Investigate the Impact of Early Treatment Initiation With Tiotropium in Patients Recovering From Hospitalization for an Acute COPD Exacerbation 1
Condition: Pulmonary Disease, Chronic Obstructive
MeSH terms: Lung Diseases; Pulmonary Disease, Chronic Obstructive
Intervention: tiotropium bromide; Placebo
Intervention description: 18 mcg once a day (QD); once a day (QD)
Intervention MeSH terms: Bromides; Tiotropium Bromide
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double
Enrollment: 79.0
Sex: All
Minimum age: 40 Years
Healthy volunteers: No

Summary:

      A randomized, placebo-controlled, double-blind, parallel group, multi center study to assess
      the safety and efficacy of tiotropium bromide (18 µg) delivered via the HandiHaler® in
      Chronic Obstructive Pulmonary Disease (COPD) subjects recovering from hospitalization for an
      acute exacerbation (Hospital Discharge 1)
    

Eligibility criteria:

        Inclusion criteria:

        The following inclusion criteria apply at Visit 0:

          1. All subjects must sign an informed consent consistent with the International
             Conference on Harmonization - Good Clinical Practice (ICH-GCP) guidelines prior to
             participation in the trial and conducting any study procedures.

          2. Male or female subjects 40 years of age or older.

          3. Hospitalization for a primary diagnosis of acute COPD exacerbation for =14 days.
             Determination of accuracy of admission diagnosis will be at the discretion of the
             investigator.

          4. Patient reported hospital length of stay and discharge date (confirmed with hospital
             discharge summary/hospital records; however, medical record confirmation may occur
             following randomization).

             The following inclusion criteria apply at Visit 1:

          5. Discharged from the hospital =10 days from date of randomization.

          6. All subjects must have a diagnosis of COPD (P12-01205), and have documented airway
             obstruction with a post-bronchodilator Force expiratory volume in 1 second
             (FEV1)/Force vital capacity (FVC )<0.7(See Section 5.1.2, Pulmonary Function Testing).
             The diagnosis of COPD can be made at Visit 1 if no Pulmonary Function Testing (PFT)
             data available within the past 12 months.

          7. Subjects must be current or ex-smoker with a smoking history of =10 pack-years:

        Pack-years = Number of cigarettes/day x years of smoking 20 cigarettes/ pack 8. Subjects
        must be able to inhale medication in a competent manner from the HandiHaler® device
        (Appendix 10.1) and from a metered dose inhaler (MDI).

        Exclusion criteria:

        The following exclusion criterion applies at Visit 0:

          1. No more than 30 days of therapy with any long-acting inhaled anticholinergic over
             preceding 3 months prior to discharge from the hospital, and no therapy with any long
             acting anticholinergic post discharge (no use between hospital discharge and
             randomization) or any other restricted concomitant medications

             The following exclusion criteria apply at Visit 1:

          2. Presence of a significant disease (in the opinion of the investigator) which may put
             the subject at risk because of participation in the study or may influence the
             subject's ability to participate in the study for up to 2 years.

          3. A documented history of myocardial infarction during the hospitalization preceding
             randomization. Subjects being stable with a history of cardiac stents are permitted.

          4. Any unstable or life-threatening cardiac arrhythmia requiring intervention or change
             in drug therapy during the last year.

          5. Subjects with asthma (subject treated for asthma in the last 2 years, history of
             childhood asthma is permitted), cystic fibrosis, clinical diagnosis of bronchiectasis,
             interstitial lung disease, pulmonary thromboembolic disease or known active
             tuberculosis.

        7. Malignancy for which the subject has undergone resection, radiation, chemotherapy or
        biological treatments within the last two years or is currently on active radiation
        therapy, chemotherapy or biological treatment. Subjects with treated basal cell carcinoma
        and non-invasive squamous cell skin carcinoma are allowed.

        8. Hospitalization for cardiac failure (New York Heart Association (NYHA) class III or IV)
        during the hospitalization preceding randomization.

        9. Known hypersensitivity to anticholinergic drugs, lactose, or any other components of the
        HandiHaler® or MDI inhalation solution delivery system.

        10. Known moderate to severe renal impairment as judged by the investigator. 11. Known
        narrow angle glaucoma as judged by the investigator. 12. Significant symptomatic prostatic
        hyperplasia or bladder-neck obstruction. Subjects whose symptoms are controlled on
        treatment may be included. 13. Pregnant or nursing women or women of childbearing potential
        not using a medically approved means of contraception (i.e., oral contraceptives,
        intrauterine devices, diaphragm or sub dermal implants e.g., Norplant) for at least three
        months prior to and for the duration of the trial.

        14. Significant alcohol or drug abuse within the past 12 months. 15. Previously randomized
        in this study or currently participating in another interventional study.

        16. Visual impairment that as judged by the investigator does not allow the subject to
        independently read and complete the questionnaires and eDiary.

        17. Any significant or new ECG findings at Visit 1 as judged by the investigator,
        including, but not limited to signs of acute ischemia, arrhythmia.

        18. Treatment with any restricted pulmonary medication. 19. Residing in an assisted living
        facility.