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This is a randomised, placebo-controlled, double-blind 3-way crossover study in which PUR1800, or placebo is dosed daily for 14 consecutive days in adult subjects with stable COPD over three discrete TPs. Subjects will be randomised to one of the following 3 treatment sequences:
Sequence Period 1 Period 2 Period 3
Since this is the first study in humans in which the iSPERSE formulation is being administered, the 3 treatment sequences are designed in order to ensure that the lower dose of PUR1800 (250 μg) is administered prior to the administration of the higher dose of PUR1800 (500 μg).
The study design is as follows
Informed Consent: Before any study specific procedures are conducted or study requirements are expected of a patient, the patient must review and sign an IEC-approved informed consent form.
Screening: Subjects will be screened for eligibility to participate in the study within 28 days before randomisation (i.e. TP1, Day 1).
Treatment Periods:
Period 1: On Day 1 all subjects who are eligible for entry into the study will be randomised to 1 of 3 treatment sequences and receive either placebo or the lowest nominal dose of PUR1800 (PUR1800 250 μg) for 14 consecutive days.
Period 2: Following a washout period of at least 28 days after the completion of Period 1 dosing, subjects will receive a treatment other than what the subject received during Period 1 for 14 consecutive days.
Period 3: Following a washout period of at least 28 days after the completion of Period 2 dosing, subjects will receive the treatment that the subject had not received during Periods 1 or 2 (either placebo or PUR1800, 500 μg) for 14 consecutive days.
End of Study (EOS): Subjects will return to the study site 28 days after the last dose of the last TP (or in the event of early withdrawal after the last dose received, if possible) for an EOS visit. Unscheduled visits are permitted at the discretion of the investigator.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | The placebo designed for administration in the proposed clinical study consists of a dry powder composed of the same excipients as the active (sodium sulfate, mannitol and polysorbate 80), pre-metered into HPMC capsules at the same 5 mg powder fill weight as the active formulations. Subjects will receive 14 doses administered once daily in the morning. |
|
| PUR1800 250 μg | Active Comparator | The PUR1800 drug product intended for use in the proposed clinical study comprises bulk powder containing 5 wt% or 10 wt% RV1162 pre-metered into HPMC capsules for oral delivery via a passive DPI. The capsules contain 5 milligrams (mg) of the powder formulation, corresponding to 250 μg and 500 μg nominal dose strengths of RV1162. Subjects will receive 14 doses administered once daily in the morning. |
|
| PUR1800 500 μg | Active Comparator | The PUR1800 drug product intended for use in the proposed clinical study comprises bulk powder containing 5 wt% or 10 wt% RV1162 pre-metered into HPMC capsules for oral delivery via a passive DPI. The capsules contain 5 milligrams (mg) of the powder formulation, corresponding to 250 μg and 500 μg nominal dose strengths of RV1162. Subjects will receive 14 doses administered once daily in the morning. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo Comparator | Drug | The placebo designed for administration in the proposed clinical study consists of a dry powder composed of the same excipients as the active (sodium sulfate, mannitol and polysorbate 80), pre-metered into HPMC capsules at the same 5 mg powder fill weight as the active formulations. Subjects will receive 14 doses administered once daily in the morning. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of treatment-emergent adverse events adult patients with stable COPD. | Review of adverse events | Day 1 through Day 28 |
| Incidence of intraday FEV1 declines (from pre-dose to post-dose) of ≥10%, ≥15%, and ≥20% adult patients with stable COPD. | Review of spirometry data | Day 1 through Day 28 |
| Respiratory rate | Breaths per minute | Day 1 through Day 28 |
| Blood presuure | Systolic pressure over diastolic pressure | Day 1 through Day 28 |
| Heart rate | Beats per minute | Day 1 through Day 28 |
| Oxygen saturation | As a percentage | Day 1 through Day 28 |
| Medical history findings | Medical record review | Day 1 through Day 28 |
| Physical examination findings | Physician's notes | Day 1 through Day 28 |
| Clinical laboratory parameters |
| Measure | Description | Time Frame |
|---|---|---|
| AUC0-t | Derived from plasma PK samples taken | Day 1 through Day 14 |
| AUCinf inhaled PUR1800 in adult patients with stable COPD. | Derived from plasma PK samples taken |
| Measure | Description | Time Frame |
|---|---|---|
| Sputum RV1162 concentration | From sputum samples obtained from subject through sputum induction | at trough on Days 2, 7, 14, and at the baseline visits prior to TP2 and TP3 as well as the EOS visit after TP3. |
Inclusion Criteria:
Patients must meet all the following:
Male or female patients aged 40 to 75 years of age with a body mass index
≥ 17 and ≤ 35 kg/m2.
Female patients must be either of non-childbearing potential or if of childbearing potential use a highly effective birth control method (See Section 9.4.1).
Male patients with female partners of childbearing potential must be vasectomised with documented medical assessment of the surgical success or use highly effective contraception together with their female partner(s) (See Section 9.4.1).
Female patients must agree not to donate ova/oocytes during the study and for 30 days after the last dose of IMP.
Male patients must agree not to donate semen during the study and for 90 days after the last dose of IMP.
Confirmed diagnosis by a physician of COPD with symptoms compatible with COPD for at least 1 year prior to screening.
Severity of Disease: patients who conform to the current severity classification for GOLD Grade II/III disease in terms of post-bronchodilator spirometry at screening: Post-salbutamol FEV1/FVC ratio of < 0.70. Post-salbutamol FEV1 ≥ 40 % and ≤ 80 % of predicted normal values (based on the Global Lung Function Initiative [GLI-2012][1]).
Current or previous tobacco smoker with a smoking history of ≥ 10 pack years (1 pack year = 20 cigarettes smoked per day for 1 year or equivalent).
Vital signs recorded from automated blood pressure equipment within the following normal ranges: Blood pressure; systolic value of 90 mmHg to 160 mmHg, diastolic value of 60 mmHg to 90 mmHg and pulse rate ≥ 60 and
≤100 beats per minute at screening and prior to randomisation.
Able to provide written Informed Consent Form (ICF) prior to participation in any study-related activities, and to comply with the requirements of the study.
Able to perform technically acceptable spirometry at screening.
Able to produce a sputum sample of adequate quality at either the Screening or Baseline visit prior to randomisation.
Able to demonstrate the correct inhalation technique for use of the delivery device and to generate sufficient peak inspiratory flow (PIF) (at least 40 L/min) using the In-Check DIAL device at screening and prior to randomisation.
Exclusion Criteria:
Patients who meet any of the following are not eligible:
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| Name | Affiliation | Role |
|---|---|---|
| Dave Singh, Prof | The Medicines Evaluation Unit | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medicines Evaluation Unit Ltd. | Manchester | Wythenshawe | M23 9QZ | United Kingdom |
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| ID | Term |
|---|---|
| D029424 | Pulmonary Disease, Chronic Obstructive |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
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PUR1800, or placebo is dosed daily for 14 consecutive days in adult subjects with stable COPD over three discrete TPs. Subjects will be randomised to one of the following 3 treatment sequences: Sequence Period 1 Period 2 Period 3
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A computerised randomisation scheme will be created and shall be considered blinded. The randomisation is available only to the clinical research unit pharmacy staff that are preparing the drug who will not be involved in any other aspect of the study including administration of the drug. It will not be made available to the subjects, site(s) PI(s), or members of the staff responsible for the monitoring and evaluation of safety assessments. PUR1800 and placebo capsules will be of the same shape, size, and color to ensure that the blind is maintained. A subject's treatment assignment will only be unblinded when knowledge of the treatment is essential for the further clinical management of the subject on this study or may potentially impact the safety of subjects currently enrolled or subjects in subsequent enrollment.
|
| PUR1800 250 ug | Drug | The PUR1800 drug product intended for use in the proposed clinical study comprises bulk powder containing 5 wt% or 10 wt% RV1162 pre-metered into HPMC capsules for oral delivery via a passive DPI. The capsules contain 5 milligrams (mg) of the powder formulation, corresponding to a 250 μg nominal dose strength of RV1162. Subjects will receive 14 doses administered once daily in the morning. |
|
| PUR1800 500 ug | Drug | The PUR1800 drug product intended for use in the proposed clinical study comprises bulk powder containing 5 wt% or 10 wt% RV1162 pre-metered into HPMC capsules for oral delivery via a passive DPI. The capsules contain 5 milligrams (mg) of the powder formulation, corresponding to a 500 μg nominal dose strength of RV1162. Subjects will receive 14 doses administered once daily in the morning. |
|
Lab reports with any out of range results flagged
| Day 1 through Day 28 |
| 12-Lead ECG findings | ECG report and tracing | Day 1 through Day 28 |
| Occurrence of PEFR decline of ≥ 30% from the established baseline PEFR | Review of spirometry data | Day 1 through Day 28 |
| Occurrence of administration of more than 12 inhalations of salbutamol per day over two consecutive days | Review of concomitant medications administered | Day 1 through Day 28 |
| Day 1 through Day 14 |
| CL | Derived from plasma PK samples taken | Day 1 through Day 14 |
| Vss | Derived from plasma PK samples taken | Day 1 through Day 14 |
| t1/2 | Derived from plasma PK samples taken | Day 1 through Day 14 |
| Cmax | Derived from plasma PK samples taken | Day 1 through Day 14 |
| tmax | Derived from plasma PK samples taken | Day 1 through Day 14 |
| Accumulation factor | Derived from plasma PK samples taken | Day 1 through Day 14 |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |