A Clinical Study to Evaluate the Effect of the Connected Inhaler System (CIS) on Adherence to Maintenance Therapy in Poorly Controlled Asthmatic Subjects

NCT ID: NCT03380429

Last Updated: 2021-04-12

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

437 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-31

Study Completion Date

2019-01-24

Brief Summary

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GlaxoSmithKline (GSK) in collaboration with Propeller Health has developed a sensor, which can clip on to the ELLIPTA® dry powder inhaler (DPI) and monitor the time and date that the ELLIPTA DPI cover is fully opened and closed. Additionally, a sensor will be attached to the rescue medication metered dose inhaler (MDI). The data from both sensors will be fed back to the subject via an application (app) on smart phone and will be reviewed by the subject's health care professional (HCP) via an online dashboard. The sensors, app, dashboard and systems to provide data comprise the CIS. This study will be the first to evaluate the effect of CIS on adherence to maintenance therapy in subjects with uncontrolled asthma. This is an open-label, randomized, parallel group study in asthmatic subjects currently on a fixed dose inhaled corticosteroid (ICS)/long-acting beta 2 agonist (LABA) maintenance therapy. Eligible subjects will receive RELVAR®/BREO® maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers during the run-in period, which may last for up to 3 months. Eligible subjects will then be randomized into five treatment arms depending on whether the data, from RELVAR/BREO ELLIPTA or RELVAR/BREO ELLIPTA and salbutamol MDI, is fed back to the subject or subject and HCP, or not at all. The treatment period for the study is approximately 6 months and there will be a follow-up period one week post last visit. The total duration of a subject in the study will be approximately 9 months. RELVAR, BREO and ELLIPTA are registered trademarks of GlaxoSmithKline group of companies.

Detailed Description

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Conditions

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Asthma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI. Clip-on sensors will be attached to both inhalers which will provide data on maintenance therapy and rescue medication use to the subjects and their HCP. Subjects will be randomized into five treatment arms in a ratio of 1:1:1:1:1 depending on whether the data, from RELVAR/BREO ELLIPTA or RELVAR/BREO ELLIPTA and salbutamol MDI, is fed back to the subject or subject and HCP, or not at all.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Data on Maintenance use supplied to Subject and HCP

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers. Information from sensor attached to RELVAR/BREO ELLIPTA will be fed back to the subject via an app on smart phone and to the subject's HCP via an online dashboard.

Group Type EXPERIMENTAL

RELVAR/BREO

Intervention Type DRUG

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

Salbutamol

Intervention Type DRUG

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Smart phone app

Intervention Type DEVICE

Subjects will be required to download an app associated with sensor on their smartphone. The sensors attached to the inhalers will be connected to the smartphone via Bluetooth.

HCP Dashboard

Intervention Type DEVICE

The information from sensors will be reviewed by the HCP via an online dashboard.

Sensors

Intervention Type DEVICE

Clip-on sensors will be fitted to electronically record the actuation data.

Data on Maintenance use supplied to Subject

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers. Information from sensor attached to RELVAR/BREO ELLIPTA will be fed back to the subject via an app on smart phone.

Group Type EXPERIMENTAL

RELVAR/BREO

Intervention Type DRUG

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

Salbutamol

Intervention Type DRUG

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Smart phone app

Intervention Type DEVICE

Subjects will be required to download an app associated with sensor on their smartphone. The sensors attached to the inhalers will be connected to the smartphone via Bluetooth.

Sensors

Intervention Type DEVICE

Clip-on sensors will be fitted to electronically record the actuation data.

Data on Maintenance and Rescue use supplied to Subject and HCP

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers. Information from sensors attached to RELVAR/BREO ELLIPTA and salbutamol MDI will be fed back to both subject and HCP. The data will be fed back to the subject through an app and to HCP through an online dashboard.

Group Type EXPERIMENTAL

RELVAR/BREO

Intervention Type DRUG

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

Salbutamol

Intervention Type DRUG

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Smart phone app

Intervention Type DEVICE

Subjects will be required to download an app associated with sensor on their smartphone. The sensors attached to the inhalers will be connected to the smartphone via Bluetooth.

HCP Dashboard

Intervention Type DEVICE

The information from sensors will be reviewed by the HCP via an online dashboard.

Sensors

Intervention Type DEVICE

Clip-on sensors will be fitted to electronically record the actuation data.

Data on Maintenance and Rescue use supplied to Subject

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers. Information from sensors attached to RELVAR/BREO ELLIPTA and salbutamol MDI will be fed back to subject through an app.

Group Type EXPERIMENTAL

RELVAR/BREO

Intervention Type DRUG

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

Salbutamol

Intervention Type DRUG

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Smart phone app

Intervention Type DEVICE

Subjects will be required to download an app associated with sensor on their smartphone. The sensors attached to the inhalers will be connected to the smartphone via Bluetooth.

Sensors

Intervention Type DEVICE

Clip-on sensors will be fitted to electronically record the actuation data.

No data supplied to Subject or HCP

Eligible subjects will receive RELVAR/BREO maintenance therapy via ELLIPTA DPI and salbutamol rescue medication via MDI with sensors attached to both inhalers. Subjects will be provided with a home hub through which their data will be uploaded during the study but the subjects and their HCP will not be able to view the data.

Group Type ACTIVE_COMPARATOR

RELVAR/BREO

Intervention Type DRUG

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

Salbutamol

Intervention Type DRUG

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Sensors

Intervention Type DEVICE

Clip-on sensors will be fitted to electronically record the actuation data.

Interventions

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RELVAR/BREO

RELVAR/BREO will be available at doses of 100/25 micrograms (µg) and 200/25 µg to be administered via ELLIPTA DPI. Subjects will be administered one inhalation of RELVAR/BREO once daily.

Intervention Type DRUG

Salbutamol

Salbutamol will be available at a dose of 100 µg to be administered via MDI. Subjects will be administered salbutamol as and when required.

Intervention Type DRUG

Smart phone app

Subjects will be required to download an app associated with sensor on their smartphone. The sensors attached to the inhalers will be connected to the smartphone via Bluetooth.

Intervention Type DEVICE

HCP Dashboard

The information from sensors will be reviewed by the HCP via an online dashboard.

Intervention Type DEVICE

Sensors

Clip-on sensors will be fitted to electronically record the actuation data.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Subjects aged 18 years or older, at the time of signing the informed consent.
* Subjects with documented physician diagnosis of asthma as their primary respiratory disease.
* ACT score \<20 at screening visit.
* Non-smokers (never smoked or not smoking for \>6 months with \<10 pack years history (Pack years = \[cigarettes per day smoked/20\] multiplied by number of years smoked).
* Male or female subjects will be included. A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: (i) Not a woman of childbearing potential (WOCBP). (ii) A WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 5 days\] after the last dose of study treatment.
* Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the consent form and protocol.
* Subject understands and is willing, able, and likely to comply with study procedures and restrictions.
* Subject must be able to read in a language supported by the smart phone app in their region.
* Subject must have been on maintenance therapy (Fixed dose combination ICS/LABA) for 3 months, cannot have changed dose in the month prior to screening and be able to change to an equivalent dose of RELVAR/BREO for the duration of the study. Other background asthma medication such as anti-leukotrienes and oral corticosteroids are permitted provided the dose has been stable for 1 month prior to screening.
* Subject must be able to change to Salbutamol/Albuterol MDI rescue for the duration of the study and judged capable of withholding albuterol/salbutamol for at least 6 hours prior to study visits.
* Subject must have their own Android or iPhone operating system (IOS) smart phone and a data package suitable for the installation and running of the app and sending and receiving data. Data used by the CIS is approximately 1 megabyte (MB) per month as a maximum; this is less data than a 1 minute video streamed from YouTube (2MB).
* Subjects must be willing and able to download the app on their personal smart phone and keep it turned on for the duration of the study. This will also require Bluetooth to be turned on for duration of the study. Subjects will also have to turn on mobile data for the app for the duration of study; unless travelling and when extra data roaming costs could be incurred.


* ACT score \<20 at randomization visit (visit 2).

Exclusion Criteria

* Subjects with a known or suspected alcohol or drug abuse which in the opinion of the investigator could interfere with the subject's proper completion of the protocol requirement.
* History of life threatening asthma: Defined as an asthma episode that required intubation and/or was associated with hypercapnea, respiratory arrest or hypoxic seizures within the last 6 months.
* A lower respiratory tract infection within 7 days of the screening visit.
* Concurrent diagnosis of chronic obstructive pulmonary disease (COPD) or other respiratory disorders including active tuberculosis, lung cancer, bronchiectasis, sarcoidosis, lung fibrosis, pulmonary hypertension, interstitial lung diseases or other active pulmonary diseases.
* History of hypersensitivity/intolerance to any components of the study inhalers (example, lactose, magnesium stearate). In addition, subjects with a history of severe milk protein allergy that, in the opinion of the study physician, contraindicates participation will also be excluded.
* Historical or current evidence of clinically significant or rapidly progressing or unstable cardiovascular, neurological, cardiovascular, neurological, renal, hepatic, immunological, endocrine (including uncontrolled diabetes or thyroid disease) or hematological abnormalities that are uncontrolled. Significant is defined as any disease that, in the opinion of the investigator, would put the safety of the subject at risk through participation, or which would affect the analysis if the disease/condition exacerbated during the study.
* Subjects who have ever received treatment with biological based therapy example, omalizumab, mepolizumab, for asthma.
* Subjects who have received an investigational drug and/or medical device within 30 days of entry into this study (Screening), or within five drug half-lives of the investigational drug, whichever is longer.
* A subject will not be eligible for this study if he/she is an immediate family member of the participating investigator, sub-investigator, study coordinator, employee of the participating investigator, or any family member of a Propeller Health employee.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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GlaxoSmithKline

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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GSK Clinical Trials

Role: STUDY_DIRECTOR

GlaxoSmithKline

Locations

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GSK Investigational Site

Aventura, Florida, United States

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Miami, Florida, United States

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Flossmoor, Illinois, United States

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Glenview, Illinois, United States

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Hazelwood, Missouri, United States

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Charlotte, North Carolina, United States

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Oklahoma City, Oklahoma, United States

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Medford, Oregon, United States

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San Antonio, Texas, United States

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Richmond, Virginia, United States

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Greenfield, Wisconsin, United States

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Kelowna, British Columbia, Canada

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Vancouver, British Columbia, Canada

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Ajax, Ontario, Canada

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Burlington, Ontario, Canada

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London, Ontario, Canada

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Sarnia, Ontario, Canada

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Toronto, Ontario, Canada

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Toronto, Ontario, Canada

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Toronto, Ontario, Canada

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Windsor, Ontario, Canada

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Montreal, Quebec, Canada

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Québec, Quebec, Canada

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Québec, Quebec, Canada

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Québec, Quebec, Canada

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Sherbrooke, Quebec, Canada

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Victoriaville, Quebec, Canada

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Rüdersdorf, Brandenburg, Germany

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Darmstadt, Hesse, Germany

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Warendorf, North Rhine-Westphalia, Germany

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Leipzig, Saxony, Germany

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Leipzig, Saxony, Germany

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Lübeck, Schleswig-Holstein, Germany

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Berlin, , Germany

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Berlin, , Germany

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Berlin, , Germany

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Berlin, , Germany

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Napoli, Campania, Italy

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Salerno, Campania, Italy

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Pordenone, Friuli Venezia Giulia, Italy

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Palermo, Sicily, Italy

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Pisa, Tuscany, Italy

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Breda, , Netherlands

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Groningen, , Netherlands

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Hengelo, , Netherlands

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Hoorn, , Netherlands

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The Hague, , Netherlands

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Zutphen, , Netherlands

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A Coruña, , Spain

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Balenyà (Barcelona), , Spain

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Barcelona, , Spain

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Barcelona, , Spain

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La Roca Del Valles (Barcelona), , Spain

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Loja/ Granada, , Spain

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Madrid, , Spain

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Madrid, , Spain

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Peralada( Girona), , Spain

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Aylesbury, Buckinghamshire, United Kingdom

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Wigan, Lancashire, United Kingdom

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Wellingborough, Northamptonshire, United Kingdom

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Addlestone, Surrey, United Kingdom

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Rotherham, Yorkshire, United Kingdom

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Bristol, , United Kingdom

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Chelmsford, , United Kingdom

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Chertsey, Surrey, , United Kingdom

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GSK Investigational Site

Harrogate, , United Kingdom

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Countries

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United States Canada Germany Italy Netherlands Spain United Kingdom

References

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Moore A, Preece A, Sharma R, Heaney LG, Costello RW, Wise RA, Ludwig-Sengpiel A, Mosnaim G, Rees J, Tomlinson R, Tal-Singer R, Stempel DA, Barnes N. A randomised controlled trial of the effect of a connected inhaler system on medication adherence in uncontrolled asthmatic patients. Eur Respir J. 2021 Jun 4;57(6):2003103. doi: 10.1183/13993003.03103-2020. Print 2021 Jun.

Reference Type DERIVED
PMID: 33334936 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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2017-002266-45

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

207040

Identifier Type: -

Identifier Source: org_study_id

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