Trial Outcomes & Findings for Ipratropium Bromide in Peri-Operative COPD (NCT NCT01943552)

NCT ID: NCT01943552

Last Updated: 2016-10-25

Results Overview

Change of forced expiratory volume in 1 second (FEV1) from pre-bronchodilator at baseline to post-nebulization one day before the surgery (Treatment day 3). Measurements of FEV1 were performed using calibrated electronic spirometers. Equipment and techniques should conform to American Thoracic Society (ATS) criteria (P05-12782). At screening visit, pulmonary function testing (PFT) was performed at baseline and repeated 30 minutes following inhalation of 4 puffs of salbutamol hydrofluoroalkanes metered-dose inhaler (HFA MDI). At treatment day 3, pulmonary function testing was performed 60 minutes following the inhalation of investigational drug. Spirometry was conducted with the patient in a seated position having abstained from medications. The best of three efforts was defined as the highest FEV1 each obtained on any of three efforts meeting the ATS criteria and it was selected regardless of whether they came from different spirometric manoeuvres or the same manoeuvre.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

192 participants

Primary outcome timeframe

Baseline and Treatment day 3

Results posted on

2016-10-25

Participant Flow

192 patients were randomized in a 1:1 ratio(96 patients in each group).1 patient each in both treatment groups did not receive the treatment.1 patient, who was randomized to the placebo group, but received nebulized ipratropium bromide, so the actual numbers of patients received nebulized ipratropium bromide and placebo were 96 and 94 respectively

This was randomised, double-blind, placebo-controlled, parallel-group, multicentre trial which aims to evaluate efficacy and safety of nebulized ipratropium bromide in Chinese peri-operative patients with chronic obstructive pulmonary disease (COPD) under general anaesthesia.

Participant milestones

Participant milestones
Measure
Nebulized Ipratropium Bromide
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Overall Study
STARTED
96
94
Overall Study
COMPLETED
71
69
Overall Study
NOT COMPLETED
25
25

Reasons for withdrawal

Reasons for withdrawal
Measure
Nebulized Ipratropium Bromide
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Overall Study
Adverse Event
3
2
Overall Study
Withdrawal by Subject
6
6
Overall Study
Other Reasons
16
17

Baseline Characteristics

Ipratropium Bromide in Peri-Operative COPD

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Nebulized Ipratropium Bromide
n=96 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=94 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Total
n=190 Participants
Total of all reporting groups
Age, Continuous
63.4 Years
STANDARD_DEVIATION 6.5 • n=99 Participants
62.4 Years
STANDARD_DEVIATION 6.4 • n=107 Participants
62.9 Years
STANDARD_DEVIATION 6.5 • n=206 Participants
Sex: Female, Male
Female
13 Participants
n=99 Participants
9 Participants
n=107 Participants
22 Participants
n=206 Participants
Sex: Female, Male
Male
83 Participants
n=99 Participants
85 Participants
n=107 Participants
168 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Baseline and Treatment day 3

Population: Full analysis set (FAS): All patients in the treated set who had observed analysable data in at least one efficacy endpoint. (Only patients with observed cases (OC) values were analysed)

Change of forced expiratory volume in 1 second (FEV1) from pre-bronchodilator at baseline to post-nebulization one day before the surgery (Treatment day 3). Measurements of FEV1 were performed using calibrated electronic spirometers. Equipment and techniques should conform to American Thoracic Society (ATS) criteria (P05-12782). At screening visit, pulmonary function testing (PFT) was performed at baseline and repeated 30 minutes following inhalation of 4 puffs of salbutamol hydrofluoroalkanes metered-dose inhaler (HFA MDI). At treatment day 3, pulmonary function testing was performed 60 minutes following the inhalation of investigational drug. Spirometry was conducted with the patient in a seated position having abstained from medications. The best of three efforts was defined as the highest FEV1 each obtained on any of three efforts meeting the ATS criteria and it was selected regardless of whether they came from different spirometric manoeuvres or the same manoeuvre.

Outcome measures

Outcome measures
Measure
Nebulized Ipratropium Bromide
n=94 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=89 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Change of Forced Expiratory Volume in 1 Second (FEV1) From Pre-bronchodilator at Baseline to Post-nebulization One Day Before the Surgery
169.9 ml
Standard Error 29.07
15.0 ml
Standard Error 29.35

SECONDARY outcome

Timeframe: Baseline and Treatment day 3

Population: Full analysis set (FAS). (Only patients with observed cases (OC) values were analysed)

Change of forced vital capacity (FVC) from pre-bronchodilator at baseline to post-nebulization one day before the surgery (Treatment day 3). Measurements of FVC were performed using calibrated electronic spirometers. Equipment and techniques should conform to American Thoracic Society (ATS) criteria (P05-12782). At Visit 1, pulmonary function testing (PFT) was performed at baseline and repeated 30 minutes following inhalation of 4 puffs of salbutamol hydrofluoroalkanes metered-dose inhaler (HFA MDI). At Visit 3, pulmonary function testing was performed 60 minutes following the inhalation of investigational drug. Spirometry was conducted with the patient in a seated position having abstained from medications. The best of three efforts was defined as the highest FVC each obtained on any of three efforts meeting the ATS criteria and it was selected regardless of whether they came from different spirometric manoeuvres or the same manoeuvre.

Outcome measures

Outcome measures
Measure
Nebulized Ipratropium Bromide
n=94 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=89 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Change of Forced Vital Capacity (FVC) From Pre-bronchodilator at Baseline to Post-nebulization One Day Before the Surgery
59.4 ml
Standard Error 48.76
8.5 ml
Standard Error 49.27

SECONDARY outcome

Timeframe: Baseline and Treatment day 3

Population: Full analysis set (FAS). (Only patients with observed cases (OC) values were analysed)

Change of blood gas analyses from pre-bronchodilator at baseline to post-nebulization one day before the surgery (Treatment day 3): arterial oxygen pressure (PaO2) value

Outcome measures

Outcome measures
Measure
Nebulized Ipratropium Bromide
n=89 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=80 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Change of Blood Gas Analyses From Pre-bronchodilator at Baseline to Post-nebulization One Day Before the Surgery: Arterial Oxygen Pressure (PaO2) Value
3.2 mmHg
Standard Error 1.92
0.5 mmHg
Standard Error 1.92

SECONDARY outcome

Timeframe: Baseline and Treatment day 3

Population: Full analysis set (FAS). (Only patients with observed cases (OC) values were analysed)

Change of blood gas analyses from pre-bronchodilator at baseline to post-nebulization one day before the surgery (Treatment day 3): Oxygen saturation

Outcome measures

Outcome measures
Measure
Nebulized Ipratropium Bromide
n=89 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=81 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Change of Blood Gas Analyses From Pre-bronchodilator at Baseline to Post-nebulization One Day Before the Surgery: Oxygen Saturation
0.6 Percentage of Oxygen
Standard Error 0.25
0.3 Percentage of Oxygen
Standard Error 0.25

SECONDARY outcome

Timeframe: Baseline and Treatment day 3

Population: Full analysis set (FAS). (Only patients with observed cases (OC) values were analysed)

Change of blood gas analyses from pre-bronchodilator at baseline to post-nebulization one day before the surgery (Treatment day 3): arterial carbon dioxide pressure (PaCO2) value

Outcome measures

Outcome measures
Measure
Nebulized Ipratropium Bromide
n=89 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=80 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Change of Blood Gas Analyses From Pre-bronchodilator at Baseline to Post-nebulization One Day Before the Surgery: Arterial Carbon Dioxide Pressure (PaCO2) Value
-0.1 mmHg
Standard Error 0.51
-0.5 mmHg
Standard Error 0.52

SECONDARY outcome

Timeframe: From surgery to 3 weeks post surgery, up to 21 days

Population: Surgery complete set (SCS): All patients who completed surgery.

Number of patients with at least one main post-operative pulmonary complications (including pneumonia, atelectasis and acute respiratory failure) within three weeks after the surgery. Post-operative pneumonia was defined by the presence of the following criteria: persistent lung infiltrate on chest X-ray or chest computerized tomography (CT)-scan, white blood cell count \>10,000 /mm3 and fever. Post-operative atelectasis was diagnosed by presence of atelectasis affecting one lobe or several lobes in chest X-ray test or chest CT-scan. Post-operative acute respiratory failure was defined by the presence of: PaO2 \< 60 mmHg and/or PaCO2 \> 50 mmHg while breathing air or other evidences which were considered as respiratory failure by investigators.

Outcome measures

Outcome measures
Measure
Nebulized Ipratropium Bromide
n=77 Participants
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=78 Participants
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Main Post-operative Pulmonary Complications (Including Pneumonia, Atelectasis and Acute Respiratory Failure) Within Three Weeks After the Surgery
8 Participants
14 Participants

Adverse Events

Nebulized Ipratropium Bromide

Serious events: 5 serious events
Other events: 15 other events
Deaths: 0 deaths

Placebo

Serious events: 4 serious events
Other events: 16 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Nebulized Ipratropium Bromide
n=96 participants at risk
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=94 participants at risk
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Cardiac disorders
Cardiac arrest
0.00%
0/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
1.1%
1/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
General disorders
Pyrexia
1.0%
1/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
0.00%
0/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Immune system disorders
Anaphylactic shock
1.0%
1/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
0.00%
0/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Infections and infestations
Post procedural pneumonia
0.00%
0/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
1.1%
1/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Respiratory, thoracic and mediastinal disorders
Acute respiratory failure
1.0%
1/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
1.1%
1/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Respiratory, thoracic and mediastinal disorders
Atelectasis
1.0%
1/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
1.1%
1/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Respiratory, thoracic and mediastinal disorders
Pneumothorax
1.0%
1/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
0.00%
0/94 • From first drug administration until 14 days after the last drug administration, up to 32 days

Other adverse events

Other adverse events
Measure
Nebulized Ipratropium Bromide
n=96 participants at risk
500 microgram (mcg) ipratropium bromide solution was administered orally via nebulizer four times a day up to 11 days.
Placebo
n=94 participants at risk
4 milliliter (ml) normal saline was administered orally via nebulizer four times a day up to 11 days.
Infections and infestations
Post procedural pneumonia
2.1%
2/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
9.6%
9/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Injury, poisoning and procedural complications
Wound complication
8.3%
8/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
10.6%
10/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Respiratory, thoracic and mediastinal disorders
Sputum retention
4.2%
4/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
7.4%
7/94 • From first drug administration until 14 days after the last drug administration, up to 32 days
Vascular disorders
Hypertension
5.2%
5/96 • From first drug administration until 14 days after the last drug administration, up to 32 days
1.1%
1/94 • From first drug administration until 14 days after the last drug administration, up to 32 days

Additional Information

Boehringer Ingelheim, Call Center

Boehringer Ingelheim

Phone: 1-800-243-0127

Results disclosure agreements

  • Principal investigator is a sponsor employee Boehringer Ingelheim (BI) acknowledges that investigators have the right to publish the study results. Investigators shall provide BI with a copy of any publication or presentation for review prior to any submission. Such review will be done with regard to proprietary information, information related to patentable inventions, medical, scientific, and statistical accuracy within 60 days. BI may request a delay of the publication in order to protect BI's intellectual property rights.
  • Publication restrictions are in place

Restriction type: OTHER