Investigation of Fixed Triple Inhaled Combination in Asthmatic Patients, in a Real-life Setting

NCT ID: NCT06678191

Last Updated: 2024-11-22

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

RECRUITING

Total Enrollment

800 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-10-24

Study Completion Date

2027-08-31

Brief Summary

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The mainstay of asthma treatment are ICSs, mostly combined with LABA. In the past decade LAMA had been accepted as an add-on treatment for patients on GINA treatment Steps 4 and 5. Recently, RCTs proved the efficacy and safety of fixed triple combinations of moderate and high dose of ICS and LABA, LAMA in a very selected asthmatic population, resulting in the market authorisation of these products. However, there is a lack of evidence on the real-world effectiveness of these therapies, especially with regards to improvement in symptom scores and quality of life. Also, there is scarcity of data regarding the phenotypes of asthmatics who benefit the most from the use of fixed triple combinations.

Detailed Description

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Study design Multicentre, national, non-interventional, prospective study evaluating the effectiveness of Trimbow 172/5/9 μg pMDI on symptom scores in 6 months after switch from previous LABA-high dose ICS containing treatment in asthmatics.

Dosage regimen and administration Name of the product: Trimbow 172 micrograms/5 micrograms/9 micrograms pressurised inhalation, solution (henceforth abbreviated as Trimbow 172/5/9 μg pMDI). Each delivered dose (the dose leaving the mouthpiece) contains 172 μg of beclometasone dipropionate, 5 μg of formoterol fumarate dihydrate and 9 μg of glycopyrronium (as 11 μg glycopyrronium bromide). Each metered dose (the dose leaving the valve) contains 200 μg of beclometasone dipropionate, 6 μg of formoterol fumarate dihydrate and 10 μg of glycopyrronium (as 12.5 μg glycopyrronium bromide). The recommended dose is two inhalations twice daily. The maximum dose is two inhalations twice daily.

1. Aim of the study (research objective)

Primary objective:

The main objective is to assess the effectiveness of BDP/FF/G 172/5/9 μg fixed triple combination in a real-world setting, with regards to improvements in symptom scores (ACT).
2. Test sample and method, recruitment principle No patient recruitment will be performed. Eligible patients will be enrolled during the participating physicians' regular asthma patient management and patients' written informed consent. Patient inclusion will take place among patients having severe asthma and attending pulmonology outpatient clinics (the chosen study sites are attached as annexes to the study protocol), strictly at the time of the patients' visit. The planned number of patients is 800.
3. Structure of the study In accordance with the requirements of non-interventional studies, the assignment of patients to Trimbow 172/5/9 μg pMDI therapy should be made independently of the study, and patients should only be considered for inclusion in the study after a prior therapeutic decision has been made by a pulmonologist. Patient enrolment can take place after the patient has been fully informed about the purpose of the study and all of its details, and the patient has read and signed the patient information leaflet and patient consent form, including any questions they may have. Once this has taken place, the data that would have been generated anyway during the outpatient examination of the patient in accordance with daily practice can be recorded. This is considered the first visit of the study (Visit 1). During this visit, the patient's main demographic data, information on comorbidities and concomitant medications, previous and current asthma therapies, asthma specific assessment (including ACT), exacerbation history, post-dose lung function values (if spirometry data is available), laboratory results (if a laboratory test is performed during the visit or was performed recently), results of other medical examinations (e.g., chest X-ray) if performed regardless of the study, maintenance and reliever inhaled \& non-inhaled therapies (former and new) baseline quality of life based on the asthma quality of life (EQ-5D-5L) questionnaire, and adherence to therapy based on Test of Adherence to Inhalers® (TAI-12) questionnaire are recorded. Patients will then attend two additional visits 30 days and 6 months after enrolment as per routine clinical practice (Visits 2 and 3). During these visits, data will also be recorded, once again, according to routine clinical practice. Assessing the usage of rescue medications and patient adherence are also planned with the use of electronic health record system (EESZT)-verified prescription dispensations (optional for investigators). Visit 4 will be a long-term follow-up to assess the exploratory endpoint of exacerbations rates.

If the patient's maintenance therapy changes during the study as decided by the treating pulmonologist, and the patient is no longer receiving Trimbow 172/5/9 μg pMDI, the patient will be automatically excluded from this NIS. The fact of the therapy modification and its exact date must be recorded on the "current medication" form in the eCRF (electronic Case Report Form) of the next visit. If the change in therapy is related to a suspected adverse reaction, it should be reported separately on the eCRF platform in accordance with section 9 of this protocol ('Collection, recording and reporting of medication safety data').

This NIS is open to all eligible patients according to the inclusion and exclusion criteria. Permitted concomitant treatments: allowed all medications according to local clinical practice (any non-inhalation therapy for asthma or other diseases) and reliever (short-acting bronchodilators) inhaled therapies for asthma. The data to be recorded will be detailed in the study data sheet that forms part of the protocol. The data is recorded in the eCRF (MrAgent - Medisol Development Ltd., see also at 10.1.) system, with consideration to the current professional and legal regulations.
4. Start and duration of the study The first patient enrolment will take place after receiving approval from the National Public Health Center (NPHC), based on a beneficial assessment of the Medical Research Council of Hungary. The study is planned to start on September 16, 2024. Accordingly, first patient first visit (FPFV) is also planned to take place in September, 2024. The launch of the participating centres is planned in two waves, in the autumn of 2024 and in the spring of 2025. Each centre will have 12 months to enrol patients. After the last visit of the last patient (LPLV), centres will have one month to collect all missing data / correct any data flagged as queries during monitoring. Thus, the LPLV will take place on Oct 31, 2026 (primary endpoint) and 30 April, 2027 (exploratory endpoint), respectively. The study is planned to be concluded on August 31, 2027.
5. Data to be recorded during the visits A total of 4 visits will be performed for the assessment of the primary and secondary endpoints during the study. The table below summarises the data collection to be carried out during the visits separately. The patient may be enrolled in the study and their data may only be recorded, if these data would also have been recorded in accordance with standard medical practice.

* Visit 1: Time of enrolment - a normal visit, according to routine clinical practice. Informed consent and baseline patient characteristics will be collected.
* Visit 2: 1 month after enrolment (± 2-3 workdays)
* Visit 3: 6 months after enrolment (± 5-7 workdays)
* Visit 4: 12 months after enrolment (± 10-15 days)

Conditions

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Asthma, Chronic Obstructive Pulmonary Disease (COPD) Asthma Bronchiale

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Asthmatic patients switched to Trimbow (BDP/FF/G 172/5/9 μg)

Asthmatic patients who had been switched to BDP/FF/G 172/5/9 μg before study enrollment, due to uncontrolled asthma.

BDP/FF/G (Beclomethasone diprprionate, formoterol fumarate, glycopyrronium bromide) 172/5/9 μg

Intervention Type DRUG

In accordance with the requirements of non-interventional studies, the assignment of patients to Trimbow 172/5/9 μg pMDI therapy should be made independently of the study, and patients should only be considered for inclusion in the study after a prior therapeutic decision has been made by a pulmonologist.

Interventions

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BDP/FF/G (Beclomethasone diprprionate, formoterol fumarate, glycopyrronium bromide) 172/5/9 μg

In accordance with the requirements of non-interventional studies, the assignment of patients to Trimbow 172/5/9 μg pMDI therapy should be made independently of the study, and patients should only be considered for inclusion in the study after a prior therapeutic decision has been made by a pulmonologist.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Physician-confirmed clinical diagnosis of asthma according to GINA guidelines and treated for at least 3 years before inclusion
* Patients ≥ 18 years of age in ambulatory care
* Uncontrolled asthma according to the physician's clinical assessment despite the use of

1. LABA - high dose ICS OR
2. LABA - high-dose ICS + LAMA multi-inhaler triple therapy for a minimum of three months.
* Patients who are eligible for the use of Trimbow 172/5/9 μg pMDI according to the SmPC and the financing protocol for asthma

1. At least on exacerbation, requiring systemic (oral or intravenous) corticosteroids in the previous 12 months
2. Uncontrolled asthma (ACT≤15)
3. FEV1\<80% at baseline
* Inhaled asthma therapy was changed to Trimbow 172/5/9 μg pMDI no more than 1 week prior to OR on the day of study inclusion
* Patient provided written, informed consent to study participation

Exclusion Criteria

* Participation in any clinical trial within 30 days prior to enrolment
* Patients hospitalized due to an exacerbation of their asthma within the last 4 weeks prior to enrolment
* Another respiratory condition, apart from asthma or COPD, that may interfere with the effectiveness of the treatment studied AND/OR another important clinical situation that may interfere with patient's compliance with the treatment.
* Continuous use of oral (\>5 mg prednisolone/day OR \>4 mg methylprednisolone/day) OR intravenous corticosteroids CHMED\_2024/01 Prof. Dr. Lilla Tamási 8(17)
* Use of continuous oxygen therapy
* Any malignant disease in the last 5 years
* Tuberculosis (active or anamnestic)
* Actual or previous use of biologics for asthma treatment in the past 12 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Chiesi Hungary Ltd.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Hajduböszörmény ESZ-V Nonprofit Kft Tüdőgyógyászat

Hajdúböszörmény, , Hungary

Site Status RECRUITING

Tüdőgondozó / Szent Erzsébet Kórház

Jászberény, , Hungary

Site Status RECRUITING

Békés Megyei Központi Kórház, 2. Tüdőgyógyászat szakrendelés - 1. rendelés

Békéscsaba, , Hungary

Site Status RECRUITING

Kispesti Egészségügyi Intézet Tüdőgondozó, Ernyőképszűrő állomás

Budapest, , Hungary

Site Status RECRUITING

Országos Korányi Pulmonológiai Intézet (OKPI)

Budapest, , Hungary

Site Status RECRUITING

Semmelweis Egyetem, Általános Orvostudományi Kar, Pulmonológiai Klinika

Budapest, , Hungary

Site Status RECRUITING

Szent Kristóf Szakrendelő XI. Kerületi Tüdőgondozó

Budapest, , Hungary

Site Status RECRUITING

Szent Kristóf Szakrendelő XXII. Kerületi Tüdőgondozó

Budapest, , Hungary

Site Status RECRUITING

XVI. Kerület Kertvárosi Egészségügyi Szolgálata, Tüdőgyógyászat

Budapest, , Hungary

Site Status RECRUITING

Csornai Margit Kórház Tüdőbeteggondozó Intézet

Csorna, , Hungary

Site Status RECRUITING

DE Klinikai Központ, Tüdőgyógyászati Klinika

Debrecen, , Hungary

Site Status RECRUITING

Debreceni Egyetem Kenézy Gyula Egyetemi Kórház Pulmonológiai Részleg

Debrecen, , Hungary

Site Status RECRUITING

Debreceni Egyetem Klinikai Központ Allergológiai Szakrendelés

Debrecen, , Hungary

Site Status RECRUITING

SZTE SZAKK Deszki Multidiszciplináris Centrum

Deszk, , Hungary

Site Status RECRUITING

Dunakeszi-SZTK Nonprofit Kft. Tüdőgyógyászat

Dunakeszi, , Hungary

Site Status RECRUITING

Vaszary Kolos Kórház Tüdőgondozó Esztergom

Esztergom, , Hungary

Site Status RECRUITING

Szabolcs-Szatmár-Bereg Megyei Kórházak és Egyetemi Oktatókórház

Fehérgyarmat, , Hungary

Site Status RECRUITING

Bugát Pál Kórház Tüdőbeteg Gondozó Intézet

Gyöngyös, , Hungary

Site Status RECRUITING

Petz Aladár Megyei Oktató Kórház

Győr, , Hungary

Site Status RECRUITING

Békés Megyei Központi Kórház 1. Tüdőgyógyászat Szakrendelés

Gyula, , Hungary

Site Status RECRUITING

Szent Kereszt Kórház Kalocsa,Tüdőgyógyászati Szakrendelés

Kalocsa, , Hungary

Site Status RECRUITING

Somogy Megyei Kaposi Mór Oktató Kórház

Kaposvár, , Hungary

Site Status RECRUITING

Keszthelyi Kórház Tüdőgondozó

Keszthely, , Hungary

Site Status RECRUITING

Kisteleki Egészségügyi Központi Nonprofit Kft.

Kistelek, , Hungary

Site Status RECRUITING

Szent Damján Görögkatolikus Kórház Tüdőgyógyászati gondozó 1.

Kisvárda, , Hungary

Site Status RECRUITING

Selye János Kórház Tüdőgyógyászati Szakellátás

Komárom, , Hungary

Site Status RECRUITING

Kunszentmárton Városi Egészségügyi Központ Tüdőgyógyászat

Kunszentmárton, , Hungary

Site Status RECRUITING

Szaplonczay Manó Marcali Kórház Tüdőgyógyászati Szakrendelés

Marcali, , Hungary

Site Status RECRUITING

Mátrai Gyógyintézet Légzőszervi szakrendelés

Mátraháza, , Hungary

Site Status RECRUITING

Karolina Kórház-Rendelőintézet Mosonmagyaróvár

Mosonmagyaróvár, , Hungary

Site Status RECRUITING

Kanizsai Dorottya Kórház

Nagykanizsa, , Hungary

Site Status RECRUITING

Szabolcs-Szatmár-Bereg Megyei Kórházak és Egyetemi Oktatókórház

Nyírbátor, , Hungary

Site Status RECRUITING

Szabolcs-Szatmár- Bereg Megyei Kórházak és Egyetemi Oktatókórház Megyei-Városi Tüdőgondozó

Nyíregyháza, , Hungary

Site Status RECRUITING

Orosházi Kórház Tüdőgondozó

Orosháza, , Hungary

Site Status RECRUITING

Margit Kórház Pásztó Tüdőgyógyászati Szakrendelés

Pásztó, , Hungary

Site Status RECRUITING

Egyesített Egészségügyi Intézmények Tüdőgondozó

Pécs, , Hungary

Site Status RECRUITING

Sarkadi Kistérségi Járóbeteg Szakellátó Központ

Sarkad, , Hungary

Site Status RECRUITING

Siófoki Kórház-Rendelőintézet Tüdőgondozó

Siófok, , Hungary

Site Status RECRUITING

Csongrád Megyei Mellkasi Betegségek Szakkórháza, Tüdőgondozó Intézet

Szeged, , Hungary

Site Status RECRUITING

Alba Szűrőközpont

Székesfehérvár, , Hungary

Site Status RECRUITING

Fejér Megyei Szent György Egyetemi Oktató Kórház, Tüdőbeteg Gondozó, Városkörnyék I. Szakrendelés Székesfehérvár

Székesfehérvár, , Hungary

Site Status RECRUITING

Jász-Nagykun-Szolnok Megyei Hetényi Géza Kórház-Rendelőintézet Tüdőgyógyászati Szakrendelés

Szolnok, , Hungary

Site Status RECRUITING

Markusovszky Egyetemi Oktatókórház

Szombathely, , Hungary

Site Status RECRUITING

Református Pulmonológiai Centrum, Törökbálint

Törökbálint, , Hungary

Site Status RECRUITING

Zala Megyei Szent Rafael Kórház

Zalaegerszeg, , Hungary

Site Status RECRUITING

Countries

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Hungary

Central Contacts

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András Keglevich, Dr.

Role: CONTACT

+36309788085

Balázs Sánta, Dr.

Role: CONTACT

+36309948432

Facility Contacts

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Árpád Vincze, Dr.

Role: primary

Brigitta Dombai, Dr.

Role: primary

Zsuzsanna Csoma, Dr.

Role: primary

Lilla Tamási, Prof.

Role: primary

Ildikó Nádudvary, Dr.

Role: primary

Lívia Medek, Dr.

Role: primary

Éva Tót, Dr.

Role: primary

Zoltán Bártfai, Dr

Role: primary

László Brúgos, Dr

Role: primary

Réka Keszthelyi, Dr.

Role: primary

Erzsébet Takács, Dr.

Role: primary

Klára Szalontay, Dr.

Role: primary

Katalin Kontz, Dr.

Role: primary

Gabriella Horváth, Dr.

Role: primary

Sándor Tóth, Dr.

Role: primary

Csilla Szabó, Dr

Role: primary

Márta Czompó, Dr.

Role: primary

Árpád Vincze, Dr

Role: primary

Gabriella Kiss, Dr.

Role: primary

Ida Nagy, dr.

Role: primary

Szabolcs Körmendy, Dr.

Role: primary

Éva Kuczkó, Dr.

Role: primary

Sándor Tehenes, Dr.

Role: primary

Ágnes Selypes, Dr.

Role: primary

Miklós Kukuly, Dr.

Role: primary

Judit Schlezák, Dr.

Role: primary

Tibor Süveges, Dr.

Role: primary

Jakoob Maha, Dr.

Role: primary

Magdolna Horváth, Dr.

Role: primary

Erika Unger, Dr.

Role: primary

Magdolna Tankó, Dr.

Role: primary

Krisztina Alb, Dr.

Role: primary

Ildikó Kerényi, Dr.

Role: primary

Erika Vecsey, Dr.

Role: primary

Margit Füleki, Dr.

Role: primary

Ágnes Varga, Dr

Role: primary

István Lopusnyik, Dr.

Role: primary

Anna Bartha, Dr.

Role: primary

László Makk, Dr

Role: primary

Zsolt Vidák, Dr.

Role: primary

Nóra Ferenczy, Dr.

Role: primary

Tibor Juhász, Dr.

Role: primary

Krisztina Hajdú, Dr.

Role: primary

Csilla Farkas, Dr.

Role: primary

Márta Beke, Dr.

Role: primary

Other Identifiers

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CHMED_2024/01

Identifier Type: -

Identifier Source: org_study_id

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