Chronic Bronchitis
Conditions
Keywords
Chronic Obstructive Pulmonary Disease (COPD), Acute exacerbation of COPD (AECOPD), chronic bronchitis, bronchitis, chest infection, smoking, lung disease, lung, lungs
Brief summary
A study to assess the safety and efficacy of moxifloxacin compared to that of amoxicillin-clavulanic acid for the treatment of subjects with acute exacerbation of chronic bronchitis.
Interventions
Subjects will be randomised to moxifloxacin 400 mg PO OD (5 days). Subjects will also take placebo tablets, so that each subject takes 3 tablets per day for 7 days. Prior to randomization, subjects are stratified based on co-administration of short-course systemic steroids.
Subjects will be randomised to amoxicillin-clavulanic acid 875/125 mg PO BID (7 days). Subjects will also take placebo tablets, so that each subject takes 3 tablets per day for 7 days. Prior to randomization, subjects are stratified based on co-administration of short-course systemic steroids.
Sponsors
Bayer
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Outpatients with chronic bronchitis * Male or female subjects, \>=60 years old * Post bronchodilator forced expiratory volume in one second (FEV1) less than or equal to 60% predicted and FEV1 / forced vital capacity (FVC) less than 70% at enrollment * Documented history of 2 or more AECB episodes, within 12 months of study enrollment, requiring a course of systemic antibiotics and/or systemic corticosteroids * All symptoms/signs must be present and confirmed by the Investigator: * increase in dyspnea * purulent sputum * increase in sputum volume * Current or past cigarette smoker with equal to or greater than 20 pack year smoking history * Subjects must be exacerbation free for at least 30 days prior to enrollment * Subjects must be willing and able to complete the questionnaires and subject booklet without assistance
Exclusion criteria
* Known hypersensitivity to quinolones, ß lactams, or to any of the excipients of the study drugs * Known to have congenital or acquired QT prolongation * Known to have clinically relevant bradycardia * Known to have clinically relevant heart failure with reduced left ventricular ejection fraction * Known to have previous history of symptomatic arrhythmias * Taking QT prolonging drugs, for example Class Ia or III antiarrhythmic agents or other QT prolonging drugs * Known electrolyte disturbances that are not controlled, particularly uncorrected hypokalemia * Known history of hereditary problems of galactose intolerance, the Lapp lactase deficiency, or glucose galactose malabsorption * History of a tendon disease/disorder * Known history of liver dysfunction (Child-Pugh C), including known elevated transaminase levels (alanine aminotransferase \[ALT\] and/or aspartate aminotransferase \[AST\] \>5 times the upper limit of normal \[5 x ULN\]) * Known severe renal impairment with glomerular filtration rate of \<30 mL/min * Known neutropenia (neutrophil count \<1000/mm3) caused by immunosuppressive therapy or malignancy * Known to have Acquired Immunodeficiency Syndrome (AIDS) (CD4 count of \<200/mm3), or be human immunodeficiency virus (HIV) positive and receiving highly active anti retroviral therapy (HAART) (testing for HIV is not mandatory) * Known chronic asthma (\>15% reversibility or at least 200 mL), bronchial carcinoma, active pulmonary tuberculosis, known diffuse bronchiectasis, cystic fibrosis, or pneumonia (a chest x ray is not mandatory) * Known history of chronic colonization of pathogenic organisms resistant to moxifloxacin and/or amoxicillin clavulanic acid (eg, P. aeruginosa, methicillin resistant Staphylococcus aureus) * Receiving long term (\>4 consecutive weeks) systemic corticosteroid treatment (\>10 mg/day of prednisolone or equivalent) * Received short course of systemic corticosteroid treatment within 30 days prior to enrollment * Life expectancy of less than 6 months * Receiving systemic antibacterial therapy within 30 days prior to study enrollment * Requiring concomitant systemic antibacterial agents * Requiring home ventilatory support (subjects requiring home/portable oxygen therapy or continuous positive airway pressure (CPAP) for sleep apnea are not excluded) and/or those who have a tracheotomy in situ * History of liver function disorders following previous treatment with amoxicillin-clavulanic acid * Receiving disulfiram therapy
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clinical failure at 8 weeks post therapy | At day 63 |
Secondary
| Measure | Time frame |
|---|---|
| Bacteriological eradication rates | Through to day 63 |
| Clinical failure rates for subjects with positive sputum culture at enrollment | Through to day 63 |
| Weekly mean symptom scores measured by the AECB SS | Through to day 63 |
| Rates and speed of symptom relief measured by the AECB SS | Through to day 63 |
| Clinical failure rates for subjects with co-administration of systemic corticosteroids (stratum 1) | Through to day 63 |
| Clinical failure rates for subjects without co-administration of systemic corticosteroids (stratum 2) | Through to day 63 |
| Clinical failure rates | Through to day 35 |
| Improvement in symptoms burden measured by the AECB SS | Through to day 63 |
| Improvement in health related QoL measured by the SGRQ | Through to day 63 |
| spirometry tests will be compared between treatment groups | Through to day 63 |
| HCRU relat. to chronic bronchitis management incl. rescue med., concomitant med., therap. adjuncts, diagn. procedures, other medical care/medical staff requirement, hospitalizations (incl. ward and duration), and work productivity and activity impairment | Through to day 63 |
| Safety and tolerability of moxifloxacin versus amoxicillin clavulanic acid, with particular attention to rates of diarrhea | Through to day 63 |
| Need for any change in dosage or additional respiratory medication such as bronchodilators and inhaled steroids, excluding short acting bronchodilators | Through to day 63 |
Countries
Andorra, Argentina, Australia, Belgium, Brazil, Canada, Chile, China, Colombia, Croatia, Czechia, France, Germany, Greece, Hong Kong, Indonesia, Ireland, Italy, Latvia, Lithuania, Mexico, Netherlands, Pakistan, Peru, Philippines, Portugal, South Africa, Spain, Switzerland, Thailand, United Kingdom
Outcome results
None listed