Comparing Treatment Efficacy With HD/MD Flu Plus Sal in Chronic Obstructive Pulmonary Disease (COPD) Patients

NCT ID: NCT01131806

Last Updated: 2010-07-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

124 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-12-31

Study Completion Date

2011-04-30

Brief Summary

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Chronic obstructive pulmonary disease is characterized as inflammatory airway with not fully reversible airflow limitation.Combination treatment with inhaled corticosteroid (ICS) and long-acting β2 agonists (LABA)attains an improved control of symptoms and lung function, that are superior to those associated with either drug alone. However, the treatment efficacy between high and medium dose of inhaled corticosteroid in combination of LABA is still unknown. The aim of the current study is to investigate the treatment efficacy with high and medium dose of fluticasone in combination with salmeterol in COPD patients.

Detailed Description

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Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and the use of health care resources worldwide. It is characterized by chronic progressive symptoms, airflow obstruction, and impaired health status, which is worse in those who have frequent, acute episodes of symptom exacerbation. Treatment for COPD is focused on minimizing risk factors, improving symptoms, and preventing exacerbations.

Pulmonary inflammation is the key factor in COPD. Inhaled long-acting β2 agonists (LABA) improve airflow obstruction, control of symptoms, and health status in patients with COPD over 3 to 4 months. Inhaled corticosteroids (ICS) are currently the most popular anti-inflammatory medications for use in symptomatic patients with COPD. Previous large scaled randomized control study discovered long-term use of ICS didn't modified annual decline of lung function in COPD patients, but may reduce the frequency of exacerbations, especially when combined with an LABA.

Combination treatment with ICS and LABA has been widely used for patients with COPD and attains an improved control of symptoms and lung function, with no greater risk of side-effects than that of treatment with either component alone. Combined ICS/LABA will result in better treatment effects that are superior to those associated with either drug alone. However, the treatment efficacy between high and medium dose of inhaled corticosteroid in combination of LABA is still unknown. The aim of the current study is to investigate the treatment efficacy with high and medium dose of fluticasone in combination with salmeterol in COPD patients.

Conditions

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Chronic Obstructive Pulmonary Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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MD Flu/Sal

fluticasone125 mcg/ salmeterol 25 mcg 2puffs (medium dose group) inhaled twice daily; salbutamol evohaler allowed from 100 to 400 mcg for inhalation as needed basis.

Group Type ACTIVE_COMPARATOR

fluticasone/ salmeterol 125/25 mcg/puff

Intervention Type DRUG

fluticasone 125mcg/salmeterol 25mcg 2puffs/day x 52 weeks

HD Flu/Sal

fluticasone 250 mcg/salmeterol 25 mcg 2puffs (high dose group) inhaled twice daily; salbutamol evohaler allowed from 100 to 400 mcg for inhalation as needed basis.

Group Type EXPERIMENTAL

fluticasone/ salmeterol 250/25 mcg/puff

Intervention Type DRUG

fluticasone 250mcg/salmeterol 25mcg 2puffs/day x 52 weeks

Interventions

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fluticasone/ salmeterol 125/25 mcg/puff

fluticasone 125mcg/salmeterol 25mcg 2puffs/day x 52 weeks

Intervention Type DRUG

fluticasone/ salmeterol 250/25 mcg/puff

fluticasone 250mcg/salmeterol 25mcg 2puffs/day x 52 weeks

Intervention Type DRUG

Other Intervention Names

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Seretide evohaler 125(GlaxoSmithKline) Seretide evohaler 250(GlaxoSmithKline)

Eligibility Criteria

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Inclusion Criteria

* Male or female outpatients aged ≧ 40 years.
* Current or ex-smoker, with smoking history ≧ 10 pack- years
* COPD (FEV1/FVC \< 70%) patients with post-bronchodilator FEV1 ≦ 70% predicted value, without bronchial reversibility (≦10% increase post bronchodilator).

Exclusion Criteria

* Diagnosis or suspicion of sleep apnea
* Concurrent rhinitis, eczema, and asthma
* Clinically overt bronchiectasis, lung cancer, active tuberculosis, or other known specific pulmonary disease
* A chest X-ray indicating diagnosis other than COPD that might interfere with the study.
* Major disease abnormalities are uncontrolled on therapy.
* Alcohol or medication abuse.
* Patients had lower respiratory tract infections or received systemic steroid in the 4 weeks prior to the commencement of study.
* Unable or unwilling to comply with all protocol specified procedures.
Minimum Eligible Age

40 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role collaborator

Far Eastern Memorial Hospital

OTHER

Sponsor Role collaborator

Taipei Veterans General Hospital, Taiwan

OTHER_GOV

Sponsor Role lead

Responsible Party

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Veterans General Hospital-TAIPEI, Department of Chest

Principal Investigators

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Diahn-Warng Perng, PhD

Role: PRINCIPAL_INVESTIGATOR

Taipei Veterans General Hospital, Taiwan

Locations

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Chest department, Veteran General Hospital-TAIPEI

Taipei, Taiwan, Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Diahn-Warng Perng, PhD

Role: CONTACT

+886-2-28712121 ext. 3194

Kang-Cheng Su, MD

Role: CONTACT

+886-2-28712121 ext. 8928

Facility Contacts

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Diahn-Warng Perng, PhD

Role: primary

+886-2-28712121 ext. 3194

Kang-Cheng Su, MD

Role: backup

+886-2-28712121 ext. 8928

References

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Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, Yates JC, Vestbo J; TORCH investigators. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007 Feb 22;356(8):775-89. doi: 10.1056/NEJMoa063070.

Reference Type BACKGROUND
PMID: 17314337 (View on PubMed)

Keating GM, McCormack PL. Salmeterol/fluticasone propionate: a review of its use in the treatment of chronic obstructive pulmonary disease. Drugs. 2007;67(16):2383-405. doi: 10.2165/00003495-200767160-00006.

Reference Type BACKGROUND
PMID: 17983257 (View on PubMed)

Hanania NA, Darken P, Horstman D, Reisner C, Lee B, Davis S, Shah T. The efficacy and safety of fluticasone propionate (250 microg)/salmeterol (50 microg) combined in the Diskus inhaler for the treatment of COPD. Chest. 2003 Sep;124(3):834-43. doi: 10.1378/chest.124.3.834.

Reference Type BACKGROUND
PMID: 12970006 (View on PubMed)

Szafranski W, Cukier A, Ramirez A, Menga G, Sansores R, Nahabedian S, Peterson S, Olsson H. Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease. Eur Respir J. 2003 Jan;21(1):74-81. doi: 10.1183/09031936.03.00031402.

Reference Type BACKGROUND
PMID: 12570112 (View on PubMed)

Other Identifiers

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CM981016

Identifier Type: OTHER

Identifier Source: secondary_id

VGHIRB No. 98-10-16

Identifier Type: -

Identifier Source: org_study_id

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