Efficacy and Safety of Levalbuterol Versus Racemic Albuterol in Asthma

A Randomized, Double-Blind Study to Determine the Efficacy of Levalbuterol Versus Racemic Albuterol in the Treatment of Acute Asthma

To investigate the Efficacy and Safety of Levalbuterol versus Racemic Albuterol in the Treatment of Acute Asthma.

Study Overview

• Status: Completed
• Conditions: Asthma
• Intervention / Treatment: Drug: Levalbuterol 1.25 mg; Drug: Racemic Albuterol Sulfate

Detailed Description

This study is a double-blind, randomized, active-controlled, multicenter, parallel-group trial of levalbuterol in adult subjects with acute reversible airways disease. Approximately 600 subjects will be enrolled and study participation will consist of 2 periods: Period I (Acute Period): Double-blind treatment in the Emergency Department (ED) or Clinic until disposition, for a maximum of 24 hours of double-blind treatment and Period II (Post-Acute Period): Subjects discharged from the ED or Clinic will continue double blind treatment (with the same treatment provided as rescue medication as MDI) for approximately 10 days. Subjects will be contacted by telephone 30 days post discharge to assess relapse. This study was previously posted by Sepracor Inc. In October 2009, Sepracor Inc. was acquired by Dainippon Sumitomo Pharma., and in October 2010, Sepracor Inc's name was changed to Sunovion Pharmaceuticals Inc.

• Study Type: Interventional
• Enrollment (Actual): 627
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Hoover, Alabama, United States
    • Montgomery, Alabama, United States
  • California
    • Encinitas, California, United States
    • Fresno, California, United States
    • Oakland, California, United States
    • Torrance, California, United States
  • Colorado
    • Colorado Springs, Colorado, United States
  • Florida
    • Gainesville, Florida, United States
    • Jacksonville, Florida, United States
    • Tampa, Florida, United States
  • Illinois
    • Chicago, Illinois, United States
  • Louisiana
    • Metairie, Louisiana, United States
  • Michigan
    • Ann Arbor, Michigan, United States
    • Detroit, Michigan, United States
  • Missouri
    • Kansas City, Missouri, United States
    • St. Louis, Missouri, United States
  • New Jersey
    • Red Bank, New Jersey, United States
  • New York
    • Brooklyn, New York, United States
    • New Hyde Park, New York, United States
    • Syracuse, New York, United States
  • North Carolina
    • Rocky Mount, North Carolina, United States
  • Ohio
    • Akron, Ohio, United States
    • Cleveland, Ohio, United States
  • Oregon
    • Lake Oswego, Oregon, United States
    • Medford, Oregon, United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States
  • Texas
    • Houston, Texas, United States
  • Utah
    • Salt Lake City, Utah, United States

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Male and female subjects must be at least greater than or equal to 18 years of age at the time of consent.
• Subjects must have history of asthma for at least 6 months.
• Subjects must present to the emergency department (ED) or clinic with forced expiratory volume in one second (FEV1) of 20 to 55% (inclusive) predicted at baseline
• Subjects must have O2 saturation greater than or equal to 90% at room air or with no more than 6 Liters/minute supplemental oxygen and no other cause of wheezing or shortness of breath other than asthma as determined by the physician.
• Prior use of a beta-agonist (e.g., Primatine Mist, albuterol, salmeterol, etc.) within 24 hours of presentation to the ED or Clinic.
• Smoked ≤ 10 pack-years or non-smoker.
• Be in good health with the exception of asthma and not suffering from any chronic condition which might affect their lung function, such as COPD or emphysema.
• Near-normal activity level between exacerbations.
• Subjects who are taking inhaled or systemic corticosteroids must be on a stable dose for at least 21 days prior to study entry.

Exclusion Criteria:

• Subjects who have received treatment for asthma in an ED, Clinic, or Urgent Care Center within 2 weeks prior to study entry.
• Based upon history or physical exam in the ED or Clinic, subjects with known or suspected cause of pulmonary symptoms other than asthma, such as COPD, CHF, pneumonia, pulmonary embolism, or angioedema.
• Subjects with a history of asthma episodes associated with hypercapnia, respiratory arrest, hypoxic seizures, or requiring intubation within 12 months prior to entry.
• Hospitalization for asthma within two months prior to entry.
• Female subjects who are pregnant or lactating.
• Subjects who have a history of a clinically significant psychiatric disorder within the last 3 months, with the exception of mild depression.
• Subjects who have participated in an investigational drug study within 30 days of study entry or have previously participated in the current trial.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1; Levalbuterol 1.25 mg	Drug: Levalbuterol 1.25 mg; levalbuterol 1.25 mg Period I: administered every 20 minutes for the first 3 doses, and then every 40 minutes for the next 3 doses; then as clinically indicated. Period II: TID for 3 days (same time of day), then PRN to TID for 7 days; Other Names: Xopenex HCl Inhalation Solution
Active Comparator: 2; Racemic Albuterol 2.5 mg	Drug: Racemic Albuterol Sulfate; Racemic Albuterol 2.5 mg Period I: every 20 min for the first 3 doses, then every 40 min for the next 3 doses, then as clinically indicated. Period II: TID for 3 days then PRN to TID for 7 days; Other Names: Ventolin Inhalation Solution

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Time to meet discharge criteria (functional airway improvement)during the first 3 hours of Period I.	24 hours

Secondary Outcome Measures

Outcome Measure	Time Frame
FEV1 (Period I): Serial spirometry, maximum FEV1, time to maximum FEV1, baseline FEV1 severity on subject response; % responders, no. nebulizations to meet discharge criteria, rate of hospitalization, time to admit decision, rate for increased care	Day 0 (5-10 min after every dose)
FEV1 (Period II): Spirometry, average FEV1; distribution of subject responses; rate of relapse; blinded study medication; length of stay in ED or Clinic during Period I; length of hospitalization, cost of care	Days 3, 10
Investigator and subject global evaluations, subject preference	Days 3, 10
Subject reported beta-mediated side effects	Days 3, 10

Collaborators and Investigators

• Sponsor: Sunovion

Study record dates

Study Major Dates

• Study Start: November 1, 2000
• Primary Completion (Actual): August 1, 2002
• Study Completion (Actual): August 1, 2002

Study Registration Dates

• First Submitted: April 24, 2008
• First Submitted That Met QC Criteria: April 25, 2008
• First Posted (Estimate): April 28, 2008

Study Record Updates

• Last Update Posted (Estimate): February 22, 2012
• Last Update Submitted That Met QC Criteria: February 21, 2012
• Last Verified: February 1, 2012

More Information

Terms related to this study

• Keywords: Asthma
• 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; Adrenergic Agonists; Bronchodilator Agents; Anti-Asthmatic Agents; Respiratory System Agents; Reproductive Control Agents; Adrenergic beta-2 Receptor Agonists; Adrenergic beta-Agonists; Tocolytic Agents; Pharmaceutical Solutions; Albuterol
• Other Study ID Numbers: 051-915