Clinical trial NCT01025648: Randomized, Placebo/Active Crossover Dose-ranging Study for Safety and Efficacy in Asthma Patients.
Official title: A Randomized, Double-blinded or Evaluator-blinded, Placebo and Active Controlled, Six-arm, Crossover, Single Dose, Dose-ranging Study, for Initial Evaluation of Safety and Efficacy in Asthma Patients
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
PHASE2
Conditions: Asthma
Keywords: Mild to Moderate Asthma
Dyspnea
Wheezing
Status Asthmaticus
Lead sponsor: Amphastar Pharmaceuticals, Inc.
Sponsor class: INDUSTRY
First posted: 2009-12-03
Enrollment: 9
Sex: ALL
Minimum age (years): 18
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: TREATMENT

Brief summary: The main objective of this study is to evaluate the efficacy and safety of the Armstrong's Epinephrine HFA-MDI (E004) formulation, in comparison to the Placebo (Placebo-HFA) and an Active Control (Epinephrine CFC-MDI), and to identify the optimum E004 dose strength(s) for the ensuing pivotal clinical trials. The study will be conducted in adult patients who have intermittent, or mild-to-moderate persistent, asthma, but are otherwise healthy.

The bronchodilatory efficacy of E004, is evaluated in terms of post-dose area under the curves (AUC) of FEV1 changes (% and volumes), from the pre-dose baseline values, in comparison to the Placebo Control and the Active Control.


Eligibility criteria: Inclusion Criteria:

1. Generally healthy, male and female adults aged 18 to 55 years at Screening.
2. Clinical diagnosis of intermittent, or mild-to-moderate persistent, asthma for at least 6 months before Screening, and having used inhaled epinephrine or β-agonist(s) for asthma control;
3. Demonstrating a baseline forced expiratory volume in 1 second (FEV1) at 50-90 percent of predicted normal at Screening;
4. Demonstrating a 12.0 percent or greater airway reversibility in FEV1 within 30 min after inhaling 2 actuations of Epinephrine CFC-MDI (440 mcg Epinephrine base) at Screening;
5. Females of child-bearing potential must be non-pregnant, non-lactating, and practicing a clinically acceptable form of birth control;
6. Demonstration of proficiency in the use of a MDI inhaler after training;
7. Having properly consented to participate in the trial.

Exclusion Criteria:

1. A smoking history of 10 or more pack-years, or having smoked within 6 months prior to Screening;
2. Upper respiratory tract infections within 2 wk, or lower respiratory tract infection within 4 wk, prior to Screening;
3. Asthma exacerbations that required emergency care or hospitalized treatment, within 4 wk prior to Screening;
4. Any current or recent respiratory conditions that, per investigator discretion, might significantly affect pharmacodynamic response to the study drugs, including cystic fibrosis, bronchiectasis, tuberculosis, emphysema, and other significant respiratory diseases besides asthma;
5. Concurrent clinically significant cardiovascular, hematological, renal, neurologic, hepatic, endocrine (including diabetes), psychiatric, neoplastic or other illnesses that in the opinion of the investigator could impact on the conduct, safety and evaluation of the study;
6. Known intolerance or hypersensitivity to any of the study MDI ingredients (i.e., Epinephrine, HFA-134a, CFC-12, CFC-114, polysorbate-80, ethanol, thymol, nitric acid and ascorbic acid);
7. Use of prohibited drugs or failure to observe the drug washout restrictions;
8. Having been on other investigational drug/device studies in the last 30 days prior to Screening.

Primary outcomes:
measure: The AUC of post-dose FEV1 percentage changes (Δ%) from the Pre-dose baseline. The primary analysis of the primary endpoint is the difference of Δ% FEV1, compared between the E004 treatment arms (T1, T2, T3 and T4) and the Placebo control (Arm P).
timeFrame: 360 minutes post-dose
Secondary outcomes:
measure: Dose response relationship of Epinephrine HFA-MDI, analyzed using efficacy data from all E004 doses.
timeFrame: 360 minutes post dose
measure: AUC of FEV1 volume post-dose changes (Δ Volume) from the Pre-dose baseline.
timeFrame: 360 minutes post dose
measure: Time to onset of bronchodilator effect, determined by linear interpolation as the point where FEV1 first reaches 12.0 percent from the Pre-dose Baseline.
timeFrame: 30 (±5) min post-dose
measure: The peak bronchodilator response (Fmax), defined as the maximum post-dose FEV1 percent change.
timeFrame: 360 minutes post dose
measure: The time to peak FEV1 effect (Tmax), defined as the time of Fmax.
timeFrame: 360 minutes post dose
measure: Duration of effect, calculated as the total duration of bronchodilator effects when post-dose FEV1 reaches and stays 12.0 percent above the Pre-dose Baseline.
timeFrame: 360 minutes post dose
measure: Response Rate of responders who demonstrate 12.0 percent or greater FEV1 changes from the Pre-dose baseline.
timeFrame: 360 minutes post dose
measure: Vital signs, i.e., blood pressure and heart rate,at Screening baseline and 15(±5) min post dosing for reversibility
timeFrame: screening and 15 minutes post dose
measure: Vital signs, i.e., blood pressure (SBP/DBP) and heart rate (HR), at: Pre-dose baseline, and 15(±5) min and 360(±15) post-dose, at each Study Visit.
timeFrame: 360 minutes post dose
measure: Post-dose 20(±5) min ECG recordings (Routine and QT, QTc analysis) at each Study Visit, compared to the Screening baseline recording.
timeFrame: 20 minutes post dose
measure: Data for physical examinations, CBC, serum comprehensive metabolic panel, and urinalysis for all subjects, and urinary pregnancy test for women of child-bearing potential
timeFrame: Screening and end of study
measure: Monitoring of adverse drug events (ADE)
timeFrame: Ongoing through End of Study
Other outcomes:
Locations:
city: San Jose
country: United States
facility: Amphastar Site 0001
state: California
city: Stockton
country: United States
facility: Amphastar Site 0003
state: California
Study officials:
affiliation: Amphastar Pharmaceuticals, Inc.
name: Jim Shi, M.D., Ph.D.
role: STUDY_CHAIR
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