Last updated: 11/04/2018 06:51:24
A Randomized Study To Evaluate The Efficacy And Safety Of An Investigational Drug In Adolescent And Adult Subjects With Asthma Uncontrolled on Low-Dose ICS Therapy.
EudraCT ID
EU CT Number
Not applicable
Trial status
Completed
Completed
Trial overview
Official title: A Randomized Double-Blind, Double Dummy, Placebo-Controlled, Parallel-Group, Multicenter Dose Ranging Study to Evaluate the Efficacy and Safety of GW685698X Inhalation Powder Once Daily and Fluticasone Propionate Inhalation Powder 250mcg Twice Daily compared with Placebo for 8 Weeks in Adolescent and Adult Subjects with Persistent Asthma Symptomatic on Low-Dose ICS Therapy
Trial description: This study is designed to determine if the investigational drug is effective and safe in individuals with asthma.
Primary purpose:
Treatment
Trial design:
Parallel Assignment
Masking:
Double (Participant, Investigator)
Allocation:
Randomized
Primary outcomes:
Mean change from Baseline in trough (evening pre-dose and pre- rescue bronchodilator) FEV1 at Week 8
Timeframe: Baseline and Week 8
Secondary outcomes:
Mean change from Baseline in daily trough (pre-dose and pre-rescue bronchodilator) evening peak expiratory flow (PEF) averaged over the 8-week Treatment Period
Timeframe: From Baseline up to Week 8
Mean change from Baseline in daily morning PEF averaged over the 8-week Treatment Period
Timeframe: From Baseline up to Week 8
Mean change from Baseline in the percentage of symptom-free 24-hour (hr) periods during the 8-week Treatment Period
Timeframe: From Baseline up to Week 8
Mean change from Baseline in the percentage of rescue free 24-hour (hr) periods during the 8-week Treatment Period
Timeframe: From Baseline up to Week 8
Number of participants who withdrew due to lack of efficacy during the 8-Week Treatment Period
Timeframe: From the first dose of study medication up to Week 8/Early Withdrawal
Number of participants with any on-treatment adverse events or serious adverse events throughout the 8-week Treatment Period
Timeframe: From the first dose of study medication up to Week 8/Early Withdrawal
Number of participants with clinical/visual evidence of oropharyngeal candidiasis
Timeframe: From Baseline up to Week 8/Early Withdrawal
Percentage of basophils, eosinophils, lymphocytes, monocytes, and total neutrophils in the blood at Baseline and Week 8
Timeframe: Baseline and Week 8
Hematocrit at Baseline and Week 8
Timeframe: Baseline and Week 8
Hemoglobin at Baseline and Week 8
Timeframe: Baseline and Week 8
Platelet count and white blood cell (WBC) count at Baseline and Week 8
Timeframe: Baseline and Week 8
Red blood cells (RBC) count at Baseline and Week 8
Timeframe: Baseline and Week 8
Clinical chemistry parameters of alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LD), and gamma glutamyltransferase (GGT) at Baseline and Week 8
Timeframe: Baseline and Week 8
Clinical chemistry parameters of albumin and total protein at Baseline and Week 8
Timeframe: Baseline and Week 8
Clinical chemistry parameters of chloride, calcium, carbon dioxide content/bicarbonate (CO2/BI), cholesterol, glucose, phosphorus inorganic(PI), potassium, sodium, and urea/blood urea nitrogen (BUN) at Baseline and Week 8
Timeframe: Baseline and Week 8
Clinical chemistry parameters of direct bilirubin (DBIL), total bilirubin (TBIL), uric acid and creatinine at Baseline and Week 8
Timeframe: Baseline and Week 8
Number of participants with the indicated result for the indicated urinalysis parameters tested by dipstick at Baseline and Week 8/Early Withdrawal
Timeframe: Baseline and Week 8/Early Withdrawal
Urine specific gravity at Baseline and Week 8/Early Withdrawal
Timeframe: Urine specific gravity at Baseline and Week 8/Early Withdrawal
Urine pH at Baseline and Week 8/Early Withdrawal
Timeframe: Baseline and Week 8/Early Withdrawal
24-hour urinary cortisol excretion at Baseline and Week 8
Timeframe: Baseline and Week 8
Change from Baseline in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at Week 8
Timeframe: Baseline and Week 8
Change from Baseline in heart rate at Week 8
Timeframe: Baseline and Week 8
Interventions:
Drug: GW685698X
Drug: placebo
Enrollment:
622
Observational study model:
Not applicable
Primary completion date:
2008-24-11
Time perspective:
Not applicable
Clinical publications:
Bleecker ER, Bateman ED, Busse WW, Woodcock A, Frith L, House KW, Jacques L, Davis AM, Haumann B, Lötvall J. Once-daily fluticasone furoate is efficacious in patients with symptomatic asthma on low-dose inhaled corticosteroids. [Ann Allergy Asthma Immunol]. 2012;109(5):353-358.e4.
Medical condition
Asthma
Product
fluticasone furoate, fluticasone propionate
Collaborators
Not applicable
Study date(s)
December 2007 to November 2008
Type
Interventional
Phase
2
Participation criteria
Sex
Female & Male
Age
12+ years
Accepts healthy volunteers
No
- Subjects eligible for enrolment in the study must meet all of the following criteria:
- Type of Subject: Outpatient
- History of Life-threatening asthma: Defined for this protocol as an asthma episode that required intubation and/or was associated with hypercapnia, respiratory arrest or hypoxic seizures.
- Respiratory Infection: Culture-documented or suspected bacterial or viral infection of the upper or lower respiratory tract, sinus or middle ear that is not resolved within 4 weeks of Visit 1 and led to a change in asthma management, or in the opinion of the Investigator is expected to affect the subjects asthma status or the subjects ability to participate in the study.
Inclusion and exclusion criteria
Inclusion criteria:
- Subjects eligible for enrolment in the study must meet all of the following criteria:
- Type of Subject: Outpatient
- Age: 12 years of age or older at Visit 1. For sites in the following countries, subjects recruited will be ≥18 years of age: Bulgaria, Czech Republic, Germany, Greece, Lithuania, New Zealand, Russian Federation, Turkey and any other countries where local regulations or the regulatory status of study medication permit enrolment of adults only.
- Gender: Male or Eligible Female -To be eligible for entry into the study, females of childbearing potential must commit to consistent and correct use of an acceptable method of birth control, as defined by the following: -Male partner who is sterile prior to the female subject's entry into the study and is the sole sexual partner for that female subject -Implants of levonorgestrel -Injectable progestogen -Oral contraceptive (either combined estrogen/progestin or progestin only) -Any intrauterine device (IUD) with a documented failure rate of less than 1% per year. -Females of childbearing potential who are not sexually active must commit to complete abstinence from intercourse throughout the clinical trial and for a period after the trial to account for elimination of the drug (minimum of six days). -Double barrier method
- spermicide plus a mechanical barrier (e.g., spermicide plus a male condom or a spermicide and female diaphragm). -NB: For German sites, female subjects must use a method of birth control other than the double barrier method. -The contraceptive transdermal patch, Ortho Evra (if the subject is less than 198 pounds) -Female subjects should not be enrolled if they are pregnant, lactating or plan to become pregnant during the time of study participation. A serum pregnancy test is required of all females. This test will be performed at the initial screening visit (Visit 1) and Visit 8. In addition, a urine pregnancy test will be performed on the evening of the double-blind treatment visit, prior to randomization (Visit 3) and at Visits 4 through 7.
- Asthma Diagnosis: Asthma as defined by the National Institutes of Health [National Institutes of Health, 2007].
- Severity of Disease: A best FEV1 of 40%-90% of the predicted normal value during Visit 1. NHANES III predicted values will be used for subjects aged ≥ 12 years and adjustments to predicted values will be made for African American subjects. [Hankinson, 1999].
- Reversibility of Disease: Demonstrated a ≥ 12% and ≥200mL reversibility of FEV1 within approximately 30-minutes following 4 inhalations of albuterol/salbutamol inhalation aerosol (if required, spacers are permitted for reversibility testing only) or one nebulized albuterol/salbutamol solution at the Screening Visit. If a subject fails to demonstrate an increase in FEV1 ≥12% and ≥200mL, then the subject is not eligible for the study and will not be allowed to re-screen.
- Current Anti-Asthma Therapy: Subjects must have been using a inhaled corticosteroid for at least 8 weeks prior to Visit 1 and maintained on a stable dose of inhaled corticosteroids for four weeks prior to Visit 1 at one of the following doses: [fluticasone propionate MDI CFC/HFA >220mcg exactuator or ≤250mcg ex valve]; [fluticasone propionate DPI ≤200mcg]; [beclomethasone dipropionate DPI ≤ 420mcg exactuator or ≤ 500mcg ex-valve]; [beclomethasone dipropionate HFA (Qvar) ≤ 160mcg exactuator or ≤ 200mcg ex-valve]; [budesonide DPI MDI ≤400mcg]; [flunisolide ≤ 1000mcg]; [triamcinolone acetonide ≤1000mcg]; [mometasone furoate DPI >200mcg or ≤ 220mcg]; [ciclesonide MDI HFA ≤ 160mcg ex-actuator dose / ≤ 200mcg ex-valve dose].
- Short- Acting Beta2-Agonists: All subjects must be able to replace their current short-acting beta2-agonists with albuterol/salbutamol inhalation aerosol at Visit 1 for use as needed for the duration of the study. The use of spacer devices with metered dose inhaler (MDI) or nebulized albuterol/salbutamol will not be allowed during the study with the exception of their use during reversibility testing at Visit 1. Subjects must be able to withhold all inhaled short-acting beta sympathomimetic bronchodilators for at least 6 hours prior to all study visits.
- Informed Consent: All subjects must be able and willing to give written informed consent to take part in the study.
- Compliance: Subjects must be able to comply with completion of the Daily Diary (includes paper medical conditions diary).
- French subjects: In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category. Inclusion Criteria for Randomization At the end of the run-in period, a subject will be eligible to enter the treatment period of the study if he/she meets the following criteria at Visit 3: 1.Evening pre-dose percent predicted FEV1 of between 40% and 90% of their predicted normal. 2.Any combination of the daily asthma symptom scores (day-time plus night-time) of ≥1 or albuterol/salbutamol use on at least 4 of the last 7 consecutive days of the run-in period (immediately preceding Visit 3).
Exclusion criteria:
- History of Life-threatening asthma: Defined for this protocol as an asthma episode that required intubation and/or was associated with hypercapnia, respiratory arrest or hypoxic seizures.
- Respiratory Infection: Culture-documented or suspected bacterial or viral infection of the upper or lower respiratory tract, sinus or middle ear that is not resolved within 4 weeks of Visit 1 and led to a change in asthma management, or in the opinion of the Investigator is expected to affect the subjects asthma status or the subjects ability to participate in the study.
- Asthma Exacerbation: Any asthma exacerbation requiring oral corticosteroids within 3 months of Visit 1. A subject must not have had any hospitalization for asthma within 6 months prior to Visit 1.
- Concurrent Diseases/Abnormalities: Historical or current evidence of clinically significant uncontrolled disease including, but not limited to: cardiovascular disease, hepatic disease, renal disease, hematological disease, neurological disease, or pulmonary disease (including, but not confined to chronic bronchitis, emphysema, bronchiectasis with the need of treatment, cystic fibrosis, bronchopulmonary dysplasia, and chronic obstructive pulmonary disease). Significant is defined as any disease that, in the opinion of the investigator, would put the safety of the subject at risk through participation, or which would affect the efficacy or safety analysis if the disease/condition exacerbated during the study. The list of additional excluded conditions/diseases includes, but is not limited to the following: congestive heart failure, clinically significant coronary artery disease, stroke within 3 months of Visit 1, poorly controlled peptic ulcer, immunologic compromise, tuberculosis (current or untreated), Addison's disease, uncontrolled thyroid disorder, known aortic aneurysm, clinically significant cardiac arrhythmia, uncontrolled hypertension, hematological, hepatic, or renal disease, current malignancy, cushings disease, uncontrolled diabetes mellitus, recent history of drug or alcohol abuse.
- Oropharyngeal Examination: A subject will not be eligible for the run-in if he/she has clinical visual evidence of oral candidiasis at Visit 1.
- Investigational Medications: A subject must not have participated in a study or used any investigational drug within 30 days prior to Visit 1.
- Drug Allergy: Any adverse reaction including immediate or delayed hypersensitivity to any beta2-agonist, sympathomimetic drug, or any intranasal, inhaled, or systemic corticosteroid therapy. Known or suspected sensitivity to the constituents of the novel dry powder inhaler or DISKUS/ACCUHALER (i.e., lactose or magnesium stearate).
- Milk Protein Allergy: History of severe milk protein allergy.
- Immunosuppressive Medications: A subject must not be using, or require use, of immunosuppressive medications during the study. NOTE: Immunotherapy for the treatment of allergies is allowed during the study provided that the treatment was initiated prior to Visit 1 and the subject is maintained on a stable regimen throughout the study period.
- Attendance: A subject will not be eligible if he/she or his/her parent or legal guardian has any infirmity, disability, or geographical location which seems likely (in the opinion of the Investigator) to impair compliance with any aspect of this study protocol or scheduled visits to the study center and non-compliant with study medication or procedures (e.g. completion of daily diary). Neurological or psychiatric disease or history of drug or alcohol abuse which in the opinion of the investigator could interfere with the subject's proper completion of the protocol requirements excludes study participation.
- Tobacco Use : Current smoker or a smoking history of 10 pack years or more (e.g. 20 cigarettes/day for 10 years). A subject may not have used tobacco products within the past one year (i.e., cigarettes, cigars, or pipe tobacco).
- Affiliation with Investigator's Site: A subject will not be eligible for this study if he/she is an immediate family member of the participating Investigator, sub‑Investigator, study coordinator, or employee of the participating Investigator.
- Corticosteroid Use: Administration of systemic, oral or depot corticosteroids within 12 weeks of Visit 1.
- Potent Cytochrome P450 3A4 (CYP3A4) inhibitors: Patients who are receiving potent CYP3A4 inhibitors within 4 weeks of Visit 1 (e.g., ritonavir, ketoconazole, itraconazole). Exclusion Criteria for Randomization At the end of the run-in period, a subject will not be eligible to enter the treatment period of the study if they meet any of the following criteria. 1.Clinical Laboratory Abnormalities: Clinically significant abnormal laboratory tests during Visit 1 which are still abnormal upon repeat analysis and are not believed to be due to disease(s) present. Each Investigator will use his/her own discretion in determining the clinical significance of the abnormality. When in doubt, GlaxoSmithKline, or designee, should be notified so that a joint decision can be made. 2.Changes in asthma medication (excluding albuterol/salbutamol inhalation aerosol provided at Visit 1). 3.Occurrence of a culture-documented or suspected bacterial or viral infection of the upper or lower respiratory tract, sinus or middle ear during the run-in period that led to a change in asthma management, or in the opinion of the Investigator is expected to affect the subjects asthma status or the subjects ability to participate in the study. 4.Asthma exacerbation, defined as any worsening of asthma requiring any treatment other than rescue albuterol/salbutamol or regular inhaled corticosteroid use. This includes requiring the use of systemic corticosteroids and / or emergency room visit or hospitalization or a change in subject's regular inhaled corticosteroid dose. 5.A subject will not be eligible for randomization if he/she has an abnormal visual oropharyngeal exam at the randomization Visit 3 (visual clinical evidence of oral candidiasis). 6.Non-compliance with completion of the Daily Diary, defined as: -Completion of AM and PM symptom scores on less than 4 days out of the last 7 days immediately preceding Visit 3. -Completion of AM and PM rescue use on less than 4 days out of the last 7 days immediately preceding Visit 3. -Completion of AM and PM PEF measurements on less than 4 days out of the last 7 days immediately preceding Visit 3. -Recording run-in asthma medication use on less than 4 days out of the last 7 days immediately preceding Visit 3.
Trial location(s)
Location
GSK Investigational Site
West Covina, California, United States, 91790
Status
Study Complete
Location
GSK Investigational Site
Bellingham, Washington, United States, 98225
Status
Study Complete
Location
GSK Investigational Site
Rockville Center, New York, United States, 11570
Status
Study Complete
Location
GSK Investigational Site
Fort Smith, Arkansas, United States, 72903
Status
Study Complete
Location
GSK Investigational Site
Roseville, California, United States, 95678
Status
Study Complete
Location
GSK Investigational Site
Gurnee, Illinois, United States, 60031
Status
Study Complete
Location
GSK Investigational Site
Rochester, Minnesota, United States, 55905
Status
Study Complete
Location
GSK Investigational Site
Bridgeport, Connecticut, United States, 06606
Status
Study Complete
Location
GSK Investigational Site
Bloomingdale/Illinois, Illinois, United States, 60108
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Charleston, South Carolina, United States, 29406
Status
Study Complete
Location
GSK Investigational Site
Evansville, Indiana, United States, 47713
Status
Study Complete
Location
GSK Investigational Site
Skillman, New Jersey, United States, 08558
Status
Study Complete
Location
GSK Investigational Site
St. Louis, Missouri, United States, 63143
Status
Study Complete
Location
GSK Investigational Site
Dickinson, Texas, United States, 77539
Status
Study Complete
Location
GSK Investigational Site
Bluffton, South Carolina, United States, 29910
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Taylor, Michigan, United States, 48180
Status
Study Complete
Location
GSK Investigational Site
Gainesville, Georgia, United States, 30501
Status
Study Complete
Location
GSK Investigational Site
Cheongju, Chungcheongbuk-do, South Korea, 361-711
Status
Study Complete
Location
GSK Investigational Site
Greensboro, North Carolina, United States, 27401
Status
Study Complete
Location
GSK Investigational Site
Suwon, Kyonggi-do, South Korea, 443-721
Status
Study Complete
Location
GSK Investigational Site
Winter Park, Florida, United States, 32789
Status
Study Complete
Location
GSK Investigational Site
DeKalb, Illinois, United States, 60115
Status
Study Complete
Location
GSK Investigational Site
BLOEMFONTEIN, South Africa, 9300
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Jackson, Mississippi, United States, 39202
Status
Study Complete
Location
GSK Investigational Site
Waterbury, Connecticut, United States, 06708
Status
Study Complete
Location
GSK Investigational Site
Palmdale, California, United States, 93551
Status
Study Complete
Location
GSK Investigational Site
Long Beach, California, United States, 90808
Status
Study Complete
Location
GSK Investigational Site
Huntington Beach, California, United States, 92647
Status
Study Complete
Location
GSK Investigational Site
Clifton/New Jersey, New Jersey, United States, 7011
Status
Study Complete
Location
GSK Investigational Site
Las Vegas, Nevada, United States, 89107
Status
Study Complete
Location
GSK Investigational Site
Bay Roberts, Newfoundland and Labrador, Canada, A0A 1G0
Status
Study Complete
Location
GSK Investigational Site
Warrensburg, Missouri, United States, 64093
Status
Study Complete
Location
GSK Investigational Site
San Antonio, Texas, United States, 78233
Status
Study Complete
Location
GSK Investigational Site
West Palm Beach, Florida, United States, 33401
Status
Study Complete
Location
GSK Investigational Site
Pittsburgh, Pennsylvania, United States, 15243
Status
Study Complete
Location
GSK Investigational Site
San Antonio, Texas, United States, 78205
Status
Study Complete
Location
GSK Investigational Site
Los Angeles, California, United States, 90048
Status
Study Complete
Location
GSK Investigational Site
Knoxville, Tennessee, United States, 37909
Status
Study Complete
Location
GSK Investigational Site
Schwetzingen, Baden-Wuerttemberg, Germany, 68723
Status
Study Complete
Location
GSK Investigational Site
Billings, Montana, United States, 59101
Status
Study Complete
Location
GSK Investigational Site
Geesthacht, Schleswig-Holstein, Germany, 21502
Status
Study Complete
Location
GSK Investigational Site
Phoenix, Arizona, United States, 85028
Status
Study Complete
Location
GSK Investigational Site
Little Rock, Arkansas, United States, 72211-3733
Status
Terminated/Withdrawn
Location
GSK Investigational Site
St. Louis, Missouri, United States, 63141
Status
Study Complete
Location
GSK Investigational Site
Spokane, Washington, United States, 99204
Status
Study Complete
Location
GSK Investigational Site
San Diego, California, United States, 92120
Status
Study Complete
Location
GSK Investigational Site
Missoula, Montana, United States, 59808
Status
Study Complete
Location
GSK Investigational Site
Oklahoma City, Oklahoma, United States, 73120
Status
Study Complete
Location
GSK Investigational Site
Torrance, California, United States, 90505
Status
Study Complete
Location
GSK Investigational Site
Wheat Ridge, Colorado, United States, 80033
Status
Study Complete
Location
GSK Investigational Site
Los Angeles, California, United States, 90095-1752
Status
Study Complete
Location
GSK Investigational Site
Oklahoma City, Oklahoma, United States, 73112
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Walnut Creek, California, United States, 94598
Status
Study Complete
Location
GSK Investigational Site
Greenville, North Carolina, United States, 27834
Status
Study Complete
Location
GSK Investigational Site
Charleston, South Carolina, United States, 29414
Status
Study Complete
Location
GSK Investigational Site
Raleigh, North Carolina, United States, 27607
Status
Study Complete
Location
GSK Investigational Site
Granada Hills, California, United States, 91344
Status
Study Complete
Location
GSK Investigational Site
Lexington, Kentucky, United States, 40536
Status
Study Complete
Location
GSK Investigational Site
Colorado Springs, Colorado, United States, 80910
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Chicago, Illinois, United States, 60617
Status
Study Complete
Location
GSK Investigational Site
Red Bank, New Jersey, United States, 07701
Status
Study Complete
Location
GSK Investigational Site
Ithaca, New York, United States, 14850
Status
Terminated/Withdrawn
Location
GSK Investigational Site
North Dartmouth, Massachusetts, United States, 02747
Status
Study Complete
Location
GSK Investigational Site
Manassas, Virginia, United States, 22015
Status
Study Complete
Location
GSK Investigational Site
Long Beach, California, United States, 90806
Status
Study Complete
Location
GSK Investigational Site
East Syracuse, New York, United States, 13057
Status
Study Complete
Location
GSK Investigational Site
Riverside, California, United States, 92506
Status
Study Complete
Location
GSK Investigational Site
San Antonio, Texas, United States, 78229
Status
Study Complete
Location
GSK Investigational Site
Spokane, Washington, United States, 99207
Status
Study Complete
Location
GSK Investigational Site
South Burlington, Vermont, United States, 05403
Status
Study Complete
Location
GSK Investigational Site
N. Efkarpia, Thessaloniki, Greece, 564 29
Status
Study Complete
Location
GSK Investigational Site
Boca Raton, Florida, United States, 33487
Status
Study Complete
Location
GSK Investigational Site
Cincinnati, Ohio, United States, 45231
Status
Study Complete
Location
GSK Investigational Site
Fresno, California, United States, 93720
Status
Study Complete
Location
GSK Investigational Site
Crescent Springs, Kentucky, United States, 41017
Status
Study Complete
Location
GSK Investigational Site
Daytona Beach, Florida, United States, 32114
Status
Study Complete
Location
GSK Investigational Site
Ypsilanti, Michigan, United States, 48197
Status
Study Complete
Location
GSK Investigational Site
Sinsheim, Baden-Wuerttemberg, Germany, 74889
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Hillsborough, New Jersey, United States, 08844
Status
Study Complete
Location
GSK Investigational Site
Metairie, Louisiana, United States, 70002
Status
Study Complete
Location
GSK Investigational Site
Detroit, Michigan, United States, 48221
Status
Terminated/Withdrawn
Location
GSK Investigational Site
Fort Worth, Texas, United States, 76104
Status
Terminated/Withdrawn
Study documents
Clinical study report
Available language(s): English
Scientific result summary
Available language(s): English
If you wish to request for full study report, please contact - [email protected]
Results overview
Results posted on ClinicalTrials.gov
Recruitment status
Completed
Actual primary completion date
2008-24-11
Actual study completion date
2008-24-11
Plain language summaries
Plain language summaries of clinical trial results for Phase 2-4 clinical trials that were initiated on or after January 2022 will be posted by GSK within one year following study completion.
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