Efficacy of NVA237 Compared to Tiotropium in Patients With Chronic Obstructive Pulmonary Disease (COPD)

Phase 4

Completed

Interventions: Drug: Placebo to NVA237
Drug: NVA237
Drug: Tiotropium
Drug: Placebo to tiotropium
Drug: Salbutamol

Brief Summary: The purpose of this study is to further figure out differences of glycopyrronium bromide compared to tiotropium in early bronchodilation measured by a comprehensive assessment of lung function that includes hyperinflation and specific airway resistance in patients with moderate to severe COPD.

Recruitment & Eligibility

Inclusion Criteria

Male or female adults aged ≥40 years
Patients with moderate to severe COPD defined by a post-bronchodilator Forced Expiratory Volume in One Second (FEV1)/(FVC) Forced Vital Capacity ratio of <0.70 and a post-bronchodilator FEV1 of ≤70% and FEV1 ≥ 30% of predicted normal values.
Current or ex-smokers who have a smoking history of at least 10 pack years.

Exclusion Criteria

Pregnant or nursing (lactating) women
Patients who have a clinically significant laboratory abnormality at run-in
Patients with narrow-angle glaucoma, symptomatic benign prostatic hyperplasia or bladder-neck obstruction or moderate to severe renal impairment (GFR <50 ml/min/1,732) or urinary retention. (BPH patients who are stable on treatment can be considered).
Patients with any history of asthma
Patients with pulmonary lobectomy or lung volume reduction surgery or lung transplantation
Patients receiving medications in the classes listed in the protocol as prohibited.

Other protocol-defined inclusion/exclusion criteria may apply

Arm && Interventions

Group	Intervention	Description
NVA237 followed by tiotropium	Placebo to tiotropium	Period 1: NVA237 plus placebo to tiotropium on day 1, followed by a 7 day washout. Period 2: tiotropium plus placebo to NVA237 on day 8. Salbutamol was used as rescue medication.
Tiotropium followed by NVA237	Placebo to NVA237	Period 1: tiotropium plus placebo to NVA237 on day 1, followed by a 7 day washout. Period 2: NVA237 plus placebo to tiotropium on day 8. Salbutamol was used as rescue medication.
NVA237 followed by tiotropium	NVA237	Period 1: NVA237 plus placebo to tiotropium on day 1, followed by a 7 day washout. Period 2: tiotropium plus placebo to NVA237 on day 8. Salbutamol was used as rescue medication.
NVA237 followed by tiotropium	Tiotropium	Period 1: NVA237 plus placebo to tiotropium on day 1, followed by a 7 day washout. Period 2: tiotropium plus placebo to NVA237 on day 8. Salbutamol was used as rescue medication.
NVA237 followed by tiotropium	Salbutamol	Period 1: NVA237 plus placebo to tiotropium on day 1, followed by a 7 day washout. Period 2: tiotropium plus placebo to NVA237 on day 8. Salbutamol was used as rescue medication.
Tiotropium followed by NVA237	Salbutamol	Period 1: tiotropium plus placebo to NVA237 on day 1, followed by a 7 day washout. Period 2: NVA237 plus placebo to tiotropium on day 8. Salbutamol was used as rescue medication.

Primary Outcome Measures

Name	Time	Method
Forced Expiratory Volume in One Second (FEV1) Area Under Curve (AUC) 0-2	Day 1	Standardized Forced Expiratory Volume in One Second (FEV1) AUC0-2h will be measured via spirometry. The AUC will be calculated from the FEV1 measurements obtained at timepoints between 0 min and 2h using the trapezoidal rule and will be standardized (=divided) by the measurement time (i.e. 2h).

Secondary Outcome Measures

Name	Time	Method
Forced Expiratory Volume in One Second (FEV1) 15 Min Post Dose	Day 1	Forced expiratory volume in 1 second (FEV1) is the amount of air that can be exhaled in one second. FEV1 will be measured by spirometry. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability.
Specific Airway Resistance (sRAW)	Day 1	Specific Airway Resistance (sRAW) indicates volume and resistance-dependent work of breathing needed in order to generate a reference flow rate of 1 L/s, measured by kPa\*s. Whole body plethysmography (Bodybox) is used to measure SRaw.
Residual Volume (RV)	Day 1	Residual Volume (RV) will be measured using whole body plethysmography (Bodybox).
Total Lung Capacity (TLC)	Day 1	Total Lung Capacity (TLC) is the best vital capacity plus residual volume (RV). Whole body plethysmography (Bodybox) will be used to measure TLC.
Inspiratory Capacity (IC)	Day 1	Inspiratory Capacity (IC) is the volume of air breathed in by a maximum inspiration at the end of a normal expiration. Whole body plethysmography (Bodybox) will be used to measure IC.
Functional Resistance Capacity (FRCpleth)	Day 1	Functional Resistance Capacity (FRCpleth) will be measured using whole body plethysmography (Bodybox).