Clinical Trial Results:
An 8 Week Study to Evaluate the Effectiveness of Adding Montelukast to Inhaled Corticosteroid (ICS) to the ICS/Long-Acting Beta 2-Agonist Therapy in Adult Subjects With Asthma and Allergic Rhinitis
Summary
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EudraCT number |
2014-004775-23 |
Trial protocol |
Outside EU/EEA |
Global end of trial date |
30 Jan 2008
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Results information
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Results version number |
v1(current) |
This version publication date |
01 Mar 2016
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First version publication date |
30 Jul 2015
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
0476-383
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT00545844 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Merck Sharp & Dohme Corp.
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Sponsor organisation address |
2000 Galloping Hill Road, Kenilworth, NJ, United States, 07033
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Public contact |
Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
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Scientific contact |
Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
30 Jan 2008
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
30 Jan 2008
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Global end of trial reached? |
Yes
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Global end of trial date |
30 Jan 2008
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
Effectiveness of adding montelukast to inhaled corticosteroids in adult participants with both uncontrolled asthma and allergic rhinitis.
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Protection of trial subjects |
This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
02 Apr 2007
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Canada: 313
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Worldwide total number of subjects |
313
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EEA total number of subjects |
0
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
13
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Adults (18-64 years) |
252
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From 65 to 84 years |
48
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85 years and over |
0
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Recruitment
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Recruitment details |
The first 25 asthmatic participants seen consecutively at each site were invited to participate. Treatment phase: From the Survey population, blocks of 8 were allowed to participate. All participants took 1 tablet of montelukast 10 mg once a day at bedtime. First participant in: 02-APR-2007 Last participant out: 25-JAN-2008 | ||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
The anticipated Enrollment was 440, with an expected dropout rate of 20% over the 8-week period, thus 369 patients should complete the study. | ||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | ||||||||||||||||||||||||||||
Blinding implementation details |
This was an open-label study.
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Arms
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Are arms mutually exclusive |
No
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Arm title
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All Patients | ||||||||||||||||||||||||||||
Arm description |
Participants took montelukast sodium, 10 mg, one tablet once a day for 8 weeks as add on therapy to usual current asthma controller treatment. Participants with comorbid allergic rhinitis and uncontrolled asthma were invited to participate in the treatment phase of the study. Of the 1004 participants who completed the survey phase, there were 319 eligible participants who advanced and participated in the treatment phase. Of the 319 eligible participants who advanced to the treatment phase 6 did not meet inclusion criteria leaving 313 patients. | ||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||
Investigational medicinal product name |
Montelukast sodium
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Investigational medicinal product code |
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Other name |
SINGULAIR®
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Montelukast sodium 10 mg tablet taken by mouth at bedtime.
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Arm title
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Treatment Phase (All Patients) Week 8 | ||||||||||||||||||||||||||||
Arm description |
- | ||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||
Investigational medicinal product name |
Montelukast sodium
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Investigational medicinal product code |
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Other name |
SINGULAIR®
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Montelukast sodium 10 mg tablet taken by mouth at bedtime.
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Arm title
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Treatment Phase (All Patients) Week 0 | ||||||||||||||||||||||||||||
Arm description |
- | ||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||
Investigational medicinal product name |
Montelukast sodium
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Investigational medicinal product code |
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Other name |
SINGULAIR®
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Montelukast sodium 10 mg tablet taken by mouth at bedtime.
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Baseline characteristics reporting groups
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Reporting group title |
All Patients
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Reporting group description |
Participants took montelukast sodium, 10 mg, one tablet once a day for 8 weeks as add on therapy to usual current asthma controller treatment. Participants with comorbid allergic rhinitis and uncontrolled asthma were invited to participate in the treatment phase of the study. Of the 1004 participants who completed the survey phase, there were 319 eligible participants who advanced and participated in the treatment phase. Of the 319 eligible participants who advanced to the treatment phase 6 did not meet inclusion criteria leaving 313 patients. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
All Patients
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Reporting group description |
Participants took montelukast sodium, 10 mg, one tablet once a day for 8 weeks as add on therapy to usual current asthma controller treatment. Participants with comorbid allergic rhinitis and uncontrolled asthma were invited to participate in the treatment phase of the study. Of the 1004 participants who completed the survey phase, there were 319 eligible participants who advanced and participated in the treatment phase. Of the 319 eligible participants who advanced to the treatment phase 6 did not meet inclusion criteria leaving 313 patients. | ||
Reporting group title |
Treatment Phase (All Patients) Week 8
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Reporting group description |
- | ||
Reporting group title |
Treatment Phase (All Patients) Week 0
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Reporting group description |
- | ||
Subject analysis set title |
Treatment Phase (All Patients) Week 0
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
All participants at Week 0.
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Subject analysis set title |
Treatment Phase (All Patients) Week 8
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
All participants at Week 8.
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Subject analysis set title |
Treatment Phase (All Patients) Week 8
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
All participants at Week 8.
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Subject analysis set title |
Treatment Phase (All Patients) Week 8
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
All participants at Week 8.
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End point title |
Asthma Control [1] | |||||||||||||||||||||
End point description |
Asthma control was assessed by the Canadian Asthma Consensus Guidelines at week 0 and week 8. Participants were considered uncontrolled if they answered “yes” to at least 2 of the 8 asthma control parameters.
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End point type |
Primary
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End point timeframe |
8 weeks (from Week 0 to Week 8)
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Notes [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point. Justification: Only descriptive statistics were to be provided. |
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Notes [2] - Results are based on 301 participants in the Intent-to-Treat (ITT) population with results at Week 8 |
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No statistical analyses for this end point |
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End point title |
The mean change in Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) overall score | ||||||||||||
End point description |
Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) consists of 14 questions to assess participant's overall quality of life related to allergic rhinitis on a scale of 0 (least impairment) to 6 (greatest impairment). The score is the mean of the 14 questions, ranging from 0 to 6. Change is computed as Week 8 score – Week 0 score.
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End point type |
Secondary
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End point timeframe |
8 weeks (from Week 0 to Week 8)
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Notes [3] - Baseline is set to zero for the purpose of this analysis. [4] - Result based on 286 participants in the ITT population with MiniRQLQ data at Week 8. |
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Statistical analysis title |
Mean Change in Mini Rhinoconjunctivitis Quality | ||||||||||||
Statistical analysis description |
Change from baseline at Week 8
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Comparison groups |
Treatment Phase (All Patients) Week 8 v Treatment Phase (All Patients) Week 0
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Number of subjects included in analysis |
599
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Analysis specification |
Pre-specified
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Analysis type |
other [5] | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
t-test, 2-sided | ||||||||||||
Confidence interval |
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Notes [5] - A total of 286 participants were included in the Week 8 analysis. |
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End point title |
Effectiveness of Montelukast Therapy Used in Combination With Inhaled Corticosteroids or Inhaled Corticosteroids / Long-Acting Beta 2-Agonist in Improving the Symptoms of Asthma Using the Asthma Control Questionnaire (ACQ) | ||||||||||||
End point description |
The Asthma Control Questionnaire consists of 7 specific questions that were used to assess participant's asthma control at Week 0 and Week 8. The mean score per question is used to determine the level of control, with a final score ranging from 0 (well-controlled) to 6 (extremely poorly-controlled) units on a scale.
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End point type |
Secondary
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End point timeframe |
8 weeks (from Week 0 to Week 8)
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Notes [6] - 300 participants in the ITT population completed the ACQ at Week 8. |
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Statistical analysis title |
Change from baseline in ACQ | ||||||||||||
Statistical analysis description |
Change from baseline at Week 8
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Comparison groups |
Treatment Phase (All Patients) Week 0 v Treatment Phase (All Patients) Week 8
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Number of subjects included in analysis |
613
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Analysis specification |
Pre-specified
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Analysis type |
other [7] | ||||||||||||
P-value |
< 0.001 | ||||||||||||
Method |
t-test, 2-sided | ||||||||||||
Confidence interval |
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Notes [7] - 300 participants were included in the Week 8 analysis. |
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End point title |
Patient Global Satisfaction | ||||||||||||||||||||||||||||||
End point description |
At week 0 and week 8, patients were asked to complete a single question describing how satisfied they were regarding their asthma controller medication.
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End point type |
Other pre-specified
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End point timeframe |
8 weeks (from Week 0 to Week 8)
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Notes [8] - Results are based on 301 participants in the ITT population that completed Week 8. |
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Statistical analysis title |
Change in patient satisfaction | ||||||||||||||||||||||||||||||
Statistical analysis description |
McNemar-Bowker test is McNemar chi-squared statistic for binary matched pairs, with Bowker chi-squared fit test of symmetry model (tests all rows of data) (cf. Agresti, 2007)
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Comparison groups |
Treatment Phase (All Patients) Week 0 v Treatment Phase (All Patients) Week 8
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Number of subjects included in analysis |
614
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Analysis specification |
Pre-specified
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Analysis type |
other [9] | ||||||||||||||||||||||||||||||
P-value |
< 0.001 | ||||||||||||||||||||||||||||||
Method |
McNemar-Bowker | ||||||||||||||||||||||||||||||
Confidence interval |
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Notes [9] - 301 participants were included in the Week 8 analysis. |
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End point title |
Physician Global Satisfaction | ||||||||||||||||||||||||||||||
End point description |
At week 0 and week 8, physicians were asked to complete a single question describing how satisfied they were regarding their patient’s asthma controller medication.
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End point type |
Other pre-specified
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End point timeframe |
8 weeks (from Week 0 to Week 8)
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Notes [10] - Results are based on the 301 participants in the ITT population that completed Week 8. |
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Statistical analysis title |
Change in Physician Global Satisfaction | ||||||||||||||||||||||||||||||
Statistical analysis description |
McNemar-Bowker test is McNemar chi-squared statistic for binary matched pairs, with Bowker chi-squared fit test of symmetry model (tests all rows of data) (cf. Agresti, 2007)
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Comparison groups |
Treatment Phase (All Patients) Week 0 v Treatment Phase (All Patients) Week 8
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Number of subjects included in analysis |
614
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Analysis specification |
Pre-specified
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Analysis type |
other [11] | ||||||||||||||||||||||||||||||
P-value |
< 0.001 | ||||||||||||||||||||||||||||||
Method |
McNemar-Bowker | ||||||||||||||||||||||||||||||
Confidence interval |
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Notes [11] - 301 participants were included in the Week 8 analysis. |
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End point title |
Patient Global Allergic Rhinitis Symptoms Assessment | ||||||||||||||||||||||||||||||
End point description |
At week 0 and week 8, patients were asked to complete one question describing their perception of their allergic rhinitis symptoms.
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End point type |
Other pre-specified
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End point timeframe |
8 weeks (from Week 0 to Week 8)
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Notes [12] - Results are based on 301 participants in the ITT population that completed Week 8. |
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Statistical analysis title |
Change in Patient Global Allergic Rhinitis | ||||||||||||||||||||||||||||||
Statistical analysis description |
McNemar-Bowker test is McNemar chi-squared statistic for binary matched pairs, with Bowker chi-squared fit test of symmetry model (tests all rows of data) (cf. Agresti, 2007)
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Comparison groups |
Treatment Phase (All Patients) Week 0 v Treatment Phase (All Patients) Week 8
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Number of subjects included in analysis |
614
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Analysis specification |
Pre-specified
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Analysis type |
other [13] | ||||||||||||||||||||||||||||||
P-value |
< 0.001 | ||||||||||||||||||||||||||||||
Method |
McNemar-Bowker | ||||||||||||||||||||||||||||||
Confidence interval |
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Notes [13] - 301 participants were included in the Week 8 analysis. |
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Adverse events information
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Timeframe for reporting adverse events |
Up to 10 weeks
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
10.0
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Reporting groups
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Reporting group title |
All Patients
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0.3% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? No | |||
Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |