Male and female subjects with mild to moderate asthma will be recruited to enroll in a 2-way crossover during which escalating doses of albuterol will be administered at 30 minute intervals on a single treatment day. Albuterol will be administered by the Halix albuterol unit dose disposable inhaler on one day and by Ventolin albuterol HFA MDI on the other day. Assignment to device for albuterol delivery will be by random allocation.
Study Design: This is a phase 2A, open label, cumulative dose, randomized 2-way crossover study designed to assess the safety, efficacy, pharmacodynamics, pharmacokinetics (PK), and extrapulmonary pharmacodynamics of cumulative doses of Halix™ albuterol 90mcg compared with cumulative doses of Ventolin HFA MDI. After completing all screening assessments and meeting all eligibility criteria \[including SABA-free screening forced expiratory volume in 1 second (FEV1) ≥50% to \<85% of that predicted for age, gender, height, and ethnicity\], enrolled subjects will withdraw from use of Ventolin MDI with substitution of Atrovent HFA as the only inhaled bronchodilator for at least 72 hours before each of 2 Treatment Days. On each Treatment Day study treatments will consist of single doses of study drug (albuterol) administered at 30-minute intervals as follows: Halix™ albuterol UDDI - 1 + 1 + 2 + 4 inhalations \[90 mcg per inhalation\] Ventolin albuterol MDI -- 2 + 2 + 4 + 8 inhalations \[90 mcg (1 puff) per inhalation\] The order in which each treatment will be administered to a subject will be based on randomization to one of 2 possible sequences. Equal numbers of subjects will be assigned to each sequence. The beginning of each Treatment Day will be separated by a washout period of at least 72 hours after the preceding Treatment Day; the washout period not to exceed 240 hours. After Treatment Day 2, subjects will be assessed at an End-of-Study (EOS) Visit which will occur 1 to 5 days after the last administration of study drug. Prior to each Treatment Day, the subject must not have used \>8 actuations of (non-study drug) rescue Ventolin MDI on each of 3 or more days during the previous 7 days and must not have used any non-study drug rescue Ventolin MDI during the 72 hours prior to the start of the Treatment Day. The Treatment Day will not proceed if either of these instances has occurred. Within the 75 minutes prior to the first study drug dose on each of the 2 Treatment Days, the following procedures will be performed: vital signs (BP and HR), ECG, collection of urine for pregnancy test if subject is a WOCBP, collection of blood for baseline glucose, potassium, and PK, and spirometry at 60 minutes and at 30 minutes prior to the anticipated time of first study drug dose. The average of the FEV1 at 60 minutes and 30 minutes prior to the first study drug dose on Treatment Day 1 must be ≥ 50% and \< 85% of percent predicted in order for the Treatment Day to proceed. On Treatment Day 2, the average of the FEV1 at 60 minutes and 30 minutes obtained predose must be ≥ 50% and \<85% of predicted in order for Treatment Day 2 to proceed. After the first study drug dose on Treatment Day 1 and on Treatment Day 2, and after each of the following two cumulative doses on each Treatment Day, subjects will undergo spirometry at 5 (+ 2) minutes and at 25 (+/- 2) minutes post-dose. Blood for glucose, potassium and PK sample will be collected at 15 (+/- 5) minutes after the first study drug dose and after each of the following two cumulative doses and vital signs and ECG will be performed at 15 (+/- 5) minutes after the first study drug dose and after each of the following two cumulative doses. Following the last cumulative study drug dose on each Treatment Day, blood for PK sample will be collected at 10, 20, 45, 120, 180, 240, 300, 360, 480, 600 and 720 minutes after the last dose. After the last cumulative dose, spirometry will be performed at 5 (+ 2) minutes and at 25 (+/- 2) minutes. ECG and vital signs will be performed at 15 (+/-5) minutes after the last cumulative dose. After the last cumulative dose, blood will be collected for glucose and potassium at 45 and 120 minutes. Vital signs (BP and HR) will be measured hourly after the last cumulative dose up to 360 minutes and at 480, 600, and 720 minutes after the last dose. The time of each study drug dose will be recorded as the time of the last inhalation of study drug for each individual cumulative dose administered when multiple inhalations are required to administer the dose. After Treatment Day 2, subjects will be assessed at an End-of-Study (EOS) that will occur 1 to 5 days after the day of the last administration of study drug.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
13
albuterol unit dose disposable DPI delivers 90 mcg of albuterol in the excipient lactose with each inhalation. Albuterol 90 mcg will be given on one of the treatment days in cumulative doses up to a total dose of 720 mcg
albuterol HFA MDI delivers 90 mcg of albuterol with each inhalation. Albuterol 90 mcg will be given on one of the treatment days in cumulative doses up to a total dose of 1440 mcg
North Carolina Clinical Research
Raleigh, North Carolina, United States
Analyses of baseline-adjusted FEV1 (liters) at 25 (+/- 2) minutes after each initial and cumulative dose of albuterol
Change from treatment day baseline in forced expiratory volume in one second (FEV1) (liters) will be assessed at 25 minutes after each cumulative dose of albuterol and serially up to 360 minutes after the last dose
Time frame: At each of the treatment visits, FEV1 will be measured prior to initial drug administration and at 25 minutes after each cumulative and hourly up to 6 hours after last dose
Analyses of baseline-adjusted FEV1 at 5 (+2) minutes after each initial and cumulative dose of albuterol
Change from treatment day baseline in forced expiratory volume in one second (FEV1) will be assessed at 5 minutes after each cumulative dose of albuterol and serially up to 360 minutes after the last dose of albuterol
Time frame: At each of the two treatment visits, FEV1 (forced expiratory volume in one second) will be measured prior to initial drug administration and at 5 minutes after each cumulative dose adminstered at 30 minute intervals and up to 6 hours after the last dose
Baseline-adjusted FEV1 AUC0-6 (liter-hour) after the last cumulative dose of albuterol
Area under the efficacy curve (AUC) for the period of 0 to 6 hours after the last dose of albuterol
Time frame: At each of the treatment visits, FEV1 will be measured hourly from after the last dose of albuterol until 6 hours post-dose
Comparison of the FEV1 at the lowest dose of albuterol and the highest cumulative dose of albuterol for each drug/device
Change from treatment day baseline in FEV1 will be assessed at 5 and 25 minutes after the first dose of albuterol and at 5 and 25 minutes after the last dose of albuterol to assess the dose-response for each drug/device evaluated
Time frame: At each of the treatment visits, FEV1 (liters) will be measured prior to the first dose of albuterol and at 5 and 25 minutes after each dose of albuterol
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Systolic and diastolic blood pressure (mmHg) before and after each dose of albuterol
Change from treatment day baseline in sytolic and diastolic blood pressure (mmHg) will be evaluated by the maximum change in mmHg (systolic and diastolic) and minimum change in mmHg (systolic and diastolic) from baseline blood pressures, and the weighted mean change (in mmHg) from baseline in systolic and diastolic blood pressure
Time frame: Serial measurements of systolic and diastolic blood pressure in mmHg will be taken at baseline on each treatment day, at 15 minutes after each dose of albuterol, and at each hour post-dose for 6 hours after the last dose of albuterol
Heart rate (beats per minute) before and after each dose of albuterol
Change from treatment day baseline in heart rate (beats per minute) will be evaluated by the maximum change in beats per minute and minimum change in beats per minuet from baseline heart rate, and the weighted mean change in beats per minute from baseline in heart rate
Time frame: Serial measurements of heart rate (beats per minute) will be taken at baseline on each treatment day, at 15 minutes after each dose of albuterol, and at each hour for 6 hours after the last dose of albuterol
Serum potassium and glucose before and after each dose of albuterol
Change from baseline serum potassium (mg/dL) and glucose (mg/dL) will be evaluated by the description of changes in mg/dL from baseline values
Time frame: Serial measurments of serum potassium (mg/dL) and glucose (mg/dL) will be obtained pre-dose and at at 10-20 minutes after each dose of albuterol up to and including 2 hours after the last dose of albuterol
Electrocardiographic QTc interval (milliseconds) before and after inhalation of initial and cumulative doses of albuterol
Change from treatment day baseline ECG (electrocardiogram) will assess the maximum and mean change from baseline of the corrected QT interval in milliseconds (QT measures the time between the start of the Q wave and the end of the T wave in the heart's electrical cycle) following each of the doses of albuterol
Time frame: Serial ECGs (electrocardiograms) will be obtained before the first albuterol dose on each treatment day, at 15 minutes after each albuterol dose, and at hourly intervals up to 6 hours after the last albuterol dose
Assessment of adverse events following administration of albuterol
Incidence, type, and severity of adverse events reported after each of two cumulative dose regimens of albuterol
Time frame: At each of the treatment visits, spontaneously reported adverse events will be assessed continually during the time subject is in clinic up to approximately 15 hours after first dose of albuterol