The Purpose of This Study is to Evaluate the Spirometric Effect (Trough FEV1) of Umeclidinium/Vilanterol 62.5/25 mcg Once Daily Compared With Tiotriopium 18 mcg Once Daily Over a 24-week Treatment Period in Subjects With COPD



Status:Completed
Conditions:Chronic Obstructive Pulmonary Disease, Pulmonary
Therapuetic Areas:Pulmonary / Respiratory Diseases
Healthy:No
Age Range:40 - Any
Updated:1/26/2018
Start Date:January 23, 2013
End Date:September 24, 2013

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A Multicenter, Trial Comparing the Efficacy and Safety of Umeclidinium/Vilanterol 62.5/25 mcg Once Daily With Tiotropium 18 mcg Once Daily Over 24 Weeks in Subjects With Chronic Obstructive Pulmonary Disease (COPD)

The purpose of this 24 week study is to evaluate the spirometric lung function effect (trough
FEV1) of Umeclidinium/Vilanterol 62.5/25 once daily compared to Tiotropium 18 mcg once daily
along with safety assessments in subjects with COPD.

This is a Phase IIIb multicenter, randomized, double-dummy, parallel group study to evaluate
the efficacy and safety of UMEC/VI Inhalation Powder (62.5/25 mcg) when administered
once-daily via a novel dry powder inhaler (DPI) compared with tiotropium (18 mcg)
administered once-daily via the HandiHaler over a treatment period of 24 weeks in subjects
with COPD. Eligible subjects will be randomized 1:1 to UMEC/VI Inhalation Powder (62.5/25
mcg), or tiotropium (18 mcg) for 24 weeks.

There will be a total of 10 study clinic visits conducted on an outpatient basis. Subjects
who meet the eligibility criteria at Screening (Visit 1) will complete a 7- to 10-day run-in
period followed by a 24-week treatment period. Clinic visits will be at Screening,
Randomization (Day 1), Day 2 and after 4, 8, 12, 16, 20 and 24 weeks, and 1 day after the
Week 24 visit (Visit 1 to Visit 10, respectively). Additionally a safety Follow-Up assessment
will be conducted either by phone call or clinic visit where required approximately 7 days
after the end of the study treatment (Visit 10 or Early Withdrawal, if applicable). The total
duration of subject participation, including the Follow-Up will be approximately 26 weeks.

Inclusion Criteria:

- Type of subject: Outpatient.

- Informed Consent: A signed and dated written informed consent prior to study
participation.

- Age: Subjects 40 years of age or older at Visit 1.

- Gender: Male or female subjects.

A female is eligible to enter and participate in the study if she is of:

Non-child bearing potential (i.e. physiologically incapable of becoming pregnant, including
any female who is post-menopausal or surgically sterile). Surgically sterile females are
defined as those with a documented hysterectomy and/or bilateral oophorectomy or tubal
ligation. Post-menopausal females are defined as being amenorrhoeic for greater than 1 year
with an appropriate clinical profile, e.g. age appropriate, > 45 years, in the absence of
hormone replacement therapy.

OR

Child bearing potential, has a negative pregnancy test at screening, and agrees to one of
the following acceptable contraceptive methods used consistently and correctly (i.e. in
accordance with the approved product label and the instructions of the physician for the
duration of the study - screening to follow-up contact):

- Abstinence

- Oral Contraceptive, either combined or progestogen alone

- Injectable progestogen

- Implants of levonorgestrel

- Estrogenic vaginal ring

- Percutaneous contraceptive patches

- Intrauterine device (IUD) or intrauterine system (IUS) that meets the SOP
effectiveness criteria as stated in the product label

- Male partner sterilization (vasectomy with documentation of azoospermia) prior to the
female subject's entry into the study, and this male is the sole partner for that
subject. For this definition, "documented" refers to the outcome of the
investigator's/designee's medical examination of the subject or review of the
subject's medical history for study eligibility, as obtained via a verbal interview
with the subject or from the subject's medical records.

- Double barrier method: condom and an occlusive cap (diaphragm or cervical/vault caps)
with a vaginal spermicidal agent (foam/gel/film/cream/suppository)

- COPD Diagnosis: An established clinical history of COPD in accordance with the
definition by the American Thoracic Society/European Respiratory Society [Celli,
2004].

- Smoking History: Current or former cigarette smokers with a history of cigarette
smoking of >=10 pack-years [number of pack years = (number of cigarettes per day
/ 20) x number of years smoked (e.g., 20 cigarettes per day for 10 years, or 10
cigarettes per day for 20 years)]. Previous smokers are defined as those who have
stopped smoking for at least 6 months prior to Visit 1.

Note: Pipe and/or cigar use cannot be used to calculate pack-year history

- Severity of Disease: A pre and post-albuterol/salbutamol FEV1/FVC ratio of <0.70 and a
pre and post-albuterol/salbutamol FEV1 of FEV1 of <=70% of predicted normal values
calculated using NHANES III reference equations at Visit 1 [Hankinson, 1999;
Hankinson, 2010].

- Dyspnea: A score of ≥2 on the Modified Medical Research Council Dyspnea Scale (mMRC)
at Visit 1.

Exclusion Criteria:

- Pregnancy: Women who are pregnant or lactating or are planning on becoming pregnant
during the study.

- Asthma: A current diagnosis of asthma.

- Other Respiratory Disorders: Known alpha 1 antitrypsin deficiency, active lung
infections (such as tuberculosis), and lung cancer are absolute exclusionary
conditions. A subject who, in the opinion of the investigator, has any other
significant respiratory conditions in addition to COPD should be excluded. Examples
may include clinically significant bronchiectasis, pulmonary hypertension,
sarcoidosis, or interstitial lung disease.

- Other Diseases/Abnormalities: Subjects with historical or current evidence of
clinically significant cardiovascular, neurological, psychiatric, renal, hepatic,
immunological, endocrine (including uncontrolled diabetes or thyroid disease) or
hematological abnormalities that are uncontrolled and/or a previous history of cancer
in remission for <5 years prior to Visit 1 (localized carcinoma of the skin that has
been resected for cure is not exclusionary). 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.

- Contraindications: A history of allergy or hypersensitivity to any
anticholinergic/muscarinic receptor antagonist, beta2-agonist, lactose/milk protein or
magnesium stearate or a medical condition such as narrow-angle glaucoma, prostatic
hypertrophy or bladder neck obstruction that, in the opinion of the study physician
contraindicates study participation or use of an inhaled anticholinergic.

- Hospitalization: Hospitalization for COPD or pneumonia within 12 weeks prior to Visit
1.

- Lung Resection: Subjects with lung volume reduction surgery within the 12 months prior
to Screening (Visit 1).

- 12-Lead ECG: An abnormal and significant ECG finding from the 12-lead ECG conducted at
Visit 1, including the presence of a paced rhythm on a 12-lead electrocardiogram (ECG)
which causes the underlying rhythm and ECG to be obscured. Investigators will be
provided with ECG reviews conducted by a centralized independent cardiologist to
assist in evaluation of subject eligibility. Specific ECG findings that preclude
subject eligibility are listed in Appendix 4. The study investigator will determine
the medical significance of any ECG abnormalities not listed in Appendix 4.

- Medication Prior to Spirometry: Unable to withhold albuterol/salbutamol for the 4 hour
period required prior to spirometry testing at each study visit.

- Use of certain medications according to defined time intervals prior to Screening
(Visit 1).

- Oxygen: Use of long-term oxygen therapy (LTOT) described as oxygen therapy prescribed
for greater than 12 hours a day. As-needed oxygen use (i.e., >=12 hours per day) is
not exclusionary.

- Nebulized Therapy: Regular use (prescribed for use every day, not for as-needed use)
of short-acting bronchodilators (e.g., albuterol/salbutamol) via nebulized therapy.

- Pulmonary Rehabilitation Program: Participation in the acute phase of a pulmonary
rehabilitation program within 4 weeks prior to Visit 1. Subjects who are in the
maintenance phase of a pulmonary rehabilitation program are not excluded.

- Drug or Alcohol Abuse: A known or suspected history of alcohol or drug abuse within 2
years prior to Visit 1.

- Affiliation with Investigator Site: Is an investigator, sub-investigator, study
coordinator, employee of a participating investigator or study site, or immediate
family member of the aforementioned that is involved in this study.

- Previous use of study drug: Previous participation in DB2113360 or DB2113374.
We found this trial at
18
sites
Charleston, South Carolina 29425
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Ciudad Autnónoma de Buenos Aires, Buenos Aires
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Coeur d'Alene, Idaho 83814
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Columbus, Ohio 43219
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Columbus, OH
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DeLand, Florida 32720
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DeLand, FL
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Easley, South Carolina 29640
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Easley, SC
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Gaffney, South Carolina 29340
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Greenville, South Carolina 29615
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Johnson City, Tennessee 37601
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Johnson City, TN
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Omaha, Nebraska 68131
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Omaha, NE
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Panama City, Florida 32405
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Riverside, California 92506
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Rock Hill, South Carolina 29732
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Saint Charles, Missouri 63301
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Saint Charles, MO
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San Diego, California 92111
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San Diego, CA
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Spartanburg, South Carolina 29303
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Tucson, Arizona 85724
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Union, South Carolina 29379
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Union, SC
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