A Single Inhalation Dose Study to Assess Efficacy, Pharmacokinetics (PK), Safety and Tolerability of AZD8871 in Patients With Long-term Lung Diseases.

Sponsor
AstraZeneca (Industry)
Overall Status
Completed
CT.gov ID
NCT03645434
Collaborator
Parexel (Industry)
73
5
6
9.9
14.6
1.5

Study Details

Study Description

Brief Summary

This study will evaluate the efficacy and safety data of AZD8871 in patients with moderate to severe chronic obstructive pulmonary disease (COPD). This study will determine the 24-hour efficacy (lung function) profile of AZD8871 600 μg relative to placebo dry powder inhaler (DPI) based on trough forced expiratory volume in 1 second (FEV1) following repeated dosing (2 weeks). Anoro® Ellipta® (umeclidinium/vilanterol) once daily is included as an active control. This study aims at providing a novel approach to the treatment of COPD with greater efficacy than single-mechanism bronchodilators, equivalent to long-acting muscarinic antagonist (LAMA) and long-acting β2-agonist (LABA) administered as free- or fixed-dose combination therapies, with an equivalent or superior safety and tolerability profile.

Condition or Disease Intervention/Treatment Phase
Phase 2

Detailed Description

This randomized, double-blind, placebo and active-controlled crossover study will be conducted at 5 sites in Germany and the United Kingdom (UK). Approximately 180 patients will be screened in order to randomize 72 patients into the study. Based on previous studies estimate, it is anticipated that 54 patients will be evaluable (study completers) assuming an approximate 25% dropout rate. A subset of 36 patients, who will have specifically consented for pharmacokinetics (PK), will undergo PK assessments. The study will consist of -

  • A Screening period: Will last up to 28 days and consists of 2 Screening visits (Visit 1 and Visit 2) and a run-in period (between a minimum of 14 and a maximum of 28 days; from Visit 2 to Visit 3).

  • Three treatment periods (Visit 3; 14 days each; each separated by a wash-out period of 42 to 49 days) and

  • A Follow-up Visit: 42 days (up to 49 days) after last investigational product (IP) administration.

Patients will be requested to stop their usual COPD therapy after signing the informed consent form (ICF) at Visit 1 and will be maintained on a mono-component inhaled corticosteroid (ICS) therapy, if required. Patients that were taking any LAMA will be maintained with ipratropium (34 µg × 2 puffs 4 times per day) between Visit 1 and Visit 2. In addition, salbutamol 100 µg will be provided as rescue medication during the study as needed (rescue medication has to be discontinued 6 hours before any pulmonary function test). Visit 1 and Visit 2 could be performed on the same day if no wash-out of prior medication is required and the patient visits the site in fasting condition. In case any wash-out of prior medication is required, then Visit 2 will be performed after the wash-out is complete. If reversibility criteria and forced expiratory volume in 1 second (FEV1) predicted values are fulfilled according to inclusion criteria, the patient will be started on run-in period to assess clinical stability. If reversibility criteria or FEV1 predicted values are not met, pulmonary function tests could be rescheduled at the latest, up to Day 14. During the run in period, all patients will receive ipratropium 34 µg × 2 puffs 4 times per day (must be discontinued 8 hours prior to previous any pulmonary function test). A paper diary will be used to collect adverse events (AEs) and concomitant medication during run-in and wash-out periods.

Eligible patients will be randomized in 1:1:1:1:1:1 ratio to 1 of 6 treatment sequences and will receive orally 1 of the following 3 treatments sequence in the form of inhalation powder using DPI :

  • AZD8871 600 µg once daily (double-blind).

  • Anoro® Ellipta® (55 µg umeclidinium [UMEC]/ 22 µg vilanterol [VI]) once daily (double-blind).

  • Placebo (double-blind). Study treatment administration during all the visits at the sites (Day 1, Day 2, Day 8, and Day 14 of each treatment period) will be supervised by study personnel.

During the treatment period Visits, safety and tolerability assessments and pulmonary function measurements will be taken pre-dose and up to 24 hours (Day 1) and up to 4 hours (Day 8) post-dose, respectively.

At Visits 3 to 11, a subset of 36 patients will undergo PK assessments. Blood samples will be collected pre-dose and up to 24 hours post dose.

In follow-up visit, AEs, safety laboratory, electrocardiogram (ECG), vital signs and physical examination will be assessed.

The study includes 12 visits and the entire study period is scheduled to take from a minimum of 6.5 months (182 days) to a maximum of 7.5 months (217 days) for each individual patient. The estimated study duration is 12 months.

Study Design

Study Type:
Interventional
Actual Enrollment :
73 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
Double (Participant, Investigator)
Masking Description:
This study will be performed in a double-blind manner. Each investigational product (IP) and its placebo will be supplied in identical packaging to enable double-blind conditions.
Primary Purpose:
Treatment
Official Title:
A Phase IIa, Randomised, Multi-centre, Double-blind, Placebo and Active-controlled, 3 Periods, Crossover Study to Investigate the Efficacy, Pharmacokinetics, Safety and Tolerability of Inhaled AZD8871 Administered Once Daily for 2 Weeks in Patients With Moderate to Severe COPD
Actual Study Start Date :
Oct 10, 2018
Actual Primary Completion Date :
Aug 7, 2019
Actual Study Completion Date :
Aug 7, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: Treatment sequence A

Randomized patients will receive multiple oral dose of inhalation powder via DPI as follow: Treatment period 1: AZD8871 600 µg and Anoro® Ellipta® matching placebo. Treatment period 2: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 3: Matching placebo of AZD8871 and Anoro® Ellipta®

Drug: AZD8871
Randomized patients will receive 14 repeated daily doses of AZD8871 600 µg inhalation powder via DPI.

Drug: Anoro® Ellipta®
Randomized patients will receive 14 repeated daily doses of Anoro® Ellipta® (55 µg/22 µg) inhalation powder via DPI.
Other Names:
  • Anoro® - Umeclidinium/Vilanterol
  • Ellipta® - Device
  • Experimental: Treatment sequence B

    Randomized patients will receive multiple oral dose of inhalation powder via DPI as follows: Treatment period 1: AZD8871 600 µg and Anoro® Ellipta® matching placebo. Treatment period 2: Matching placebo of AZD8871 and Anoro® Ellipta® Treatment period 3: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg.

    Drug: AZD8871
    Randomized patients will receive 14 repeated daily doses of AZD8871 600 µg inhalation powder via DPI.

    Drug: Anoro® Ellipta®
    Randomized patients will receive 14 repeated daily doses of Anoro® Ellipta® (55 µg/22 µg) inhalation powder via DPI.
    Other Names:
  • Anoro® - Umeclidinium/Vilanterol
  • Ellipta® - Device
  • Experimental: Treatment sequence C

    Randomized patients will receive multiple oral dose of inhalation powder via DPI as follows: Treatment period 1: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 2: AZD8871 600 µg and Anoro® Ellipta® matching placebo. Treatment period 3: Matching placebo of AZD8871 and Anoro® Ellipta®

    Drug: AZD8871
    Randomized patients will receive 14 repeated daily doses of AZD8871 600 µg inhalation powder via DPI.

    Drug: Anoro® Ellipta®
    Randomized patients will receive 14 repeated daily doses of Anoro® Ellipta® (55 µg/22 µg) inhalation powder via DPI.
    Other Names:
  • Anoro® - Umeclidinium/Vilanterol
  • Ellipta® - Device
  • Experimental: Treatment sequence D

    Randomized patients will receive multiple oral dose of inhalation powder via DPI as follow: Treatment period 1: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 2: Matching placebo of AZD8871 and Anoro® Ellipta® Treatment period 3: AZD8871 600 µg and Anoro® Ellipta® matching placebo.

    Drug: AZD8871
    Randomized patients will receive 14 repeated daily doses of AZD8871 600 µg inhalation powder via DPI.

    Drug: Anoro® Ellipta®
    Randomized patients will receive 14 repeated daily doses of Anoro® Ellipta® (55 µg/22 µg) inhalation powder via DPI.
    Other Names:
  • Anoro® - Umeclidinium/Vilanterol
  • Ellipta® - Device
  • Experimental: Treatment sequence E

    Randomized patients will receive multiple oral dose of inhalation powder via DPI as follow: Treatment period 1: Matching placebo of AZD8871 and Anoro® Ellipta® Treatment period 2: AZD8871 600 µg and Anoro® Ellipta® matching placebo. Treatment period 3: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg.

    Drug: AZD8871
    Randomized patients will receive 14 repeated daily doses of AZD8871 600 µg inhalation powder via DPI.

    Drug: Anoro® Ellipta®
    Randomized patients will receive 14 repeated daily doses of Anoro® Ellipta® (55 µg/22 µg) inhalation powder via DPI.
    Other Names:
  • Anoro® - Umeclidinium/Vilanterol
  • Ellipta® - Device
  • Experimental: Treatment sequence F

    Randomized patients will receive multiple oral dose of inhalation powder via DPI as follow: Treatment period 1: Matching placebo of AZD8871 and Anoro® Ellipta® Treatment period 2: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 3: AZD8871 600 µg and Anoro® Ellipta® matching placebo.

    Drug: AZD8871
    Randomized patients will receive 14 repeated daily doses of AZD8871 600 µg inhalation powder via DPI.

    Drug: Anoro® Ellipta®
    Randomized patients will receive 14 repeated daily doses of Anoro® Ellipta® (55 µg/22 µg) inhalation powder via DPI.
    Other Names:
  • Anoro® - Umeclidinium/Vilanterol
  • Ellipta® - Device
  • Outcome Measures

    Primary Outcome Measures

    1. Change From Baseline in Trough FEV1 at Day 15 [Day 15]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe chronic obstructive pulmonary disease (COPD).

    2. Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) at Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14 [Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD. At each visit, patients are asked to evaluate the impact of COPD on their wellbeing and daily life on a 6-point Likert scale ranging from 0 to 5, with higher scores indicating a higher impact of COPD. The CAT is expressed as a total score, which is a sum of the 8 questions, ranging from 0 to 40.

    Secondary Outcome Measures

    1. FEV1 AUC(0-4)/4h (Area Under the Curve for the Change in FEV1 From Baseline to 4h, Normalised by the Time Window) [At Day 1, Day 8, and Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    2. FEV1 AUC(0-8)/8h (Area Under the Curve for the Change in FEV1 From Baseline to 8h, Normalised by the Time Window) [Day 1 and Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    3. FEV1 AUC(0-12)/12h (Area Under the Curve for the Change in FEV1 From Baseline to 12h, Normalised by the Time Window) [Day 1 and Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    4. FEV1 AUC(0-24)/24h (Area Under the Curve for the Change in FEV1 From Baseline to 24h, Normalised by the Time Window) [Day 1 and Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    5. Change From Baseline in Trough FEV1 on Day 2 and Day 8. [Day 2 and Day 8.]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    6. Change From Baseline in Peak FEV1 on Day 1, Day 8 and Day 14. [At Day 1, Day 8, and Day 14.]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    7. Change From Baseline in Breathlessness, Cough and Sputum Scale (BCSS) Total Score at Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14 [Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD. The BCSS questionnaire is a 3-item, patient-reported outcome (PRO) measure. On a daily basis, patients are asked to evaluate each of their 3 symptoms (breathlessness, cough, and sputum) on a 5-point Likert scale ranging from 0 to 4, with higher scores indicating a higher severity of the symptom. The BCSS questionnaire is expressed as a daily total score, which is the sum of the 3 symptom scores, ranging from 0 to 12.

    8. Number of Participants With Adverse Events. [From Screening to folow-up or discontinuation (42 days after last study drug)]

      To evaluate the safety and tolerability of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    9. Maximum Plasma Concentration (Cmax) [At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the Cmax of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD

    10. Time to Reach Maximum Plasma Concentration (Tmax) [At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the Tmax of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD

    11. Time to Reach Last Quantifiable Plasma Concentration (Tlast) [At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the Tlast of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD

    12. Area Under the Plasma Concentration-curve From Time 0 to the Time of Last Quantifiable Concentration (AUClast) [At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the AUClast of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD

    13. Area Under the Plasma Concentration-curve From Time 0 to 24 Hours Post-dose [AUC(0-24)] [At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the AUC(0-24) of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD

    14. Average Plasma Concentration During a Dosing Interval (Cavg) [At Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the Cavg of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD

    15. Fluctuation Index During a Dosing Interval (%Fluctuation) [At Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)]

      To investigate the %Fluctuation of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD. Fluctuation index during a dosing interval is estimated as 100*(Cmax - Cmin)/Cavg (%), where Cmin is the minimum concentration at the end of the dosing interval.

    16. Accumulation Ratio for Cmax (Rac(Cmax)) [At Day 14]

      To investigate the Rac (Cmax) of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD. Accumulation ratio for Cmax estimated as (Cmax on Day 14/Cmax on Day 1).

    17. Accumulation Ratio for AUC(0-24) Rac(AUC(0-24)) [At Day 14]

      To investigate the Rac(AUC(0-24) of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD. Accumulation ratio for AUC0-24 estimated as (AUC0-24 on Day 14/AUC0-24 on Day 1).

    18. Change From Baseline in Use of Rescue Medication [Day 1 to Day 8 and Day 9 to Day 14]

      To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    40 Years to 85 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    1. Provision of signed and dated, written ICF prior to any study-specific procedures, sampling, and analyses.

    2. Patient must be 40 to 85 years male and/or females of non-childbearing potential who are not pregnant/lactating at the time of signing the ICF (Screening; Visit 1).

    3. Patient with an established clinical history of moderate to severe COPD for more than 1 year at Screening, according to the GOLD COPD guidelines.

    4. Patient who is a current or former smoker (defined as one who has stopped smoking for at least 6 months prior to Screening) with a history of ≥10 pack-years of cigarette smoking [Number of pack-years=(number of cigarettes per day/20)* number of years smoked (eg, 1 pack-year=20 cigarettes smoked per day for 1 year)].

    5. Patient with post-bronchodilator FEV1/forced vital capacity (FVC) ratio <70% based on the value reached after inhalation of salbutamol (400 µg) at Visit 2. If criterion is not met, the test can be repeated at the latest, up to Day -14.

    6. Patient with post-bronchodilator FEV1 that must be ≥40% and <80% predicted normal value at Visit 2. If criterion is not met, the test can be repeated at the latest, up to Day -14.

    7. Patient is willing and, in the opinion of the Investigator, able to change current COPD therapy as required by the protocol and willing to use ipratropium following the approved dosage and regimen (during run-in and wash-out periods) with or without ICS for maintenance therapy of COPD and rescue medication salbutamol (as needed) from Visit 1 to Visit 11.

    8. Patient must be able to read, speak and understand local language, and be willing to remain at the study centre as required per-protocol to complete all visit assessments.

    9. Body mass index (BMI) <40 kg/m2 at the time of Screening.

    10. Female patients must be of non-childbearing potential defined as:

    • Permanently or surgically sterilised, including hysterectomy and/or bilateral oophorectomy and/or bilateral salpingectomy.

    • Post-menopausal; aged <50 years and amenorrhoeic for 12 months or more following cessation of exogenous hormonal treatments and with luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in the post menopausal range of the local laboratory.

    • Post-menopausal; aged ≥50 years and amenorrhoeic for 12 months or more, following cessation of all exogenous hormonal treatments.

    1. Male patients should use a condom and spermicide to prevent pregnancy and drug exposure of a partner, regardless of the gender or childbearing potential of the partner from the day of the first administration of the IP until 3 months after the last administration of the IP. In addition to a condom with spermicide, a second highly effective method of contraception (oral, intravaginal or transdermal hormonal contraceptives, intrauterine device, intrauterine hormone-releasing system, or sexual abstinence until 3 months after the last administration of the IP) should be used with female partners of childbearing potential. Double barrier methods (a combination of male condom with either a cap, diaphragm or sponge with spermicide) are not considered to be highly effective methods of contraception. Male patients with a pregnant partner should use a condom and spermicide.
    Exclusion Criteria:
    1. Patient has significant diseases other than COPD, (ie, clinically relevant disease or condition or an abnormality in prior ECGs, medical history or physical examinations) which, in the opinion of the Investigator, may put the patient at risk because of participation in the study or may influence either the results of the study or the patient's ability to participate in the study.

    2. Patient has alpha-1 antitrypsin deficiency as the cause of COPD.

    3. Patient has other active pulmonary disease such as predominant asthma, active tuberculosis, lung cancer, bronchiectasis, sarcoidosis, idiopathic interstitial pulmonary fibrosis, primary pulmonary hypertension, or uncontrolled sleep apnoea. Allergic rhinitis is not exclusionary.

    4. Lung surgery for volume reduction or lung transplantation: Patient has undergone lung volume reduction surgery, lobectomy, or bronchoscopic lung volume reduction (endobronchial blockers, airway bypass, endobronchial valves, thermal vapour ablation, biological sealants, massive pulmonary embolism and airway implants) within 1 year of Screening (Visit 1).

    5. Patient is using nocturnal positive pressure (eg, continuous positive airway pressure or bi level positive airway pressure). Patient is using any non-invasive positive pressure ventilation device. Note: A patient using continuous positive airway pressure or bi level positive airway pressure for Sleep Apnoea Syndrome is allowed in the study.

    6. Patient who had 2 or more exacerbations of COPD (moderate or severe in intensity) within the last year prior to Screening (see Section 7.1 for definition of exacerbation of COPD).

    7. Patient has been hospitalised due to poorly controlled COPD within 3 months of the Screening period.

    8. Patient has acute worsening of COPD that requires treatment with corticosteroids or antibiotics in the 6 week interval prior to or during the Screening period.

    9. Patient has had lower respiratory tract infection(s) that required antibiotics within 6 weeks prior to the Screening period.

    10. Patient has significant cardiovascular disease that may be vulnerable to cardiovascular instability. Note: Some examples of clinically significant cardiovascular conditions are:

    • Myocardial infarction within the 6 months prior to Screening Visit (Visit 1).

    • Unstable angina or unstable arrhythmia which has required changes in the pharmacological therapy or other intervention within 12 months prior to Screening (Visit 1), or newly diagnosed arrhythmia within the previous 3 months prior to Screening (Visit 1).

    • Second degree atrio-ventricular block.

    • Use of pacemaker.

    • Hospitalisation within 12 months prior to Screening (Visit 1) for heart failure functional classes III (marked limitation of activity and only comfortable at rest) and IV per the "New York Heart Association".

    1. Patient with a QT interval corrected using Fridericia's formula (QTcF) value >450 ms for male and >470 ms for female or an ECG that is not suitable for QT measurements (eg, poorly defined termination of the T wave).

    2. Patient with a heart rate <50 or >120 beats per minute (bpm).

    3. Patient has clinically significant uncontrolled hypertension (>180 mmHg) as assessed by the Investigator.

    4. Patient has seizures or a history of seizures requiring anticonvulsants within 12 months prior to Screening.

    5. Patient is taking selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors whose dose has not been stable for at least 4 weeks prior to Screening, or exceeds the maximum recommended dose.

    6. Patient has a symptomatic bladder neck obstruction, acute urinary retention or symptomatic non-stable prostate hypertrophy.

    7. Any laboratory abnormality or suspicion of any clinically relevant disease or disorder (on history or examination), including uncontrolled diabetes or hypokalaemia (serum potassium <3.5 mmol/L), which, in the opinion of the Investigator, may either put the patient at risk because of participation in the study, or influence the results or the patient's ability to participate in the study, or any other safety concerns in the opinion of the Investigator. Note: Potassium replacement and re-test is allowed once if serum potassium concentration was <3.5 mmol/L at Screening or prior to randomisation.

    8. Patient has known human immunodeficiency virus (HIV) infection or chronic hepatitis B or C infection.

    9. History of malignancy of any organ system, treated or untreated within the past 5 years, with the exception of localised basal cell carcinoma of the skin.

    10. Patient has known narrow-angle glaucoma.

    11. Patient has a history of drug of abuse within the past 2 years or consuming more than 14 (female patients) or 21 (male patients) units of alcohol a week, or shows positive for drugs of abuse and alcohol tests at Screening and prior to randomisation.

    Note: If a patient tests positive to any drugs of abuse tests, which cannot be explained by use of prescription medication, he/she will be excluded from the study. Unit=1 glass of wine (125 mL)=1 measure of spirits=½ pint of beer.

    1. Patient has a history of hypersensitivity (including paradoxical bronchospasm) to β2-agonists, muscarinic anticholinergics or lactose/milk protein. Lactose intolerance is not an exclusion criterion.

    2. Patient has received a live attenuated vaccination within 30 days prior to Screening.

    Note: Inactivated influenza vaccination, pneumococcal vaccination, or any other inactivated vaccine is acceptable provided it is not administered within 7 days prior to Screening or randomisation (Visit 3).

    1. Patient who, in the opinion of the Investigator, is unable to abstain from protocol-defined prohibited medications during the study.

    2. Patient was treated with an investigational drug or device in another clinical trial within the last 30 days or 5 half-lives (whichever is longer) prior to Screening.

    Note: Patient participation in observational studies (ie, studies that do not require change to medication or an additional intervention) is not exclusionary.

    1. Previous participation or prior screen failure in the present study.

    2. Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site).

    3. Patient has changed their smoking status (ie, restarted or stopped smoking) or initiation of a smoking cessation program within 6 weeks of Screening.

    4. Patient has participated in the acute phase of a pulmonary rehabilitation program within 4 weeks prior to Screening or who will enter the acute phase of a pulmonary rehabilitation program during the study. A patient in the maintenance phase of a pulmonary rehabilitation program is not to be excluded.

    5. Judgment by the Investigator that the patient should not participate in the study if the patient is unlikely to comply with study procedures, restrictions and requirements. Inability to comply with requirements includes having an e-Diary completion rate of <70% during the run-in period.

    6. Patient who have donated or lost >500 mL of blood and/or plasma within the previous 3 months prior to Screening.

    7. Vulnerable patients (who has been placed in an institution due to a regulatory or court order).

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Research Site Berlin Germany 14050
    2 Research Site Grosshansdof Germany 22927
    3 Research Site Wiesbaden Germany 65187
    4 Research Site London United Kingdom HA1 3UJ
    5 Research Site Manchester United Kingdom M23 9QZ

    Sponsors and Collaborators

    • AstraZeneca
    • Parexel

    Investigators

    None specified.

    Study Documents (Full-Text)

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    AstraZeneca
    ClinicalTrials.gov Identifier:
    NCT03645434
    Other Study ID Numbers:
    • D6640C00006
    First Posted:
    Aug 24, 2018
    Last Update Posted:
    Dec 17, 2020
    Last Verified:
    Nov 1, 2020
    Individual Participant Data (IPD) Sharing Statement:
    Undecided
    Plan to Share IPD:
    Undecided
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Keywords provided by AstraZeneca
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details Subjects who met all the inclusion and none of the exclusion criteria were enrolled at 3 sites in Germany and 2 sites in the United Kingdom (UK).
    Pre-assignment Detail Subjects attended Screening Visit within a 14 to 28-days Screening Period, before receiving their first dose of AZD8871. All subjects underwent inclusion exclusion criteria assessment and all eligible subjects signed the informed consent before undergoing any study related procedures.
    Arm/Group Title Treatment Sequence A Treatment Sequence B Treatment Sequence C Treament Sequence D Treatment Sequence E Treatment Sequence F
    Arm/Group Description Randomized subjects received 14 repeated daily oral doses of inhalation powder via DPI as follows: Treatment period 1: AZD8871 600 μg and Anoro® Ellipta® matching placebo. Treatment period 2: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 3: Matching placebo of AZD8871 and Anoro® Ellipta®. Randomized subjects received 14 repeated daily oral doses of inhalation powder via DPI as follows: Treatment period 1: AZD8871 600 μg and Anoro® Ellipta® matching placebo. Treatment period 2: Matching placebo of AZD8871 and Anoro® Ellipta®. Treatment period 3: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Randomized subjects received 14 repeated daily oral doses of inhalation powder via DPI as follows: Treatment period 1: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 2: AZD8871 600 μg and Anoro® Ellipta® matching placebo. Treatment period 3: Matching placebo of AZD8871 and Anoro® Ellipta®. Randomized subjects received 14 repeated daily oral doses of inhalation powder via DPI as follows: Treatment period 1: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 2: Matching placebo of AZD8871 and Anoro® Ellipta®. Treatment period 3: AZD8871 600 μg and Anoro® Ellipta® matching placebo. Randomized subjects received 14 repeated daily oral doses of inhalation powder via DPI as follows: Treatment period 1: Matching placebo of AZD8871 and Anoro® Ellipta®. Treatment period 2: AZD8871 600 μg and Anoro® Ellipta® matching placebo. Treatment period 3: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Randomized subjects received 14 repeated daily oral doses of inhalation powder via DPI as follows: Treatment period 1: Matching placebo of AZD8871 and Anoro® Ellipta®. Treatment period 2: AZD8871 matching placebo and Anoro® Ellipta® 55 μg / 22 μg. Treatment period 3: AZD8871 600 μg and Anoro® Ellipta® matching placebo.
    Period Title: Period 1
    STARTED 12 13 13 11 12 12
    COMPLETED 12 13 13 10 11 12
    NOT COMPLETED 0 0 0 1 1 0
    Period Title: Period 1
    STARTED 10 13 13 10 11 11
    COMPLETED 10 13 13 10 11 11
    NOT COMPLETED 0 0 0 0 0 0
    Period Title: Period 1
    STARTED 10 13 11 10 11 11
    COMPLETED 10 13 11 10 11 11
    NOT COMPLETED 0 0 0 0 0 0

    Baseline Characteristics

    Arm/Group Title All Participants
    Arm/Group Description Subjects received AZD8871 inhalation powder 600 μg, 1 inhalation per day; umeclidinium 55 μg / vilanterol 22 μg. as oral inhalation once per day; Placebo to AZD8871 via oral inhalation, 1 inhalation per day.
    Overall Participants 73
    Age (Years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [Years]
    66.0
    (7.6)
    Sex: Female, Male (Count of Participants)
    Female
    23
    31.5%
    Male
    50
    68.5%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    Asian
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    Black or African American
    0
    0%
    White
    73
    100%
    More than one race
    0
    0%
    Unknown or Not Reported
    0
    0%

    Outcome Measures

    1. Primary Outcome
    Title Change From Baseline in Trough FEV1 at Day 15
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe chronic obstructive pulmonary disease (COPD).
    Time Frame Day 15

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Mean (Standard Deviation) [Liters]
    0.1904
    (0.2052)
    0.2260
    (0.2275)
    -0.0222
    (0.1404)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value 0.202
    Confidence Interval (2-Sided) 95%
    0.151 to 0.253
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    2. Secondary Outcome
    Title FEV1 AUC(0-4)/4h (Area Under the Curve for the Change in FEV1 From Baseline to 4h, Normalised by the Time Window)
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame At Day 1, Day 8, and Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1
    0.3604
    (0.1753)
    0.2912
    (0.1677)
    0.0430
    (0.0783)
    Day 8
    0.4296
    (0.2197)
    0.3796
    (0.2133)
    0.0808
    (0.2117)
    Day 14
    0.4060
    (0.2448)
    0.3358
    (0.2011)
    0.0209
    (0.1210)
    3. Secondary Outcome
    Title FEV1 AUC(0-8)/8h (Area Under the Curve for the Change in FEV1 From Baseline to 8h, Normalised by the Time Window)
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame Day 1 and Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1
    0.3072
    (0.1565)
    0.2798
    (0.1695)
    0.0230
    (0.0923)
    Day 14
    0.3394
    (0.2462)
    0.3102
    (0.1998)
    0.0021
    (0.1204)
    4. Secondary Outcome
    Title FEV1 AUC(0-12)/12h (Area Under the Curve for the Change in FEV1 From Baseline to 12h, Normalised by the Time Window)
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame Day 1 and Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1
    0.2668
    (0.1494)
    0.2720
    (0.1697)
    0.0096
    (0.0946)
    Day 14
    0.3024
    (0.2141)
    0.2919
    (0.2027)
    -0.0032
    (0.1150)
    5. Secondary Outcome
    Title FEV1 AUC(0-24)/24h (Area Under the Curve for the Change in FEV1 From Baseline to 24h, Normalised by the Time Window)
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame Day 1 and Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1
    0.1832
    (0.1399)
    0.2333
    (0.1742)
    -0.0132
    (0.0920)
    Day 14
    0.2223
    (0.2154)
    0.2417
    (0.2012)
    -0.0324
    (0.1104)
    6. Secondary Outcome
    Title Change From Baseline in Trough FEV1 on Day 2 and Day 8.
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame Day 2 and Day 8.

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 2
    0.1359
    (0.1672)
    0.2249
    (0.1897)
    0.0339
    (0.1139)
    Day 8
    0.2161
    (0.1613)
    0.2748
    (0.1894)
    0.0121
    (0.1240)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 2
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value 0.098
    Confidence Interval (2-Sided) 95%
    0.051 to 0.146
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 8
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value 0.195
    Confidence Interval (2-Sided) 95%
    0.148 to 0.242
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    7. Secondary Outcome
    Title Change From Baseline in Peak FEV1 on Day 1, Day 8 and Day 14.
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame At Day 1, Day 8, and Day 14.

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1
    0.403
    (0.182)
    0.333
    (0.176)
    0.092
    (0.086)
    Day 8
    0.511
    (0.240)
    0.454
    (0.227)
    0.120
    (0.130)
    Day 14
    0.464
    (0.255)
    0.391
    (0.215)
    0.066
    (0.131)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 1
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value 0.306
    Confidence Interval (2-Sided) 95%
    0.266 to 0.346
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 8
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value 0.374
    Confidence Interval (2-Sided) 95%
    0.324 to 0.425
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 14
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value 0.388
    Confidence Interval (2-Sided) 95%
    0.329 to 0.447
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    8. Secondary Outcome
    Title Change From Baseline in Breathlessness, Cough and Sputum Scale (BCSS) Total Score at Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD. The BCSS questionnaire is a 3-item, patient-reported outcome (PRO) measure. On a daily basis, patients are asked to evaluate each of their 3 symptoms (breathlessness, cough, and sputum) on a 5-point Likert scale ranging from 0 to 4, with higher scores indicating a higher severity of the symptom. The BCSS questionnaire is expressed as a daily total score, which is the sum of the 3 symptom scores, ranging from 0 to 12.
    Time Frame Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1 to Day 8
    -0.37
    (1.27)
    -0.61
    (1.31)
    0.16
    (1.11)
    Day 9 to Day 14
    -0.35
    (1.58)
    -0.63
    (1.49)
    0.53
    (1.43)
    Day 1 to Day 14
    -0.36
    (1.33)
    -0.63
    (1.32)
    0.36
    (1.26)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 1 to Day 8
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.0010
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -0.551
    Confidence Interval (2-Sided) 95%
    -0.876 to -0.226
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 9 to Day 14
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -0.867
    Confidence Interval (2-Sided) 95%
    -1.248 to -0.486
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 1 to Day 14
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -0.722
    Confidence Interval (2-Sided) 95%
    -1.047 to -0.397
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    9. Primary Outcome
    Title Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) at Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD. At each visit, patients are asked to evaluate the impact of COPD on their wellbeing and daily life on a 6-point Likert scale ranging from 0 to 5, with higher scores indicating a higher impact of COPD. The CAT is expressed as a total score, which is a sum of the 8 questions, ranging from 0 to 40.
    Time Frame Day 1 to Day 8, Day 9 to Day 14, Day 1 to Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1 to Day 8
    -2.11
    (4.34)
    -2.78
    (4.34)
    -0.57
    (4.69)
    Day 9 to Day 14
    -2.87
    (5.01)
    -3.29
    (4.94)
    -0.52
    (5.06)
    Day 1 to Day 14
    -2.42
    (4.49)
    -3.01
    (4.51)
    -0.59
    (4.81)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 1 to Day 8
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.0022
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -1.571
    Confidence Interval (2-Sided) 95%
    -2.563 to -0.579
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 9 to Day 14
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -2.386
    Confidence Interval (2-Sided) 95%
    -3.541 to -1.230
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 3
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 1 to Day 14
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value 0.0003
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -1.912
    Confidence Interval (2-Sided) 95%
    -2.923 to -0.901
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    10. Secondary Outcome
    Title Number of Participants With Adverse Events.
    Description To evaluate the safety and tolerability of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame From Screening to folow-up or discontinuation (42 days after last study drug)

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Any AE
    39
    53.4%
    38
    NaN
    35
    NaN
    Any AE with outcome=death
    0
    0%
    0
    NaN
    0
    NaN
    Any SAE (including events with outcome=death)
    0
    0%
    2
    NaN
    2
    NaN
    Any AE leading to discontinuation of treatment
    0
    0%
    1
    NaN
    0
    NaN
    Any AE leading to withdrawal from study
    0
    0%
    1
    NaN
    0
    NaN
    11. Secondary Outcome
    Title Maximum Plasma Concentration (Cmax)
    Description To investigate the Cmax of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD
    Time Frame At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871 - Day 1
    310.4
    (61.30)
    AZD8871 - Day 14
    532.9
    (46.58)
    LAS191861- Day 1
    26.64
    (53.33)
    LAS191861- Day 14
    63.29
    (52.12)
    12. Secondary Outcome
    Title Time to Reach Maximum Plasma Concentration (Tmax)
    Description To investigate the Tmax of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD
    Time Frame At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871- Day 1
    0.99
    AZD8871- Day 14
    0.98
    LAS191861 - Day 1
    2.00
    LAS191861 - Day 14
    2.00
    13. Secondary Outcome
    Title Time to Reach Last Quantifiable Plasma Concentration (Tlast)
    Description To investigate the Tlast of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD
    Time Frame At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871 -Day 1
    23.93
    AZD8871-Day 14
    24.03
    LAS191861 - Day 1
    23.92
    LAS191861 - Day 14
    24.03
    14. Secondary Outcome
    Title Area Under the Plasma Concentration-curve From Time 0 to the Time of Last Quantifiable Concentration (AUClast)
    Description To investigate the AUClast of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD
    Time Frame At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871- Day 1
    1655
    (85.24)
    AZD8871-Day 14
    4001
    (55.64)
    LAS191861 -Day 1
    251.9
    (97.81)
    LAS191861 -Day 14
    943.3
    (63.08)
    15. Secondary Outcome
    Title Area Under the Plasma Concentration-curve From Time 0 to 24 Hours Post-dose [AUC(0-24)]
    Description To investigate the AUC(0-24) of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD
    Time Frame At Day 1 and Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871- Day 1
    1661
    (83.55)
    AZD8871- Day 14
    3996
    (55.66)
    LAS191861 - Day 1
    289.5
    (57.83)
    LAS191861 - Day 14
    941.7
    (63.11)
    16. Secondary Outcome
    Title Average Plasma Concentration During a Dosing Interval (Cavg)
    Description To investigate the Cavg of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD
    Time Frame At Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871 -Day 14
    166.5
    (55.63)
    LAS191861 - Day 14
    39.23
    (63.06)
    17. Secondary Outcome
    Title Fluctuation Index During a Dosing Interval (%Fluctuation)
    Description To investigate the %Fluctuation of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD. Fluctuation index during a dosing interval is estimated as 100*(Cmax - Cmin)/Cavg (%), where Cmin is the minimum concentration at the end of the dosing interval.
    Time Frame At Day 14 (at pre-dose and at 30 minutes (min), 1, 2, 4, 6, 8, 12, and 24 hours post-dose)

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871- Day 14
    273.1
    LAS191861 - Day 14
    91.03
    18. Secondary Outcome
    Title Accumulation Ratio for Cmax (Rac(Cmax))
    Description To investigate the Rac (Cmax) of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD. Accumulation ratio for Cmax estimated as (Cmax on Day 14/Cmax on Day 1).
    Time Frame At Day 14

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871 -Day 14
    1.725
    (44.77)
    LAS191861 - Day 14
    2.377
    (40.02)
    19. Secondary Outcome
    Title Accumulation Ratio for AUC(0-24) Rac(AUC(0-24))
    Description To investigate the Rac(AUC(0-24) of AZD8871 600 μg and its primary metabolite after multiple dose administration of inhaled AZD8871 in patients with moderate to severe COPD. Accumulation ratio for AUC0-24 estimated as (AUC0-24 on Day 14/AUC0-24 on Day 1).
    Time Frame At Day 14

    Outcome Measure Data

    Analysis Population Description
    PK analysis set (PKS): All participants participating in the subset of the PK participants, who received at least 1 dose of AZD8871 600 μg.
    Arm/Group Title AZD8871
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F.
    Measure Participants 70
    AZD8871 - Day 14
    2.406
    (50.37)
    LAS191861 -Day 14
    3.443
    (47.15)
    20. Secondary Outcome
    Title Change From Baseline in Use of Rescue Medication
    Description To evaluate the efficacy of inhaled AZD8871 600 μg in patients with moderate to severe COPD
    Time Frame Day 1 to Day 8 and Day 9 to Day 14

    Outcome Measure Data

    Analysis Population Description
    The full analysis set (FAS): All participants randomised and receiving study treatment, irrespective of their protocol adherence and continued participation in the study.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    Measure Participants 70 69 68
    Day 1 to Day 8
    -1.00
    (1.83)
    -0.95
    (2.03)
    0.18
    (2.13)
    Day 9 to Day 14
    -0.78
    (1.97)
    -0.87
    (1.96)
    0.52
    (1.80)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 1 to Day 8
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -1.268
    Confidence Interval (2-Sided) 95%
    -1.741 to -0.794
    Parameter Dispersion Type:
    Value:
    Estimation Comments
    Statistical Analysis 2
    Statistical Analysis Overview Comparison Group Selection AZD8871, Placebo
    Comments Day 9 to Day 14
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value <0.0001
    Comments
    Method Mixed Models Analysis
    Comments
    Method of Estimation Estimation Parameter Mean Difference (Final Values)
    Estimated Value -1.302
    Confidence Interval (2-Sided) 95%
    -1.804 to -0.800
    Parameter Dispersion Type:
    Value:
    Estimation Comments

    Adverse Events

    Time Frame AEs starting on or after the first administration of study treatment, up to and including 42 days after the last dose of study treatment.
    Adverse Event Reporting Description An adverse event was the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. An undesirable medical condition might be symptoms, signs or the abnormal results of an investigation. The safety population was defined as all randomized patients who took at least one dose of IMP.
    Arm/Group Title AZD8871 Anoro® Ellipta® Placebo
    Arm/Group Description Subjects received AZD8871 (as saccharinate) inhalation powder 600 μg, orally 1 inhalation per day in treatment period 1 under sequences A and B; treatment period 2 under sequences C and E; and treatment period 3 under sequences D and F. Subjects received Anoro® Ellipta® (umeclidinium / vilanterol) 55 μg / 22 μg orally 1 inhalation per day in treatment period 1 under sequences C and D; treatment period 2 under sequences A and F; and treatment period 3 under sequences B and E. Placebo to AZD8871 and Anoro® Ellipta® orally 1 inhalation per day in treatment periods 1, 2 and 3 under all sequences A, B; C, D, E and F.
    All Cause Mortality
    AZD8871 Anoro® Ellipta® Placebo
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/70 (0%) 0/69 (0%) 0/68 (0%)
    Serious Adverse Events
    AZD8871 Anoro® Ellipta® Placebo
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/70 (0%) 2/69 (2.9%) 2/68 (2.9%)
    Cardiac disorders
    Acute coronary syndrome 0/70 (0%) 1/69 (1.4%) 0/68 (0%)
    Infections and infestations
    Tooth abscess 0/70 (0%) 1/69 (1.4%) 0/68 (0%)
    Vestibular neuronitis 0/70 (0%) 0/69 (0%) 1/68 (1.5%)
    Injury, poisoning and procedural complications
    Humerus fracture 0/70 (0%) 0/69 (0%) 1/68 (1.5%)
    Other (Not Including Serious) Adverse Events
    AZD8871 Anoro® Ellipta® Placebo
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 19/70 (27.1%) 19/69 (27.5%) 17/68 (25%)
    Infections and infestations
    Nasopharyngitis 6/70 (8.6%) 8/69 (11.6%) 3/68 (4.4%)
    Nervous system disorders
    Headache 14/70 (20%) 13/69 (18.8%) 14/68 (20.6%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title AstraZeneca AB
    Organization AstraZeneca AB
    Phone 1-877-400-4656
    Email clinicaltrialtransparency@astrazeneca.com
    Responsible Party:
    AstraZeneca
    ClinicalTrials.gov Identifier:
    NCT03645434
    Other Study ID Numbers:
    • D6640C00006
    First Posted:
    Aug 24, 2018
    Last Update Posted:
    Dec 17, 2020
    Last Verified:
    Nov 1, 2020