than 10% of the corresponding GLI-predicted value following administration of ipratropium bromide. Bronchodilator responsiveness will be calculated separately for FEV₁ and FVC as:
- [(post-bronchodilator value - pre-bronchodilator value) / predicted value] × 100.
Key exclusion criteria (6 listed)
- Other chronic respiratory diseases (e.g., asthma, cystic fibrosis).
- Anatomical abnormalities of the respiratory tract or presence of glaucoma.
- Congenital malformations of the uropoetic tract or cardiac arrhythmias/congenital heart defects.
- Concomitant use of anticholinergic medications for enuresis nocturna.
- Pregnancy (mandatory urine screening required for all female participants aged 13 years and older).
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 bromide (Spiriva Respimat)Inhaled tiotropium bromide administered via Spiriva Respimat inhaler. Dose: 5 µg (2 actuations of 2.5 µg) once daily for a total duration of 12 weeks. | Drug | Sequence A: Tiotropium first, Sequence B: Control first |
Primary outcome
Absolute change from Baseline in Forced Expiratory Volume in 1 Second (FEV1) expressed in liters (L)
Time frame: At the end of the 3-month treatment period and at the end of the 3-month control period (specifically at Week 12 and Week 28 for Sequence A, or at Week 12 and Week 24 for Sequence B)
The outcome will be the within-participant difference in forced expiratory volume in 1 second (FEV₁), expressed in litres (L) and Forced Vital Capacity in liters - FVC, between the end of the 3-month tiotropium treatment period and the end of the 3-month control observation period. FEV₁ and FVC will also be expressed as a z-score and percentage of the predicted value calculated using the applicable Global Lung Function Initiative (GLI) reference equations. The treatment effect will be calculated as: FEV₁ after the tiotropium treatment period (L) - FEV₁ after the control observation period (L).
2 secondary outcomes
Change from Baseline in Secondary Spirometric Parameters (FVC expressed in liters [L], PEF in liters per second [L/s], and MEF25-75 in liters per second [L/s])
Time frame: At the end of the 3-month treatment period and at the end of the 3-month control period (specifically at Week 12 and Week 28 for Sequence A, or at Week 12 and Week 24 for Sequence B)
Frequency of Acute Respiratory Exacerbations and Rescue Medication Use
Time frame: Continuously throughout both 3-month periods (treatment and control) and the 4-week washout phase, evaluated over a total span of up to 7 months per participant.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Sep 2026.
- Individual participant dataSharing planned: No. Individual participant data (IPD) will not be shared to protect patient privacy, as this study evaluates a vulnerable pediatric population and is subject to strict GDPR and institutional data protection regulations.
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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.
Jana Tuková, MUDr., Ph.D. principal investigator
General University Hospital, Prague
1 site 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 bromide (Spiriva Respimat) in people with Bronchial Obstruction and Premature Birth, run by General University Hospital, Prague at 1 site in Czechia.
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 8 inclusion and 6 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: opening soon, as of the sponsor's last update on 18 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Czechia. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Martina Racková, Mgr., MBA (+420 224 963 097, martina.rackova@vfn.cz), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Absolute change from Baseline in Forced Expiratory Volume in 1 Second (FEV1) expressed in liters (L) (time frame: At the end of the 3-month treatment period and at the end of the 3-month control period (specifically at Week 12 and Week 28 for Sequence A, or at Week 12 and Week 24 for Sequence B)). 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 18 Sep 2026; AzTrials last refreshed its copy on 7 Nov 2026.