Study to Assess Effect of HFO MDI Propellant on Mucociliary Clearance Compared to HFA MDI Propellant in Healthy Participants

A Randomized, Double-blind, Two-way Crossover Study to Assess the Effect of Hydrofluoroolefin (HFO) Propellant Metered Dose Inhaler (MDI) on Mucociliary Clearance Compared With Hydrofluoroalkane (HFA) Propellant MDI in Healthy Participants

A Study to Assess the Effect of the HFO MDI Propellant on Mucociliary Clearance Compared to the HFA MDI Propellant in Healthy Participants

Study Overview

• Status: Recruiting
• Conditions: Mucociliary Clearance
• Intervention / Treatment: Drug: HFO MDI; Drug: HFA MDI

Detailed Description

A randomized, double-blind, multi-site, two-way crossover study to assess the effect on MCC and safety of HFO propellant compared to HFA propellant in healthy participants. Mucociliary clearance will be determined after 1 week of twice daily (BID) administration of HFO MDI (test) and HFA MDI (reference).

The study will comprise a Screening Period 7 to 14 days prior to first dosing; Two Treatment Periods (TPs) of 7 days each (+ up to 3 days), with a 7 to 14 day Washout Period between the 2 TPs; and a final safety Follow-up Visit 5 to 7 days after the final dose administration in TP2.

Participants will receive treatments in 1 of 2 possible treatment sequences: A followed by B, or B followed by A.

Study treatment will be administered via MDI device as 6 inhalations BID (every morning and evening approximately 12 hours apart):

Treatment A: HFO MDI; 6 inhalations per dose - test formulation Treatment B: HFA MDI; 6 inhalations per dose - reference formulation

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Phase 3

Contacts and Locations

• Study Contact: Name: AstraZeneca Clinical Study Information Center; Phone Number: 1-877-240-9479; Email: information.center@astrazeneca.com

Study Locations

• United States
  • California
    • San Diego, California, United States, 92103
      • Not yet recruiting
      • Research Site
    • Stanford, California, United States, 94305
      • Not yet recruiting
      • Research Site
  • Kansas
    • Kansas City, Kansas, United States, 66160
      • Recruiting
      • Research Site
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Recruiting
      • Research Site
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27599
      • Recruiting
      • Research Site
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15213
      • Recruiting
      • Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

Participants are eligible to be included in the study only if all of the following criteria apply:

1. Capable of giving signed informed consent as described in the protocol which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
2. Healthy non-smoking male and/or female participants aged 18 to 60 years inclusive at the time of signing the informed consent, without respiratory comorbidities.
3. Participant must have a forced expiratory volume in 1 second (FEV1) ≥ 80% of the predicted value for age, height, and ethnicity at screening, and FEV1/forced vital capacity (FVC) ratio of > 70%.
4. Participant must demonstrate acceptable MDI administration using empty training MDI.
5. Participant willing to comply with study IP administration requirements, defined as ≥ 80% participant medication adherence during the Treatment Periods.
6. Participant willing to use the CIS digital system per training instructions and functional requirements, including keeping the smartphone components enabled to permit data transfer, keeping the inhaler within 10 feet of the smartphone to enable syncing, etc.
7. Body mass index (BMI) within the range 18 to 35 kg/m2 (inclusive), and weight within the range 50 to 120 kg (inclusive).

8. Female participants of childbearing potential must have a negative pregnancy test at screening.

   (a) Women not of childbearing potential are defined as women who are either permanently sterilized (hysterectomy, bilateral oophorectomy, or bilateral salpingectomy), or who are postmenopausal. Women will be considered postmenopausal if they have been amenorrheic for 12 months prior to the planned date of randomization without an alternative medical cause. The following age-specific requirements apply:

   • Women < 50 years old would be considered postmenopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatment and follicle stimulating hormone (FSH) levels in the postmenopausal range.
   • Women ≥ 50 years old would be considered postmenopausal if they have been amenorrheic for 12 months or more following cessation of all exogenous hormonal treatment.

9. Female participants of childbearing potential must use one highly effective form of birth control.

   • A highly effective method of contraception is defined as one that can achieve a failure rate of less than 1% per year when used consistently and correctly. At enrollment, women of childbearing potential who are sexually active with a non-sterilized male partner should be stable on their chosen method of highly effective birth control, as defined below, and willing to remain on the birth control until at least 14 days after last dose of study intervention. Cessation of contraception after this point should be discussed with a responsible physician. Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception. Female condom and male condom should not be used together. All women of childbearing potential must have a negative serum pregnancy test result at Visit 1.

Exclusion Criteria:

Participants are excluded from the study if any of the following criteria apply:

1. History of smoking > 10 pack-years, or participant quit smoking < 6 months prior to screening.
2. Acute or chronic upper or lower respiratory illness within 30 days of screening.
3. Respiratory medication or medication impacting ciliary clearance for any indication within 30 days of screening.
4. History of radiation exposure within the past year that would cause the participant to exceed limits for adults established by Federal Regulations.
5. History of any clinically significant disease or disorder which, in the opinion of the investigator, may either put the participant at risk because of participation in the study, or influence the results or the participant's ability to participate in the study.
6. Any clinically significant illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of the IP.
7. History of any cancer except squamous cell and basal cell carcinomas of the skin.
8. Any clinically significant abnormalities in clinical chemistry, hematology, or urinalysis results, at screening as judged by the investigator.
9. Any clinically significant abnormal findings in vital signs at screening, as judged by the investigator.
10. Any clinically significant abnormalities on 12-lead ECG at screening, as judged by the investigator. Note: Participants with ECG QT interval corrected for heart rate using Fridericia's formula (QTcF) > 480 msec will be excluded.
11. A SARS-CoV-2 infection in the 8 weeks prior to Visit 1, or during the Screening Period, or that required hospitalization at any time prior to Visit 1 or during the Screening Period.
12. Participant has clinical signs and symptoms consistent with SARS-CoV-2 infection; eg, fever, dry cough, dyspnea, sore throat, fatigue, or laboratory-confirmed acute infection with SARS-CoV-2.
13. Participant who had severe course of COVID-19 (extracorporeal membrane oxygenation, mechanically ventilated, Intensive Care Unit stay).
14. History of any respiratory disorders such as asthma, chronic obstructive pulmonary disease, or idiopathic pulmonary fibrosis, alpha-1 antitrypsin, primary ciliary dyskinesia, cystic fibrosis.
15. Known or suspected history of drug abuse, as judged by the investigator.
16. Current smokers or those who have smoked or used nicotine products (including electronic cigarettes) marijuana, vaping, etc, within the 6 months prior to screening.
17. Positive screen for drugs of abuse or cotinine at screening.
18. Use of any prescribed or non-prescribed medication including antacids, analgesics (other than paracetamol/acetaminophen), herbal remedies, megadose vitamins (intake of 20 to 600 times the recommended daily dose), and minerals within 14 days or 5 half-lives (whichever is longer) prior to the first administration of IP.
19. Excessive intake of caffeine-containing drinks or food (eg, coffee, tea, chocolate) as judged by the investigator. Excessive intake of caffeine defined as the regular consumption of more than 600 mg of caffeine per day (eg, > 5 cups of coffee) or would likely be unable to refrain from the use of caffeine-containing beverages.
20. Using any herbal products either by inhalation or by nebulizer within 2 weeks of Visit 1, and does not agree to stop for the duration of the study.
21. Participation in another clinical study with an IP administered in the last 30 days or 5 half-lives, whichever is longer.
22. Involvement of any AstraZeneca, Labcorp, or study site employee or their close relatives.
23. Participants who have previously received HFO via inhalation (eg, BGF [also known as PT010, Breztri, Trixeo] HFO).
24. Judgment by the investigator that the participant should not participate in the study if they have any ongoing or recent (ie, during the Screening Period) minor medical complaints that may interfere with the interpretation of study data or are considered unlikely to comply with study procedures, restrictions, and requirements.
25. Participants who cannot communicate reliably with the investigator.
26. Vulnerable participants, eg, kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or judicial order.
27. Female participants who are currently pregnant (confirmed with positive pregnancy test), breast feeding, or planned pregnancy during the study or women of childbearing potential not using acceptable contraception measures (see Inclusion Criterion).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Treatment A: HFO MDI; Test arm, 6 inhalations BID for 7 days	Drug: HFO MDI; Dose formulation: MDI; Unit dose strength(s): Experimental (propellant only); Dosage level(s): 6 inhalations, BID; Route of administration: Oral inhalation; Participants will receive treatment A in 1 of 2 possible treatment sequences: AB or BA; Other Names: Propellant in MDI
Active Comparator: Treatment B: HFA MDI; Reference arm, 6 inhalations BID for 7 days	Drug: HFA MDI; Dose formulation: MDI; Unit dose strength(s): Reference (propellant only); Dosage level(s): 6 inhalations, BID; Route of administration: Oral inhalation; Participants will receive treatment B in 1 of 2 possible treatment sequences: AB or BA.; Other Names: Propellant in MDI

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in MCC through 60 minutes following inhalation of 99m technetium sulfur colloid and gamma camera imaging.	To assess MCC after administration of HFO MDI as compared to HFA MDI in healthy participants	7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change from baseline in MCC at 3 hours following inhalation of 99m technetium sulfur colloid and gamma camera imaging	To assess MCC after administration of HFO MDI as compared to HFA MDI in healthy participants	7 days

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety and tolerability will be evaluated in terms of AEs	To assess the safety and tolerability after administration of HFO MDI as compared to HFA MDI in healthy participants	up to 35 days

Collaborators and Investigators

• Sponsor: AstraZeneca
• Investigators: Principal Investigator: William D Bennett, PhD, University of North Carolina, Chapel Hill; Principal Investigator: Andreas Schmid, MD, University of Kansas Medical Center; Principal Investigator: Timothy Corcoran, PhD, UPMC Montefiore Hospital; Principal Investigator: Peter Mogayzel, MD, PhD, MBA, Johns Hopkins University; Principal Investigator: Douglas Conrad, MD, University of California, San Diego

Publications and helpful links

General Publications

• Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, Hallstrand TS, Kaminsky DA, McCarthy K, McCormack MC, Oropez CE, Rosenfeld M, Stanojevic S, Swanney MP, Thompson BR. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med. 2019 Oct 15;200(8):e70-e88. doi: 10.1164/rccm.201908-1590ST.
• Investigator's Brochure - Budesonide, Glycopyrronium and Formoterol Fumarate Inhalation Aerosol (BGF MDI); Budesonide and Formoterol Fumarate Inhalation Aerosol (BFF MDI); Budesonide Inhalation Aerosol (BD MDI); Glycopyrronium Inhalation Aerosol (GP MDI) (Also known as PT010 [BGF MDI], PT009 [BFF MDI], PT008 (BD MDI); PT001 (GP MDI); Edition Number 8.0, 22 April 2020.
• Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, Enright PL, Hankinson JL, Ip MS, Zheng J, Stocks J; ERS Global Lung Function Initiative. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012 Dec;40(6):1324-43. doi: 10.1183/09031936.00080312. Epub 2012 Jun 27.
• Laube BL, Carson KA, Sharpless G, Paulin LM, Hansel NN. Mucociliary Clearance in Former Tobacco Smokers with Both Chronic Obstructive Pulmonary Disease and Chronic Bronchitis and the Effect of Roflumilast. J Aerosol Med Pulm Drug Deliv. 2019 Aug;32(4):189-199. doi: 10.1089/jamp.2018.1459. Epub 2019 Apr 8.
• Bennett WD, Wu J, Fuller F, Balcazar JR, Zeman KL, Duckworth H, Donn KH, O'Riordan TG, Boucher RC, Donaldson SH. Duration of action of hypertonic saline on mucociliary clearance in the normal lung. J Appl Physiol (1985). 2015 Jun 15;118(12):1483-90. doi: 10.1152/japplphysiol.00404.2014. Epub 2015 Apr 24.

Study record dates

Study Major Dates

• Study Start (Actual): June 14, 2023
• Primary Completion (Estimated): April 30, 2024
• Study Completion (Estimated): April 30, 2024

Study Registration Dates

• First Submitted: February 23, 2023
• First Submitted That Met QC Criteria: February 23, 2023
• First Posted (Actual): March 6, 2023

Study Record Updates

• Last Update Posted (Actual): January 23, 2024
• Last Update Submitted That Met QC Criteria: January 22, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Keywords: Mucociliary Clearance, Propellant
• Other Study ID Numbers: D5985C00006

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No