E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Regular treatment of asthma |
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E.1.1.1 | Medical condition in easily understood language |
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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 | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10003560 |
E.1.2 | Term | Asthma NOS |
E.1.2 | System Organ Class | 100000004855 |
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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 is to assess and compare the systemic exposure of budesonide and salmeterol after administration of the study products (two dosages of Budesonide-Salmeterol fixed dose combination versus Serevent® Diskus® 50 μg + Pulmicort® Turbuhaler® 100 µg co-administration) using Cmax, AUC∞, AUC0-30min, AUC0-2h, tmax and t1/2.
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E.2.2 | Secondary objectives of the trial |
- To assess and compare the pulmonary exposure of Budesonide-Salmeterol fixed dose combination versus Serevent® Diskus® 50 μg + Pulmicort® Turbuhaler® 100 µg co-administration.
- To assess and compare the safety profile of Budesonide-Salmeterol fixed dose combination versus Serevent® Diskus® 50 μg + Pulmicort® Turbuhaler® 100 µg co-administration.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or premenarchal female subjects aged between 6 and 11 years, inclusive.
2. Caucasian.
3. Asthma diagnosed according to the GINA guidelines based on symptoms typical of childhood asthma, within at least 3 months prior to screening.
4. Subject presenting an increase in FEV1 of at least 12% of the FEV1 predicted value at reversibility test after 200 µg of salbutamol at screening visit. If the level of reversibility is not achieved at screening, 1 repeat measurement of reversibility is allowed during the screening period within seven days after Visit 1 if there is reasonable belief that the patient can achieve the expected reversibility.
5. Patients not weighing less than 19 kg
6. Body mass index (BMI) within the 5th to 95th percentile of the BMI charts/tables recommended by the world health organization (WHO) based on stature-for-age and weight-for-age and by gender. (Charts presented in appendix 18.5)
7. Able to comply with all study procedures, including the use of study inhalers (Vertical-Haler®, Diskus®, Turbuhaler®) and spirometer. Note: Since formal training and test for the correct handling of the DISKUS® and TURBUHALER® inhalers could not be provided the Investigator should check if the child understands the instructions provided for the inhalers use and is aware of their proper use. Willing to withhold the use of short acting β-agonists for at least 6 hours prior to the screening visit and at least 6 hours prior to each study visit.
8. Written informed consent for the patient to participate in the study by the parent(s) or legal guardian(s) as applicable and if possible - a written assent by the patient.
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E.4 | Principal exclusion criteria |
1. Drug addiction or excessive use of xanthine containing beverages (5 cups of tea, coffee, cacao, cola, ice tea)
2. Severe, life-threatening asthma or hospitalisation for an asthma exacerbation within 3 months prior to the screening visit and hospitalisation for a related disorder (pneumothorax, bronchopneumonia etc) in the past 3 months
3. Evidence of any unstable or untreated clinically significant immunological, neoplastic, endocrine, haematological, hepatic, renal, gastrointestinal, neurological or psychiatric abnormality, or disease
4. Respiratory tract infection requiring treatment with antibiotics within 4 weeks prior to the screening visit
5. Any significant upper and lower respiratory infection (other than asthma) within the previous 4 weeks before screening visit
6. Pure seasonal asthma and/ or a history of seasonal exacerbation of asthma
7. Use of any of the prohibited medications as detailed in the concomitant medication section 10.9
8. Clinical evidence of candidiasis or other fungal airway infection at the screening visit
9. Participation in any other clinical trial within 3 months of the screening visit
10. Blood donation within 3 months before the screening visit
11. Presence of any other condition or illness, which, in the opinion of the investigator would interfere with optimal participation in the study
12 Patients with any sensitivity or allergy to any of the products (including excipients) used within this clinical trial
13 Patient known to have, or at risk of contracting, human immunodeficiency virus (HIV), Hepatitis B or Hepatitis C or patients with positive virology laboratory tests (HBsAg, HCV Ab, HIV 1+2 Ab)
14 Patients with diabetes mellitus
15 Subjects previously enrolled into the current study.
16 First-degree relative of a study investigator, or of employee of the clinical study site or of the sponsor
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E.5 End points |
E.5.1 | Primary end point(s) |
The following pharmacokinetic parameters will be considered:
- AUC∞, AUC0-30min, AUC0-2h, tmax, % of residual AUC and t1/2 for budesonide.
- AUC∞, AUC0-30min, tmax, % of residual AUC and t1/2 for salmeterol.
Cmax and AUC0-t will be considered as primary endpoints
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Period I, Period II, Period III |
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E.5.2 | Secondary end point(s) |
The following safety endpoints will be considered:
- Adverse event profiles
- Vital signs (heart rate, SBP, DBP, Respiratory rate)
- Tremor
- Serum glucose and potassium
- Haematology, chemistry and urine standard safety lab parameters
- 12-lead ECG measurements
- Physical examination
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Screening visit, Period I, Period II, Period III, End of study visit |
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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 | No |
E.6.6 | Pharmacokinetic | Yes |
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) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | Yes |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
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 | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
Partially blinded, two stage design |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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.8.5 | 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 | No |
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 | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |