Evaluating the Efficacy and Safety of PT027 Compared With PT007 Administered As Needed in Participants 12 to < 18 Years of Age With Asthma

Official title

A Randomized, Double-blind, Multicenter, Parallel-group, Phase IIIb 52 Week Study Evaluating the Efficacy and Safety of PT027 Compared With PT007 Administered as Needed in Participants 12 to < 18 Years of Age With Asthma (ACADIA)

Overview

The purpose of this study is to compare the effect of budesonide/albuterol metered-dose inhaler (BDA MDI) with albuterol sulfate metered-dose inhaler (AS MDI), both administered as needed, on the annualized rate of severe asthma exacerbations in adolescents with a documented clinical diagnosis of asthma and at least one severe exacerbation in the prior year.

Detailed description

This is a randomized, double-blind, multicenter, parallel-group Phase IIIb study with a fixed treatment period of 52 weeks.

The study will consist of 3 periods:

1. Screening period (7 to 28 days) 2. Treatment period of 52 weeks 3. Safety follow-up period (7 to 14 days after the end of treatment \[EOT\] visit)

Participants who meet the eligibility criteria will be randomly assigned to BDA MDI 160/180 micrograms (μg) or AS MDI 180 μg treatment groups in a 1:1 ratio on top of their own usual maintenance therapy during treatment period.

This study will also include a pharmacokinetic (PK) sub-study with single visit scheduled after the safety follow-up visit in the main study. During PK sub-study, single dose of open-label BDA MDI 160/180 μg will be administered.

Interventions

• Combination product BDA MDI
  Participants will receive oral inhalation of BDA MDI 160/180 μg taken as 2 puffs of 80/90 μg as needed.
• Combination product AS MDI
  Participants will receive oral inhalation of AS MDI 180 μg taken as 2 puffs of 90 μg as needed.

Primary outcome measures

• Annualized rate of severe asthma exacerbations (AAER) [Time frame: From Randomization (Day 1) to Week 52 (EOT)]

Secondary outcome measures (12)

• Time to first (TTF) severe asthma exacerbation [Time frame: From Randomization (Day 1) to Week 52 (EOT)]
• Annualized total systemic corticosteroids (SCS) exposure for treatment of asthma [Time frame: From Randomization (Day 1) to Week 52 (EOT)]
• Number of participants with adverse events (AEs) and severe adverse events (SAEs) [Time frame: Up to Week 52]
• Maximum Observed Concentration (Cmax) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Area under concentration-time curve from time 0 to last quantifiable concentration (AUClast) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Area under concentration-time curve from time 0 to infinity (AUCinf) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Time to reach maximum concentration following drug administration (Tmax) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Time of last quantifiable concentration (Tlast) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Terminal elimination half-life (t½λz) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Terminal elimination rate constant (λz) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Apparent total body clearance (CL/F) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]
• Apparent volume of distribution based on the terminal phase (Vz/F) [Time frame: At 0, 10, 20, 40 minutes and 1, 2, 4, 6, 8, 10, and 12 hours post-dose]

Eligibility criteria

Inclusion criteria

• Confirmed clinical diagnosis of asthma at least 12 months.
• Receiving one of the following scheduled asthma maintenance therapies for at least 3 months with stable dosing for at least the last one month

• Low-to-high-dose Inhaled corticosteroid(s) (ICS)
• Low-to-high-dose ICS or ICS/long-acting β2-agonist (LABA) with or without one additional maintenance therapy from the following: leukotriene receptor antagonist (LTRA), long-acting muscarinic antagonist (LAMA), or theophylline
• Receiving inhaled short-acting β2-agonist (SABA) as needed.
• A documented history of at least one severe asthma exacerbation within 12 months.
• Use of Sponsor-provided albuterol sulfate inhalation aerosol medication.
• Demonstrate acceptable MDI administration technique as assessed by the investigator; use of spacers is prohibited.
• Able to perform acceptable and reproducible peak expiratory flow (PEF) measurements as assessed by the investigator.
• Participants must adhere to protocol specific contraception methods.
• Negative urine pregnancy test for participants of childbearing potential.
• Have a BMI < 40 kg/ m\^2.
• Capable of giving assent (signing the assent form) to participate in the study which includes compliance with the requirements and restrictions. The caregiver of the patient must be capable of giving written informed consent for the patient's participation in the study. Consent and assent forms must be completed prior to any study-specific procedures.

Exclusion criteria

• Life-threatening asthma defined as any history of significant asthma episode(s) requiring intubation associated with hypercapnia, respiratory arrest, hypoxic seizures, or asthma-related syncopal episode(s).
• Experienced > 3 severe asthma exacerbations within 12 months before screening.
• Completed treatment for lower respiratory infection and severe asthma exacerbation with SCS within 4 weeks of screening.
• Upper respiratory infection involving antibiotic treatment not resolved.
• Current smokers, former smokers with > 10 pack-years history, or former smokers who stopped smoking < 6 months (including all forms of tobacco, e-cigarettes \[vaping\], and marijuana).
• Other significant lung disease, including regular or occasional use of oxygen.
• Historical or current evidence of a clinically significant disease including, but not limited to: cardiovascular, hepatic, renal, hematological, neuropsychological, endocrine, or gastrointestinal disorders.
• Cancer not in complete remission for at least 5 years.
• History or hospitalization for psychiatric disorder or attempted suicide within one year.
• Significant abuse of alcohol or drugs, in the opinion of the investigator.
• Oral corticosteroid(s) (OCS)/SCS use (any dose and any indication) within 4 weeks before Visit 1 or chronic use of OCS/SCS (≥ 3 weeks use in 3 months prior to Visit 1).
• Use of any oral SABAs within one month.
• Having a known or suspected hypersensitivity to albuterol/salbutamol, or budesonide and/or their excipients.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Double blind

Primary purpose

Treatment

Study locations

United States · 109 centers

• Research Site — Anchorage
• Research Site — Gilbert
• Research Site — Phoenix
• Research Site — Little Rock
• Research Site — Huntington Beach
• Research Site — Huntington Beach
• Research Site — Long Beach
• Research Site — Long Beach
• … and 101 more centers

China · 22 centers

Center list to be confirmed — check the primary protocol.

South Africa · 8 centers

Center list to be confirmed — check the primary protocol.

Mexico · 5 centers

Center list to be confirmed — check the primary protocol.

Publications

• Bacharier LB, Raissy H, Bardsley S, Dunsire L, Hermansson E, Surujbally R, Sobande O, Murphy KR. Efficacy and safety of as-needed albuterol-budesonide versus albuterol in patients with asthma aged 12 to <18 years: design of the randomised, double-blind, parallel-group phase IIIb ACADIA trial. BMJ Open Respir Res. 2026 Mar 6;13(1):e003843. doi: 10.1136/bmjresp-2025-003843. PMID 41791845

Identifiers

NCT: NCT06307665 · D6934C00001

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗