Fixed Dose Triple vs Dual Combination for COPD

(TRITON Trial)

Not currently recruiting at 567 trial locations
CC
Overseen ByChiesi Clinical Trial Info
Age: 18+
Sex: Male
Trial Phase: Phase 3
Sponsor: Chiesi Farmaceutici S.p.A.
Must be taking: Inhaled maintenance therapy
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the effectiveness of a triple combination inhaler treatment compared to a dual combination inhaler for people with COPD, a lung disease that makes breathing difficult. The trial focuses on improving lung function and reducing symptom flare-ups. Participants will use an inhaler with either three medications—Beclomethasone Dipropionate, Formoterol Fumarate, and Glycopyrronium Bromide—or two medications for about a year. This trial suits those diagnosed with COPD for over a year, who experience frequent symptom flare-ups, and currently use a daily inhaler. As a Phase 3 trial, it represents the final step before FDA approval, offering participants a chance to contribute to a potentially groundbreaking treatment for COPD.

Do I need to stop my current medications for this trial?

The trial requires that you stop using certain medications before and during the trial. Specifically, you must not use systemic/oral/parenteral corticosteroids, antibiotics for lower respiratory tract infections or COPD exacerbations, long-term chronic maintenance antibiotics, or oral xanthine derivatives like theophylline within specified periods before the screening visit. Additionally, you cannot be on non-cardioselective β-blockers or require long-term oxygen therapy. If you are on any of these medications, you may need to stop them to participate in the trial.

Will I have to stop taking my current medications?

The trial requires that you stop taking certain medications before joining, such as oral corticosteroids, antibiotics for respiratory infections, and oral xanthine derivatives. If you're on these, you'll need to stop them for a specific period before the screening.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that the treatment combinations being tested, CHF 5993 and CHF 1535, have promising safety records from previous studies.

CHF 5993 combines three ingredients: beclomethasone dipropionate, formoterol fumarate, and glycopyrronium bromide. Studies indicate that this combination is generally well-tolerated, improving lung function and reducing COPD flare-ups without major safety concerns. However, some studies report mild to moderate side effects, which are common with similar treatments.

CHF 1535 contains two ingredients: beclomethasone dipropionate and formoterol fumarate. Evidence suggests it is safe for most people and has been used in other COPD treatments with a good safety record. Some users might experience mild side effects, but these are usually manageable.

Overall, both treatments have been tested and are considered safe based on previous research. Participants can expect the usual side effects associated with inhaled COPD medications, but serious issues are rare.12345

Why do researchers think this study treatment might be promising for COPD?

Unlike the standard treatments for COPD, which often involve dual combination inhalers, the study treatment combines three active ingredients: Beclomethasone Dipropionate, Formoterol Fumarate, and Glycopyrronium Bromide. This fixed-dose triple combination offers the benefits of an inhaled corticosteroid, a long-acting beta-agonist, and a long-acting muscarinic antagonist all in one, potentially enhancing lung function and symptom control. Researchers are excited because this could mean fewer inhalers for patients to manage and possibly better overall outcomes by targeting multiple pathways of the disease simultaneously.

What evidence suggests that this trial's treatments could be effective for COPD?

This trial will compare two treatment arms for COPD. The triple combination treatment, CHF 5993, includes beclomethasone dipropionate, formoterol fumarate, and glycopyrronium bromide. Studies have shown that this combination improves lung function and reduces flare-ups in people with COPD, outperforming treatments with only two medications.

The dual treatment, CHF 1535, contains beclomethasone dipropionate and formoterol fumarate. Research indicates that it reduces COPD flare-ups and improves lung function, offering more benefits than using formoterol alone. Both treatments in this trial aim to help patients breathe more easily and reduce the frequency of COPD flare-ups.46789

Who Is on the Research Team?

GM

Gregory Feldman, MD

Principal Investigator

Vitalink Research - Spartanburg

Are You a Good Fit for This Trial?

This trial is for COPD patients aged 40 or above with a history of smoking and recent exacerbations. They must have used stable inhaled maintenance therapy for at least 3 months, demonstrate correct inhaler use, and agree to birth control if applicable. Cancer patients, those under age 50 without COPD diagnosis, or hospital visits for COPD within the last year are excluded.

Inclusion Criteria

You have a pre- and post-bronchodilator FEV1/FVC ratio <0.
I have been diagnosed with COPD for over a year.
Documentation (including imagery and report) of chest x-ray (CXR) or CT scan performed within 6 months prior to the screening visit, without evidence of significant abnormalities (other than those related to the presence of COPD).
See 18 more

Exclusion Criteria

I've been to the hospital or doctor for my COPD getting worse in the last year.
Do you have any uncontrolled heart conditions? (Afib, heart disease, acute myocardial infraction) in the last 6 months?
Do you use a nebulizer to take your medication?
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Run-in

Participants continue their regular COPD maintenance therapies before randomization

2 weeks
1 visit (in-person)

Treatment

Participants receive either CHF 5993 or CHF 1535 for 52 weeks with assessments at 4 weeks and every 6 weeks thereafter

52 weeks
9 visits (in-person)

Follow-up

A follow-up safety phone call is performed a week after the last clinic visit

1 week
1 call (virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Beclomethasone Dipropionate
  • Formoterol Fumarate
  • Glycopyrronium Bromide
Trial Overview The study compares two treatments: CHF 5993 (a triple combination) versus CHF 1535 (a dual combination), both containing drugs that help improve lung function. It aims to see which one better reduces lung issues and is safer over time.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: BDP/FF/GB - CHF 5993Experimental Treatment3 Interventions
Group II: BDP/FF - CHF 1535Active Control2 Interventions

Beclomethasone Dipropionate is already approved in European Union, United States, Canada, Japan for the following indications:

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Approved in European Union as Beclomethasone Dipropionate for:
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Approved in United States as Beclomethasone Dipropionate for:
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Approved in Canada as Beclomethasone Dipropionate for:
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Approved in Japan as Beclomethasone Dipropionate for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Chiesi Farmaceutici S.p.A.

Lead Sponsor

Trials
206
Recruited
315,000+
Founded
1935
Headquarters
Parma, Italy
Known For
Respiratory diseases
Top Products
NEXThaler, Trimbow, Curosurf, Holoclar

Published Research Related to This Trial

In a study involving 2691 patients with severe COPD, the fixed triple therapy (beclometasone dipropionate, formoterol fumarate, and glycopyrronium bromide) significantly reduced the rate of moderate-to-severe exacerbations compared to tiotropium alone, demonstrating its superior efficacy.
The fixed triple therapy also showed a significant improvement in lung function (measured by FEV1) compared to tiotropium, while being non-inferior to the open triple therapy, indicating its effectiveness in managing COPD symptoms.
Single inhaler extrafine triple therapy versus long-acting muscarinic antagonist therapy for chronic obstructive pulmonary disease (TRINITY): a double-blind, parallel group, randomised controlled trial.Vestbo, J., Papi, A., Corradi, M., et al.[2022]
In a study involving 708 patients with COPD, the extrafine combination of beclometasone dipropionate, formoterol fumarate, and glycopyrronium (BDP/FF/G) significantly improved lung function compared to the non-extrafine budesonide/formoterol (BUD/FF) after 24 weeks, with greater increases in both pre-dose and post-dose FEV1.
BDP/FF/G also reduced the rate of moderate to severe COPD exacerbations by 43% compared to BUD/FF, indicating its superior efficacy in managing COPD symptoms and preventing flare-ups.
Efficacy and safety of single-inhaler extrafine triple therapy versus inhaled corticosteroid plus long-acting beta2 agonist in eastern Asian patients with COPD: the TRIVERSYTI randomised controlled trial.Zheng, J., Baldi, S., Zhao, L., et al.[2021]
The fixed-dose combination of indacaterol, glycopyrronium, and mometasone furoate (IND/GLY/MF) was found to be non-inferior to the combination of salmeterol/fluticasone and tiotropium (SAL/FLU + TIO) in improving asthma quality of life after 24 weeks in patients with uncontrolled asthma, based on a study involving adults aged 18 and older.
IND/GLY/MF high-dose not only matched the efficacy of SAL/FLU + TIO but also showed significant improvements in lung function and asthma control, while the medium-dose provided similar benefits with a lower steroid dose, indicating a potentially safer option for patients.
Fixed-dose combination of indacaterol/glycopyrronium/mometasone furoate once-daily versus salmeterol/fluticasone twice-daily plus tiotropium once-daily in patients with uncontrolled asthma: A randomised, Phase IIIb, non-inferiority study (ARGON).Gessner, C., Kornmann, O., Maspero, J., et al.[2021]

Citations

NCT04320342 | A Study Comparing Efficacy, Safety and ...The purpose of this study is to compare CHF 5993 with CHF 1535 in improving lung function, reducing moderate and severe COPD exacerbations, and other clinical ...
Real-World Effectiveness of Triple Extrafine Fixed-Dose ...The triple extrafine BDP/FF/G FDC effectively improves health status and lung function in real-world COPD patients, supporting its use as a viable therapeutic ...
Study Details | NCT00929851 | BDP/FF Versus Formoterol ...... beclomethasone dipropionate plus formoterol fumarate versus formoterol in patients with severe chronic obstructive pulmonary disease ... The efficacy of ...
Sharing Clinical Study Report SynopsisOverall, efficacy data showed that CHF 1535 treatment resulted in greater benefits than FF treatment in terms of COPD annual exacerbation rate, pulmonary ...
5.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39420338/
Effects of inhaled beclometasone dipropionate/formoterol ...In patients with COPD, BDP/FF/G provided significant and clinically relevant improvements vs. placebo and BDP/FF in static and dynamic hyperinflation.
Beclometasone for chronic obstructive pulmonary diseaseThis study was a very high‐dose trial with stable stage 2 and 3 COPD participants. No statistically significant results in change in lung function, mortality, ...
Effects of inhaled beclometasone dipropionate/formoterol ...In patients with COPD, BDP/FF/G provided significant and clinically relevant improvements vs. placebo and BDP/FF in static and dynamic hyperinflation.
Beclometasone Dipropionate/Formoterol Fumarate is ...The current study evaluated the efficacy and safety of BDP/FF pMDI in Chinese patients with COPD, as part of registration for COPD in China.
Inhaled corticosteroids in COPD: Benefits and risksThe efficacy and safety of fixed triple inhaler therapy was also demonstrated in TRILOGY as well as TRINITY where the combination of Beclometasone Dipropionate, ...
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