AsthmaPhase 3POPCICLENCT00163293
Efficacy of Ciclesonide Inhaled Once Daily Versus Other Corticosteroids Used for Treatment of Mild Asthma in Children (4 to 11 Years) (BY9010/CA-101)
A Phase 3 study testing Ciclesonide in people with Asthma, run by AstraZeneca at 7 sites in 3 countries.
Trial summary
The aim of this study is to compare the efficacy of ciclesonide with respect to reduction of the number of asthma exacerbations in children with mild persistent asthma. Treatment medication will be administered as follows: ciclesonide will be inhaled once daily, using one of the two dose levels versus placebo together… Read more about this study
- Who is it for?
- Ages 4 to 11 years
- Conditions the study is for
- Asthma
- What is being tested?
- Ciclesonide
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 240 participants
- Where
- 7 sitesin 3 countries
- Study dates
- 1 Jan 2005to 1 Apr 2010
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 4 to 11 years
- All sexes
- No healthy volunteers
- Child
Main Inclusion Criteria:
- Outpatients
- Symptoms consistent with the diagnosis of asthma for at least 12 months
- Forced Expiratory Volume in one Second (FEV) at least 80% of predicted
- Participants who have a history of reversible airway obstruction
- Good health with the exception of asthma
Main Exclusion Criteria:
- History of life-threatening asthma
- A hospitalization for asthma within the last 3 months, or more than two hospitalizations for asthma within the last year
- Concomitant severe diseases or diseases which are contraindications for the use of inhaled steroids
- Participants suffering from relevant lung diseases causing alternating impairment in lung function (e.g. chronic bronchitis or emphysema)
- Prematurely born children (<36 weeks of gestation)
- Smokers
- Pregnancy (or intention to become pregnant during the course of the trial), breast feeding or lack of safe contraception by female of child-bearing potential
Trial locations and contacts
7 sites in 3 countries.
7 sites in 3 countries
Canada5 sites
Altana Pharma/Nycomed
Calgary, T2T5C7
Altana Pharma/Nycomed
Fleurimont, J1H 5M4
Altana Pharma/Nycomed
London, N6C 4Y7
Altana Pharma/Nycomed
London,ON, N6A1V2
Altana Pharma/Nycomed
Winnipeg, R3A1R9
About this study
Official title: Effect of Low Dose Continuous Treatment With Ciclesonide Over One Year on the Time to First Exacerbation in Children With Mild Asthma Versus Intermittent Treatment for Exacerbations
The aim of this study is to compare the efficacy of ciclesonide with respect to reduction of the number of asthma exacerbations in children with mild persistent asthma. Treatment medication will be administered as follows: ciclesonide will be inhaled once daily, using one of the two dose levels versus placebo together with other corticosteroids used as intermittent treatment. The study duration consists of a baseline period (3 to 4 weeks) and a treatment period (12 months). The study will provide further data on safety and tolerability of ciclesonide.
Read the detailed description
The drug being tested in this study is called ciclesonide. Ciclesonide is being tested to treat children who have mild asthma.
The study enrolled 240 patients. Participants were randomly assigned (by chance, like flipping a coin) to one of the three treatment groups-which remained undisclosed to the patient and study doctor during the study (unless there was an urgent medical need):
- Ciclesonide 100 µg
- Ciclesonide 200 µg
- Placebo (dummy inactive inhalation) - this is a metered-dose inhaler that looks like the study drug but has no active ingredient.
All participants were asked to take two puffs from a metered-dose inhaler once daily, in the evening, for up to 12 months.
This multi-center trial was conducted in Canada, Hungary and South Africa. The overall time to participate in this study was 12 months preceded by a baseline washout period of 3 to 4 weeks. Participants made multiple visits to the clinic including a safety follow-up visit within 30 days of the last treatment.
- Conditions
- Asthma
- Being tested
- Ciclesonide, Placebo
- Keywords
- Asthma, Ciclesonide, Exacerbation
- Medical subject headings
- Asthma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CiclesonideDrug
Also called Alvesco®
Ciclesonide metered-dose inhaler
PlaceboDrug
Ciclesonide placebo-matching metered-dose inhaler
| Study group | Role | What they receive |
|---|---|---|
| Placebo | Placebo comparator | Not described Receives: Drug: Placebo |
| Ciclesonide 100 µg | Active comparator | Ciclesonide 100 µg, metered-dose inhaler, two puffs once daily, in the evening, for up to 12 months. Receives: Drug: Ciclesonide |
| Ciclesonide 200 µg | Active comparator | Ciclesonide 200 µg, metered-dose inhaler, two puffs once daily, in the evening, for up to 12 months. Receives: Drug: Ciclesonide |
What is being measured
The primary outcome is the main question the study is designed to answer.
Time to First Asthma Exacerbation
Time to first asthma exacerbation is defined as the time in days until the first asthma exacerbation, or to the end of treatment visit. In the absence of an exacerbation, an early treatment discontinuation is treated as a censored observation on the day following the last use of study drug.
Measured: Up to 12 months
Exacerbations (Post-hoc Analysis of Annual Rates)
A model-based analysis of asthma exacerbation was performed to adjust to important covariables. The distribution of the data suggested a Poisson regression modeling (zero inflated) strategy. After a variable selection process considering also variable-by-treatment interactions, the variables centre, age [years] and race were identified to be important beside treatment. The parameters centre and age [years] were allocated to zero-model part and the variables treatment and race to the Poisson model part. The estimates of the per-treatment rates are based on a negative-binomial distribution.
Measured: Up to 12 months
Secondary outcomes (21)
Growth Velocity as Assessed by Stadiometric Height Measurement
Standing height measured in millimeters (mm) with a wall-mounted stadiometer.
Measured: Up to 12 months
Mean Rate of Asthma Exacerbations Per Year
Rate of asthma exacerbations per year is equal to total number of asthma exacerbations during treatment/time on treatment (year).
Measured: Up to 12 months
Duration of Exacerbations
Duration of exacerbation was defined as the time in days when the criteria for an exacerbation were met to the time when peak flow measurements returned to baseline.
Measured: Up to 12 months
Number of Exacerbations Per Participant
The mean number of asthma exacerbations per participant is reported.
Measured: Up to 12 months
Percentage of Participants Who Dropped-out Due to Asthma Exacerbation
Measured: Up to 12 months
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) (Absolute Value)
FEV1 is the maximal amount of air forcefully exhaled from the lungs in one second. Spirometry was used for assessment of FEV1. A positive change from Baseline indicates improvement.
Measured: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) (Percent Predicted)
FEV1 is the maximal amount of air forcefully exhaled from the lungs in one second. Spirometry was used for assessment of FEV1. A positive change from Baseline indicates improvement.
Measured: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Morning and Evening Peak Expiratory Flow (PEF) Measurements by Diary Entries
PEF is the maximum speed of expiration. Spirometry was used for assessment of PEF.
Measured: Months 1, 2, 4, 6, 8, 10 and 12
Change From Baseline in PEF by Diary Entries
PEF is the maximum speed of expiration. Spirometry was used for assessment of PEF. A positive change from Baseline indicates improvement.
Measured: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Change From Baseline in Diurnal PEF Fluctuation
Diurnal PEF Fluctuation is equal to [(Higher PEF - Lower PEF)/0.5*(Higher PEF + Lower PEF)] * 100%. A positive change from Baseline indicates improvement.
Measured: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Total Asthma Symptom Score by Diary Entries
Total Asthma Score = daytime asthma score + night-time asthma score, where higher score indicates worsening of disease. Night-time asthma score is assessed on a 5 point scale where 0=No symptoms, slept through the night, 1=Slept well but some complaints in the morning, 2=Woke up once because of asthma (including early wakening), 3=Woke up several times because of asthma (including early wakening) and 4=Bad night, awake most of the night because of asthma. Day-time asthma score is assessed on a 5 point scale where 0= Very well, no symptoms, 1= One episode of wheezing, cough or breathlessness, 2= More than one episode of wheezing, cough or breathlessness without interfering with normal activities, 3= Wheezing, cough or shortness of breath most of the day which interfered to some extent with normal activities and 4= Asthma very bad. Unable to carry out daily activities as usual.
Measured: Months 1, 2, 4, 6, 8, 10 and 12
Percentage of Nights With Nocturnal Awakenings Due to Asthma Symptoms
Nocturnal awakenings due to asthma symptoms were recorded in the participant's diary.
Measured: Months 1, 2, 4, 6, 8, 10 and 12
Rescue Medication Use Per Day
Salbutamol (100 μg/puff) was used as rescue medication according to the individual needs of the participant. Each use was documented in the participant's diary.
Measured: Months 1, 2, 4, 6, 8, 10 and 12
Percentage of Rescue Medication Free Days
Days without use of rescue medication documented in the participant's diary were reported.
Measured: Months 1, 2, 4, 6, 8, 10 and 12
Percentage of Asthma Symptom Free Days
Days without Asthma Symptom documented in the participant's diary were reported.
Measured: Months 1, 2, 4, 6, 8, 10 and 12
Quality of Life Assessments as Per Paediatric Asthma Quality of Life Questionnaire, Standardized (PAQLQ[S])
The PAQLQ(S) consists of 23 items divided into three domains: Activity limitations (items 1-3, 19, 22); Symptoms (items 4, 6, 8, 10, 12, 14, 16, 18, 20, 23) and Emotional function (items 5, 7, 9, 11, 13, 15, 17, 21). Participants were asked to answer each question using a seven-point scale (where "1" indicated maximum impairment and "7" indicated no impairment) and recall their experience during the previous week. Overall PAQLQ score is equal to the mean of all 23 items for a total possible score 1 (worst) to 7 (best).
Measured: Months 2, 6 and 12
Quality of Life Assessments as Per Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ)
The PACQLQ consists of 13 items divided into two domains: Activity limitations (items 2, 4, 6, 8) and Emotional function (items 1, 3, 5, 7, 9, 10, 11, 12, 13). Caregivers answered each question using a seven-point scale (whereby "1" indicated maximum impairment and "7" indicated no impairment) and recalled their experiences during the previous week. Overall PACQLQ score is equal to the mean of all 13 items for a total possible score of 1 (worst) to 7 (best).
Measured: Months 2, 6 and 12
Number of Participants With Clinically Significant Vital Signs Findings
Vital signs included body temperature, systolic and diastolic blood pressure and heart rate in beats per minute (bpm). The investigator determined if the result was clinically significant based on the following criteria: Systolic Blood Pressure >130 mmHg or <80 mmHg or a >20 mmHg difference from Baseline; Diastolic Blood Pressure > 85 mmHg; and Resting Heart Rate >140 bpm or <60 bpm or a >30 bpm difference from Baseline.
Measured: Up to 12 months
Number of Participants With Clinically Significant Physical Examination Findings
A thorough physical examination was performed consisting of examinations of the following body systems: (1) eyes; (2) ears, nose, throat; (3) lungs/thorax; (4) heart/cardiovascular system; (5) abdomen; (6) skin and mucosae; (7) nervous system; (8) lymph nodes; (9) musculo-skeletal system; (10) physical examinations other than body systems described in (1) to (9). The investigator determined if any of the findings were clinically significant.
Measured: Up to 12 months
Number of Participants With Clinically Significant Laboratory Values
Clinically significant laboratory values were hematology and chemistry tests determined by the investigator to be clinically significant based on the following criteria: Hemoglobin <9.5 g/dL; Erythrocytes <3.0 x 10^6/μL or >6.5 x 10^6/μL; White Blood Count <3000/mm^3 or >20000/mm^3; serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), gamma-glutamyl transpeptidase (GGT), Total Bilirubin and Glucose >2 times Upper limit of Normal Range (ULNR); Alkaline Phosphatase and Creatine Kinase >3 times ULNR; Creatinine >1.5 times ULN; Potassium >5.0 mmol/L or <3.0 mmol/L; and Sodium >150 mmol/L or 130 mmol/L.
Measured: Up to 12 months
Number of Participants With Adverse Events and Serious Adverse Events
An Adverse Event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. A SAE is any untoward medical occurrence that at any dose results in death, is life-threatening, requires in-patient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, results in congenital anomaly/birth defect or any other important medical condition considered serious based on medical and scientific judgement.
Measured: Up to 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Sep 2005 (estimated)
- Study start1 Jan 2005
- Primary completion1 Jun 2009
- Study completion1 Apr 2010
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for AsthmaStudies of the same condition, open and under way.
- More trials run by AstraZenecaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 240 participants (actual)
Sponsor and investigators
- Lead sponsor
- AstraZeneca
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- AstraZeneca AstraZeneca, Study director, AstraZeneca
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00163293
- Sponsor's protocol ID
- BY9010/CA-101
- Other IDs
- 2007-003736-34, U1111-1189-7814
- Acronym
- POPCICLE
- Status last verified
- Mar 2017
- First submitted
- 12 Sep 2005
- Last updated
- 26 Apr 2017
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 26 Apr 2017. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Low Dose Continuous Treatment With Ciclesonide Over One Year on the Time to First Exacerbation in Children With Mild Asthma Versus Intermittent Treatment for Exacerbations
- ClinicalTrials.gov ID
- NCT00163293
- Acronym / sponsor ID
- POPCICLE / BY9010/CA-101
- Conditions
- Asthma
- Keywords
- Asthma, Ciclesonide, Exacerbation
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 240 participants (actual)
- Lead sponsor
- AstraZenecaIndustry (pharma, biotech, devices)
- Study start
- 1 Jan 2005 (actual)
- Primary completion
- 1 Jun 2009 (actual)
- Study completion
- 1 Apr 2010 (actual)
- First posted
- 14 Sep 2005 (estimated)
- Results
- Posted 22 Dec 2010
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this study is to compare the efficacy of ciclesonide with respect to reduction of the number of asthma exacerbations in children with mild persistent asthma. Treatment medication will be administered as follows: ciclesonide will be inhaled once daily, using one of the two dose levels versus placebo together with other corticosteroids used as intermittent treatment. The study duration consists of a baseline period (3 to 4 weeks) and a treatment period (12 months). The study will provide further data on safety and tolerability of ciclesonide.
Detailed description
The drug being tested in this study is called ciclesonide. Ciclesonide is being tested to treat children who have mild asthma.
The study enrolled 240 patients. Participants were randomly assigned (by chance, like flipping a coin) to one of the three treatment groups-which remained undisclosed to the patient and study doctor during the study (unless there was an urgent medical need):
- Ciclesonide 100 µg
- Ciclesonide 200 µg
- Placebo (dummy inactive inhalation) - this is a metered-dose inhaler that looks like the study drug but has no active ingredient.
All participants were asked to take two puffs from a metered-dose inhaler once daily, in the evening, for up to 12 months.
This multi-center trial was conducted in Canada, Hungary and South Africa. The overall time to participate in this study was 12 months preceded by a baseline washout period of 3 to 4 weeks. Participants made multiple visits to the clinic including a safety follow-up visit within 30 days of the last treatment.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Placebo | Placebo comparator | Drug: Placebo |
| Ciclesonide 100 µg | Active comparator | Drug: CiclesonideCiclesonide 100 µg, metered-dose inhaler, two puffs once daily, in the evening, for up to 12 months. |
| Ciclesonide 200 µg | Active comparator | Drug: CiclesonideCiclesonide 200 µg, metered-dose inhaler, two puffs once daily, in the evening, for up to 12 months. |
Who may qualify
- Ages
- 4 to 11 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| CiclesonideAlso: Alvesco®Ciclesonide metered-dose inhaler | Drug | Ciclesonide 100 µg, Ciclesonide 200 µg |
| PlaceboCiclesonide placebo-matching metered-dose inhaler | Drug | Placebo |
Primary outcome
Time to First Asthma Exacerbation
Time frame: Up to 12 months
Time to first asthma exacerbation is defined as the time in days until the first asthma exacerbation, or to the end of treatment visit. In the absence of an exacerbation, an early treatment discontinuation is treated as a censored observation on the day following the last use of study drug.
Exacerbations (Post-hoc Analysis of Annual Rates)
Time frame: Up to 12 months
A model-based analysis of asthma exacerbation was performed to adjust to important covariables. The distribution of the data suggested a Poisson regression modeling (zero inflated) strategy. After a variable selection process considering also variable-by-treatment interactions, the variables centre, age [years] and race were identified to be important beside treatment. The parameters centre and age [years] were allocated to zero-model part and the variables treatment and race to the Poisson model part. The estimates of the per-treatment rates are based on a negative-binomial distribution.
21 secondary outcomes
Growth Velocity as Assessed by Stadiometric Height Measurement
Time frame: Up to 12 months
Mean Rate of Asthma Exacerbations Per Year
Time frame: Up to 12 months
Duration of Exacerbations
Time frame: Up to 12 months
Number of Exacerbations Per Participant
Time frame: Up to 12 months
Percentage of Participants Who Dropped-out Due to Asthma Exacerbation
Time frame: Up to 12 months
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) (Absolute Value)
Time frame: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) (Percent Predicted)
Time frame: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Morning and Evening Peak Expiratory Flow (PEF) Measurements by Diary Entries
Time frame: Months 1, 2, 4, 6, 8, 10 and 12
Change From Baseline in PEF by Diary Entries
Time frame: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Change From Baseline in Diurnal PEF Fluctuation
Time frame: Baseline and Months 1, 2, 4, 6, 8, 10 and 12
Total Asthma Symptom Score by Diary Entries
Time frame: Months 1, 2, 4, 6, 8, 10 and 12
Percentage of Nights With Nocturnal Awakenings Due to Asthma Symptoms
Time frame: Months 1, 2, 4, 6, 8, 10 and 12
Rescue Medication Use Per Day
Time frame: Months 1, 2, 4, 6, 8, 10 and 12
Percentage of Rescue Medication Free Days
Time frame: Months 1, 2, 4, 6, 8, 10 and 12
Percentage of Asthma Symptom Free Days
Time frame: Months 1, 2, 4, 6, 8, 10 and 12
Quality of Life Assessments as Per Paediatric Asthma Quality of Life Questionnaire, Standardized (PAQLQ[S])
Time frame: Months 2, 6 and 12
Quality of Life Assessments as Per Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ)
Time frame: Months 2, 6 and 12
Number of Participants With Clinically Significant Vital Signs Findings
Time frame: Up to 12 months
Number of Participants With Clinically Significant Physical Examination Findings
Time frame: Up to 12 months
Number of Participants With Clinically Significant Laboratory Values
Time frame: Up to 12 months
Number of Participants With Adverse Events and Serious Adverse Events
Time frame: Up to 12 months
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 Apr 2017.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
AstraZeneca AstraZeneca study director
AstraZeneca
7 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Ciclesonide in people with Asthma, run by AstraZeneca at 7 sites in 3 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 Apr 2017. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 7 sites in Canada, Hungary, South Africa. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 22 Dec 2010). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Time to First Asthma Exacerbation (time frame: Up to 12 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Apr 2017.