E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Chronic Obstructive Pulmonary Disease (COPD) |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10010952 |
E.1.2 | Term | COPD |
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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 the study is to evaluate structural changes effected by AZD9668 in the airways of adults with Chronic Obstructive Pulmonary Disease (COPD) by Multi-Slice Computed Tomography (MSCT). |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of the study are:
To relate structural changes in the airways to pulmonary function variables and symptoms of COPD.
To evaluate safety of AZD9668 in COPD patients |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provision of informed consent prior to any study specific procedures at Visit 1a.
2. Male or female aged 50-80 years inclusive at Visit 1b. Female patients may be of non-childbearing potential (i.e. post menopausal or surgically sterile) or of child bearing potential: - Women will be considered post menopausal if they are i) over 50 years old and have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatments or ii) over 57 years old - Surgically sterile is defined as having undergone hysterectomy and/or bilateral oophrectomy and/or bilateral salpingectomy; tubal ligation on its own is not adequate - Women will be considered of child bearing potential if they are between menarche and menopause, and have not been permanently or surgically sterilised. Women of child bearing potential must have a pregnancy test at visit 1b and at visit 2 prior to randomisation, and at the follow up visit, and must be using suitable methods of birth control. Further details of methods of birth control that are considered suitable for use are given in Section 5.1. in the protocol.
3. Documented clinical diagnosis of COPD, according to GOLD guidelines (GOLD 2008) with symptoms for ≥1 year before Visit 1b.
4. Ex-smokers for at least 12 months prior to Visit 1b.
5. A smoking history of at least 10 pack years (1 pack year = tobacco consumption corresponding to 20 cigarettes smoked per day for 1 year).
6. FEV1 40-70% (inclusive) of the predicted normal value (post-bronchodilator) at Visit 1b.
7. FEV1/FVC <70% (post-bronchodilator) at Visit 1b.
8. Able to use the handheld electronic devices (assessed at Visit 1a).
For randomisation into the study at Visit 2 the patients must also fulfil the following criteria:
1. MSCT performed during the last 2 to 7 days before randomisation with acceptable quality and the whole lung is visible on the images, as judged by the radiologist visual read.
2. No clinically relevant abnormal findings in baseline CT besides CT changes related to COPD, (e.g. congestive heart failure, lung cancer, tuberculosis, lung fibrosis, sarcoidosis, cystic fibrosis) which in the opinion of the Investigator, may put the patient at risk because of his/her participation in the study, or may influence the results of the study, or the patient’s ability to participate in the study.
3. Complete morning recordings of daily FEV1 data at least 10 days out of the last 14 days before Visit 2. |
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E.4 | Principal exclusion criteria |
1. Any clinically relevant disease or disorder (e.g. infectious/viral disease (including hepatitis B or C) cardiovascular, pulmonary other than COPD, gastrointestinal, liver, renal, neurological, musculoskeletal, endocrine, metabolic, malignant, psychiatric, major physical impairment), past or present, which in the opinion of the Investigator, may either put the patient at risk because of participation in the study, or may influence the results of the study, or the patient’s ability to participate in the study.
2. Significant or unstable ischemic heart disease, arrhythmia, cardiomyopathy, heart failure, uncontrolled hypertension, or any other relevant cardiovascular disorder as judged by the Investigator.
3. Current diagnosis of asthma according to GINA guidelines (GINA 2008).
4. Malignancy or neoplastic disease within the past 5 years other than treated basal/squamous cell skin carcinoma or treated cervical cancer in situ.
5. Patients who require long term oxygen therapy (LTOT).
6. Worsening of COPD within 4 weeks prior to Visit 1b and during the run-in period (defined as an increase in respiratory symptoms requiring hospitalisation and/or a course of oral glucocorticosteroids and/or increased usage/dose of inhaled steroids and/or antibiotic treatment).
7. Acute infections requiring treatment in the 4 weeks prior to Visit 1b and during the run-in period.
8. Any clinically relevant abnormal findings in physical examination, vital signs, haematology, clinical chemistry, or urinalysis at Visit 1b, which in the opinion of the Investigator, may put the patient at risk because of his/her participation in the study, or may influence the results of the study, or the patient’s ability to participate in the study.
9. A QTcB interval of >450 msec for males and >470 msec for females at Visit 1b.
10. Any ECG abnormality (including arrhythmia), which in the opinion of the investigator may put the patient at risk or interfere with study assessments at Visit 1b.
11. A past history of or current clinical or laboratory evidence of renal failure, or an estimated creatinine clearance of <50 mL/min (as calculated by the Cockcroft-Gault formula) at Visit 1b.
12. Alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) level ≥1.5 x upper limit of normal (ULN) at Visit 1b.
13. Pregnancy, breast-feeding or planned pregnancy during the study.
14. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site).
15. Previous randomisation to treatment in the present study.
16. Previous participation in a study with AZD9668.
17. Participation (defined as administration of at least 1 dose of investigational product) in another clinical study, the last follow-up visit of which is within 12 weeks of Visit 1b in this study.
18. Excessive alcohol consumption or known drug abuse, as judged by the investigator.
19. Scheduled in patient surgery or hospitalisation during the course of the study.
20. Patients scheduled for an intensive COPD rehabilitation programme. (Patients who are in the maintenance phase of a rehabilitation programme are eligible to take part.)
21. Known or suspected hypersensitivity to the investigational product or excipients or additional non-investigational study drugs provided for the study (tiotropium and reliever medication).
22. Patients with conditions that may worsen if treated with tiotropium, according to the prescribing information for tiotropium in each participating country.
23. Patient with an unremovable metallic object in the chest area (including piercing, pacemakers, stents).
24. Patient with a history of lung/cardiothoracic surgery in the past (lung volume reduction surgery, lung transplant, bypass etc.).
25. MSCT performed during the last 9 months before Visit 1b.
26. Presence of 1 or more non-calcified lung nodules with diameter ≥5 mm, identified from baseline MSCT scan. |
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E.5 End points |
E.5.1 | Primary end point(s) |
AWT-Pi10 (airway wall thickness of a theoretical airway with an internal perimeter of 10 mm) |
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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 | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
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 | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 7 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Yes |
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
|
The end of the study is defined as ”the last visit of the last patient undergoing the study”. |
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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 | 14 |
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 |
E.8.9.2 | In all countries concerned by the trial days | 14 |