Clinical Trial Results:
EFFECT OF ELECTRONIC MONITORING AND FEEDBACK ON ADHERENCE TO EASYHALER CONTROLLER MEDICATION IN PATIENTS WITH ASTHMA
Summary
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EudraCT number |
2019-003082-17 |
Trial protocol |
DE |
Global end of trial date |
24 Apr 2024
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Results information
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Results version number |
v1(current) |
This version publication date |
26 Apr 2025
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First version publication date |
26 Apr 2025
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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 |
3103017
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT04869384 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Orion Corporation
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Sponsor organisation address |
Orionintie 1, Espoo, Finland, 02200
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Public contact |
Clinical Trial Information Desk, Orion Corporation Orion Pharma, +358 104261, clinicaltrials@orionpharma.com
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Scientific contact |
Clinical Trial Information Desk, Orion Corporation Orion Pharma, +358 104261, clinicaltrials@orionpharma.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? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
24 Apr 2024
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
24 Apr 2024
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Global end of trial reached? |
Yes
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Global end of trial date |
24 Apr 2024
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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 |
The primary objective was to compare mean weekly adherence to controller medication between the intervention group using Connected Easyhaler and the control group (active usual care) during the last 6 weeks of the study.
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Protection of trial subjects |
Use of Connected Easyhaler was not considered to add any safety concern compared to normal use of inhalers. The trial enrolled adult asthmatic patients with suboptimal asthma control who were currently receiving inhaled budesonide, budesonide/formoterol combination or salmeterol/fluticasone propionate combination as their controller medication. Adverse events were collected from the time that a trial participant signed the IC form until the end-of-trial visit at 6 months.
Salbutamol was used as rescue medication as needed.
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Background therapy |
In addition to study medication, the use of possible other asthma medications was permitted and the dose continued as before the trial. | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
23 Jun 2021
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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 |
Germany: 158
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Worldwide total number of subjects |
158
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EEA total number of subjects |
158
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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) |
0
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Adults (18-64 years) |
157
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From 65 to 84 years |
1
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85 years and over |
0
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Recruitment
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Recruitment details |
A total of 171 participants were screened for the trial in Germany, with 78 participants being randomised into the Intervention group and 80 participants randomised into the Usual Care group. | |||||||||||||||
Pre-assignment
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Screening details |
Male and female participants, aged 18-65 years with asthma, ACT score 19 or less, were recruited. Participant must have been used their control medication (budesonide, budesonide/formoterol combination or salmeterol/fluticasone) at constant dose for at least 3 months before screening, and to be able to switch to Easyhaler. | |||||||||||||||
Pre-assignment period milestones
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Number of subjects started |
158 | |||||||||||||||
Number of subjects completed |
158 | |||||||||||||||
Period 1
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Period 1 title |
Overall trial (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Not blinded | |||||||||||||||
Blinding implementation details |
This was an open-label trial.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Intervention | |||||||||||||||
Arm description |
Participants in the Intervention group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones. The sensors monitored use of medications by capturing date, time and number of uses. The participants in this group got reminders (sound and/or light) on the controller medication use via sensor and mobile application. In addition, there were push notifications via mobile application. At study visits, the adherence data accumulated since the previous visit was reviewed by the investigator/nurse using the Provider Portal and discussed with the subject. | |||||||||||||||
Arm type |
Experimental | |||||||||||||||
Investigational medicinal product name |
Budesonide Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Individual dosing instructed by the treating physician.
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Investigational medicinal product name |
Budesonide/Formoterol Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Individual dosing instructed by the treating physician.
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Investigational medicinal product name |
Salmeterol/Fluticasone propionate Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Individual dosing instructed by the treating physician.
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Investigational medicinal product name |
Salbutamol Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Reliever medication, used as needed (in accordance with SmPC).
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Arm title
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Usual Care | |||||||||||||||
Arm description |
Participants in the Usual Care group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones as in the Intervention group. They were told that the sensors monitor how much the inhalers are used; however, the reminders/alarms of the sensors were disabled, and the participants or health care professionals could not review information collected from the sensor via the mobile application. | |||||||||||||||
Arm type |
Active comparator | |||||||||||||||
Investigational medicinal product name |
Budesonide Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Individual dosing instructed by the treating physician.
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Investigational medicinal product name |
Salbutamol Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Reliever medication, used as needed (in accordance with SmPC).
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Investigational medicinal product name |
Salmeterol/Fluticasone propionate Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Individual dosing instructed by the treating physician.
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Investigational medicinal product name |
Budesonide/Formoterol Easyhaler
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Inhalation powder
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Routes of administration |
Inhalation use
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Dosage and administration details |
Individual dosing instructed by the treating physician.
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Baseline characteristics reporting groups
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Reporting group title |
Intervention
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Reporting group description |
Participants in the Intervention group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones. The sensors monitored use of medications by capturing date, time and number of uses. The participants in this group got reminders (sound and/or light) on the controller medication use via sensor and mobile application. In addition, there were push notifications via mobile application. At study visits, the adherence data accumulated since the previous visit was reviewed by the investigator/nurse using the Provider Portal and discussed with the subject. | ||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Usual Care
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Reporting group description |
Participants in the Usual Care group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones as in the Intervention group. They were told that the sensors monitor how much the inhalers are used; however, the reminders/alarms of the sensors were disabled, and the participants or health care professionals could not review information collected from the sensor via the mobile application. | ||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Intervention
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Reporting group description |
Participants in the Intervention group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones. The sensors monitored use of medications by capturing date, time and number of uses. The participants in this group got reminders (sound and/or light) on the controller medication use via sensor and mobile application. In addition, there were push notifications via mobile application. At study visits, the adherence data accumulated since the previous visit was reviewed by the investigator/nurse using the Provider Portal and discussed with the subject. | ||
Reporting group title |
Usual Care
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Reporting group description |
Participants in the Usual Care group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones as in the Intervention group. They were told that the sensors monitor how much the inhalers are used; however, the reminders/alarms of the sensors were disabled, and the participants or health care professionals could not review information collected from the sensor via the mobile application. |
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End point title |
Mean weekly adherence to controller medication | ||||||||||||
End point description |
The primary efficacy variable was mean weekly adherence to controller medication (the percentage of doses taken of the doses prescribed) during the last 6 weeks of treatment. The use of controller medication was recorded by the sensor attached to the inhaler in both groups. The adherence was compared between participants who did and did not receive reminders and feedback on their medication use via Connected Easyhaler.
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End point type |
Primary
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End point timeframe |
The last 6 weeks of treatment of the 6 month treatment period.
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Statistical analysis title |
Comparison of change in adherence from baseline | ||||||||||||
Statistical analysis description |
Comparison of change in adherence from baseline between the groups.
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Comparison groups |
Intervention v Usual Care
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Number of subjects included in analysis |
158
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
< 0.05 | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Mean difference (net) | ||||||||||||
Point estimate |
21.72
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
11.75 | ||||||||||||
upper limit |
31.68 |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events were collected from the time that a trial participant signed the IC form until the end-of-trial visit at 6 months.
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Adverse event reporting additional description |
The adverse events reported during the run-in period were included.
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Assessment type |
Systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
26.1
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Reporting groups
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Reporting group title |
Intervention
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Reporting group description |
Participants in the Intervention group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones. The sensors monitored use of medications by capturing date, time and number of uses. The participants in this group got reminders (sound and/or light) on the controller medication use via sensor and mobile application. In addition, there were push notifications via mobile application. At study visits, the adherence data accumulated since the previous visit was reviewed by the investigator/nurse using the Provider Portal and discussed with the subject. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Usual Care
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Reporting group description |
Participants in the Usual Care group had sensors attached to their controller and reliever medication inhalers and the mobile application installed to their mobile phones as in the Intervention group. They were told that the sensors monitor how much the inhalers are used; however, the reminders/alarms of the sensors were disabled, and the participants or health care professionals could not review information collected from the sensor via the mobile application. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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12 Feb 2020 |
Amendment 1. Changes requested by German regulatory authority BfArM:
-Further rationale for patient selection was added to the protocol to justify the inclusion of participants with ACT score ≤19 (5-19).
-The use of other asthma mediation was clarified.
-Time period for the use of the controller medication at constant dose from at least 1 month was extended to 3 months prior to the screening visit.
-A summary of pertinent safety information was included.
-The 6-week phone call was removed in order not to create bias.
-Pregnancy testing was included to screening for WOCBP
-The requirement for WOCBP to use adequate contraception was included.
-Paradoxical bronchospasm was added as an example for discontinuing the trial treatment for a participant.
-Criteria for discontinuation of the trial were added.
-The use of Salbutamol Easyhaler as a reliever medication was clarified.
-A new section containing potent inhibitors of CYP3A was added.
-Trial procedures at screening were clarified.
-It was clarified that participants can call Propeller customer support if they have any questions or concerns related to the sensor or the application.
-More detailed information on spirometric measurements was given.
-Clarification for pregnancy during the trial was added.
-Text concerning discontinuation of the trial was reorganised and added under section 4.7.
-Detailed information on contraception methods considered acceptable in this trial based on the Clinical Trial Facilitation Group recommendation was added. |
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28 May 2020 |
The amended protocol was created to implement changes requested by German central ethics committee.
-Primary objective was clarified.
- Secondary objectives were clarified.
-Timeline the participant had used an investigational drug was determined more precisely.
-Exclusion of individuals who are subordinate to the Sponsor or institutionalised as a result of an administrative or court order were added.
-Race as a data to be collected was removed.
-Protocol deviation as a reason for participant’s discontinuation was removed
-A reason for discontinuing the trial was added.
-Ratio for distribution into treatment groups were added.
-Easyhaler inhaler technique checking and training missing from randomisation visit was added.
-Data related to variable Healthcare utilisation related to asthma to be collected from CRF was removed.
-Data related to variable Number of missing working or trial days due to asthma symptoms to be collected from CRF was removed.
-Clarification that non-compliance is not considered as a protocol deviation for per-protocol population was added.
-Statistical analysis for the primary endpoint was described in more detail.
-Clarification related to secondary variable adherence to controller medication was added. |
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24 Nov 2020 |
An amendment to a protocol was created and implemented due to Covid-19 pandemic.
-Obtaining baseline data about adherence was added.
-Benefit-risk assessment was updated to include the possible risks associated with Covid-19.
-The smart phone versions supported were updated.
-Time from previous upper or lower respiratory infection was prolonged from 7 to 14 days due to possible covid-19 infection.
-The need to return Easyhaler inhalers at every visit was removed because post-randomisation visits (Visit 3 and Visit 4) could have been carried out remotely (a telephone visit, home visit or video call) due to restrictions related to covid-19.
-Asthma symptom control was removed as it was accidentally included into the original protocol. Assessment of asthma control according to GINA was considered at the time of protocol development but left out as ACT was included. This correction was missed in the previous amendments.
-The precautions due to Covid-19 pandemic and possible protocol assessments during remote visits were added.
-Clarifications into data collection was added. |
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02 Mar 2021 |
An amendment was created to implement the changes requested by German central ethics committee.
-Additional covid-19 precautions including covid-19 testing were added.
-Trial dates (start and complete) were updated due to Covid-19. |
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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 |