A Serious Asthma Outcome Study With Mometasone Furoate/Formoterol Versus Mometasone Furoate in Asthmatics 12 Years and Over (P06241) (SPIRO)
A 26-Week Randomized, Double-Blinded, Active Controlled Study Comparing the Safety of Mometasone Furoate/Formoterol Fumarate MDI Fixed Dose Combination Versus Mometasone Furoate MDI Monotherapy in Adolescents and Adults With Persistent Asthma (Protocol No. P06241 Also Known as P202)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Persistent asthma for at least 1-year
- Must use a daily asthma controller medication for at least 4 weeks prior to randomization, including an inhaled corticosteroid (ICS) with or without a long-acting beta agonist (LABA) or other adjunctive asthma therapy OR be using a leukotriene receptor antagonist (LTRA), xanthine or short acting beta agonist (SABA) as a monotherapy.
- Must be able to discontinue current asthma medication
- Must have a history of at least one asthma exacerbation in previous 4 to 52 weeks
Exclusion Criteria:
- Unstable asthma
- Taking high dose ICS with or without other adjunctive therapy who have an Asthma Control Questionnaire 6 (ACQ6) total score ≥ 1.5
- Taking LTRA, xanthine or SABA monotherapy with an ACQ-6 total score < 1.5 (controlled)
- Chronic obstructive pulmonary disease (COPD), cystic fibrosis (CF), or other significant, non-asthmatic, lung disease
- Clinically significant abnormality, illness or disorder of any body or organ system
- Significant underlying cardiovascular condition which may contraindicate use of a beta-agonist.
- History of smoking greater than 10-pack years
- Had an asthma exacerbation within 4 weeks of the Baseline Visit
- Had more than 4 asthma exacerbations or 2 hospitalizations within 52 weeks of the randomization visit
- Known or suspected hypersensitivity or intolerance to corticosteroids, beta-2 agonists, or any of the (inactive ingredients) excipients present in the medications used in this study
- Require the use of chronic systemic steroids, omalizumab, or other monoclonal or polyclonal antibodies
- Requires the use of beta-blockers
- History of life-threatening asthma, including an asthma episode that required intubation and/or was associated with hypercapnia requiring noninvasive ventilatory support
- Lactating, pregnant, or plans to become pregnant during the course of the trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Mometasone Furoate/Formoterol MDI BID
MF/F MDI BID (pooled MF/F MDI 200/10 mcg BID and MF/F MDI 400/10 mcg BID treatments)
|
two inhalations BID
Other Names:
two inhalations BID
Other Names:
use as needed for asthma symptoms
Oral prednisone/prednisolone used only as an emergency rescue medication at the discretion of the investigator
|
|
Active Comparator: Mometasone Furoate MDI BID
MF MDI BID (pooled from MF MDI 200 mcg BID and MF MDI 400 mcg BID treatments)
|
use as needed for asthma symptoms
Oral prednisone/prednisolone used only as an emergency rescue medication at the discretion of the investigator
two inhalations BID
Other Names:
two inhalations BID
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time-to-First Serious Asthma Outcomes (SAO): Number of First SAO in the MF/F vs MF Arms
Time Frame: 26 weeks, or 7 days after the last treatment dose, whichever occurred later
|
The primary safety outcome was the time-to-first SAO (a composite endpoint of adjudicated asthma-related hospitalizations, adjudicated asthma-related intubations, and adjudicated asthma-related deaths).
To accomplish this, the number of participants experiencing a first SAO was collected for 26 weeks following initiation of study treatment (or 7 days after the last treatment dose, whichever occurred later).
Data generated by this methodology were used to compute a hazard ratio (HR) and 95% confidence interval (CI), modeling the likelihood of a first SAO occurring at any given time in the MF/F arm relative to the MF arm.
Although data were sufficient to generate a HR and 95% CI, time-to-first SAO in the overall population could not be accurately reported due to insufficient SAO occurrence.
Therefore, the number of first SAO in either arm is reported as a descriptive measure.
For each participant, first SAO denotes first event per participant.
|
26 weeks, or 7 days after the last treatment dose, whichever occurred later
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time-to-First Severe Asthma Exacerbation (SAEX): Number of First SAEX in the MF/F vs MF Arms
Time Frame: 26 weeks, plus 7 days after the last treatment
|
The key secondary efficacy outcome was time-to-first protocol-defined asthma exacerbation (SAEX).
The SAEX were deteriorations of asthma requiring: use of systemic corticosteroids (tablets, suspension, or injection) for >= 3 consecutive days, in-patient hospitalization >= 24 hours, or an emergency department (ED) visit < 24 hours that required systemic corticosteroids in the MF/F MDI BID arm versus the MF MDI BID arm.
The number of first SAEX occurred from initiation of study treatment to 7 days after the last treatment (modified intention-to-treat).
This outcome was measured as the HR and 95% CI for the number of first SAEX in the MF/F MDI BID arm versus the number of first SAEX in the MF MDI BID arm.
Given insufficient data for SAEX events, it was not informative to report the time-to-first SAEX in the overall population.
Therefore, the number of first SAEXs in either arm is reported as a descriptive measure.
For each participant, first SAEX denotes first event per participant.
|
26 weeks, plus 7 days after the last treatment
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of SAO Components in MF/F Participants vs MF Participants
Time Frame: 26 weeks, or 7 days after the last treatment dose, whichever occurred later
|
To further examine the primary safety outcome, each adjudicated component of the SAO composite endpoint (asthma-related hospitalization, asthma-related intubation and asthma-related death), was tabulated for descriptive purposes only to show the relative contribution of each component to the SAO composite.
Hospitalizations were defined as an in-patient stay of >= 24 hour in a hospital, emergency department or equivalent healthcare facility.
Intubation was defined as endotracheal intubation only.
|
26 weeks, or 7 days after the last treatment dose, whichever occurred later
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Medical Director, Merck Sharp & Dohme LLC
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Immune System Diseases
- Lung Diseases
- Hypersensitivity, Immediate
- Bronchial Diseases
- Lung Diseases, Obstructive
- Respiratory Hypersensitivity
- Hypersensitivity
- Asthma
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Adrenergic Agonists
- Dermatologic Agents
- Bronchodilator Agents
- Anti-Asthmatic Agents
- Respiratory System Agents
- Reproductive Control Agents
- Anti-Allergic Agents
- Adrenergic beta-2 Receptor Agonists
- Adrenergic beta-Agonists
- Tocolytic Agents
- Prednisolone
- Prednisone
- Albuterol
- Mometasone Furoate
- Formoterol Fumarate
- Mometasone Furoate, Formoterol Fumarate Drug Combination
Other Study ID Numbers
Other Study ID Numbers
- P06241
- 2011-002142-13 (EudraCT Number)
- MK-0887A-202 (Other Identifier: Merck Protocol Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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