This 12-week clinical study evaluates the safety and efficacy of Albuterol Sulfate HFA Inhalation Aerosol (Albuterol-HFA, or: A004), Armstrong's proposed HFA formulation of metered dose inhaler (MDI) of Albuterol (Treatment T), in comparison with: 1. Placebo control: (HFA propellant only, Treatment P); and 2. Active control: 3M/Key's Proventil-HFA (Treatment R). The treatments will be given as self-administered oral inhalations in adult and adolescent patients with mild-to-moderate asthma, for 12-weeks. Dosing regimen throughout the 12-week study is two actuations four times daily (QID).
This is a randomized, parallel, multicenter, 12-week study in adolescent and adult patients with mild-to-moderate asthma, to evaluate the efficacy and safety of Armstrong's Albuterol-HFA MDI, in comparison to a Placebo Control and an Active Control of Proventil-HFA. While Albuterol-HFA (Treatment T) and Placebo (Treatment P) will be double-blinded to both the subjects and investigational staff, the active comparator drug, Proventil-HFA (Treatment R), can only be evaluator-blinded, due to: (1) its physical appearance differing from that of the T and P devices; and (2) unavailability of a Proventil-HFA placebo which would otherwise be used for a double-dummy design. All study medications will have the canisters and all product-identifying text or graphics (e.g., molded text on actuator) masked so that the treatments cannot be identified. No subject in any study arm will be given any information that could reveal the nature of the treatment given. All study subjects will be instructed not to reveal or discuss the study medications to the study staff or other subjects. The designated study evaluator(s), who conduct the clinical visits and safety and efficacy evaluations and perform the data recording and transcription, will be blinded to the study medications. All subjects will be screened for enrollment, and will be randomized into the following three treatment groups in a double-blinded (for Treatments T and P) or evaluator-blinded (for Treatment R) manner: Treatment T (Albuterol-HFA, N=200): 216 mcg albuterol sulfate (equivalent to 180 mcg albuterol base), QID; Treatment R (Proventil-HFA, N=50): 216 mcg albuterol sulfate (equivalent to 180 mcg albuterol base), QID; Treatment P (Placebo-HFA, N=50): two actuations of placebo, QID. Randomization is achieved with blocks of six (6), with four (4) patients receiving Albuterol-HFA for every one (1) patient receiving Proventil-HFA and every one (1) receiving the Placebo-HFA. At each Clinical Visit that takes place every 3 weeks, the double-blinded (T, P) or evaluator-blinded (R) study drugs will be distributed in resealable masking pouches to the subjects of each arm. An additional aim of the study is to evaluate the effect of weekly cleaning on the Albuterol-HFA MDI device clinical performance throughout the four, 3-week life-of-device treatment cycles, in conformance with the FDA's specific requirements. Arms: All subjects will be screened for enrollment, and will be randomized into the following three treatment groups in a double-blinded (for Treatments T and P) or evaluator-blinded (for Treatment R) manner: Treatment T (Albuterol-HFA, N=200): 216 mcg albuterol sulfate (equivalent to 180 mcg albuterol base), QID; Treatment R (Proventil-HFA, N=50): 216 mcg albuterol sulfate (equivalent to 180 mcg albuterol base), QID; Treatment P (Placebo-HFA, N=50): two actuations of placebo, QID.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
300
180 mcg QID 12 weeks
180 mcg QID 12 weeks
2 actuations QID 12 weeks or until use of rescue drug
Pulmonary Associates of Mobile, PC
Mobile, Alabama, United States
Allergy & Asthma Specialists Medical Group
Huntington Beach, California, United States
Allergy Asthma & Respiratory Care Medical Center
Long Beach, California, United States
Allergy & Asthma Care Center
Long Beach, California, United States
Southern California Research
Mission Viejo, California, United States
The primary endpoint is the bronchodilator effect expressed as the mean area under the curve (AUC) of FEV1 (% change from Same-Day Baseline FEV1) versus time.
Time frame: Concurent with each visit
The comparative analysis of AUC of FEV1 (% change from the Same-Day Baseline) versus time, for bronchodilator effect (between Albuterol-HFA and Proventil-HFA).
Time frame: End of Study
AUC of FEV1-time curve (changes of actual volumes from the Same-Day Baseline).
Time frame: End of Study
Time to onset of bronchodilator effect, determined by linear interpolation as the time point where FEV1 first reaches 12% over Same-Day Baseline.
Time frame: End of Study
The peak bronchodilator response, defined as the maximum FEV1 (% change from Same-Day Baseline) post-dose.
Time frame: end of study
The time to peak FEV1 effect, measured as the time point of peak response, as defined (4) above.
Time frame: End of Study
Duration of bronchodilator effect, defined as the total length of time when FEV1 is maintained 12% above the respective Same-Day Baseline values (time points calculated with linear interpolation).
Time frame: Concurrent with each visit
Percentage of positive responders including those whose FEV1 exceed the Same-Day Baseline by 12% within 30 minutes post-dose (quick responders), and during the entire 6 hr post-dose (overall responders).
Time frame: Concurrent with visit
Number of inhalations of the rescue inhalers taken.
Time frame: Concurrent with each visit
Global assessment of Overall Asthma Control Scores by investigators.
Time frame: End of Study
Total daytime asthma symptom scores.
Time frame: End of Study
Nighttime sleep disturbance scores.
Time frame: End of Study
Morning pre-dose Peak Expiratory Flow Rate (PEF).
Time frame: Concurrent with each visit
The clinical performances of the Albuterol-HFA MDI at the representative first, middle and last one third of the usable life stage, are compared with each other, and are also compared to those of the active control, Proventil-HFA.
Time frame: End of Study
The in vitro performance of the Albuterol-HFA MDI will be evaluated.
Time frame: Concurrent with each visit
Vital signs (SBP/DBP, and heart rate) will be monitored at Clinical Visit 1, 3 and 5, at baseline (within 30 minutes prior to dosing), and 90+/-15 min, and 360+/-30 min, post-dose.
Time frame: concurrent with study visits as noted
A 12-lead ECG (for HR, QT and QTc intervals) will be recorded at Screening Visit, and at baseline (within 30 min) pre-dose and at 90+/-15 min post-dose (predicted time of peak effect).
Time frame: Clinical Visits 1 and 5
Data for CBC, blood chemistry panel (8-hr fasted), and urinalysis.
Time frame: Screening and end-of-study
Study compliance and diaries will be reviewed
Time frame: at all cliniical visits
Concomitant medications will be reviewed and recorded
Time frame: each study visit
Adverse events/side effects whether observed by investigators or reported by subjects, will be documented, evaluated, followed up, and treated if deemed necessary.
Time frame: concurrent with each study visit
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CHOC PSF, AMC, Divison AA and I
Orange, California, United States
Clinical Trials of Orange County
Orange, California, United States
Peninsula Research Associates
Rolling Hills Estates, California, United States
Allergy Associates Medical Group
San Diego, California, United States
Allergy & Asthma Associates of Santa Clara Valley Research Centere
San Jose, California, United States
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