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Formoterol Dose Ranging Study (ACHIEVE Duaklir USA Phase IIb)

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ClinicalTrials.gov Identifier: NCT02796651
Recruitment Status : Completed
First Posted : June 13, 2016
Results First Posted : February 7, 2018
Last Update Posted : February 7, 2018
Sponsor:
Collaborator:
Parexel
Information provided by (Responsible Party):
AstraZeneca

Tracking Information
First Submitted Date  ICMJE June 7, 2016
First Posted Date  ICMJE June 13, 2016
Results First Submitted Date  ICMJE November 30, 2017
Results First Posted Date  ICMJE February 7, 2018
Last Update Posted Date February 7, 2018
Actual Study Start Date  ICMJE June 30, 2016
Actual Primary Completion Date December 7, 2016   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: January 11, 2018)
Change From Baseline in Normalized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) Over the 12 h Period Immediately After Morning Study Drug Administration, AUC0-12/12h at Day 7 on Treatment [ Time Frame: Day 7: 30 min, 1 to 4 hours, 6 hours, 9 hours and 12 hours post-dose ]
To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) twice daily (BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate(20 μg). Pre-dose spirometry was performed before the morning daily dose at Day 1 and Day 7 of each treatment period. Two sets of measurements were performed during the hour preceding the scheduled morning study drug administration, allowing approximately 30 minutes between them. Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation.
Original Primary Outcome Measures  ICMJE
 (submitted: June 7, 2016)
Change from baseline in normalized FEV1 area under the curve (AUC) over the 12 h period immediately after morning study drug administration, AUC0-12/12h at Day 7 on treatment. [ Time Frame: Day 7 ]
The primary efficacy variable is the change from baseline in normalized FEV1 area under the curve from time 0 to 12 hours (FEV1 AUC0-12/12h) on treatment at Day 7 across treatment periods.
Change History Complete list of historical versions of study NCT02796651 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: January 11, 2018)
  • Change From Baseline in FEV1 AUC0-6/6h at Day 1 on Treatment [ Time Frame: Day 1: zero time to 6 hours post-dose ]
    To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg and 40 μg). 6-hour serial spirometry was performed at Day 1 of each treatment period: spirometry was performed post-dose at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours and 6 hours post-dose.
  • Change From Baseline in FEV1 AUC0-6/6h at Day 7 on Treatment [ Time Frame: Day 7: zero time to 6 hours post-dose ]
    To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg). 6-hour serial spirometry was performed at Day 7 of each treatment period: spirometry was performed post-dose at 30 minutes, 1 hour, 2 hours, 3 hours, 4 hours and 6 hours post-dose Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation
  • Change From Baseline in Morning Pre-dose (Trough) FEV1 at Day 7 on Treatment [ Time Frame: At baseline and Day 7 ]
    To assess the bronchodilation of 3 doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label nebulised formoterol fumarate (20 μg). Trough value was defined as the mean of the 2 pre-dose measurements on Day 7. If 1 of the 2 measurements was missing, the non-missing measurement was used as the trough value. Note: Perforomist® 40 μg treatment periods lasted for 1 day only. Hence, was not included in the calculation.
Original Secondary Outcome Measures  ICMJE
 (submitted: June 7, 2016)
  • Change from baseline in FEV1 AUC0-6/6h at Day 1 and Day 7 on treatment. [ Time Frame: Day 1 and Day 7 ]
    Change from baseline in FEV1 AUC0-6/6h at Day 1 and Day 7 on treatment.
  • Change from baseline in morning pre-dose (trough) FEV1 at Day 7 on treatment. [ Time Frame: Day 7 ]
    Change from baseline in morning pre-dose (trough) FEV1 at Day 7 on treatment.
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Formoterol Dose Ranging Study (ACHIEVE Duaklir USA Phase IIb)
Official Title  ICMJE A Randomized, Double-blind, Placebo-controlled, Incomplete Unbalanced, Crossover Study to Assess the Efficacy and Safety of Three Doses of Formoterol Fumarate in Pressair® Compared With Perforomist® Inhalation Solution (20 and 40 μg Open-label) in Moderate to Severe COPD Patients With Reversible Airway Disease.
Brief Summary To assess the bronchodilation of three doses of formoterol fumarate (6 μg, 12 μg and 24 μg) twice daily (BID) administered via Pressair® compared to placebo and to open-label nebulized formoterol fumarate (20 μg and 40 μg).
Detailed Description This is a prospective, randomized, double-blind, 5-period incomplete unbalanced crossover, placebo and active comparator (open-label) controlled, multicenter clinical trial to assess the efficacy and safety of three doses of formoterol fumarate (6 μg, 12 μg and 24 μg) BID administered via Pressair® compared to placebo and to open-label formoterol fumarate (20 μg BID and 40 μg single dose) administered as an inhalation solution via a standard jet nebulizer (with a mouthpiece) connected to an air compressor (Perforomist® Inhalation Solution). The drug product is an inhalation powder comprising of micronized aclidinium bromide and micronized formoterol fumarate with α-lactose monohydrate as the carrier, presented in a breathactuated device-metered dry-powder inhaler (DPI). It has been approved under the trademarks of Genuair® and/or Pressair® in some territories.
Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 2
Study Design  ICMJE Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Condition  ICMJE Chronic Obstructive Pulmonary Disease - COPD
Intervention  ICMJE
  • Drug: Formoterol fumarate (6 μg)
    Oral Inhalation (by Pressair® Dry Powder Inhaler, DPI)
    Other Name: Formoterol (Pressair®)
  • Drug: Formoterol furmarate (20 μg)
    Oral Inhalation (via a standard jet nebulizer connected to an air compressor.
    Other Name: Perforomist® Inhalation Solution
  • Drug: Placebo for formoterol fumarate
    Oral Inhalation (by Pressair® Dry Powder Inhaler, DPI)
    Other Name: Placebo (Pressair®)
  • Drug: Formoterol fumarate (12 μg)
    Oral Inhalation (by Pressair® Dry Powder Inhaler, DPI)
    Other Name: Formoterol (Pressair®)
  • Drug: Formoterol fumarate (40 μg)
    Oral Inhalation (via a standard jet nebulizer connected to an air compressor.
    Other Name: Perforomist® Inhalation Solution
Study Arms  ICMJE
  • Experimental: Formoterol 6 μg
    Participants received formoterol fumarate 6 μg administered via Pressair twice daily (BID).
    Intervention: Drug: Formoterol fumarate (6 μg)
  • Experimental: Formoterol 12 μg
    Participants received formoterol fumarate 12 μg administered via Pressair BID.
    Intervention: Drug: Formoterol fumarate (12 μg)
  • Experimental: Formoterol 24 μg
    Participants received formoterol fumarate 24 μg administered via Pressair BID.
    Intervention: Drug: Formoterol fumarate (12 μg)
  • Placebo Comparator: Placebo
    Participants received placebo to formoterol fumarate administered via Pressair BID.
    Intervention: Drug: Placebo for formoterol fumarate
  • Experimental: Formoterol 20 μg
    Participants received Perforomist inhalation solution and were instructed to take one puff from each of the two Pressair inhalers or to inhale one vial from the Perforomist 20 μg inhalation solution BID for 7 ± 1 consecutive days.
    Intervention: Drug: Formoterol furmarate (20 μg)
  • Experimental: Formoterol 40 μg
    Participants received Perforomist 40 μg (2 vials of Performist 20 μg) as a single dose of administration.
    Intervention: Drug: Formoterol fumarate (40 μg)
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Completed
Actual Enrollment  ICMJE
 (submitted: July 4, 2017)
132
Original Estimated Enrollment  ICMJE
 (submitted: June 7, 2016)
120
Actual Study Completion Date  ICMJE December 7, 2016
Actual Primary Completion Date December 7, 2016   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Adult male or non-pregnant, non-lactating female patients aged ≥40.
  • Patients with a diagnosis of COPD (GOLD guidelines, 2016) for a period of at least 6 months prior to Visit 1.
  • Patients with moderate to severe stable COPD: post-bronchodilator FEV1 ≥ 30% and <80% of the predicted normal and post-bronchodilator FEV1/FVC < 70% at Visit 1.
  • Patients with reversible airway obstruction defined as an increase in FEV1 of at least 12% and 200 mL over the baseline value after four inhalations of albuterol sulfate 108 µg via a pMDI at Visit 1.
  • Current or former-smokers, with a smoking history of ≥ 10 pack-years.
  • Patients able to perform acceptable and repeatable pulmonary function testing for FEV1 according to the American Thoracic Society (ATS)/European Respiratory Society (ERS) 2005 criteria at Visit 1.
  • Patients eligible and able to participate in the study and who had signed an Informed Consent Form prior to initiation of any study-related procedures.

Exclusion Criteria:

  • Patients with asthma.
  • Any respiratory tract infection (including the upper respiratory tract) or COPD exacerbation (including the mild COPD exacerbation) within 6 weeks prior to Visit 1 or during the run-in period.
  • Patients hospitalized for a COPD exacerbation (an emergency room visit for longer than 24 hours is considered a hospitalization) within 3 months prior to Visit 1.
  • Clinically significant respiratory conditions other than COPD.
  • Patients who in the investigator's opinion may need to start a pulmonary rehabilitation program during the study and/or patients who started/finished it within 3 months prior to Visit 1.
  • Use of long-term oxygen therapy (≥ 15 hours/day).
  • Patients who do not maintain regular day/night, waking/sleeping cycles including night shift workers.
  • Clinically significant cardiovascular conditions.
  • Patients with uncontrolled Type I or Type II diabetes, uncontrolled hypo-or hyperthyroidism, hypokalaemia, or hyperadrenergic state, uncontrolled hypertension.
  • Patients with history of long QT syndrome or whose QTc (calculated according to Fridericia's Formula QTc=QT/RR1/3) > 470 ms as indicated in the centralized reading report assessed at Visit 1.
  • Patients with clinically significant abnormalities in the laboratory tests, ECG parameters (other than QTc) or in the physical examination at Visit 1 that might compromise patient safety.
  • Patients with a history of hypersensitivity reaction to an inhaled medication or any component thereof, including paradoxical bronchospasm.
  • Patients with known narrow-angle glaucoma, symptomatic bladder neck obstruction, acute urinary retention or symptomatic unstable prostate hypertrophy.
  • History of malignancy of any organ system (including lung cancer), treated or untreated, within the past 5 years other than basal or squamous cell skin cancer.
  • Patients with any other serious or uncontrolled physical or mental dysfunction.
  • Patients with a history (within 2 years prior to screening) of drug and/or alcohol abuse that may prevent study compliance based on the Investigator judgment.
  • Patients unlikely to be cooperative or who cannot comply with the study procedures.
  • Patients treated with any investigational drug within 30 days (or 6 half-lives, whichever is longer) prior to Visit 1.
  • Patients who intended to use any concomitant medication not permitted by this protocol or who had not undergone the required washout period for a particular prohibited medication.
  • Patients unable to give consent, or patients of consenting age but under guardianship, or vulnerable patients.
  • Any other conditions that, in the investigator's opinion, might render the patient to be unsuitable for the study.
  • Involvement in the planning and/or conduct of the study (applies to AstraZeneca staff and/or site staff), or patients employed by or relatives of the employees of the site or sponsor.
  • Previous randomization in the present study D6571C00002.
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 40 Years to 130 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE Contact information is only displayed when the study is recruiting subjects
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT02796651
Other Study ID Numbers  ICMJE D6571C00002
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party AstraZeneca
Study Sponsor  ICMJE AstraZeneca
Collaborators  ICMJE Parexel
Investigators  ICMJE
Principal Investigator: Mark H. Gotfried, MD 1112 East McDowell Road, Phoenix, AZ 85006, United States.
PRS Account AstraZeneca
Verification Date January 2018

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP