Phase 3
Completed N=1,323
Evaluation of Tolerability and Pharmacokinetics of Roflumilast, 250μg and 500μg, as add-on to Standard COPD Treatment to Treat Severe COPD
Source: ClinicalTrials.gov NCT02165826 ↗Enrolled (actual)
1,323
Serious AEs
4.4%
Results posted
Mar 2017
Primary outcomePrimary: Percentage of Participants Prematurely Discontinuing Study Treatment Due to Any Reason — 18.4; 20.1; 24.6 percentage of participants — p=0.017
◆ Published Evidence
Emerging
13citations · ~2 / year
Pharmacokinetic and Pharmacodynamic Modelling to Characterize the Tolerability of Alternative Up-Titration Regimens of Roflumilast in Patients with Chronic Obstructive Pulmonary Disease.
Summary
The purpose of this study is to evaluate discontinuation rates of roflumilast using an up-titration regimen for the first 4 weeks of treatment compared with continuous treatment of 500 μg one daily (OD) during the entire 12-week main period, and to evaluate if participants who do not tolerate roflumilast 500 μg OD have a drug exposure with 250 μg roflumilast OD similar to that observed in other participants with the 500 μg OD dose.
Linked Publications
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Pharmacokinetic and Pharmacodynamic Modelling to Characterize the Tolerability of Alternative Up-Titration Regimens of Roflumilast in Patients with Chronic Obstructive Pulmonary Disease.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants Prematurely Discontinuing Study Treatment Due to Any Reason |
18.4; 20.1; 24.6 | 0.017 sig |
| SECONDARY Percentage of Participants With Adverse Events of Interest |
45.4; 48.3; 54.2 | 0.001 sig |
| SECONDARY Change From Baseline (V0DT) in Pre-bronchodilator Forced Expiratory Volume in First Second (FEV1) to Final Visit of the Down-Titration Period |
0.030; 0.055; 0.007 | — |
| SECONDARY Percentage of Participants Prematurely Discontinuing Study Treatment Due to Any Reason During Down-Titration Period |
25.9; 28.2; 18.4 | — |
| SECONDARY Change From Baseline in Pre-bronchodilator Forced Expiratory Volume in First Second (FEV1) During the Down-Titration Period |
0.128; 0.223; 0.097; 0.162; 0.218; 0.070 | — |
| SECONDARY Change From Baseline in Pre-bronchodilator Forced Expiratory Volume in First Second (FEV1) During the Main Period |
0.067; 0.094; 0.094; 0.099; 0.115; 0.116 | — |
| SECONDARY Change From Baseline in Pre-bronchodilator Forced Vital Capacity (FVC) During the Main Period |
0.096; 0.112; 0.104; 0.139; 0.143; 0.149 | — |
| SECONDARY Change From Baseline in Pre-bronchodilator Forced Vital Capacity (FVC) During the Down-Titration Period |
0.087; 0.303; 0.104; 0.125; 0.191; 0.067 | — |
| SECONDARY Change From Baseline in Treatment Satisfaction Scores During the Main Period |
-0.4; -0.3; -0.3; -0.5; -0.5; -0.5 | — |
| SECONDARY Change From Baseline in Treatment Satisfaction Scores During the Down-Titration Period |
-1.1; -0.8; -0.8; -1.2; -0.8; -0.9 | — |
| SECONDARY Population PK Model Point Estimate for Absorption Rate Constant (Ka) of Roflumilast and Roflumilast N-oxide |
0.90; 0.57; 0.90; 0.57; 0.90; 0.57 | — |
| SECONDARY Population PK Model Point Estimate for Apparent Oral Clearance (CL/F) of Roflumilast and Roflumilast N-oxide |
5.64; 0.73; 5.64; 0.89; 5.64; 1.12 | — |
| SECONDARY Population PK Model Point Estimate for Apparent Central Volume (Vc/F) of Roflumilast and Roflumilast N-oxide |
26.0; 4.5; 63.9; 11.0; 175.2; 30.2 | — |
| SECONDARY Population PK Model Point Estimate for Apparent Peripheral Volume (Vp/F) of Roflumilast and Roflumilast N-oxide |
69.6; 5.0; 171.0; 12.4; 468.8; 34.0 | — |
| SECONDARY Total PDE4 Inhibitory Activity (tPDE4i) |
1.17; 0.608; 0.563; 0.583; 1.06; 0.559 | — |
| SECONDARY Summary Statistics of Predicted Total PDE4 Inhibitory Activity (tPDE4i) |
1.17; 0.611; 1.28; 0.647; 1.16; 0.436 | — |
| SECONDARY Median Simulated Percentage of Participants With Adverse Events of Interest |
53.2; 53.2; 61.8; 52.3; 52.3; 60.1 | — |
| SECONDARY Median Simulated Absolute Change From Baseline in FEV1 at Weeks 4 and 12 |
50; 32; 60.5; 56; 108; 157 | — |
Eligibility Criteria
Inclusion Criteria
- In the opinion of the investigator, the participant is capable of understanding and complying with protocol requirements.
- The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
- Has a history of chronic obstructive pulmonary disease (COPD) (according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2013) for at least 12 months prior to Screening (Visit V0) associated with chronic productive cough for 3 months in each of the 2 years prior to Screening (Visit V0, with other causes of productive cough excluded).
- Shows a post-bronchodilator forced expiratory volume in 1 second (FEV1) of ≤50% of predicted.
- Shows an FEV1/forced vital capacity (FVC) ratio (post-bronchodilator) <70%.
- Has at least one documented COPD exacerbation within one year prior to Screening (Visit V0).
- Is on standard of care COPD maintenance treatment including Long Acting β2-Agonist (LABAs), long-acting anticholinergics, or any combination thereof taken on a constant daily dose within 12 weeks prior to Screening (Visit V0).
- Must be a former smoker (defined as smoking cessation at least one year ago) or current smoker both with a smoking history of at least 10 pack years.11
- Is male or female and aged 40 or older.
- A female participant of childbearing potential who is sexually active with a nonsterilized male partner agrees to use routinely adequate contraception from signing of informed consent throughout the duration of the study.
Exclusion Criteria
Criteria affecting the read-out parameters of the study
- Has a COPD exacerbation ongoing at the Screening (Visit V0), or has a COPD exacerbation between V0 and V1.
- Has a lower respiratory tract infection not resolved 4 weeks prior to Screening (Visit V0).
- Has a diagnosis of asthma and/or other relevant lung disease (eg, history of primary bronchiectases, cystic fibrosis, bronchiolitis, lung resection, lung cancer, interstitial lung disease [eg, fibrosis, silicosis, sarcoidosis], or active tuberculosis).
- Has a known α1-antitrypsin deficiency.
- Has taken roflumilast within 6 months of Screening (Visit V0).
Criteria within ethical considerations in terms of general health
- Has clinically relevant abnormal laboratory values suggesting an undiagnosed disease requiring further clinical evaluation (as assessed by the investigator).
- Has a history of severe psychiatric or neurological disorders.
- Has a history of depression associated with suicidal ideation or behavior.
- Has congestive heart failure severity grade IV according to New York Heart Association (NYHA) Functional Classification.
- Has hemodynamically significant cardiac arrhythmias or heart valve deformations.
- Has computed tomography (CT) or chest x-ray findings indicating an acute pulmonary disease other than COPD (eg, tuberculosis, severe bronchiectasis, tumors).
- Has severe immunological diseases (eg, known human immune deficiency virus (HIV) infection, multiple sclerosis, lupus erythematosus, progressive multifocal leukoencephalopathy).
- Has liver impairment Child-Pugh B or C and/or active viral hepatitis.
- Has severe acute infectious diseases (eg, tuberculosis, or acute hepatitis).
- Has a history of malignant disease (except basal cell carcinoma) within 5 years before Screening (Visit V0).
- Has a history of drug abuse (defined as any illicit drug use) or a history of alcohol abuse within one year before Screening (Visit V0).
- Has a history of hypersensitivity or allergies to roflumilast or rescue medication or ingredients thereof, or any other contraindication for the use thereof.
- If female, the participant is pregnant or lactating or intending to become pregnant before, during, or within 12 weeks after participating in this study; or intending to donate ova during such ti
Data sourced from ClinicalTrials.gov (NCT02165826) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.