E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
All patients must have a diagnosis of chronic obstructive pulmonary disease and must meet the following spirometric criteria: Patients must have relatively stable airway obstruction with a pre-dose FEV1 equal to or below 60% of predicted normal, and FEV1 equal to or below 70% of FVC at Visits 1 and 2.
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10010952 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this trial is to establish non-inferiority of lung function response to 25-µg salmeterol, administered as the xinafoate salt in an inhalation powder delivered from hard polyethylene capsules via the HandiHaler 2 compared to Serevent Diskus (salmeterol xinafoate 50 μg) following single dose inhalation in patients with COPD. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to characterize the pharmacokinetics of salmeterol inhalation powder delivered by HandiHaler 2 from the hard polyethylene capsules and salmeterol xinafoate delivered by Serevent Diskus, and to compare the safety of the two formulations. |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
1. All patients must sign an informed consent consistent with ICH-GCP guidelines and local legislations prior to any study-related procedures, which includes medication washout and restrictions. 2. All patients must have a diagnosis of chronic obstructive pulmonary disease and must meet the following spirometric criteria: Patients must have relatively stable airway obstruction with a pre-dose FEV1 equal to or below 60% of predicted normal and FEV1 equal to or below 70% of FVC at Visits 1 and 2. 3. At Visit 1, patients must demonstrate an improvement in FEV1 of >= 12% over the baseline value 45 minutes after inhalation of 4 puffs of 100 μg salbutamol (Sultanol® MDI). 4. Male or female patients 40 years of age or older. 5. Patients must be current or ex-smokers with a smoking history of more than 10 pack-years. 6. Patients must be able to perform technically acceptable pulmonary function tests during the study period as required in the protocol. 7. Patients must be able to inhale medication in a competent manner from the HandiHaler 2 device and the Diskus device.
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E.4 | Principal exclusion criteria |
1. Patients with significant diseases other than COPD will be excluded. 2. Patients with a recent history (i.e., six months or less) of myocardial infarction. 3. Patients who have been hospitalized for heart failure (NYHA class III or IV) within the past year. 4. Patients with any unstable or life threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention or a change in drug therapy within the past year. 5. Patients with malignancy for which the patient has undergone resection, radiation therapy or chemotherapy within the last five years. Patients with treated basal cell carcinoma are allowed. 6. Patients with a history of asthma, allergic rhinitis or atopy or who have a total blood eosinophil count >= 600/mm3. A repeat eosinophil count will not be conducted in these patients. 7. Patients with a history of life threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis. 8. Patients with known active tuberculosis. 9. Patients with significant alcohol or drug abuse within the past two years. 10. Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1. 11. Patients who have completed a pulmonary rehabilitation program in the six weeks prior to the Screening Visit (Visit 1) or patients who are currently in a pulmonary rehabilitation program that will not be maintained throughout the duration of the study. 12. Patients who regularly use daytime oxygen therapy for more than one hour per day and in the investigator’s opinion will be unable to abstain from the use of oxygen therapy. 13. Patients who are being treated with antihistamines (H1 receptor antagonists), antileukotrienes or leukotriene receptor antagonists for asthma or excluded allergic conditions. 14. Patients who have been treated with cromolyn sodium or nedocromil sodium within one month prior to Visit 1 or during the run-in period. 15. Patients using oral corticosteroid medication at unstable doses (i.e., less than six weeks on a stable dose) or at doses in excess of the equivalent of 10 mg of prednisone per day or 20 mg every other day. 16. Patients with known hypersensitivity to beta-adrenergics, lactose or any other components of the inhalation powder delivery system or the Diskus. 17. Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous three months. 18. Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Visit 1. 19. Patients who have been treated with oral beta-adrenergics within one month prior to Visit 1 or during the run-in period. 20. Patients who have been treated with theophylline preparations within one month prior to Visit 1 or during the run-in period. 21. Patients who have been treated with the long-acting anticholinergic tiotropium (Spiriva®) within one month prior to Visit 1 or during the run-in period. 22. Patients with any respiratory infections in the six weeks prior to the Screening Visit (Visit 1) or during the run-in period. In the case of a respiratory infection during the run in period the latter may be extended up to six weeks. 23. Patients who are currently participating in another study.
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy variable will be forced expiratory volume in one second (FEV1). The primary efficacy endpoint is the FEV1 area under the curve for the time period 0 to 12 hours [FEV1 AUC(0-12)] measured on each test day. To obtain FEV1 AUC0-12, spirometry will be performed on each test day, prior to the administration of study medication (-10 minutes) and at 15, 30, 60 minutes, 2, 3, 4, 6, 8, 10, 12, 14, 22, 23 and 24 hours post-dosing. The FEV1 AUC(0-12) will be calculated as area under the curve from pre-dose to 12 hours using the trapezoidal rule divided by full duration (12 hours) to report in litre units. The pre-dose FEV1 value will be assigned to zero time. Pre dose FEV1 is the FEV1 value measured at each test day in the morning prior to the administration of randomized treatment.
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Completion of the second day of Visit 4 marks the conclusion of patient participation. The End-of-Trial CRF page must be completed, and the patient will then be discharged from the study. Additional visit(s) might be required if persistent/unresolved adverse events have to be followed up.
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 9 |