Chronic Obstructive Pulmonary DiseasePhase 3NCT04535986
A Phase 3 Clinical Trial to Evaluate the Safety and Efficacy of Ensifentrine in Patients With COPD
A Phase 3 study testing Ensifentrine in people with Chronic Obstructive Pulmonary Disease, run by Verona Pharma, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA at 122 sites in 12 countries.
Trial summary
The purpose of this study is to evaluate the efficacy and safety of ensifentrine in patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD). Read more about this study
- Who is it for?
- Ages 40 to 80 years
- Conditions the study is for
- Chronic Obstructive Pulmonary Disease
- What is being tested?
- Ensifentrine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 763 participants
- Where
- 122 sitesin 12 countries
- Study dates
- 29 Sep 2020to 2 Dec 2022
- 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 40 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Informed Consent
- Capable of giving informed consent indicating that they understand the purpose of the study and study procedures and agree to comply with the requirements and restrictions listed in the informed consent form (ICF).
- Age and Sex
- Age: Patient must be 40 to 80 years of age inclusive, at the time of Screening.
- Sex:
- Males are eligible to participate if they agree to use contraception as described in the contraceptive guidance from Screening and throughout the study and for at least 30 days after the last dose of blinded study medication.
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- Females are eligible to participate if they are not pregnant, not breastfeeding, and at least one of the following conditions apply:
- Not a woman of childbearing potential (WOCBP) as defined in Or
- A WOCBP who agrees to follow the contraceptive guidance from Screening and throughout the study and for at least 30 days after the last dose of blinded study medication.
- Smoking History
- Smoking History: Current or former cigarette smokers with a history of cigarette smoking ≥10 pack years at Screening (Visit 0) [number of pack years = (number of cigarettes per day / 20) × number of years smoked (eg, 20 cigarettes per day for 10 years, or 10 cigarettes per day for 20 years)]. Pipe and/or cigar use cannot be used to calculate pack-year history. Former smokers are defined as those who have stopped smoking for at least 6 months prior to Visit 0. Smoking cessation programs are permitted during the study.
- COPD Diagnosis, Symptoms, Severity and Maintenance Therapy
- COPD Diagnosis: Patients with an established clinical history of COPD as defined by the American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines with symptoms compatible with COPD.
- COPD Symptoms: A score of ≥2 on the Modified Medical Research Council (mMRC) Dyspnea Scale.
- COPD Severity:
- Pre- and Post-albuterol/salbutamol FEV1/FVC ratio of <0.70.
- Post-albuterol/salbutamol FEV1 ≥30 % and ≤70% of predicted normal calculated using the National Health and Nutrition Examination Survey III.
- Maintenance Therapy: Patients on no maintenance/background therapy or patients on stable maintenance LAMA or LABA therapy are eligible. Patients taking maintenance LAMA or LABA therapy must demonstrate stable use of the maintenance LAMA or LABA therapy for at least 3 months prior to Screening and agree to continue use for the duration of the study. Background maintenance LAMA or LABA bronchodilator therapy will be capped at 50% of patients.
- Other Requirements for Inclusion
- Capable of withholding SABAs for 4 hours prior to initiation of any spirometry. Patients in the maintenance LAMA or LABA therapy stratum must be capable of withholding Twice-Daily maintenance LAMA or LABA for 24 hours and Once-Daily maintenance LAMA or LABA for 48 hours prior to initiation of any spirometry.
- Capable of using the study nebulizer correctly and complying with all study restrictions and procedures.
- Ability to perform acceptable spirometry in accordance with ATS/ERS guidelines.
- Symptoms of COPD: A score of ≥2 on the mMRC Dyspnea Scale.
- Completion of the e-Diary at least 5 of the last 7 days of the Run-in period.
Who cannot join
- Current Condition or Medical History
- History of life-threatening COPD including Intensive Care Unit admission and/or requiring intubation.
- Hospitalizations for COPD, pneumonia, or Corona Virus Disease 2019 (COVID-19) in the 12 weeks prior to Screening and/or a positive COVID-19 test result indicating an active infection at Screening. Patients with COVID-19 antibodies from a previous exposure with no active infection are not excluded.
- COPD exacerbation requiring oral or parenteral steroids within 3 months of Screening.
- Previous lung resection or lung reduction surgery within 1-year of Screening.
- Long term oxygen use defined as oxygen therapy prescribed for greater than 12 hours per day. As needed oxygen use (≤12 hours per day) is not exclusionary.
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- Pulmonary rehabilitation, unless such treatment has been in a stable maintenance phase for 4 weeks prior to Visit 1 and remains stable during the study.
- Lower respiratory tract infection within 6 weeks of Screening.
- Other respiratory disorders including, but not limited to, a current diagnosis of asthma, active tuberculosis, lung cancer, sarcoidosis, lung fibrosis, interstitial lung diseases, unstable sleep apnea, known alpha-1 antitrypsin deficiency, core pulmonale, clinically significant pulmonary hypertension, clinically significant bronchiectasis, or other active pulmonary diseases.
- Major surgery (requiring general anesthesia) in the 6 weeks prior to Screening, lack of full recovery from surgery at Screening, or planned surgery through the end of the study.
- Historical or current evidence of clinically significant cardiovascular disease defined as any disease that in the opinion of the Investigator would put the safety of the patient at risk through participation or which could affect the efficacy or safety analysis if the disease/condition were to exacerbate during the study, including, but not limited to:
- Myocardial infarction or unstable angina within 6 months prior to Screening.
- Unstable or life-threatening cardiac arrhythmia requiring intervention within 3 months prior to Screening.
- Diagnosis of New York Heart Association Class III and Class IV heart failure.
- Chronic uncontrolled disease including, but not limited to, endocrine, active hyperthyroidism, neurological, hepatic, gastrointestinal, renal, hematological, urological, immunological, psychiatric, or ophthalmic diseases that the Investigator believes are clinically significant.
- Unstable liver disease defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices or persistent jaundice, cirrhosis, known biliary abnormalities (except for Gilbert's syndrome or asymptomatic gallstones).
- History of or current malignancy of any organ system, treated or untreated within the past 5 years, except for localized basal or squamous cell carcinoma of the skin.
- Findings on physical examination that an investigator considers to be clinically significant at Screening.
- Prior/Concomitant Therapy
- Use of prohibited medications within the time intervals.
- History or Suspicion of Drug or Alcohol Abuse
- Current or history of past drug or alcohol abuse within the past 5 years.
- Laboratory and Other Diagnostic Parameters
- Glomerular Filtration Rate (eGFR) <30 mL/min. The Chronic Kidney Disease Epidemiology Collaboration Creatinine (2009) calculation will be used (Levey, 2009).
- Alanine aminotransferase (ALT) ≥ 2 x upper limit of normal (ULN), alkaline phosphatase and/or bilirubin > 1.5 x ULN (isolated bilirubin >1.5 x ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%).
- Any other abnormal hematology, biochemistry, or viral serology deemed by an investigator to be clinically significantly abnormal. Abnormal chemistry and/or hematology may be repeated during Screening.
- Chest X-ray (CXR; posterior-anterior) at Screening, or in the 12 months prior to Screening with clinically significant abnormalities not attributable to COPD. If a CXR within the past 12 months is not available but a computerized tomography (CT) scan within the same time period is available, the CT scan may be reviewed in place of a CXR. For subjects in Germany, if a CXR or CT scan is not available in the 12 months prior to Screening, the subject is not eligible for the study.
- Electrocardiogram (ECG) finding that is significantly abnormal on the 12-lead ECG obtained at Screening.
- Other Exclusions
- Use of an experimental drug within 30 days or 5 half-lives of Screening, whichever is longer, and/or participation in a study treatment-free follow-up phase of a clinical study within 30 days prior to Screening.
- Use of an experimental medical device or participation in a follow-up phase of an experimental medical device clinical study within 30 days prior to Screening.
- Intolerance or hypersensitivity to albuterol/salbutamol or ensifentrine (RPL554) or any of its excipients/components.
- Prior receipt of blinded study medication in an ensifentrine (RPL554) study.
- Affiliation with the investigator site, including an Investigator, Sub-Investigator, study coordinator, study nurse, other employee of participating investigator or study site or a family member of the aforementioned.
- Inability to read, understand, and/or complete questionnaires (in the opinion of the Investigator).
- A disclosed history or one known to the Investigator of significant non-compliance in previous investigational studies or with prescribed medications.
- Any other reason that the Investigator considers makes the patient unsuitable to participate.
- COPD exacerbation or lower respiratory tract infection between Screening and Randomization (defined as use of any additional treatment other than current treatment and rescue medication and/or emergency department or hospital visit). Patients with a severe COPD exacerbation that requires hospitalization may not be rescreened.
- Positive COVID-19 result at Screening or between Screening and Randomization.
- Prohibited medication use between Screening Visit 0 and Visit 1.
- Significantly abnormal ECG finding on the 12-lead ECG obtained at Screening as assessed by the investigator or site medical doctor/medically qualified person or on the pre-dose (prior to randomization) ECG obtained at Visit 1.
- In the event that the central ECG reviewer discovers a significant ECG abnormality on the Visit 1 ECG, the patient will be discontinued.
- Did not meet one or more of the Inclusion Criteria or met one or more of the Exclusion Criteria.
Trial locations and contacts
122 sites in 12 countries.
122 sites in 12 countries
United States39 sites
Pulmonary Research of Abingdon, LLC
Abingdon, Virginia, 24210
John Hopkins University School of Medicine
Baltimore, Maryland, 21224
Chattanooga Research & Medicine (CHARM)
Chattanooga, Tennessee, 37404
Clinical Research of West Florida, Inc.
Clearwater, Florida, 33765
St. Francis Medical Institute
Clearwater, Florida, 33765
Medtrial
Columbia, South Carolina, 29204
Remington Davis Clinical Research
Columbus, Ohio, 43215
iResearch Atlanta, LLC
Decatur, Georgia, 30030
Clinical Research Associates of Central PA, LLC
DuBois, Pennsylvania, 15801
Pulmonary Research Institute of SE Michigan
Farmington Hills, Michigan, 48336
Velocity Clinical Research - Grants Pass
Grants Pass, Oregon, 97527
Qway Research, LLC
Hialeah, Florida, 33010
West Houston Clinical Research Services
Houston, Texas, 77055
Beach Physicians Medical Group
Huntington Beach, California, 92647
MultiSpecialty Clinical Research, Inc.
Johnson City, Tennessee, 37601
New Phase Research Development
Knoxville, Tennessee, 37909
Multi-Specialty Research Associates, Inc.
Lake City, Florida, 32055
MDFirst Research
Lancaster, South Carolina, 29720
Sierra Clinical Research
Las Vegas, Nevada, 89106
Alliance for Multispecialty Research, LLC
Las Vegas, Nevada, 89119
Downtown LA Research Center, Inc.
Los Angeles, California, 90017
Elite Clinical Research
Miami, Florida, 33144
Global Research Solutions Corp
Miami, Florida, 33144
Phoenix Medical Research
Miami, Florida, 33165
Monroe Biomedical Research
Monroe, North Carolina, 28112
IMA Clinical Research, LLC
New York, New York, 10036
Florida Institute for Clinical Research
Orlando, Florida, 32825
LinQ Research, LLC
Pearland, Texas, 77584
Phoenix Medical Group
Peoria, Arizona, 85381
University of Pittsburgh Physicians, Emphysema/COPD Research Center
Pittsburgh, Pennsylvania, 15213
IACT Health
Rincon, Georgia, 31326
Midwest Chest Consultants
Saint Charles, Missouri, 63301
Sherman Clinical Research
Sherman, Texas, 75092
The Clinical Research Center, LLC
St Louis, Missouri, 63141
Precision Clinical Research
Sunrise, Florida, 33351
In-Quest Medical Research, LLC
Suwanee, Georgia, 30024
Clinical Research of West Florida, Inc.
Tampa, Florida, 33606
AMR Tempe
Tempe, Arizona, 85281
TPMG Clinical Research Williamsburg
Williamsburg, Virginia, 23188
Russia17 sites
NSHI "Departmental CH on St. Barnaul of JSCO "Russian Railways"
Barnaul, 656038
SBHI "Regional Clinical Hospital #3"
Chelyabinsk, 454091
FSBI "Scientific-research Institute for Complex Problems of cardiovascular disease"
Kemerovo, 650002
LLC "Novosibirsk GastroCenter"
Novosibirsk, 630007
SBIH of Novosibirsk Region "Clinical Emergency Hospital #2"
Novosibirsk, 630008
City Clinical Hospital #25
Novosibirsk, 630075
SPb SBHI "Vvedenskaya hospital"
Saint Petersburg, 191180
"LEC at the LLC "LLC "Energiy Zdorovya"
Saint Petersburg, 194156
LLC "Institute of Medical Examinations"
Saint Petersburg, 196084
Research center Eco-safety, LLC
Saint Petersburg, 196143
Pavlov First Saint Petersburg State Medical University
Saint Petersburg, 197022
SPb SBIH "City Hospital # 40 of Kurortnyi region"
Sestroretsk, 197706
SBHI of Yaroslavl Region "Clinical Hospital # 2"
Yaroslavl, 1500030
SBHI of Yaroslavl Region "Clinical Hospital # 2"
Yaroslavl, 150010
SBHI Outpatient 2
Yaroslavl, 150047
LLC MA New Hospital
Yekaterinburg, 620109
City Hospital #6
Yekaterinburg, 620149
Germany15 sites
Clinical Studies Pankow Dr Dr Evelin Liefring/Ishak Teber
Berlin, Free Hanseatic City of Bremen, 13187
Studienpraxis Berlin-Brandenburg
Berlin, 10119
Praxis an der Oper.
Berlin, 10625
Zentrum fur Klinische Forschung
Cologne, North Rhine-Westphalia, 51069
MECS GmbH Cottbus
Cottbus, Brandenburg, 03050
Praxis Dr. Keller
Frankfurt am Main, Hesse, 60389
IKF Pneumologie GmbH & Co. KG
Frankfurt am Main, Hesse, 60596
PRI Pulmonary Research Institute, Pneumologisches Forschungsinstitut GmbH
Großhansdorf, Schleswig-Holstein, 22927
Pneumologische Praxis Dr. Falk Brunner
Leipzig, Saxony, 04157
Salvus-Klinische Studien GmbH.
Leipzig, Saxony, 04207
KLB Gesundheitsforschung Luebeck GmbH; Praxis Dr. med. Jens Becker
Lübeck, Schleswig-Holstein, 23552
SMO.MD GmbH
Magdeburg, Saxony-Anhalt, 39120
Ballenberger, Freytag, Wenisch Institut für klinische Forschung
Neu-Isenburg, 63263
Dr. Christian Schlenska
Peine, Lower Saxony, 31224
Framol-med GmbH, Pneumologische Gemeinschaftspraxis Rheine
Rheine, North Rhine-Westphalia, 48431
Czechia12 sites
MUDr. I. Cierna Peterova s.r.o.
Brandýs nad Labem, 25001
Fakultni nemocnice Brno, Dept of Klinika nemoci plicnich a tuberkulozy
Brno, 625 00
EDUMED s.r.o.
Broumov, 550 01
MUDr. Petr Pravda
Hlučín, 74801
MediTrial s.r.o.
Jindřichův Hradec, 377 01
Plicni ambulance Kralupy s.r.o.
Kralupy nad Vltavou, 278 01
CEFISPIRO s.r.o.
Lovosice, 41002
Odborná plicní ambulance Opava s.r.o.
Opava, 74601
DAWON spol. s.r.o., Plicni ambulance
Prague, 149 00
Plicni centrum s.r.o.
Prague, 15300
MUDr. Josef Veverka, Plicni ambulacne
Rokycany, 33701
Plicni stredisko Teplice s.r.o.
Teplice, 41501
Romania9 sites
S.C Centrul Medical Unirea S.R.L, Campus Medical Brasov
Brasov, 500091
S.C Centrul Medical de Diagnostic si Tratament Ambulator Neomed S.R.L
Brasov, 500283
Spitalul Clinic de Pneumoftiziologie "Leon Daniello" Cluj-Napoca
Brasov, 500366
Quantum Medical Center S.R.L.
Bucharest, 012071
Institutul de Pneumoftiziologie "Marius Nasta"
Bucharest, 050159
S.C Cardiomed S.R.L
Cluj-Napoca, 400371
Impatiens SRL
Codlea, 505100
Fundatia Cardioprevent
Timișoara, 300134
Spitalul Clinic de Boli Infectioase si Pneumoftiziologie "Dr. Victor Babes" Timisoara
Timișoara, 300310
Hungary6 sites
Clinexpert Kft.
Budapest, 1033
Szalay János Rendelőintézet Tüdőgyógyászati Szakrendelés
Hajdúnánás, 4080
Bajcsy-Zsilinszky Kórház és Rendelőintézet Monori Rendelőintézete
Monor, 2200
Karolina Kórház-Rendelőintézet, Tüdőgyógyászat
Mosonmagyaróvár, 9200
Püspökladányi Egészségügyi Szolgáltató Nonprofit Kft.
Püspökladány, 4150
Markusovszky Egyetemi Oktatókórház Tüdőgondozó
Szombathely, 9700
Poland6 sites
NZOZ Centrum Medyczne KERmed
Bydgoszcz, 85-231
Uniwersyteckie Centrum Kliniczne
Gdansk, 80-214
Centrum Alergologii Sp. z o. o.
Lublin, 20-552
ETG Siedlce
Siedlce, 08-110
NASZ LEKARZ Ośrodek Badań Klinicznych
Torun, 87-100
ETG Warszawa
Warsaw, 02-793
Bulgaria5 sites
SHATPPD - Haskovo, EOOD
Haskovo, 6300
Medical center Medconsult Pleven OOD
Pleven, 5800
UMHAT-Plovdiv AD
Plovdiv, 4003
Medical Center Hera EOOD
Sofia, 1510
MC "Sv. Ivan Rilski", OOD
Vidin, 3700
South Korea5 sites
Yeungnam University Hospital
Daegu, 42415
Kyung Hee University Hospital
Seoul, 02447
Asan Medical Center
Seoul, 05505
The Catholic University of Korea, Seoul St. Mary's Hospital
Seoul, 06591
The Catholic University of Korea, Yeouido St.Mary's Hospital
Seoul, 07345
Greece4 sites
General Hospital of Athens of Chest Diseases "SOTIRIA", 7th Respiratory Clinic
Athens, 11527
University General Hospital of Heraklion, Pulmonary Clinic
Heraklion, 71110
University General Hospital of Ioannina, University Respiratory Clinic
Ioannina, 45500
University General Hospital of Larissa, University Pulmonary Clinic
Larissa, 41110
Slovakia3 sites
Nemocnica s poliklinikou Sv. Jakuba, n.o. Bardejov
Bardejov, 08501
Inspiro, s.r.o.
Humenné, 06601
Plucna ambulancia Hrebenar, s.r.o.
Spišská Nová Ves, 05201
United Kingdom1 site
Respiratory Clinical Trials Ltd
London, Greater London, W1T6AH
About this study
Official title: A Phase III Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Ensifentrine Over 24 Weeks (With a 48-week Safety Subset) in Subjects With Moderate to Severe COPD
The purpose of this study is to evaluate the efficacy and safety of ensifentrine in patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD).
- Conditions
- Chronic Obstructive Pulmonary Disease
- Being tested
- Ensifentrine, Placebo
- Keywords
- COPD
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EnsifentrineDrug
Dosage Formulation: Ensifentrine Nebulizer suspension Dosage 3mg Frequency: Twice Daily for 24 weeks or 48 weeks
PlaceboDrug
Dosage Formulation: Ensifentrine Placebo Nebulizer solution Frequency: Twice Daily for 24 weeks or 48 weeks
| Study group | Role | What they receive |
|---|---|---|
| Arm 1 | Experimental | Ensifentrine Nebulized Suspension; 3 mg BID Receives: Drug: Ensifentrine |
| Arm 2 | Placebo comparator | Placebo Nebulized BID Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Least Square (LS) Mean Change From Baseline in Average Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve Over 12 Hours (AUC0-12h) at Week 12
Forced spirometry maneuvers including the FEV1 were used to assess pulmonary function. Average FEV1 AUC0-12h was defined as AUC over 12 hours of the FEV1, divided by 12 hours. Baseline FEV1 is the mean of the 2 measurements taken before study medication on the day of first dosing, that is, <=40 minutes pre-dose on Day 1. Spirometry assessments were performed in accordance with American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines.
Measured: Baseline (pre-dose on Day 1) and Week 12
Secondary outcomes (9)
LS Mean Change From Baseline FEV1 to Peak FEV1 at Day 1 and Weeks 6, 12 and 24
Forced spirometry maneuvers including the FEV1 were used to assess pulmonary function. Peak FEV1 is the maximum value in the 4 hours after dosing. Baseline FEV1 is the mean of the 2 measurements taken before study medication on the day of first dosing, that is, <=40 minutes pre-dose on Day 1. Spirometry assessments were performed in accordance with ATS/ERS guidelines.
Measured: Baseline (pre-dose on Day 1), post-dose on Day 1, Weeks 6, 12, and 24
LS Mean Change From Baseline to the Mean Weekly Evaluating-Respiratory Symptoms (E-RS) Total Score at Weeks 6, 12 and 24
The E-RS scale consists of 11 questions, with 3 sub-domains of: breathlessness, cough and sputum, and chest symptoms. The E-RS sub-domain score was calculated as the sum from the relevant questions. The E-RS total score was derived as the sum of the raw scores of the 11 items ranging from 0 to 40. Higher scores indicates severe respiratory symptoms. Scores were derived weekly as the mean over 7 days prior to the visit, using only days where data was recorded. The E-RS was collected daily by electronic diary (e-diary). Baseline is the mean over the 7 days prior to the first intake of study medication, using only days where data was recorded.
Measured: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Change From Baseline in the St. George's Respiratory Questionnaire (SGRQ) Total Score at Weeks 6, 12 and 24
The SGRQ questionnaire consists of 17 questions, split into 2 parts. Part 1 consisted of the first 8 questions and was related to the symptoms subdomain. The remaining 9 questions were in Part 2, which were related to the activity and impacts subdomains. The total score was calculated by dividing the summed weights by the maximum possible weight for all items in the questionnaire and expressing the result as a percentage. Score ranging from 0 to 100 and higher scores indicated a worse outcome. Baseline is the score calculated on Day 1 prior to 4 hour post-dose spirometry.
Measured: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Change From Baseline FEV1 to Morning Trough FEV1 at Weeks 6, 12 and 24
Forced spirometry maneuvers including the FEV1 were used to assess pulmonary function. Morning trough FEV1 was the last value collected prior to the morning dose. Baseline FEV1 is the mean of the two measurements taken before study medication on the day of first dosing, that is, <=40 minutes pre-dose on day 1. Spirometry assessments were performed in accordance with ATS/ERS guidelines.
Measured: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Change From Baseline in Average FEV1 Area Under the Curve Over 4 Hours (AUC0-4h) at Day 1 and Weeks 6, 12 and 24
Forced spirometry maneuvers including the FEV1 were used to assess pulmonary function. Average FEV1 AUC0-4h was defined as area under the curve over 4 hours of the FEV1, divided by 4 hours. Baseline FEV1 is the mean of the 2 measurements taken before study medication on the day of first dosing, that is, <=40 minutes pre-dose on Day 1. Spirometry assessments were performed in accordance with ATS/ERS guidelines.
Measured: Baseline (pre-dose on Day 1), post-dose on Day 1, Weeks 6, 12, and 24
Percentage of SGRQ Responders at Weeks 6, 12 and 24
The SGRQ questionnaire consists of 17 questions, split into 2 parts. Part 1 consisted of the first 8 questions and was related to the symptoms subdomain. The remaining 9 questions were in Part 2, which were related to the activity and impacts subdomains. The total score was calculated by dividing the summed weights by the maximum possible weight for all items in the questionnaire and expressing the result as a percentage. Responder was a patient with an improvement from baseline in SGRQ total score of 4 or more. Percentage of SGRQ responders are reported.
Measured: Weeks 6, 12 and 24
LS Mean Change From Baseline to the Mean Weekly Rescue Medication Use at Weeks 6, 12 and 24
Use of rescue medication (albuterol/salbutamol) per week was calculated as the LS mean use daily over 7 days. Daily rescue medication use was collected in an e-diary throughout the study. Baseline is the mean over the 7 days prior to the first intake of study medication, calculated as the sum of puffs taken, divided by number of days data has been recorded.
Measured: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Transition Dyspnea Index (TDI) Questionnaire Total Score at Weeks 6, 12 and 24
The TDI is a questionnaire that focused on 3 sub-domains: functional impairment, magnitude of task and magnitude of effort. Sub-domain score was calculated as the sum from the related questions. Total score was calculated as the sum of the sub-domain scores. The TDI measures the change in dyspnea severity from the baseline as measured by the baseline dyspnea index. It was rated by 7 grades ranging from -3 (major deterioration) to +3 (major improvement). Higher scores indicate better outcome. Change from baseline was assessed with the Baseline Dyspnea Index.
Measured: Weeks 6, 12 and 24
LS Mean Change From Baseline FEV1 to Evening Trough FEV1 at Week 12
Forced spirometry maneuvers including the FEV1 were used to assess pulmonary function. Evening trough FEV1 was the value collected at 12 hours post-morning dose and prior to the evening dose. Baseline FEV1 is the mean of the 2 measurements taken before study medication on the day of first dosing, that is, <=40 minutes pre-dose on day 1. Spirometry assessments were performed in accordance with ATS/ERS guidelines.
Measured: Baseline (pre-dose on Day 1) and Week 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted2 Sep 2020
- Study start29 Sep 2020
- Primary completion12 Sep 2022
- Study completion2 Dec 2022
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.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Chronic Obstructive Pulmonary DiseaseStudies of the same condition, open and under way.
- 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
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 763 participants (actual)
Sponsor and investigators
- Lead sponsor
- Verona Pharma, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- IQVIA Pty Ltd
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04535986
- Sponsor's protocol ID
- RPL554-CO-301
- Status last verified
- Nov 2023
- First submitted
- 19 Aug 2020
- Last updated
- 13 Nov 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Dransfield M, Marchetti N, Kalhan R, Reyner D, Dixon AL, Rheault T, Rickard KA, Anzueto A. Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies. Chron Respir Dis. 2025 Jan-Dec;22:14799731251314874. doi: 10.1177/14799731251314874.
PubMed 39854278Sciurba FC, Christenson SA, Rheault T, Bengtsson T, Rickard K, Barjaktarevic IZ. Effect of Dual Phosphodiesterase 3 and 4 Inhibitor Ensifentrine on Exacerbation Rate and Risk in Patients With Moderate to Severe COPD. Chest. 2025 Feb;167(2):425-435. doi: 10.1016/j.chest.2024.07.168. Epub 2024 Aug 27.
PubMed 39197510Mahler DA, Bhatt SP, Rheault T, Reyner D, Bengtsson T, Dixon A, Rickard K, Singh D. Effect of ensifentrine on dyspnea in patients with moderate-to-severe chronic obstructive pulmonary disease: pooled analysis of the ENHANCE trials. Expert Rev Respir Med. 2024 Aug;18(8):645-654. doi: 10.1080/17476348.2024.2389960. Epub 2024 Aug 8.
PubMed 39106052Anzueto A, Barjaktarevic IZ, Siler TM, Rheault T, Bengtsson T, Rickard K, Sciurba F. Ensifentrine, a Novel Phosphodiesterase 3 and 4 Inhibitor for the Treatment of Chronic Obstructive Pulmonary Disease: Randomized, Double-Blind, Placebo-controlled, Multicenter Phase III Trials (the ENHANCE Trials). Am J Respir Crit Care Med. 2023 Aug 15;208(4):406-416. doi: 10.1164/rccm.202306-0944OC.
PubMed 37364283
Study at a glance
From the registry record, last updated by the sponsor on 13 Nov 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Ensifentrine Over 24 Weeks (With a 48-week Safety Subset) in Subjects With Moderate to Severe COPD
- ClinicalTrials.gov ID
- NCT04535986
- Acronym / sponsor ID
- RPL554-CO-301
- Conditions
- Chronic Obstructive Pulmonary Disease
- Keywords
- COPD
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 763 participants (actual)
- Lead sponsor
- Verona Pharma, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USAIndustry (pharma, biotech, devices)
- Collaborators
- IQVIA Pty Ltd
- Study start
- 29 Sep 2020 (actual)
- Primary completion
- 12 Sep 2022 (actual)
- Study completion
- 2 Dec 2022 (actual)
- First posted
- 2 Sep 2020 (actual)
- Results
- Posted 13 Nov 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the efficacy and safety of ensifentrine in patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD).
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Arm 1 | Experimental | Drug: EnsifentrineEnsifentrine Nebulized Suspension; 3 mg BID |
| Arm 2 | Placebo comparator | Drug: PlaceboPlacebo Nebulized BID |
Who may qualify
- Ages
- 40 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (24 listed)
- Informed Consent
- Capable of giving informed consent indicating that they understand the purpose of the study and study procedures and agree to comply with the requirements and restrictions listed in the informed consent form (ICF).
- Age and Sex
- Age: Patient must be 40 to 80 years of age inclusive, at the time of Screening.
- Sex:
Key exclusion criteria (43 listed)
- Current Condition or Medical History
- History of life-threatening COPD including Intensive Care Unit admission and/or requiring intubation.
- Hospitalizations for COPD, pneumonia, or Corona Virus Disease 2019 (COVID-19) in the 12 weeks prior to Screening and/or a positive COVID-19 test result indicating an active infection at Screening. Patients with COVID-19 antibodies from a previous exposure with no active infection are not excluded.
- COPD exacerbation requiring oral or parenteral steroids within 3 months of Screening.
- Previous lung resection or lung reduction surgery within 1-year of Screening.
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 |
|---|---|---|
| EnsifentrineDosage Formulation: Ensifentrine Nebulizer suspension Dosage 3mg Frequency: Twice Daily for 24 weeks or 48 weeks | Drug | Arm 1 |
| PlaceboDosage Formulation: Ensifentrine Placebo Nebulizer solution Frequency: Twice Daily for 24 weeks or 48 weeks | Drug | Arm 2 |
Primary outcome
Least Square (LS) Mean Change From Baseline in Average Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve Over 12 Hours (AUC0-12h) at Week 12
Time frame: Baseline (pre-dose on Day 1) and Week 12
Forced spirometry maneuvers including the FEV1 were used to assess pulmonary function. Average FEV1 AUC0-12h was defined as AUC over 12 hours of the FEV1, divided by 12 hours. Baseline FEV1 is the mean of the 2 measurements taken before study medication on the day of first dosing, that is, <=40 minutes pre-dose on Day 1. Spirometry assessments were performed in accordance with American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines.
9 secondary outcomes
LS Mean Change From Baseline FEV1 to Peak FEV1 at Day 1 and Weeks 6, 12 and 24
Time frame: Baseline (pre-dose on Day 1), post-dose on Day 1, Weeks 6, 12, and 24
LS Mean Change From Baseline to the Mean Weekly Evaluating-Respiratory Symptoms (E-RS) Total Score at Weeks 6, 12 and 24
Time frame: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Change From Baseline in the St. George's Respiratory Questionnaire (SGRQ) Total Score at Weeks 6, 12 and 24
Time frame: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Change From Baseline FEV1 to Morning Trough FEV1 at Weeks 6, 12 and 24
Time frame: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Change From Baseline in Average FEV1 Area Under the Curve Over 4 Hours (AUC0-4h) at Day 1 and Weeks 6, 12 and 24
Time frame: Baseline (pre-dose on Day 1), post-dose on Day 1, Weeks 6, 12, and 24
Percentage of SGRQ Responders at Weeks 6, 12 and 24
Time frame: Weeks 6, 12 and 24
LS Mean Change From Baseline to the Mean Weekly Rescue Medication Use at Weeks 6, 12 and 24
Time frame: Baseline (pre-dose on Day 1) and Weeks 6, 12, and 24
LS Mean Transition Dyspnea Index (TDI) Questionnaire Total Score at Weeks 6, 12 and 24
Time frame: Weeks 6, 12 and 24
LS Mean Change From Baseline FEV1 to Evening Trough FEV1 at Week 12
Time frame: Baseline (pre-dose on Day 1) and Week 12
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Nov 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 39854278Dransfield M, Marchetti N, Kalhan R, Reyner D, Dixon AL, Rheault T, Rickard KA, Anzueto A. Ensifentrine in COPD patients taking long-acting bronchodilators: A pooled post-hoc analysis of the ENHANCE-1/2 studies. Chron Respir Dis. 2025 Jan-Dec;22:14799731251314874. doi: 10.1177/14799731251314874.
- Derived from this study: PubMed 39197510Sciurba FC, Christenson SA, Rheault T, Bengtsson T, Rickard K, Barjaktarevic IZ. Effect of Dual Phosphodiesterase 3 and 4 Inhibitor Ensifentrine on Exacerbation Rate and Risk in Patients With Moderate to Severe COPD. Chest. 2025 Feb;167(2):425-435. doi: 10.1016/j.chest.2024.07.168. Epub 2024 Aug 27.
- Derived from this study: PubMed 39106052Mahler DA, Bhatt SP, Rheault T, Reyner D, Bengtsson T, Dixon A, Rickard K, Singh D. Effect of ensifentrine on dyspnea in patients with moderate-to-severe chronic obstructive pulmonary disease: pooled analysis of the ENHANCE trials. Expert Rev Respir Med. 2024 Aug;18(8):645-654. doi: 10.1080/17476348.2024.2389960. Epub 2024 Aug 8.
- Derived from this study: PubMed 37364283Anzueto A, Barjaktarevic IZ, Siler TM, Rheault T, Bengtsson T, Rickard K, Sciurba F. Ensifentrine, a Novel Phosphodiesterase 3 and 4 Inhibitor for the Treatment of Chronic Obstructive Pulmonary Disease: Randomized, Double-Blind, Placebo-controlled, Multicenter Phase III Trials (the ENHANCE Trials). Am J Respir Crit Care Med. 2023 Aug 15;208(4):406-416. doi: 10.1164/rccm.202306-0944OC.
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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.
The record lists no contact. Use the official record to reach the sponsor.
122 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Ensifentrine in people with Chronic Obstructive Pulmonary Disease, run by Verona Pharma, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA at 122 sites in 12 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 24 inclusion and 43 exclusion criteria. 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 13 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 122 sites in United States, Russia, Germany, Czechia, Romania and 7 more countries. 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 13 Nov 2023). 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?
Least Square (LS) Mean Change From Baseline in Average Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve Over 12 Hours (AUC0-12h) at Week 12 (time frame: Baseline (pre-dose on Day 1) and Week 12). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04535986, which also lists 4 linked publications.
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 13 Nov 2023.