Effects of Mometasone Furoate Dry Powder Inhaler, Fluticasone Propionate, and Montelukast on Bone Mineral Density in Asthmatics (Study P03418AM4)(COMPLETED)

Overview[ - collapse ][ - ]

Purpose This is a randomized, multi-center, parallel-group, active-controlled, double-blind study evaluating the effects of mometasone furoate (MF) dry powder inhaler (DPI) on bone mineral density (BMD) in subjects with asthma. The mean percent change in lumbar spine BMD from the averaged baseline value (the average of the two scan results prior to treatment) to the endpoint of treatment time point (the average of the last two valid post-baseline scan results during treatment) for the comparison of MF DPI 400 mcg daily in the evening versus montelukast (ML) 10 mg daily in the evening.
ConditionAsthma
InterventionDrug: mometasone furoate dry powder inhaler
Drug: mometasone furoate dry powder inhaler
Drug: fluticasone propionate hydrofluoroalkane (HFA)
Drug: montelukast
PhasePhase 4
SponsorMerck Sharp & Dohme Corp.
Responsible PartyMerck Sharp & Dohme Corp.
ClinicalTrials.gov IdentifierNCT00394355
First ReceivedOctober 31, 2006
Last UpdatedJanuary 24, 2014
Last verifiedJanuary 2014

Tracking Information[ + expand ][ + ]

First Received DateOctober 31, 2006
Last Updated DateJanuary 24, 2014
Start DateSeptember 2006
Estimated Primary Completion DateOctober 2009
Current Primary Outcome MeasuresMean Percent Change in Lumbar Spine Bone Mineral Density (BMD) From the Averaged Baseline Value to the Endpoint of Treatment Time Point [Time Frame: Baseline and up to ~ one year of treatment] [Designated as safety issue: Yes]The averaged baseline value is the average of the two scan results prior to treatment. The endpoint of treatment time point is the average of the last two valid post baseline BMD scans during the treatment period carried forward.
Current Secondary Outcome Measures
  • Mean Percent Change in the Left Total Femur From the Averaged Baseline Value to the Averaged Value at the Endpoint of Treatment Time Point [Time Frame: Baseline and up to ~ one year of treatment] [Designated as safety issue: Yes]The averaged baseline value is the average of the two scan results prior to treatment. The endpoint of treatment time point is the average of the last two valid post baseline BMD scans during the treatment period carried forward.
  • Mean Percent Change in the Femoral Neck BMD From the Averaged Baseline Value to the Averaged Value at the Endpoint of Treatment Time Point [Time Frame: Baseline and up to ~ one year of treatment] [Designated as safety issue: Yes]The averaged baseline value is the average of the two scan results prior to treatment. The endpoint of treatment time point is the average of the last two valid post baseline BMD scans during the treatment period carried forward.
  • Summary of Change From Baseline to Endpoint in FEV1 (Forced Expiratory Volume in One Second). [Time Frame: Baseline and up to ~ one year of treatment] [Designated as safety issue: No]Mean percent change from Baseline (the last non-missing value prior to treatment) in pulmonary function test FEV1 from in-office visits and at Endpoint (last non-missing postbaseline value carried forward)

Descriptive Information[ + expand ][ + ]

Brief TitleEffects of Mometasone Furoate Dry Powder Inhaler, Fluticasone Propionate, and Montelukast on Bone Mineral Density in Asthmatics (Study P03418AM4)(COMPLETED)
Official TitleComparative Study of the Effect of Two Doses of Mometasone Furoate Dry Powder Inhaler 200 Mcg and 400 Mcg QD PM, Fluticasone Propionate 250 Mcg BID, and Montelukast 10 mg QD PM, on Bone Mineral Density in Adults With Asthma
Brief Summary
This is a randomized, multi-center, parallel-group, active-controlled, double-blind study
evaluating the effects of mometasone furoate (MF) dry powder inhaler (DPI) on bone mineral
density (BMD) in subjects with asthma. The mean percent change in lumbar spine BMD from the
averaged baseline value (the average of the two scan results prior to treatment) to the
endpoint of treatment time point (the average of the last two valid post-baseline scan
results during treatment) for the comparison of MF DPI 400 mcg daily in the evening versus
montelukast (ML) 10 mg daily in the evening.
Detailed DescriptionNot Provided
Study TypeInterventional
Study PhasePhase 4
Study DesignAllocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
ConditionAsthma
InterventionDrug: mometasone furoate dry powder inhaler
400 mcg MF DPI via a breath-actuated, dry-powder inhaler and a placebo tablet given by mouth once daily in the evening for 1 year.
Other Names:
AsmanexDrug: mometasone furoate dry powder inhaler
200 mcg MF DPI via a breath-actuated, dry-powder inhaler and a placebo tablet given by mouth once daily in the evening for 1 year.
Other Names:
AsmanexDrug: fluticasone propionate hydrofluoroalkane (HFA)
250 mcg FP HFA given twice a day via a metered-dose inhaler and a placebo tablet given once daily in the evening for 1 year
Other Names:
Flovent HFADrug: montelukast
10 mg given once daily in the evening by mouth for 1 year.
Other Names:
Singulair
Study Arm (s)
  • Experimental: Group 1
    MF DPI 400 mcg once a day (QD) in the evening (PM)
  • Experimental: Group 2
    MF DPI 200 mcg QD PM
  • Active Comparator: Group 3
    Fluticasone propionate (FP) metered dose inhaler (MDI) 250 mcg twice a day (BID)
  • Active Comparator: Group 4
    ML 10 mg QD PM

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment566
Estimated Completion DateOctober 2009
Estimated Primary Completion DateOctober 2009
Eligibility Criteria
Inclusion Criteria:

- Informed consent, adhere to schedules.

- Inform usual treating medical doctor (MD) of study participation.

- Female 18 to 40, male 18 to 50, any race.

- >=3-month asthma history.

- Never treated with inhaled corticosteroids (ICS) for asthma or not have taken ICS for
≥3 months prior to Screening.

- Prebronchodilator forced expiratory volume (liters) in 1 second (FEV1) >=60% & <=90%
predicted at both Screening & Baseline, when all restricted medications withheld.

- Prior to randomization, demonstrate increase in absolute FEV1 of >=12%, with absolute
volume increase of >=200 mL, after reversibility testing.

- Lab tests normal/acceptable to investigator/sponsor. Electrocardiogram (ECG)
performed at screening or <30 days of screening normal/acceptable to investigator.
Chest x-ray performed at screening or <12 months of screening normal/acceptable to
investigator.

- 25-hydroxy vitamin D level >=15 ng/mL. If <15, re-tested after taking calcium plus
vitamin D for 4 weeks.

- Free of significant disease (other than asthma) known to affect bone mineral
metabolism including renal disease, unstable hyperthyroidism or other
endocrinopathies, Paget's disease, osteoporosis, malabsorption, or others that could
interfere with study evaluations (eg scoliosis, metal pins, calcification in
spine/femur).

- Women of childbearing potential must use birth control. Includes: hormonal
contraceptive, intra-uterine device (IUD); condom in combination with spermicide;
monogamous relationship with male who had vasectomy or is using condom. Started
method ≥3 months prior to Screening (exception condom), & agree to continue for
duration. Women who are not currently sexually active must agree/consent to using
double-barrier method if become active. Females must have negative serum pregnancy
test at Screening.

- 2 valid scans, as confirmed by local dual energy x-ray absorptiometry (DXA) center,
for lumbar spine, left total femur, & femoral neck prior to randomization. Valid
scans will be 2 scans of same region, performed on same day, that agree within 5% &
scans are technically satisfactory (eg correct scan mode, no artifacts present,
correct region).

Exclusion Criteria:

- >12 inhalations/day of salbutamol on 2 consecutive days between Screening & Baseline.

- Increase/decrease in FEV1 of >=20% between Screening & Baseline.

- Treated with methotrexate, cyclosporin, gold, or other cytotoxic agents, for asthma
or concurrent condition within last 3 months.

- Pipe/cigar smoking history.

- Smoker/ex-smoker who smoked within previous year or has smoking history ≥10
pack-years.

- Upper/lower respiratory tract infection within 2 weeks prior to Screening & Baseline.
Can be rescheduled.

- >14 days of oral steroids within previous 12 months or required burst of systemic
steroids within previous month.

- Ever required ventilator support for respiratory failure secondary to asthma.

- Treated in emergency room (ER) for asthma exacerbation or admitted to hospital for
management of airway obstruction on 1 occasion in last 3 months or on >=2 occasions
within last 6 months.

- Chronic bronchitis, bronchiectasis, emphysema or cystic fibrosis.

- Participated in study within last 30 days.

- Allergic to/intolerant of ICS, beta-agonists, or drugs/excipients in study.

- Average of 2 lumbar spine (L1-L4) scans at Screening is >2 standard deviations below
normal.

- Condition that might affect ability to ambulate normally, (ie major surgical
procedure). Condition that may interfere with BMD measurement.

- History of renal, hepatic, cardiovascular, metabolic, neurologic, hematologic,
respiratory, gastrointestinal, cerebrovascular, or other which could interfere with
study or require treatment which might interfere (eg calcium urolithiasis or
absorptive hypercalcuria, insulin dependent diabetes, cancer within last 10 years
(except basal cell carcinoma), active hepatitis, coronary artery disease, stroke,
rheumatoid arthritis, human immunodeficiency virus (HIV), or respiratory conditions
such as chronic obstructive pulmonary disease (COPD), chronic bronchitis, cystic
fibrosis. Others which are well-controlled & stable (eg hypertension, arrhythmia,
subjects on stable thyroid hormone replacement for at least 3 months whose thyroid
stimulating hormone (TSH) levels are normal) may be allowed.

- Treated within last year with drug known to interfere with bone metabolism including:
bisphosphonates, estrogens such as depot injectables (estrogens used in oral combined
hormonal contraceptives are allowed if dose is stable throughout), high-dose
fluoride, & thyroid replacement hormones (if not stabilized).

- History &/or presence of intraocular pressure in either eye >=22 mm Hg, glaucoma,
&/or posterior subcapsular cataracts. History &/or presence of nuclear cataract or
undergone bilateral lens extraction may be eligible.

- The subject has undergone incisional or intraocular surgery in which the natural lens
is still present in the eye.

- The subject has a history of penetrating trauma to both eyes.

- The subject has one or more of the following lens opacities classification system
version III (LOCS III) grades at screening: nuclear opalescence (NO) >=3.0, nuclear
color (NC) >=3.0, cortical (C) >=2.0, posterior (P) >=0.5.

- Pregnant, breast-feeding, or postmenopausal women. Amenorrhea >6 months will be
excluded (exception hysterectomy). Bilateral oophorectomy excluded.

- Relevant abnormal Baseline vital sign.

- Body mass index (BMI) >35 kg/m2.

- HIV positive (testing not performed).

- Alcoholic or illicit drug abuser.

- Evidence of oropharyngeal candidiasis at Baseline with or without treatment. If
evidence at Screening, may be treated as appropriate & visit can be scheduled upon
resolution. If evidence at Baseline Visit, may be treated as appropriate & visit can
be rescheduled upon resolution.

- Normal sleep/wake cycle is inverted (eg night shift workers).

- Taken restricted medications prior to Screening.

- Cannot adhere to prohibited & permitted concomitant medications.

- No subject may participate in this same study at another site or simultaneously in
any other study.

- No person directly associated with administration of study may participate.
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesNot Provided

Administrative Information[ + expand ][ + ]

NCT Number NCT00394355
Other Study ID NumbersP03418
Has Data Monitoring CommitteeNo
Information Provided ByMerck Sharp & Dohme Corp.
Study SponsorMerck Sharp & Dohme Corp.
CollaboratorsNot Provided
Investigators Not Provided
Verification DateJanuary 2014