Trial Outcomes & Findings for A Study on Whether Patients Prefer the Spiriva® Respimat® or the Spiriva® Handihaler® for Treating Their Chronic Obstructive Pulmonary Disease (COPD) (NCT NCT03964207)

NCT ID: NCT03964207

Last Updated: 2023-10-13

Results Overview

The score on the performance domain of the Patient satisfaction and preference questionnaire (PASAPQ) after 4 weeks of treatment is reported. The performance domain score is the sum of 7 questions (Q) within the domain (Q1, Q2, Q3, Q4, Q5, Q10 and Q11), the range for each question went from 1 to 7 the higher the better. The score was then transformed to a 0 (least) to 100 (most) point scale following ((Q1+Q2+Q3+Q4+Q5+Q10+Q11)/49)\*100, the higher the better performance. The performance domain of PASAPQ) was analysed using Mixed-effects Model for Repeated Measures (MMRM), with treatment and period as fixed effects, and patient as a random effect. Compound symmetry was used as a covariance structure for within-patient variation.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

72 participants

Primary outcome timeframe

After 4 weeks of treatment (at week 4 and week 8)

Results posted on

2023-10-13

Participant Flow

This was a randomised, open-label, 2 -way cross-over design, to compare patient acceptability/preference of Tiotropium Respimat® (T1),with Tiotropium Handihaler® (T2) in patients with moderate to very severe chronic obstructive pulmonary disease (COPD).

All subjects were screened for eligibility prior to participation in the trial. Subjects attended a specialist site which ensured that they (the subjects) strictly met all inclusion and none of the exclusion criteria. Subjects were not to be allocated to a treatment group if any of the entry criteria were violated.

Participant milestones

Participant milestones
Measure
(T1): 5μg Tiotropium Respimat®, Then (T2): 18μg Tiotropium Handihaler®
From Day 1 of Period 1 participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®. From Day 1 of Period 2 participants received comparator treatment(T2): tiotropium Handihaler® (Spiriva®) 18μg once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
(T2): 18μg Tiotropium Handihaler®, Then (T1): 5μg Tiotropium Respimat®
From Day 1 of Period 1 participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device. From Day 1 of Period 2 participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
First Treatment
STARTED
37
35
First Treatment
Treated
36
35
First Treatment
COMPLETED
34
33
First Treatment
NOT COMPLETED
3
2
Second Treatment
STARTED
34
33
Second Treatment
COMPLETED
33
30
Second Treatment
NOT COMPLETED
1
3

Reasons for withdrawal

Reasons for withdrawal
Measure
(T1): 5μg Tiotropium Respimat®, Then (T2): 18μg Tiotropium Handihaler®
From Day 1 of Period 1 participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®. From Day 1 of Period 2 participants received comparator treatment(T2): tiotropium Handihaler® (Spiriva®) 18μg once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
(T2): 18μg Tiotropium Handihaler®, Then (T1): 5μg Tiotropium Respimat®
From Day 1 of Period 1 participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device. From Day 1 of Period 2 participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
First Treatment
Withdrawal by Subject
1
2
First Treatment
Protocol Violation
1
0
First Treatment
Lost to Follow-up
1
0
Second Treatment
Lost to Follow-up
0
1
Second Treatment
Adverse Event
1
2

Baseline Characteristics

A Study on Whether Patients Prefer the Spiriva® Respimat® or the Spiriva® Handihaler® for Treating Their Chronic Obstructive Pulmonary Disease (COPD)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
(T1): 5μg Tiotropium Respimat®, Then (T2): 18μg Tiotropium Handihaler®
n=36 Participants
From Day 1 of Period 1 participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®. From Day 1 of Period 2 participants received comparator treatment(T2): tiotropium Handihaler® (Spiriva®) 18μg once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
(T2): 18μg Tiotropium Handihaler®, Then (T1): 5μg Tiotropium Respimat®
n=35 Participants
From Day 1 of Period 1 participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device. From Day 1 of Period 2 participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
Total
n=71 Participants
Total of all reporting groups
Age, Continuous
67.4 Years
STANDARD_DEVIATION 6.54 • n=99 Participants
65.2 Years
STANDARD_DEVIATION 7.23 • n=107 Participants
66.3 Years
STANDARD_DEVIATION 6.93 • n=206 Participants
Sex: Female, Male
Female
2 Participants
n=99 Participants
0 Participants
n=107 Participants
2 Participants
n=206 Participants
Sex: Female, Male
Male
34 Participants
n=99 Participants
35 Participants
n=107 Participants
69 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
36 Participants
n=99 Participants
35 Participants
n=107 Participants
71 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
36 Participants
n=99 Participants
35 Participants
n=107 Participants
71 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
White
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants

PRIMARY outcome

Timeframe: After 4 weeks of treatment (at week 4 and week 8)

Population: Full analysis set (FAS) is defined as all patients who were randomized to treatment sequence and received at least one dose of one study drug and providing at least one PASAPQ score measurement. Only patients with no missing values were included for the analysis.

The score on the performance domain of the Patient satisfaction and preference questionnaire (PASAPQ) after 4 weeks of treatment is reported. The performance domain score is the sum of 7 questions (Q) within the domain (Q1, Q2, Q3, Q4, Q5, Q10 and Q11), the range for each question went from 1 to 7 the higher the better. The score was then transformed to a 0 (least) to 100 (most) point scale following ((Q1+Q2+Q3+Q4+Q5+Q10+Q11)/49)\*100, the higher the better performance. The performance domain of PASAPQ) was analysed using Mixed-effects Model for Repeated Measures (MMRM), with treatment and period as fixed effects, and patient as a random effect. Compound symmetry was used as a covariance structure for within-patient variation.

Outcome measures

Outcome measures
Measure
(T1): 5μg Tiotropium Respimat®
n=66 Participants
Participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
(T2): 18μg Tiotropium Handihaler®
n=68 Participants
Participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
Performance Domain of the Patient Satisfaction and Preference Questionnaire (PASAPQ) After 4 Weeks of Treatment
79.830 Scores on a scale
Standard Deviation 15.052
85.112 Scores on a scale
Standard Deviation 11.583

SECONDARY outcome

Timeframe: After 4 weeks of treatment (at week 4 and week 8)

Population: Full analysis set (FAS) is defined as all patients who were randomized to treatment sequence and received at least one dose of one study drug and providing at least one PASAPQ score measurement. Only participants with non-missing results were included in the analysis.

The total score on the Patient satisfaction and preference questionnaire (PASAPQ) after 4 weeks of treatment is reported. The Total score is the sum of 13 questions (Q1-Q13) and then transformed to a 0 (least) to 100 (most) point scale. This continuous secondary endpoint was analyzed using a similar MMRM model as for the primary endpoint.

Outcome measures

Outcome measures
Measure
(T1): 5μg Tiotropium Respimat®
n=66 Participants
Participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
(T2): 18μg Tiotropium Handihaler®
n=68 Participants
Participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
PASAPQ Total Score After 4 Weeks of Treatment
81.51 Scores on a scale
Standard Deviation 13.67
85.69 Scores on a scale
Standard Deviation 10.802

SECONDARY outcome

Timeframe: At Week 8.

Population: Full analysis set (FAS) is defined as all patients who were randomized to treatment sequence and received at least one dose of one study drug and providing at least one PASAPQ score measurement.

The percentage of patients indicating preference in the Patient satisfaction and preference questionnaire (PASAPQ) at week 8 is reported. The questionnaire PASAPQ is a two part questionnaire, in Part II of the PASAPQ the stand-alone question 15 (Q15) was asked for a response to indicate the preference for the trial device, it had three possible answers: "I prefer Respimat", "I prefer Handihaler", "No answer to this question " and "no preference". Chi-squared test was used to analyze proportion of patients indicating preference in the Patient satisfaction and preference questionnaire (PASAPQ) at week 8.

Outcome measures

Outcome measures
Measure
(T1): 5μg Tiotropium Respimat®
n=69 Participants
Participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
(T2): 18μg Tiotropium Handihaler®
Participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
Percentage of Patients Indicating Preference at Week 8
I prefer Respimat
50.7 Percentage
Percentage of Patients Indicating Preference at Week 8
I prefer Handihaler
37.7 Percentage
Percentage of Patients Indicating Preference at Week 8
No preference
5.8 Percentage
Percentage of Patients Indicating Preference at Week 8
No answer to this question
5.8 Percentage

SECONDARY outcome

Timeframe: At the end of 4 weeks of treatment

Population: Full analysis set (FAS) is defined as all patients who were randomized to treatment sequence and received at least one dose of one study drug and providing at least one PASAPQ score measurement. Only participants with non-missing endpoints were included in the analysis.

The overall satisfaction question score in the Patient satisfaction and preference questionnaire (PASAPQ) at week 4 and 8 is reported (after 4 weeks of treatment). In Part I of the questionnaire PASAPQ: the Question 14 (Q14) asked for the overall satisfaction with the device used in the study. Q14 had Likert-type response options of 1 (very dissatisfied) to 7 (very satisfied) and was then transformed to a 0 (least) to 100 (most) point scale (if a patient scored "x", the transfer to 0-100 scale was x/7\*100). Mixed-effects Model for Repeated Measures (MMRM) was used to analyze the overall satisfaction question score, with treatment and period as fixed effects, and patient as a random effect.

Outcome measures

Outcome measures
Measure
(T1): 5μg Tiotropium Respimat®
n=66 Participants
Participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
(T2): 18μg Tiotropium Handihaler®
n=68 Participants
Participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
Overall Satisfaction Question Score From PASAPQ After 4 Weeks of Treatment
82.56 Score on a scale
Standard Deviation 19.702
87.24 Score on a scale
Standard Deviation 12.257

SECONDARY outcome

Timeframe: At Week 8.

Population: Full analysis set (FAS) is defined as all patients who were randomized to treatment sequence and received at least one dose of one study drug and providing at least one PASAPQ score measurement. Only participants with non-missing results were included in the analysis.

The score on willingness to continue in the Patient satisfaction and preference questionnaire (PASAPQ) at week 8 is reported. The PASAPQ is a two part questionnaire, in Part I of the questionnaire PASAPQ the Question 16 (Q16) asked for a response between 0 and 100 with 0 indicating not willing to continue using the trial device and 100 indicating definitely willingness to continue. Mixed-effects Model for Repeated Measures (MMRM) was used to analyze the score on willingness to continue, with treatment and period as fixed effects, and patient as a random effect.

Outcome measures

Outcome measures
Measure
(T1): 5μg Tiotropium Respimat®
n=65 Participants
Participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
(T2): 18μg Tiotropium Handihaler®
n=65 Participants
Participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
Score on Willingness to Continue at Week 8
82.9 Scores on a scale
Standard Deviation 28.10
87.3 Scores on a scale
Standard Deviation 19.19

Adverse Events

(T1): 5μg Tiotropium Respimat®

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

(T2): 18μg Tiotropium Handihaler®

Serious events: 2 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
(T1): 5μg Tiotropium Respimat®
n=69 participants at risk
Participants received Test treatment (T1): tiotropium Respimat® (Spiriva® Respimat®) 5 microgram (μg) once daily for a duration of 4 weeks, given as 2.5μg per puff, two puffs (2.5μg per puff) inhalation solution of tiotropium, orally via Respimat®.
(T2): 18μg Tiotropium Handihaler®
n=69 participants at risk
Participants received comparator treatment (T2): tiotropium Handihaler® (Spiriva®) 18 microgram (μg) once daily for a duration of 4 weeks, inhalation powder tiotropium with 1 Handihaler® device.
Musculoskeletal and connective tissue disorders
Foot deformity
0.00%
0/69 • From first treatment intake until 28 days after last treatment intake. Up to 56 days.
Treated set (TS) is defined as all patients who were dispensed study medication and were documented to have at least one dose of investigational treatment.
1.4%
1/69 • From first treatment intake until 28 days after last treatment intake. Up to 56 days.
Treated set (TS) is defined as all patients who were dispensed study medication and were documented to have at least one dose of investigational treatment.
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion
1.4%
1/69 • From first treatment intake until 28 days after last treatment intake. Up to 56 days.
Treated set (TS) is defined as all patients who were dispensed study medication and were documented to have at least one dose of investigational treatment.
0.00%
0/69 • From first treatment intake until 28 days after last treatment intake. Up to 56 days.
Treated set (TS) is defined as all patients who were dispensed study medication and were documented to have at least one dose of investigational treatment.
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
1.4%
1/69 • From first treatment intake until 28 days after last treatment intake. Up to 56 days.
Treated set (TS) is defined as all patients who were dispensed study medication and were documented to have at least one dose of investigational treatment.
1.4%
1/69 • From first treatment intake until 28 days after last treatment intake. Up to 56 days.
Treated set (TS) is defined as all patients who were dispensed study medication and were documented to have at least one dose of investigational treatment.

Other adverse events

Adverse event data not reported

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