A Randomised, Double-Blind, Placebo-Controlled, Crossover Efficacy and Safety Evaluation of 8-Week Treatment Periods of Two Doses [5 µg (2 actuations of 2.5 µg) and µg (2 actuations of 5 µg)] of Tiotropium Inhalation Solution Delivered by the Respimat® Inhaler as Add-on Therapy in Patients with severe persistent Asthma.
- Conditions
- Patients with severe persistent asthmaMedDRA version: 8.1Level: LLTClassification code 10003555Term: Asthma bronchial
- Registration Number
- EUCTR2005-005615-21-DE
- Lead Sponsor
- Boehringer Ingelheim Pharma GmbH & Co. KG
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Recruiting
- Sex
- All
- Target Recruitment
- 115
1.All patients must sign and date an Informed Consent Form consistent with ICH-GCP guidelines and local legalisation prior to participation in the trial (i.e. prior to any study procedures, including any pre-study washout of medications and medication restrictions for pulmonary function test at Visit 1).
2.Male or female patients 18 years of age or older, but not older than 75 years.
3.Patients must have an ACQ mean score at screening (Visit1) of >/= 1.5.
4.Patients must be symptomatic (as defined in inclusion criterion #3) and at least 6 weeks on a high, stable dose of inhaled corticosteroids* + a long-acting beta adrenergic (additional sustained release theophylline and/or leukotriene modifier and/or oral glucocorticosteroids (cf. exclusion criterion No.13) are allowed in stable doses)
*
budesonide DPI >/=800 µg per day
beclomethasone CFC>/=1000 µg per day
beclomethasone HFA>/=500 µg per day
Fluticasone >/= 500 µg per day
Flunisolide >/=2000 µg per day
mometasone furoate >/=800 µg per day
triamcinolone acetonide >/=2000 µg per day
Ciclesonide>/= 640 µg per day
5.Patients must be never smokers or ex-smokers with a cigarette smoking history of <10 pack-years (and smoking cessation at least one year prior to study enrolment).
6.All patients must have at least a 5 year history of asthma at the time enrolled into the study (confirmed in the past and documented by an increased hyperresponsiveness to histamine or methacholine or a trial of glucocorticosteroids or a bronchodilator reversibility to a beta-2-adrenergic drug > 15% of PEF or FEV1; or a PEF variability > 15%), and a current diagnosis of severe, persistent asthma and must meet the following spirometric criteria:
Post bronchodilator (i.e. 30 minutes after inhalation of 4 puffs of 100 µg salbutamol) FEV1
Predicted normal values will be calculated according to ECSC [R94-1408]:
Males: FEV1 predicted (L) = 4.30 x [height (m)] – 0.029 x [age (yrs)] – 2.49
Females: FEV1 predicted (L) = 3.95 x [height (m)] - 0.025 x [age (yrs)] – 2.60
Patients with ages 18-25 will have predicted FEV1 calculated with age 25
7.Patients must be able to inhale medication in a competent manner from the Respimat® inhaler.
8.Patients must be able to perform technically acceptable pulmonary function tests and PEF and FEV1 measurements with the electronic peak flow meter and must be able to perform all necessary recordings in the electronic diary as part of the electronic peak flow meter.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range
1.Patients with a significant disease other than asthma; a significant disease is defined as a disease which, in the opinion of the investigator, may (i) put the patient at risk because of participation in the study, (ii) influence the results of the study, or (iii) cause concern regarding the patient’s ability to participate in the study
2.Patients with clinically relevant abnormal baseline haematology or blood chemistry will be excluded.
3.Patients with a recent history (i.e., six months or less) of myocardial infarction.
4.Patients who have been hospitalized for heart failure (NYHA class III or IV) within the past year.
5.Patients with any unstable or life threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention or a change in drug therapy within the past year.
6.Patients with malignancy for which the patient has undergone resection, radiation therapy or chemotherapy within the last five years. Patients with treated basal cell carcinoma are allowed.
7.Patients with lung diseases other than asthma (e.g. COPD).
8.Patients with known active tuberculosis.
9.Patients with significant alcohol or drug abuse within the past two years.
10.Patients who have undergone thoracotomy with pulmonary resection. Patients with a history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1.
11.Patients who are in a pulmonary rehabilitation program.
12.Patients who are being treated with Omalizumab (Xolair®)
13.Patients using oral corticosteroid medication at stable doses exceeding 5 mg/d prednisolone or prednisolone equivalent every day or 10 mg/d prednisolone or prednisolone equivalent every second day.
14.Patients who are being treated with beta-blocker medication. Topical cardio-selective beta-blocker eye medication for treatment of non-narrow angle glaucoma are allowed.
15.Patients with known hypersensitivity to anticholinergic drugs or any other components of the tiotropium inhalation solution.
16.Pre-menopausal women (last menstruation = 1 year prior to informed consent) who are not surgically sterile; or are nursing or pregnant; or are of child-bearing potential and are not practicing acceptable means of birth control, do not plan to continue using this method throughout the trial and do not agree to submit to periodic pregnancy testing during participation in the trial. Acceptable means of birth control include the transdermal patch, oral, implantable or injectable contraceptives, Intra Uterine Devices (IUDs), condoms, sexual abstinence and vasectomised partner. No exceptions will be made
17.Patients who have taken an investigational drug within one month or six half lives (whichever is greater) prior to Visit 1.
18.Patients who have been treated with the long-acting anticholinergic tiotropium (Spiriva®) within four weeks prior to Visit 1.
19.Patients with any respiratory infections in the four weeks prior to the Screening Visit (Visit 1) or during the 2-week baseline period. In the case of a respiratory infection during the baseline period the latter may be extended up to six weeks.
20.Patients who are currently participating in another study.
21.Patients with prostatic hyperplasia, bladder-neck obstruction, or known narrow-angle glaucoma.
22.Patients with moderate to severe renal impairment (creatinine clearance = 50 mL/min).
23. Patients who are being treated with TNF-alpha-blockers
Study & Design
- Study Type
- Interventional clinical trial of medicinal product
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method