Randomized, Placebo-controlled, Multi-dose, Study Comparing Budesonide/Formoterol to Symbicort® in Asthmatic Patients

Phase 3

Completed

Interventions: Drug: Budesonide/Formoterol fumarate dihydrate
Drug: Placebo
Drug: Symbicort

Brief Summary: A randomized multiple-dose, placebo-controlled, parallel group design consisting of a 2-week run-in period followed by a 6-week treatment period of the placebo, Test product (Budesonide 80 mcg / Formoterol fumarate dihydrate 4.5 mcg), or Reference product Symbicort® inhalation aerosol.

Detailed Description: This is a pivotal trial that will examine therapeutic equivalence of a new generic fixed-dose combination product containing Budesonide 80 mcg / Formoterol fumarate dihydrate 4.5 mcg and reference listed drug (RLD) Symbicort® inhalation aerosol in adult patients with chronic but stable asthma as defined in National Asthma Education and Prevention Program Expert Panel Report 3 (NAEPP 3) guidelines. To ensure adequate study sensitivity the test and reference products should both be statistically superior to placebo (p\<0.05) with regard to the bioequivalent study primary endpoints.

A secondary study objective is the safety and tolerability of the test compound.

Recruitment & Eligibility

Inclusion Criteria

Adult male or female subjects of non-childbearing or of childbearing potential committed to consistent and correct use of an acceptable method of birth control
Diagnosed with asthma, as defined by the National Asthma Education and Prevention Program (NAEPP),at least 6 months prior to screening
Moderate-to-severe asthma with a pre-bronchodilator FEV1 of >45% and <85% of predicted normal, measured at least 6 hours after short-acting β agonist (SABA)and at least 24 hours after the last dose of long-acting β agonist (LABA), at the screening visit and on the day of treatment
>15% and >0.20 L reversibility of FEV1 within 30 minutes following 360 mcg of albuterol inhalation (pMDI)
Patients should be stable on their chronic asthma treatment regimen for at least 4 weeks prior to enrollment
Currently non-smoking; having not used tobacco products (i.e., cigarettes, cigars, pipe tobacco) within the past year, and having < 10 pack-years of historical use
Able to replace current regularly scheduled short-acting β agonists (SABAs) with salbutamol/albuterol inhaler for use only on an as-needed basis for the duration of the study (subjects should be able to withhold all inhaled SABAs for at least 6 hours prior to lung function assessments on study visits)
Willing to discontinue their asthma medications (inhaled corticosteroids and long-acting β agonists) during the run-in period and for the remainder of the study
Willingness to give their written informed consent to participate in the study

Exclusion Criteria

Life-threatening asthma, defined as a history of asthma episodes(s) requiring intubation, and/or associated with hypercapnia, respiratory arrest or hypoxic seizures, asthma-related syncopal episodes(s), or hospitalizations within the past year or during the run-in period
Significant respiratory disease other than asthma (chronic obstructive pulmonary disease (COPD), interstitial lung disease, etc.)
Evidence or history of clinically significant disease or abnormality including congestive heart failure, uncontrolled hypertension, uncontrolled coronary artery disease, myocardial infarction, or cardiac dysrhythmia. In addition, historical or current evidence of significant hematologic, hepatic, neurologic, psychiatric, renal, or other diseases that, in the opinion of the investigator, would put the patient at risk through study participation, or would affect the study analyses if the disease exacerbated during the study
Patients who required systemic corticosteroids (for any reason) within the past 4 weeks
Hypersensitivity to any sympathomimetic drug (e.g., formoterol or albuterol) or any inhaled, intranasal, or systemic corticosteroid therapy
Patients currently receiving β-blockers

Arm && Interventions

Group	Intervention	Description
Treatment 1	Budesonide/Formoterol fumarate dihydrate	Generic Budesonide/Formoterol Fumarate Dihydrate (80mcg/4.5mcg) Inhalation Aerosol, two inhalation twice daily, consisting of a 2-week run-in period followed by a 6-week treatment period
Treatment 3	Placebo	Placebo Inhalation Aerosol, two inhalation twice daily, consisting of a 2-week run-in period followed by a 6-week treatment period
Treatment 2	Symbicort	Symbicort (Budesonide/Formoterol Fumarate Dihydrate) Inhalation Aerosol, two inhalation twice daily, consisting of a 2-week run-in period followed by a 6-week treatment period

Primary Outcome Measures

Name	Time	Method
Area Under the Serial Forced Expiratory Volume in 1 Second (FEV1)	Day 1	FEV1 Area calculated over 12 hours (measurements at 0, 1, 2, 3, 4, 6, 8, 12 hours post-dose) on Day 1 of treatment. Because this was a primary endpoint, Per Protocol Population used to calculate this endpoint.
Change From Baseline in FEV1 Measured in the Morning at the End of Treatment Visit	Day 1 - Day 49	Average predose FEV1 at End of Treatment defined as the average of all predose assessments on Day 42 (+/- 7 days). Baseline was defined as the average of 2 predose FEV1 values obtained on Day 1. The endpoint of baseline-adjusted predose FEV1 at end of treatment was calculated as follows: \[FEV1 at end of treatment\] - \[Baseline FEV1\].

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Adverse Events	6 Weeks	Number of participants reporting at least one adverse event (safety population)

Locations (93): Clinical Research Center of Alabama LLC
🇺🇸
Birmingham, Alabama, United States
Elite Clinical Studies
🇺🇸
Phoenix, Arizona, United States
Clinical Research Consortuim Arizona
🇺🇸
Tempe, Arizona, United States
Little Rock Allergy and Asthma Clinical Research Center
🇺🇸
Little Rock, Arkansas, United States
Anaheim Clinical Trials LLC
🇺🇸
Anaheim, California, United States
Warren W Pleskow MD
🇺🇸
Encinitas, California, United States
Allergy and Asthma Specialists Medical Group
🇺🇸
Huntington Beach, California, United States
California Allergy and Asthma Medical Group Inc
🇺🇸
Los Angeles, California, United States
Jonathan Corren MD, Inc.
🇺🇸
Los Angeles, California, United States
Southern California Institute For Respiratory Diseases, Inc.
🇺🇸
Los Angeles, California, United States
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Clinical Research Center of Alabama LLC
🇺🇸Birmingham, Alabama, United States