The study investigates the effect of 3 days of twice daily treatment of two different doses of RPL554 (a phosphodiesterase \[PDE\]3/4 inhibitor) or placebo, each administered in addition to once daily tiotropium/olodaterol (Respimat) in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Patients will receive each of the three treatment combinations in a randomized sequence using a crossover design
RPL554 is a dual inhibitor of phosphodiesterase 3 (PDE3) and phosphodiesterase 4 (PDE4) which are known to have a role in modulating the inflammatory airway response in respiratory diseases, including COPD. PDE3 inhibitors act as bronchodilators whilst PDE4 inhibitors have anti-inflammatory properties and there is also evidence to suggest that combined inhibition of PDE3 and PDE4 can have additive or synergistic anti-inflammatory and bronchodilator. The two doses of RPL554 (1.5 mg and 6 mg)have been selected based on the results from prior studies investigating single and multiple ascending doses in healthy subjects, single doses in asthmatics, single/multiple ascending doses in COPD patients, and 3 days of dosing in COPD patients. These doses were demonstrated to be both effective as a bronchodilator and well tolerated. The purpose of the study is to investigate if RPL554 has an additive bronchodilator effect when administered in combination with a commonly used anticholinergic/β-agonist combination medication, tiotropium/olodaterol (Respimat), in this patient population measured by the peak forced expiratory volume in one second (FEV1), and forced vital capacity (FVC).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
79
Clinical Site Partners, LLC
Winter Park, Florida, United States
Allied Biomedical Research Holdings, d/b/a Vitalink Research
Greenville, South Carolina, United States
Respiratory Clinical Trials LTD,
London, United Kingdom
Medicines Evaluation Unit
Manchester, United Kingdom
Change From Baseline in Peak FEV1 on Day 3
Change from baseline FEV1 to peak FEV1 (measured as the greatest value in the 4 hours post-dose after the morning dose) on Day 3
Time frame: Change from pre-dose at 5, 15 and 30 minutes and 1, 1.5, 2 & 4 hours on Day 3
Change From Baseline to Trough FEV1 on Day 4
Change from baseline to morning trough FEV1 on Day 4
Time frame: Change from pre-dose on Day 1 to pre-dose on Day 4
Change From Baseline in AUC0-4h FEV1 on Day 3
Change from baseline FEV1 to AUC FEV1 over 4 hours post-dose after the morning dose on Day 3. The endpoint is measured as AUC/interval length (average) and measured in liters. (Note: Endpoint is AUC/interval length (average) so the units are in liters.)
Time frame: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4 hours on Day 3 (after the morning dose)
Change From Baseline in AUC0-12h FEV1 on Day 3
Change from baseline in AUC over 12 hours post-dose after the morning dose on Day 3. The endpoint is measured as AUC/interval length (average) and measured in liters (Note: Endpoint is AUC/interval length (average) so the units are in liters.)
Time frame: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4, 6, 8, 12 hours on Day 3 (after the morning dose)
Change From Baseline in Peak FEV1 on Day 1
Change from baseline FEV1 to peak FEV1 in the 4 hours post-dose after the morning dose on Day 1
Time frame: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4 hours on Day 1 (after the morning dose), with the maximum change reported
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Change From Baseline in Peak FEV1 After Evening Dose on Day 3
Change from baseline FEV1 to peak FEV1 in the 4 hours post-dose after the evening dose on Day 3
Time frame: Change from pre-dose to each of the ollowing timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4 hours on Day 3 (after the evening dose), with the maximum change reported
Change From Baseline in AUC0-12h FEV1 on Day 1
Change from baseline FEV1 to AUC FEV1 over 12 hours post-dose after the morning dose on Day 1. The endpoint is measured as AUC/interval length (average) and measured in liters (Note: Endpoint is AUC/interval length (average) so the units are in liters.)
Time frame: Change from pre-dose to each of the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2, 4, 6, 8, 12 hours on Day 1 (after the morning dose)
Determination of Onset of Action on Day 1
Time to \>10% increase in FEV1 from pre-first dose, censored at 2 hours
Time frame: Change from pre-dose to the following timepoints: 5, 15 and 30 minutes and 1, 1.5, 2 hours on Day 1 (after the morning dose)
Residual Volume on Day 1
Change in residual volume during treatment
Time frame: Change from pre-dose to 1.25 hours on Day 1 (after the morning dose)
Residual Volume on Day 3
Change in residual volume during treatment
Time frame: Change from pre-dose on Day 1 to the following timepoints: pre-dose, 1.25, 8.25 and 12.25 hours on Day 3 (after the morning dose)
Functional Residual Capacity on Day 1
Change in functional residual capacity during treatment
Time frame: Change from pre-dose to 1.25 hours on Day 1 (after the morning dose)
Functional Residual Capacity on Day 3
Change in functional residual capacity during treatment
Time frame: Change from pre-dose on Day 1 to the following timepoints: pre-dose, 1.25, 8.25 and 12.25 hours on Day 3 (after the morning dose)
Specific Airway Conductance on Day 1
Change in specific airway conductance during treatment
Time frame: Change from pre-dose to 1.25 hours on Day 1 (after the morning dose)
Specific Airway Conductance on Day 3
Change in specific airway conductance during treatment
Time frame: Change from pre-dose on Day 1 to the following timepoints: pre-dose, 1.25, 8.25 and 12.25 hours on Day 3 (after the morning dose)