The primary objective of this study was to compare the long-term (12-week) bronchodilator efficacy and safety of ipratropium bromide / salbutamol combination administered by the Respimat® 40 mcg / 200 mcg (one inhalation q.i.d.) to COMBIVENT Inhalation Aerosol (two inhalations q.i.d.), ipratropium bromide Respimat® (one inhalation q.i.d.) and Placebo formulations of each in patients with Chronic Obstructive Pulmonary Disease (COPD). An additional objective was to show the superiority of Combivent Respimat as compared to ipratropium bromide (40 mcg) Respimat. Steady state pharmacokinetics over one dosing interval following four weeks of therapy were also characterized.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
1,118
FEV1 TAUC0-6 (Total area under the FEV1 (forced expiratory volume in one second) curve from 0 to 6 hours divided by six)
Time frame: Day 85
FEV1 TAUC0-6
Time frame: Days 1, 29 and 57
FEV1 TAUC0-8
Time frame: Days 1, 29, 57 and 85
Peak FEV1 post treatment over two hours
Time frame: Days 1, 29, 57 and 85
Change from baseline in Peak FEV1 response
Time frame: Days 1, 29, 57 and 85
Area under the FEV1 curve from 0 to 6 hours above test-day baseline divided by six for normalization (AUC0-6)
Time frame: Days 1, 29, 57 and 85
Onset of therapeutic FEV1 response
Time frame: Days 1, 29, 57 and 85
Duration of therapeutic FEV1 response
Time frame: Days 1, 29, 57 and 85
Time to peak FEV1 response
Time frame: Days 1, 29, 57 and 85
TAUC0-6, TAUC0-8 and peak FVC (Forced vital capacity)
Time frame: Days 1, 29, 57 and 85
Amount of beta agonist therapy used as rescue medication during the treatment period
Time frame: up to day 85
Number of patients using concomitant medication including corticosteroids during the treatment period
Time frame: up to day 85
Weekly means of daily symptom scores over the treatment period
Time frame: up to day 85
Number of patients with at least one COPD exacerbation
Time frame: up to day 85
Number of COPD exacerbations during the treatment period
Time frame: up to day 85
Physician's Global Evaluation
Time frame: Days 1, 29, 57 and 85
Trough PEFR (peak expiratory flow rate) measured by the patient at home once daily
Time frame: up to day 85
Number of patients with adverse events
Time frame: up to day 85
Incidence of paradoxical bronchoconstriction on the test day
Time frame: up to day 85
Number of COPD exacerbation days
Time frame: up to day 85
Number of patients with clinically significant changes in vital signs
Time frame: Baseline, days 1, 29, 57 and 85
Number of patients with abnormal changes in laboratory parameters
Time frame: Days 29 and 85
Number of patients with abnormal changes in 12-lead electrocardiogram (ECG) parameters
Time frame: pre-treatment and 1 hour post-treatment on days 1, 29 and 85
Plasma ipratropium and salbutamol concentrations
Time frame: pre-treatment, 5, 15, 30 and 60 minutes and 2, 4 and 8 hours after inhalation of test drug on day 29
Renal excretion amounts of ipratropium and salbutamol
Time frame: 0-2 hours, 2-8 hours at day 29
Length of COPD exacerbations during the treatment period
Time frame: up to day 85
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