ClinicalTrials.gg
TerminatedNCT01025648Updated May 16, 2018

Randomized, Placebo/Active Crossover Dose-ranging Study for Safety and Efficacy in Asthma Patients.

A Phase 1/2 interventional study of E004 (epinephrine inhalation aerosol), 90 mcg/actuation and E004 Placebo in Asthma, sponsored by Amphastar Pharmaceuticals, Inc.. Terminated at 2 sites in United States. Open to participants aged 18 Years to 55 Years. Per ClinicalTrials.gov, last updated 2018-05-16.

Sponsored by Amphastar Pharmaceuticals, Inc. · Phase 1/2, Interventional, and Treatment

Why this study was terminated
Optimization of protocol
Phase
Phase 1/2
Study type
Interventional
Enrollment
9
Allocation
Randomized
Ages
18 Years to 55 Years
Sex
All
01

Study summary

The main objective of this study is to evaluate the efficacy and safety of the Armstrong's Epinephrine HFA-MDI (E004) formulation, in comparison to the Placebo (Placebo-HFA) and an Active Control (Epinephrine CFC-MDI), and to identify the optimum E004 dose strength(s) for the ensuing pivotal clinical trials. The study will be conducted in adult patients who have intermittent, or mild-to-moderate persistent, asthma, but are otherwise healthy.

The bronchodilatory efficacy of E004, is evaluated in terms of post-dose area under the curves (AUC) of FEV1 changes (% and volumes), from the pre-dose baseline values, in comparison to the Placebo Control and the Active Control.

02

Conditions studied

  • Asthma

Keywords

  • Mild to Moderate Asthma
  • Dyspnea
  • Wheezing
  • Status Asthmaticus
03

In context

Asthma

4,841 studies on the registry are indexed under Asthma; 600 are open to participants now.

This study's enrollment of 9 is below the median of 78 across 3,341 interventional studies indexed under Asthma.

Browse Asthma studies →

Lead sponsor

Amphastar Pharmaceuticals, Inc. is the lead sponsor of 21 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Generally healthy, male and female adults aged 18 to 55 years at Screening.
  2. Clinical diagnosis of intermittent, or mild-to-moderate persistent, asthma for at least 6 months before Screening, and having used inhaled epinephrine or β-agonist(s) for asthma control;
  3. Demonstrating a baseline (FEV1) at 50-90 percent of predicted normal at Screening;
  4. Demonstrating a 12.0 percent or greater airway reversibility in FEV1 within 30 min after inhaling 2 actuations of Epinephrine CFC-MDI (440 mcg Epinephrine base) at Screening;
  5. Females of must be non-pregnant, non-lactating, and practicing a clinically acceptable form of ;
  6. Demonstration of proficiency in the use of a MDI inhaler after training;
  7. Having properly consented to participate in the trial.

Exclusion criteria

Exclusion Criteria:

  1. A smoking history of 10 or more pack-years, or having smoked within 6 months prior to Screening;
  2. Upper respiratory tract infections within 2 wk, or lower respiratory tract infection within 4 wk, prior to Screening;
  3. Asthma exacerbations that required emergency care or hospitalized treatment, within 4 wk prior to Screening;
  4. Any current or recent respiratory conditions that, per investigator discretion, might significantly affect pharmacodynamic response to the study drugs, including cystic fibrosis, bronchiectasis, tuberculosis, emphysema, and other significant respiratory diseases besides asthma;
  5. Concurrent cardiovascular, hematological, renal, neurologic, hepatic, endocrine (including diabetes), psychiatric, neoplastic or other illnesses that in the opinion of the investigator could impact on the conduct, safety and evaluation of the study;
  6. Known intolerance or to any of the study MDI ingredients (i.e., Epinephrine, HFA-134a, CFC-12, CFC-114, polysorbate-80, ethanol, thymol, nitric acid and ascorbic acid);
  7. Use of prohibited drugs or failure to observe the drug restrictions;
  8. Having been on other drug/device studies in the last 30 days prior to Screening.
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

FEV1

From a breathing test (spirometry): how much air you can blow out in the first second. Often given as a percentage of what is expected for your age, height and sex.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Washout period

A planned gap after a treatment, so that its effects can lessen before the study treatment or a study assessment. Ask the study team and the doctor who prescribed it before changing any medicine.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
9 participants (actual)

Study arms

  • Experimental
    T1 - E004 90 mcg/actuation

    T1 - E004 (epinephrine inhalation aerosol) 90 mcg/actuation - treatment by 2 actuations of E004 at 90 mcg/actuation

    Drug: E004 (epinephrine inhalation aerosol), 90 mcg/actuation

  • Experimental
    T2 - E004 125 mcg/actuation

    E004 (epinephrine inhalation aerosol), 125 mcg, 2 actuations

    Drug: E004 (epinephrine inhalation aerosol), 125 mcg

  • Experimental
    T3 - 160 mcg/actuation

    E004 (epinephrine inhalation aerosol), 160 mcg - E004 (epinephrine inhalation aerosol), 160 mcg/ actuation, 2 actuations

    Drug: E004 (epinephrine inhalation aerosol), 160 mcg

  • Experimental
    T4 - 220 mcg/actuation

    E004 (epinephrine inhalation aerosol), 220 mcg - 220 mcg/actuation, 2 actuations

    Drug: E004 (epinephrine inhalation aerosol), 220 mcg

  • Active comparator
    A - Active control

    epinephrine inhalation aerosol, CFC propelled 220 mcg Epinephrine Inhalation Aerosol, CFC-MDI, 2 actuations

    Drug: epinephrine inhalation aerosol, CFC propelled

  • Placebo comparator
    P, Placebo HFA

    E004 placebo single treatment with 2 inhalations

    Drug: E004 Placebo

Interventions

  • DrugE004 (epinephrine inhalation aerosol), 90 mcg/actuation

    E004 (epinephrine inhalation aerosol), 90 mcg/actuation, 2 actuations, single dose crossover, 1 -14 day washout period

    Also known as: Primatene Mist HFA

  • DrugE004 Placebo

    E004 Placebo, 0 mcg epinephrine inhalation aerosol, 2 actuations, 1 -14 day washout period

  • DrugE004 (epinephrine inhalation aerosol), 125 mcg

    E004 (epinephrine inhalation aerosol), 125 mcg/actuation, 2 actuations, single dose crossover, 1 - 14 day washout period

    Also known as: Primatene Mist HFA

  • DrugE004 (epinephrine inhalation aerosol), 220 mcg

    E004 (epinephrine inhalation aerosol), 220 mcg - 220 mcg/actuation, 2 actuations, single dose crossover, 1 - 14 days washout period

    Also known as: Primatene Mist HFA

  • epinephrine inhalation aerosol, 220 mcg/actuation, 2 actuations, single dose crossover, 1 - 14 day washout period

    Also known as: Primatene Mist

  • DrugE004 (epinephrine inhalation aerosol), 160 mcg

    E004 (epinephrine inhalation aerosol), 160 mcg/actuation, 2 actuations, single dose crossover, 1 - 14 days washout period

    Also known as: Primatene Mist HFA

06

What researchers measure

Primary outcomes

  1. The AUC of post-dose FEV1 percentage changes (Δ%) from the Pre-dose baseline. The primary analysis of the primary endpoint is the difference of Δ% FEV1, compared between the E004 treatment arms (T1, T2, T3 and T4) and the Placebo control (Arm P).

    Time frame: 360 minutes post-dose

Secondary outcomes

  1. Dose response relationship of Epinephrine HFA-MDI, analyzed using efficacy data from all E004 doses.

    Time frame: 360 minutes post dose

  2. AUC of FEV1 volume post-dose changes (Δ Volume) from the Pre-dose baseline.

    Time frame: 360 minutes post dose

  3. Time to onset of bronchodilator effect, determined by linear interpolation as the point where FEV1 first reaches 12.0 percent from the Pre-dose Baseline.

    Time frame: 30 (±5) min post-dose

  4. The peak bronchodilator response (Fmax), defined as the maximum post-dose FEV1 percent change.

    Time frame: 360 minutes post dose

  5. The time to peak FEV1 effect (Tmax), defined as the time of Fmax.

    Time frame: 360 minutes post dose

  6. Duration of effect, calculated as the total duration of bronchodilator effects when post-dose FEV1 reaches and stays 12.0 percent above the Pre-dose Baseline.

    Time frame: 360 minutes post dose

  7. Response Rate of responders who demonstrate 12.0 percent or greater FEV1 changes from the Pre-dose baseline.

    Time frame: 360 minutes post dose

  8. Vital signs, i.e., blood pressure and heart rate,at Screening baseline and 15(±5) min post dosing for reversibility

    Time frame: screening and 15 minutes post dose

  9. Vital signs, i.e., blood pressure (SBP/DBP) and heart rate (HR), at: Pre-dose baseline, and 15(±5) min and 360(±15) post-dose, at each Study Visit.

    Time frame: 360 minutes post dose

  10. Post-dose 20(±5) min ECG recordings (Routine and QT, QTc analysis) at each Study Visit, compared to the Screening baseline recording.

    Time frame: 20 minutes post dose

  11. Data for physical examinations, CBC, serum comprehensive metabolic panel, and urinalysis for all subjects, and urinary pregnancy test for women of child-bearing potential

    Time frame: Screening and end of study

  12. Monitoring of adverse drug events (ADE)

    Time frame: Ongoing through End of Study

07

Study locations

2 sites
  • Amphastar Site 0001
    San Jose, California 95117, United States
  • Amphastar Site 0003
    Stockton, California 95207, United States
08

References and documents

Publications

  • Pinnas JL, Schachtel BP, Chen TM, Roseberry HR, Thoden WR. Inhaled epinephrine and oral theophylline-ephedrine in the treatment of asthma. J Clin Pharmacol. 1991 Mar;31(3):243-7. doi: 10.1002/j.1552-4604.1991.tb04969.x. PubMed 2019665 ↗
  • Hendeles L, Marshik PL, Ahrens R, Kifle Y, Shuster J. Response to nonprescription epinephrine inhaler during nocturnal asthma. Ann Allergy Asthma Immunol. 2005 Dec;95(6):530-4. doi: 10.1016/S1081-1206(10)61014-9. PubMed 16400891 ↗
  • Warren JB, Doble N, Dalton N, Ewan PW. Systemic absorption of inhaled epinephrine. Clin Pharmacol Ther. 1986 Dec;40(6):673-8. doi: 10.1038/clpt.1986.243. PubMed 3780129 ↗
  • Cripps A, Riebe M, Schulze M, Woodhouse R. Pharmaceutical transition to non-CFC pressurized metered dose inhalers. Respir Med. 2000 Jun;94 Suppl B:S3-9. PubMed 10919679 ↗
  • Dickinson BD, Altman RD, Deitchman SD, Champion HC. Safety of over-the-counter inhalers for asthma: report of the council on scientific affairs. Chest. 2000 Aug;118(2):522-6. doi: 10.1378/chest.118.2.522. PubMed 10936150 ↗
  • Simons FE, Gu X, Johnston LM, Simons KJ. Can epinephrine inhalations be substituted for epinephrine injection in children at risk for systemic anaphylaxis? Pediatrics. 2000 Nov;106(5):1040-4. doi: 10.1542/peds.106.5.1040. PubMed 11061773 ↗
  • Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J; ATS/ERS Task Force. Standardisation of spirometry. Eur Respir J. 2005 Aug;26(2):319-38. doi: 10.1183/09031936.05.00034805. No abstract available. PubMed 16055882 ↗
  • Crapo RO, Morris AH, Clayton PD, Nixon CR. Lung volumes in healthy nonsmoking adults. Bull Eur Physiopathol Respir. 1982 May-Jun;18(3):419-25. PubMed 7074238 ↗
  • Dauphinee B, Tashkin DP, et al: Placebo-controlled evaluation of the speed of onset of epinephrine metered-dose aerosol (Primatene Mist) in mild to moderate asthmatics. Am J Respir Crit Care Med, 149:A204, 1994
  • Armstrong Pharmaceuticals: Package Insert of Epinephrine Inhalation Aerosol USP, a CFC-MDI, current as of 2008
  • Westfall TC, Westfall DP: Adrenergic agonists and antagonists, in Brunton LL, Lazo JS, Parker KL (eds): Goodman & Gilman's Ther Pharmacological Basis of Therapeitucs, 11th Ed. P237-296, 1986
  • Montreal Protocol on substances that deplete the ozone layer, Montreal, Spet 1987; Adjusted and/or amended in London 1990; Copenhagen 1992; Vienna 1995; Montreal 1997 and Beijing 1999.
  • NHLBI/NAEPP (National Heart, Lund and Blood Institute; Natuinak /asthma Education and Prevention Program) Expert Panel Report 3 (2007): Guidelines for the diagnosis and management of asthma, Section 3, Component 1, Figure 3-4C:
  • Wyeth Consumer Healthcare: 2005N-0374, Use of ozone-depleting substances: Essential-use determination of over-the-counter (OTC) epinephrine metered dose inhalers. Submitted to teh Nonprescription Drugs and Pulmonary-Allergy Drugs Advisory Committees. Dec 2005.
  • Global Initiative for Asthma (GINA): Pocket guide for asthma management and prevention,
  • Kerwin EM, Tashkin DP, Murphy TR, Bensch GW, Marrs T, Luo MZ, Zhang JY. A Dose-Ranging Study of Epinephrine Hydrofluroalkane Metered-Dose Inhaler (Primatene(R) MIST) in Subjects with Intermittent or Mild-to-Moderate Persistent Asthma. J Aerosol Med Pulm Drug Deliv. 2020 Aug;33(4):186-193. doi: 10.1089/jamp.2019.1558. Epub 2020 Mar 6. PubMed 32150492 ↗
09

Timeline

Tracking since Sep 25, 2026
Not marked actual or estimatedDates not marked actual or estimated

The record gives a start of Dec 2009, a primary completion of Dec 2009 and a completion of Dec 2009. It does not say whether these dates are actual or estimated.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 1, 2009
First posted
Dec 3, 2009
Start
Dec 2009
Primary completionActual
Dec 2009
CompletionActual
Dec 2009
Results delay requested
Jul 10, 2013
Last update
May 16, 2018
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 16, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01025648
Lead sponsor
Amphastar Pharmaceuticals, Inc.
Responsible party
Sponsor
First posted
Dec 3, 2009
Start date
Dec 2009
Primary completion
Dec 2009
Completion
Dec 2009
Last update
May 16, 2018

Study contacts

Jim Shi, M.D., Ph.D.
study chair · Amphastar Pharmaceuticals, Inc.

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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