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It was decided that data from this study are no longer required and therefore it is not necessary to expose patients to the study medication
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The Fluticasone Propionate/Salmeterol combination (FSC) at a dose of 100/50 micrograms (mcg) twice daily in DISKUS inhaler (also known as ACCUHALER®, Ddpi) inhaler is a recognised and licensed therapy for the treatment of asthma. GlaxoSmithKline (GSK) is developing the ROTAHALER/ ROTACAPS® (Rdpi) inhaler as an alternative treatment option for asthmatic patients. This study is a Phase I, randomised, double-blind, double-dummy, two- treatment, four-way cross-over (replicate design), two sequence, repeat dose, two centre study in mild to moderate asthmatics to compare the pharmacokinetics and pharmacodynamics of fluticasone proprionate/salmeterol (100/50 mcg) delivered via the Rdpi versus the Ddpi. A total of 58 subjects will be enrolled to ensure 52 subjects complete all dosing occasions. Each subject will be allocated to one of two treatment sequences and will participate in four treatment periods, receiving each of the treatments twice.
DISKUS, ACCUHALER, ROTAHALER and ROTACAPS are registered trademarks of GSK groups of companies.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sequence 1 | Experimental | Subjects will receive FSC 100/50 mcg delivered via the Ddpi (Treatment A) and FSC 100/50 mcg delivered via the Rdpi (Treatment B) in the sequence of A-B-B-A in four treatment periods of 10 days each. Subjects will receive both active treatment and matching placebo at the same time from two separate devices twice daily. There will be no wash-out between treatment periods |
|
| Sequence 2 | Experimental | Subjects will receive FSC 100/50 mcg delivered via the Ddpi (Treatment A) and FSC 100/50 mcg delivered via the Rdpi (Treatment B) in the sequence of B-A-A-B in four treatment periods of 10 days each. Subjects will receive both active treatment and matching placebo at the same time from two separate devices twice daily. There will be no wash-out between treatment periods |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fluticasone Propionate/Salmeterol Xinafoate DISKUS | Drug | A blister strip contained within the DISKUS inhaler. Each blister contains a small quantity of powder comprising of a blend of fluticasone propionate (micronized)(100 mcg), salmeterol xinafoate (micronized) (50 mcg) and excipient(s). One blister to be administered twice daily via DISKUS inhaler |
| Measure | Description | Time Frame |
|---|---|---|
| Fluticasone propionate (FP) area under the concentration-time curve over the dosing interval (AUCtau) | FP AUCtau will be determined from the plasma FP concentration-time data | Day 10 of each treatment period (pre-morning dose and at 5, 10, 30 minutes and 1, 2, 4, 8, 10 and 12 hours post- morning dose) |
| Salmeterol maximum observed concentration (Cmax) | Salmeterol Cmax will be determined from the plasma salmeterol concentration-time data | Day 10 of each treatment period (pre-morning dose and at 5, 10, 30 minutes and 1, 2, 4, 8, 10 and 12 hours post- morning dose) |
| Measure | Description | Time Frame |
|---|---|---|
| Salmeterol AUCtau | Salmeterol AUCtau will be determined from the plasma FP concentration-time data | Day 10 of each treatment period (pre-morning dose and at 5, 10, 30 minutes and 1, 2, 4, 8, 10 and 12 hours post- morning dose) |
| FP Cmax |
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Inclusion Criteria:
Subjects with a known physician diagnosis of asthma with a best Forced Expiratory Volume in 1 Second (FEV1) of >70% of the predicted normal value at the Screening visit. Percent predicted will be calculated using the European Respiratory Society Global Lung Function Initiative reference equations. Subjects must abstain from short acting beta-2 agonists (SABA) use for 6 hours prior to the Screening visit.
During the screening visit, subjects must either demonstrate the presence of reversible airway disease, defined as an increase in FEV1 of >=12.0% over baseline and an absolute change of >=200 millilitres (mL) within 60 minutes following 4 inhalations of albuterol/salbutamol inhalation aerosol (or equivalent nebulized treatment with albuterol/salbutamol solution) or in the absence of reversibility have documented evidence of a physician diagnosed asthma for at least 6 months
Male/females aged between 18 and 65 years of age inclusive, at the time of signing the informed consent.
Body weight >= 50 kilograms (kg) and body mass index (BMI) within the range 18 - 35.0 kilogram/square meter (kg/m^2) (inclusive).
A female subject is eligible to participate if she is of: Non-childbearing potential defined as pre-menopausal females with a documented tubal ligation or hysterectomy for this definition, "documented" refers to the outcome of the investigator's/designee's review of the subject's medical history for study eligibility, as obtained via a verbal interview with the subject or from the subject's medical records; or postmenopausal defined as 12 months of spontaneous amenorrhea. In questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) >40 milliinternational units per/millilitre (MIU/mL) and estradiol <40 picogram/millilitre (pg/mL) (<147 picomoles per liter [pmol/L]) is confirmatory. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the contraception methods, if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment. For most forms of HRT, at least 2-4 weeks will elapse between the cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method.; Child-bearing potential with negative pregnancy test as determined by serum or human chorionic gonadotropin (hCG) test at screening or urine hCG test prior to dosing AND ; Agrees to use one of the contraception methods for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until the follow-up visit.; OR has only same-sex partners, when this is her preferred and usual lifestyle.
Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form
Subjects who are current non-smokers and who have a pack history of <=10 pack years. A subject may not have used inhaled tobacco products within the past 3 months (i.e., cigarettes, cigars or pipe tobacco). [number of pack years = (number of cigarettes per day / 20) x number of years smoked].
Alanine transaminase (ALT), alkaline phosphatase and bilirubin <= 1.5x Upper limit of normal (ULN) (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%).
Based on single or averaged corrected QT interval (QTc) values of triplicate electrocardiogram (ECGs) obtained over a brief recording period: QT duration corrected for heart rate by Fridericia's formula (QTcF) <450 milliseconds (msec); or QTcF <480 msec in subjects with Bundle Branch Block.
Asthma therapy: Subjects must have been on their current therapy for at least eight weeks and a stable dose for four weeks prior to the screening visit:
Exclusion Criteria:
Criteria Based Upon Medical Histories
Criteria Based Upon Diagnostic Assessments
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| Name | Affiliation | Role |
|---|---|---|
| GSK Clinical Trials | GlaxoSmithKline | Study Director |
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|
| Placebo to Match DISKUS | Drug | A blister strip contained within the DISKUS inhaler. Each blister contains a small quantity of lactose and powder comprising of excipient(s). One blister to be administered twice daily via DISKUS inhaler |
|
| Fluticasone Propionate/Salmeterol Xinafoate ROTACAPS | Drug | A capsule containing a small quantity of powder comprising of a blend of fluticasone propionate (micronized) (100 mcg), salmeterol xinafoate (micronized) (50 mcg) and excipient(s). One capsule to be administered twice daily via ROTAHALER inhaler |
|
| Placebo to Match ROTACAPS | Drug | A capsule containing a small quantity of lactose and powder comprising of excipient(s). One capsule to be administered twice daily via ROTAHALER inhaler |
|
FP Cmax will be determined from the plasma FP concentration-time data
| Day 10 of each treatment period (pre-morning dose and at 5, 10, 30 minutes and 1, 2, 4, 8, 10 and 12 hours post- morning dose) |
| FP and salmeterol time to Cmax (Tmax) | FP and salmeterol Tmax will be determined from the plasma FP concentration-time data | Day 10 of each treatment period (pre-morning dose and at 5, 10, 30 minutes and 1, 2, 4, 8, 10 and 12 hours post- morning dose) |
| Weighted mean serum cortisol over 12 hours on the last day of each treatment period (Day 10) | Blood sampling for measurement of serum cortisol will be performed on the last day of each treatment period (Day 10) at pre-morning dose and at 30 min, 1,2,4,8,10 and 12 hours post- morning dose. Weighted mean concentration from 0 to 12 hours will be derived from the serum cortisol concentration data | Day 10 of each treatment period |
| Serum cortisol minimum observed concentration (Cmin) | Blood sampling for measurement of serum cortisol will be performed on the last day of each treatment period (Day 10) at pre-morning dose and at 30 min, 1,2,4,8,10 and 12 hours post- morning dose. Cmin will be derived from the serum cortisol concentration data | Day 10 of each treatment period |
| Heart rate (HR) measurements | Up to 10 weeks |
| Blood pressure (BP) measurements | Systolic and diastolic blood pressure will be measured | Up to 10 weeks |
| Potassium and Glucose measurements | Blood sampling for measurement of potassium and glucose will be performed on Day 1 Treatment Period 1 (pre-dose) and on Day 10 of each treatment period (pre-morning dose and at 30, 60 minutes, 2 and 4 hours post the morning dose) | Up to 10 weeks |
| Number of subjects with adverse events | An adverse event is any untoward medical occurrence in a subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product | Up to 12 weeks |
| Clinical laboratory safety assessments | Haematology, clinical chemistry, and urinalysis parameters | Up to 12 weeks |
| ID | Term |
|---|---|
| D001249 | Asthma |
| ID | Term |
|---|---|
| D001982 | Bronchial Diseases |
| D012140 | Respiratory Tract Diseases |
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012130 | Respiratory Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D000068298 | Fluticasone |
| ID | Term |
|---|---|
| D000730 | Androstadienes |
| D000736 | Androstenes |
| D000731 | Androstanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
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