Berodual® Respimat® Versus Berodual® Metered Aerosol (MA) Inhaler in Patients With Asthma, Chronic Obstructive Pulmonary Disease, or Mixed Condition

Study Overview
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Brief Summary
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The primary objective of this study was to investigate patients acceptability / preference of Berodual® Respimat® inhaler as compared to the conventional Berodual® Metered Aerosol (MA) inhaler. Ease of handling and assembling the Respimat® inhaler at home under real life conditions was also evaluated.

Official Title
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Berodual® Respimat® Inhaler Versus Berodual® MA Using HFA (Hydrofluoroalkane) 134a as Propellant in Adult Patients With Asthma, Chronic Obstructive Pulmonary Disease, or Mixed Conditions, an Open-label, Crossover Trial Over a 7-week Treatment Period With Each Formulation: ' A Study to Compare Patient Preference'

Conditions
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Pulmonary Disease, Chronic Obstructive, Asthma

Intervention / Treatment
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* Drug: Berodual® Respimat®
* Drug: Berodual® MA HFA


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of chronic obstructive pulmonary disease, asthma, or mixed conditions for a minimum of 6 months Male or female patients 18 years of age or older Patients who use at least 2 puffs t.i.d. of Berodual® MA HFA on regular use or at least 4 weeks prior to study Patients should be able to perform all study related tests including using a peak flow meter, to perform acceptable PEFR measurements, and should be able to maintain records (Patient Daily Diary Cards) during the study period as required in the protocol All patients must sign and Informed Consent Form prior to participation in the trial, i.e., prior to the run-in period in accordance with International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) Exclusion Criteria: Patients with significant disease other than chronic airways obstruction (CAO) will be excluded. A significant disease is defined as a disease which in the opinion of the investigator may either put the patient at risk because of participation in the study or a disease which may influence the results of the study or the patient's ability to participate in the study Patients with a recent history (i.e., six months - or less) of myocardial infarction Patients with any cardiac arrhythmia requiring drug therapy or who have been hospitalized for heart failure within the past three years, including patients with hypertrophic cardiomyopathy and tachyarrhythmia Patients who regularly use oxygen therapy Patients with known active tuberculosis Patients with a history of cancer within the last five years. Patients with treated basal cell carcinoma are allowed Patients with a history of life-threatening pulmonary obstruction, or a history of cystic fibrosis or clinically evident bronchiectasis Patients who have undergone thoracotomy with pulmonary resection. Patients with history of thoracotomy for other reasons should be evaluated as per exclusion criterion No. 1 Patients with any upper or lower respiratory infection in the past six weeks prior to the screening visit (Visit 1) or during the run-in period Patients hospitalized or having had visits to the emergency room in the past six weeks before run-in period Patients who are currently in a pulmonary rehabilitation programme that will not be maintained throughout the duration of the study or who have completed a pulmonary rehabilitation programme in the six weeks prior to the screening visit (Visit 1) Patients with known hypersensitivity to anticholinergic drugs or any other components of the trial medication including excipients Patients medically treated for prostatic hyperplasia or bladder neck obstruction Patients with known narrow-angle glaucoma or raised intra-ocular pressure Patients who are being treated with beta-blocker medications Note: beta1-blocker eye medications for treatment of non-narrow angle glaucoma are allowed Patients using oral corticosteroid medication at unstable dose (i.e., less than six weeks on a stable dose) or at doses in excess of the equivalent of 10 mg of prednisolone per day or 20 mg every other day Patients on inhaled or short-acting beta-adrenergics other than the study medication Patients on inhaled or short-acting beta-anticholinergics other than the study medication Patients taking monoamine oxidase inhibitors Patients taking tricyclic antidepressants Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for the previous three months (i.e., oral contraceptives, intrauterine inhalers, diaphragm or subdermal implants) Patients with a history of and/or active significant alcohol or drug abuse Patients who have taken an investigational drug within one month or six half-lives (whichever is greater) prior to the screening visit (Visit 1) Patients who have already been enrolled and randomised to a treatment group in this study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Berodual® Respimat® - Berodual® MA HFA<br>randomized sequence Berodual® Respimat® (20 µg ipratropium bromide + 50 µg fenoterol hydrobromide per actuation for 49 days) Berodual® MA HFA (20 µg ipratropium bromide + 50 µg fenoterol hydrobromide per puff for 49 days) | Drug: Berodual® Respimat®<br> <br> Drug: Berodual® MA HFA<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Patient's assessment of inhaler preference | patient preference questionnaire | Day 98 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rating of inhaler satisfaction | patient satisfaction questionnaire | Day 49 and 98 | 
| Rating of willingness to continue using inhaler | patient preference questionnaire | Day 98 | 
| Post-dose PEFRpm (Peak expiratory flow rate) |  | 30 minutes post-dose up to day 98 | 
| Retention of inhaler technique | proficiency questionnaire | day 49 and 98 (after 7 weeks of treatment) | 
| Use of rescue medication |  | up to day 98 | 
| Daytime and night-time symptom scores |  | up to day 98 |