| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| Chronic Obstructive Pulmonary Disease (COPD) in patients who are considered to be at a higher risk of Coronary Artery Disease (CAD), myocardial infarction, and excess mortality. |
|
| E.1.1.1 | Medical condition in easily understood language |
| A progressive lung condition that makes it difficult to breathe. |
|
| E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 18.0 |
| E.1.2 | Level | PT |
| E.1.2 | Classification code | 10009033 |
| E.1.2 | Term | Chronic obstructive pulmonary disease |
| E.1.2 | System Organ Class | 10038738 - Respiratory, thoracic and mediastinal disorders |
|
| 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 |
| To establish if treatment with blood thinning medications such as Aspirin and Ticagrelor in patients with a lung condition called chronic obstructive pulmonary disease (COPD) who are predicted to be at an increased risk of heart disease or heart attacks, will affect the function of the blood cells called platelets. This will be measured using a bedside Multiplate platelet function test. |
|
| E.2.2 | Secondary objectives of the trial |
1)To establish if treatment with medicines that stop blood cells from sticking together and forming a blood clot (antiplatelet therapy) will lead to reduced levels of markers commonly used to detect inflammation in the body. 2)To establish if treatment with antiplatelet therapy has an effect on the stiffness of the arteries and the thickness of the inner two layers of the main blood vessels that supply the head and neck (carotid artery). 3)To capture adverse event rates (such as bleeding and worsening of breathlessness) in the chronic obstructive pulmonary disease (COPD) population. |
|
| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
1)Abnormal spirometry with FEV1<80% and FEV1/FVC ratio <70% of predicted 2)Smoking history that is 10-pack years or greater (current or ex smokers can be included) 3)Patient has the capacity to consent 4)18 years or over
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| E.4 | Principal exclusion criteria |
1)Any condition that is being concurrently treated through anticoagulation or antiplatelet therapy (atrial fibrillation, deep vein thrombosis, valve prosthesis, recent myocardial infarction, use of drug eluting stents) 2)Other specific contraindications to management with antiplatelet medication (bleeding risks, allergies) 3)Any contraindication for Aspirin and Ticagrelor use 4)Other concurrent terminal illnesses with life expectancy less than 1 year (congestive cardiac failure, carcinoma etc.) 5)Current involvement in another clinical trial or exposure to another IMP within the previous 30 days 6)COPD with an atypical cause (e.g. A1- antitrypsin deficiency) 7)Planned/ Expected major surgery where anti-platelet therapy would be ceased 8)Pregnancy, planned pregnancy or current breast-feeding 9)Patient is unable to provide informed consent 10)Younger than 18 years |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
| Inhibition of Adenosine disphosphate-induced platelet aggregation from baseline to 1-month and 6-months. |
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
| E.5.2 | Secondary end point(s) |
1)Changes in inflammatory markers including fibrinogen, hsCRP, TNF alpha, IL6, MPO from baseline to 1-month and 6-months.
2)Changes in carotid intima media thickness and non-invasive measures of vascular stiffness from baseline to 6-months.
3)Quality of life using questionnaires (EQ5D, St. George’s COPD questionnaire) at baseline and 6-months. |
|
| E.5.2.1 | Timepoint(s) of evaluation of this end point |
1) Baseline, 1-month and 6-months. 2) Baseline and 6-months. 3) Baseline and 6-months. |
|
| 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 | No |
| 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 | 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.8.2.4 | Number of treatment arms in the trial | 4 |
| E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
| E.8.4 | The trial involves multiple sites in the Member State concerned | No |
| E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
| 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 | No |
| 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
|
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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 | 2 |
| E.8.9.1 | In the Member State concerned months | 6 |
| E.8.9.1 | In the Member State concerned days | 1 |
| E.8.9.2 | In all countries concerned by the trial years | 2 |
| E.8.9.2 | In all countries concerned by the trial months | 6 |
| E.8.9.2 | In all countries concerned by the trial days | 1 |