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Efficacy and Safety of Aclidinium Bromide at Two Dose Levels Versus Placebo Administered in Chronic Obstructive Pulmonary Disease (COPD) Patients

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ClinicalTrials.gov Identifier: NCT01001494
Recruitment Status : Completed
First Posted : October 26, 2009
Results First Posted : September 17, 2012
Last Update Posted : January 4, 2017
Sponsor:
Information provided by (Responsible Party):
AstraZeneca

Study Type Interventional
Study Design Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Double (Participant, Investigator);   Primary Purpose: Treatment
Condition Chronic Obstructive Pulmonary Disease (COPD)
Interventions Drug: Aclidinium bromide 200 μg bid
Drug: Aclidinium bromide 400 μg bid
Drug: Placebo
Enrollment 828
Recruitment Details This study was conducted at 103 sites (100/103 randomised patients), 10 sites in the Czech Republic, 5 in France, 17 in Germany, 13 in Hungary, 3 in Italy, 1 in Peru, 21 in Poland, 10 in the Russian Federation, 5 in Spain, 13 in South Africa and 5 in the Ukraine. The first patient was screened in Oct 2009 and the last patient visit was in Nov 2010.
Pre-assignment Details Patients fulfilling inclusion/exclusion criteria at the time of the Screening Visit were entered into a run-in period of 14±3 days to assess patient's disease stability.
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description Aclidinium bromide 200 μg twice-daily via inhalation Aclidinium bromide 400 μg twice-daily via inhalation Placebo via inhalation
Period Title: Overall Study
Started 277 [1] 269 [2] 273 [3]
Completed 253 252 232
Not Completed 24 17 41
Reason Not Completed
Adverse Event             8             4             6
Protocol Violation             0             1             1
Lost to Follow-up             2             0             1
Withdrawal by Subject             9             7             17
COPD exacerbation             3             4             5
Lack of Efficacy             2             0             8
Other             0             1             3
[1]
280 patients were randomized, but baseline data was missing from 3 patients in one center
[2]
272 patients were randomized, but baseline data was missing from 3 patients in one center
[3]
276 patients were randomized, but baseline data was missing from 3 patients in one center
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo Total
Hide Arm/Group Description Aclidinium bromide 200 μg twice-daily via inhalation Aclidinium bromide 400 μg twice-daily via inhalation Placebo via inhalation Total of all reporting groups
Overall Number of Baseline Participants 277 269 273 819
Hide Baseline Analysis Population Description
[Not Specified]
Age, Categorical  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 277 participants 269 participants 273 participants 819 participants
<=18 years
0
   0.0%
0
   0.0%
0
   0.0%
0
   0.0%
Between 18 and 65 years
169
  61.0%
161
  59.9%
179
  65.6%
509
  62.1%
>=65 years
108
  39.0%
108
  40.1%
94
  34.4%
310
  37.9%
Age, Continuous  
Mean (Standard Deviation)
Unit of measure:  Years
Number Analyzed 277 participants 269 participants 273 participants 819 participants
62.3  (7.8) 62.9  (8.4) 62.0  (8.0) 62.4  (8.0)
Gender  
Measure Type: Count of Participants
Unit of measure:  Participants
Number Analyzed 277 participants 269 participants 273 participants 819 participants
Female
96
  34.7%
87
  32.3%
84
  30.8%
267
  32.6%
Male
181
  65.3%
182
  67.7%
189
  69.2%
552
  67.4%
Region of Enrollment  
Measure Type: Number
Unit of measure:  Participants
Number Analyzed 277 participants 269 participants 273 participants 819 participants
Spain 6 7 5 18
Ukraine 8 8 11 27
Russian Federation 14 16 15 45
Italy 4 2 2 8
France 8 8 8 24
Hungary 35 30 32 97
Czech Republic 22 20 19 61
Poland 79 74 77 230
South Africa 46 47 48 141
Germany 55 57 56 168
1.Primary Outcome
Title Change From Baseline in Morning Pre-dose (Trough) Forced Expiratory Volume in the First Second (FEV1) at Week 24 on Treatment
Hide Description [Not Specified]
Time Frame Baseline and Week 24
Hide Outcome Measure Data
Hide Analysis Population Description
Intention-to-treat (ITT) population: all randomised patients who took at least one dose of Investigational Medicinal Product and who had a baseline and at least 1 post-baseline FEV1 assessment.
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description:
Aclidinium bromide 200 μg twice-daily via inhalation
Aclidinium bromide 400 μg twice-daily via inhalation
Placebo via inhalation
Overall Number of Participants Analyzed 277 269 273
Least Squares Mean (Standard Error)
Unit of Measure: Liters
0.026  (0.016) 0.055  (0.016) -0.073  (0.016)
2.Primary Outcome
Title Change From Baseline in Morning Pre-dose (Trough) Forced Expiratory Volume in the First Second (FEV1) at Week 12 on Treatment
Hide Description [Not Specified]
Time Frame Baseline and Week 12
Hide Outcome Measure Data
Hide Analysis Population Description
Intention-to-treat (ITT) population: all randomised patients who took at least one dose of Investigational Medicinal Product and who had a baseline and at least 1 post-baseline FEV1 assessment.
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description:
Aclidinium bromide 200 μg twice-daily via inhalation
Aclidinium bromide 400 μg twice-daily via inhalation
Placebo via inhalation
Overall Number of Participants Analyzed 277 269 273
Least Squares Mean (Standard Error)
Unit of Measure: Liters
0.030  (0.014) 0.058  (0.015) -0.047  (0.015)
3.Secondary Outcome
Title Change From Baseline in Peak Forced Expiratory Volume in the First Second (FEV1) at Week 24 on Treatment
Hide Description [Not Specified]
Time Frame Baseline and Week 24
Hide Outcome Measure Data
Hide Analysis Population Description
Intention-to-treat (ITT) population: all randomised patients who took at least one dose of Investigational Medicinal Product and who had a baseline and at least 1 post-baseline FEV1 assessment.
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description:
Aclidinium bromide 200 μg twice-daily via inhalation
Aclidinium bromide 400 μg twice-daily via inhalation
Placebo via inhalation
Overall Number of Participants Analyzed 277 269 273
Least Squares Mean (Standard Error)
Unit of Measure: Liters
0.206  (0.017) 0.231  (0.017) 0.022  (0.017)
4.Secondary Outcome
Title Percentage of Patients Who Achieved at Least a 1-unit Decrease From Baseline in TDI Focal Score at Week 24 on Treatment
Hide Description Number of patients achieving a clinically meaningful improvement (≥1-unit) in Transition Dyspnoea Index (TDI) focal score at Week 24 on Treatment
Time Frame Week 24
Hide Outcome Measure Data
Hide Analysis Population Description
Intention-to-treat (ITT) population: all randomised patients who took at least one dose of Investigational Medicinal Product and who had a baseline and at least 1 post-baseline FEV1 assessment.
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description:
Aclidinium bromide 200 μg twice-daily via inhalation
Aclidinium bromide 400 μg twice-daily via inhalation
Placebo via inhalation
Overall Number of Participants Analyzed 270 262 257
Measure Type: Number
Unit of Measure: Percentage of participants
Yes (% Patients with a 1-unit decrease) 53.3 56.9 45.5
No (% Patients with a 1-unit decrease) 46.7 43.1 54.5
5.Secondary Outcome
Title Percentage of Patients Who Achieved at Least a 4-unit Decrease From Baseline in the SGRQ Total Score at Week 24 on Treatment
Hide Description Number of patients who achieved a clinically meaningful improvement (≥4-units) in Saint George Respiratory Questionnaire (SGRQ) total score at week 24 on treatment
Time Frame Week 24
Hide Outcome Measure Data
Hide Analysis Population Description
Intention-to-treat (ITT) population: all randomised patients who took at least one dose of Investigational Medicinal Product and who had a baseline and at least 1 post-baseline FEV1 assessment.
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description:
Aclidinium bromide 200 μg twice-daily via inhalation
Aclidinium bromide 400 μg twice-daily via inhalation
Placebo via inhalation
Overall Number of Participants Analyzed 275 269 271
Measure Type: Number
Unit of Measure: Percentage of participants
Yes (% Patients with 4-unit decrease) 56.0 57.3 41.0
No (% Patients with 4-unit decrease) 44.0 42.8 59.0
Time Frame 24 Weeks
Adverse Event Reporting Description [Not Specified]
 
Arm/Group Title Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Hide Arm/Group Description Aclidinium bromide 200 μg twice-daily via inhalation Aclidinium bromide 400 μg twice-daily via inhalation Placebo via inhalation
All-Cause Mortality
Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Affected / at Risk (%) Affected / at Risk (%) Affected / at Risk (%)
Total   --/--      --/--      --/--    
Hide Serious Adverse Events
Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   12/277 (4.33%)      15/269 (5.58%)      15/273 (5.49%)    
Blood and lymphatic system disorders       
Iron deficiency anaemia  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Cardiac disorders       
Myocardial ischaemia  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Angina Pectoris  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Cardiac discomfort  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Cardiac failure acute  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Cardiac failure congestive  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Sick sinus syndrome  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Left vetricular failure  1  0/277 (0.00%)  0 0/269 (0.00%)  0 1/273 (0.37%)  1
Myocardial infarction  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Ear and labyrinth disorders       
Mixed deafness  1  0/277 (0.00%)  0 0/269 (0.00%)  0 1/273 (0.37%)  1
Gastrointestinal disorders       
Subileus  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Hepatobiliary disorders       
Cholecystitis  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Infections and infestations       
Pneumonia  1  0/277 (0.00%)  0 1/269 (0.37%)  1 1/273 (0.37%)  1
Bronchopneumonia  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Pulmonary tuberculosis  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Injury, poisoning and procedural complications       
Ligament ruptures  1  1/277 (0.36%)  1 1/269 (0.37%)  1 0/273 (0.00%)  0
Rib fracture  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Road traffic accident  1  0/277 (0.00%)  0 0/269 (0.00%)  0 1/273 (0.37%)  1
Tibia fracture  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Musculoskeletal and connective tissue disorders       
Bursitis  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Musculoskeletal pain  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Invertebral disc protrusion  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Neoplasms benign, malignant and unspecified (incl cysts and polyps)       
Bladder transitional cell carcinoma stage III  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Mycosis fungoides  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Benign lung neoplasm  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Pancreatic neuroendocrine tumour  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Nervous system disorders       
Cerebral haemorrhage  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Demyelinating polyneuropathy  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Psychiatric disorders       
Completed suicide  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Renal and urinary disorders       
Nephrolithiasis  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Respiratory, thoracic and mediastinal disorders       
Chronic Obstructive Pulmonary Disease  1  3/277 (1.08%)  4 2/269 (0.74%)  2 10/273 (3.66%)  10
Pneumothorax  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Acute Pulmonary Oedema  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Skin and subcutaneous tissue disorders       
Erythema nodosum  1  0/277 (0.00%)  0 0/269 (0.00%)  0 1/273 (0.37%)  1
Vascular disorders       
Arteriosclerosis  1  0/277 (0.00%)  0 1/269 (0.37%)  1 0/273 (0.00%)  0
Aortis stenosis  1  0/277 (0.00%)  0 0/269 (0.00%)  0 1/273 (0.37%)  1
Subclavian atery stenosis  1  1/277 (0.36%)  1 0/269 (0.00%)  0 0/273 (0.00%)  0
Indicates events were collected by systematic assessment
1
Term from vocabulary, MedDRA (13.1)
Hide Other (Not Including Serious) Adverse Events
Frequency Threshold for Reporting Other Adverse Events 5%
Aclidinium Bromide 200 μg Bid Aclidinium Bromide 400 μg Bid Placebo
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total   44/277 (15.88%)      38/269 (14.13%)      56/273 (20.51%)    
Infections and infestations       
Nasopharyngitis  1  32/277 (11.55%)  30/269 (11.15%)  23/273 (8.42%) 
Nervous system disorders       
Headache  1  30/277 (10.83%)  33/269 (12.27%)  22/273 (8.06%) 
Respiratory, thoracic and mediastinal disorders       
Chronic obstructivce pulmonary disease  1  44/277 (15.88%)  38/269 (14.13%)  56/273 (20.51%) 
Indicates events were collected by systematic assessment
1
Term from vocabulary, MedDRA (13.1)
Certain Agreements
Principal Investigators are NOT employed by the organization sponsoring the study.
There IS an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.
All the information related to this clinical trial is considered strictly confidential and is the property of Almirall. This information will not be given to a third party without the written consent of Almirall. Publication and/or presentation, whether complete or partial, of any part of the data or results of this trial will be subject to revision and written agreement between the investigator and Almirall.
Results Point of Contact
Layout table for Results Point of Contact information
Name/Title: AstraZeneca Clinical
Organization: Study Information Center
Phone: 1-877-240-9479
EMail: information.center@astrazeneca.com
Layout table for additonal information
Responsible Party: AstraZeneca
ClinicalTrials.gov Identifier: NCT01001494    
Other Study ID Numbers: M/34273/34
ATTAIN
First Submitted: October 22, 2009
First Posted: October 26, 2009
Results First Submitted: August 14, 2012
Results First Posted: September 17, 2012
Last Update Posted: January 4, 2017