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Safety And Efficacy of BIBF 1120 in Idiopathic Pulmonary Fibrosis

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT00514683
First Posted: August 10, 2007
Last Update Posted: January 6, 2015
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by:
Boehringer Ingelheim
  Purpose

The general purpose of this trial is to investigate the efficacy and safety of 4 dose strategies of BIBF 1120 treatment for 12 months, compared to placebo in patients with idiopathic pulmonary fibrosis.

The primary objective of this study is to demonstrate whether at least one dose strategy is superior to placebo in patients with IPF, in modifying the rate of decline of Forced Vital Capacity (FVC).

As a secondary objective, additional parameters will be assessed in order to differentiate between dose strategies on the basis of safety and efficacy


Condition Intervention Phase
Pulmonary Fibrosis Drug: low dose BIBF1120 once daily Drug: low dose BIBF 1120 twice daily Drug: intermediate dose BIBF 1120 twice daily Drug: high dose BIBF 1120 twice daily Drug: placebo Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double
Primary Purpose: Treatment
Official Title: A 12 Month, Double Blind, Randomized, Placebo-controlled Trial Evaluating the Effect of BIBF 1120 Administered at Oral Doses of 50 mg qd, 50 mg Bid, 100 mg Bid and 150 mg Bid on Forced Vital Capacity Decline During One Year, in Patients With Idiopathic Pulmonary Fibrosis, With Optional Active Treatment Extension Until Last Patient Out.

Resource links provided by NLM:


Further study details as provided by Boehringer Ingelheim:

Primary Outcome Measures:
  • Rate of Decline in FVC [ Time Frame: Baseline until 52 weeks ]

    Rate of decline in Forced Vital Capacity (FVC) evaluated from baseline until 52 weeks of treatment.

    The means presents actually the adjusted rate based on a MMRM with fixed terms for treatment*time, gender*height, gender*age and random terms for patient effect, patient*time.



Secondary Outcome Measures:
  • Absolute Change From Baseline in FVC%Pred [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in percentage of predicted Forced Vital Capacity (FVC%pred) at 52 weeks.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline and region.


  • Absolute Change From Baseline in FVC [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in percentage of absolute Forced Vital Capacity (FVC) at 52 weeks.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline and region.


  • Relative Change From Baseline in FVC%Pred [ Time Frame: Baseline and 52 weeks ]

    Percent change from baseline in percentage of predicted Forced Vital Capacity (FVC%pred) at 52 weeks.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline and region.


  • Relative Change From Baseline in FVC [ Time Frame: Baseline and 52 weeks ]

    Percent change from baseline in absolute Forced Vital Capacity (FVC) at 52 weeks.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline and region


  • Number of Participants With Change From Baseline in FVC by Categories [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in percentage of Forced Vital Capacity (FVC) at 52 weeks in below mentioned categories:

    1. Decrease > 10% or 200mL
    2. Change within <= 10% or <=200 mL
    3. Increase > 10% or 200mL

  • Survival (All Causes of Death and Lung-transplant Free) [ Time Frame: 52 weeks ]

    Survival (all causes of death and lung-transplant free) at 52 weeks, based on overall mortality and on-treatment survival.

    Failure means participants with event and Censored means participants with no event.


  • Absolute Change From Baseline in SpO2 at Rest [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in oxygen saturation (SpO2) at rest.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Absolute Change From Baseline in SpO2 at Rest by Categories [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in oxygen saturation (SpO2) at rest by below mentioned categories:

    SpO2 (non-invasive) at 52 weeks:

    1. Decrease > 4% SpO2
    2. Change within +/- 4% SpO2
    3. Increase > 4% SpO2

  • Absolute Change From Baseline in PaO2 [ Time Frame: Baseline and 52 weeks ]
    Absolute change from baseline in Arterial oxygen partial pressure (PaO2) at week 52. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Absolute Change From Baseline in P(A-a)O2 [ Time Frame: Baseline and 52 weeks ]
    Absolute change from baseline in Alveolo-arterial oxygen gradient (P(A-a)O2) at week 52. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Absolute Change From Baseline in PaCO2 [ Time Frame: Baseline and 52 weeks ]
    Absolute change from baseline in Arterial carbon dioxyde partial pressure (PaCO2) at week 52. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Absolute Change From Baseline in PaO2 by Categories [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in Arterial oxygen partial pressure (PaO2) by below mentioned categories:

    1. Decrease > 4 mmHg
    2. Change within +/- 4 mmHg
    3. Increase > 4 mmHg

  • Absolute Change From Baseline in P(A-a) O2 by Categories [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in Alveolo-arterial oxygen gradient (P(A-a) O2) by below mentioned categories:

    1. Decrease > 4 mmHg
    2. Change within +/- 4 mmHg
    3. Increase > 4 mmHg

  • Absolute Change From Baseline in DLCO [ Time Frame: Baseline and 52 weeks ]

    Absolute change from Baseline in Diffusing capacity of the lung for carbon monoxide (DLCO) at 52 weeks.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Absolute Change From Baseline in DLCO by Categories [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in Diffusing capacity of the lung for carbon monoxide (DLCO) by below mentioned categories:

    1. Decrease > 15% or > 1
    2. Change <= 15% or <= 1
    3. Increase > 15% or > 1

  • Absolute Change From Baseline in Distance Walk (6-MWT) [ Time Frame: Baseline and 52 weeks ]
    Absolute change from baseline in distance walk (6-MWT) at 52 weeks. The 6-Minutes Walk Test (6-MWT) was conducted according to the American Thoracic Society (ATS) Criteria. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Absolute Change From Baseline in Dyspnoea Rating on Borg Scale Before Exercise (6-MWT) [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in Dyspnoea rating before exercise (6-MWT) at 52 weeks based on Borg scale as mentioned below :

    0: Nothing at all, 0.5: Very, very slight (just noticable), 1: Very slight, 2: Slight (light), 3: Moderate, 4: Somewhat severe, 5: Severe (heavy), 6, 7:Very severe, 8, 9, 10: Very, very severe (Maximal).

    The 6-Minutes Walk Test (6-MWT) was conducted according to the ATS Criteria. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Change From Baseline in Dyspnoea Rating on Borg Scale After Exercise (6-MWT) [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in Dyspnoea rating after exercise (6-MWT) at 52 weeks based on Borg scale as mentioned below :

    0: Nothing at all, 0.5: Very, very slight (just noticable), 1: Very slight, 2: Slight (light), 3: Moderate, 4: Somewhat severe, 5: Severe (heavy), 6, 7:Very severe, 8, 9, 10: Very, very severe (Maximal).

    The 6-Minutes Walk Test (6-MWT) was conducted according to the ATS Criteria. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Absolute Change From Baseline in MRC Dyspnea Scale by Categories [ Time Frame: Baseline and 52 weeks ]

    Absolute change from baseline in Medical Research Council (MRC) dyspnea scale by below mentioned categories:

    1. Decrease
    2. No Change
    3. Increase

  • Absolute Change From Baseline in FEV1/FVC [ Time Frame: Baseline and 52 weeks ]

    Change from baseline of percentage of FVC expelled in the first second of a forced expiration (FEV1/FVC) at 52 weeks.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Change From Baseline in SGRQ Total Score [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in Saint George's Respiratory Questionnaire (SGRQ) total score. Total score is defined as sum of the three domain scores symptoms, activities and impacts. Scores range from 0 to 100, with higher scores indicating worst possible health status.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Change From Baseline in SGRQ Domain Score Symptoms [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in Saint George's Respiratory Questionnaire (SGRQ) domain score symptoms. Scores range from 0 to 100, with higher scores indicating more limitations.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Change From Baseline in SGRQ Domain Score Impacts [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in Saint George's Respiratory Questionnaire (SGRQ) domain score impacts. Scores range from 0 to 100, with higher scores indicating worst possible health status.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • Change From Baseline in St George's Respiratory Questionnaire (SGRQ) Domain Score Activities [ Time Frame: Baseline and 52 weeks ]

    Change from baseline in Saint George's Respiratory Questionnaire (SGRQ) domain score activities. Scores range from 0 to 100, with higher scores indicating worst possible health status.

    Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.


  • St George's Respiratory Questionnaire (SGRQ) Responder [ Time Frame: 52 weeks ]
    St George's Respiratory Questionnaire (SGRQ) responder (<= -4 points change) (%) at 52 weeks-worst case

  • Change From Baseline in TLC [ Time Frame: Baseline and 52 weeks ]
    Change from Baseline in Total Lung Capacity (TLC) at 52 weeks. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Change From Baseline in RV [ Time Frame: Baseline and 52 weeks ]
    Change from Baseline in Residual volume (RV) at 52 weeks. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Change From Baseline in TGV [ Time Frame: Baseline and 52 weeks ]
    Change from Baseline in Thoracic gas volume (TGV) at 52 weeks. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Change From Baseline in VC [ Time Frame: Baseline and 52 weeks ]
    Change from baseline in Vital capacity (VC) at 52 weeks. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Change From Baseline in IC [ Time Frame: Baseline and 52 weeks ]
    Change from Baseline in Inspiratory Capacity (IC) at 52 weeks. Means were adjusted based on an ANCOVA with fixed terms for treatment, baseline, region.

  • Number of Patients With at Least One IPF Exacerbation [ Time Frame: 52 weeks ]
    Number of patients with at least one Idiopathic Pulmonary Fibrosis (IPF) exacerbation at 52 weeks

  • Occurrences of IPF Exacerbations Per Patient Per Year [ Time Frame: 52 weeks ]
    Occurrences of Idiopathic Pulmonary Fibrosis (IPF) exacerbations per patient per year at 52 weeks

  • Time to First Occurrence of IPF Exacerbation [ Time Frame: 52 weeks ]

    This endpoint is called time to first occurrence of IPF exacerbation however it was actually analysed as the proportion of patients having occurrence of Idiopathic Pulmonary Fibrosis (IPF) exacerbation at 52 weeks.

    Failure means participants with event and Censored means participants with no event.


  • Survival (Death Due to Respiratory Cause, and Lung-transplant Free) [ Time Frame: 52 weeks ]

    Survival (death due to respiratory cause, and lung-transplant free) at 52 weeks.

    Failure means participants with event and Censored means participants with no event.


  • Time to Progression [ Time Frame: 52 weeks ]

    Time to progression. Progression was defined as at least one of the following: 5mmHg increase in the alveolo-arterial pressure difference in oxygen (P(A-a)O2), 10% decrease in FVC (FVC(baseline)-FVC(progression) >= 10%) or Death.

    Failure means participants with event and Censored means participants with no event.


  • Pre-dose Plasma Concentration of Nintedanib in Plasma at Steady State on Day 365 (Cpre,ss,365) and Day 729 (Cpre,ss,729). [ Time Frame: day 365 and day 729 ]
    Cpre,ss,729 represents the pre-dose plasma concentration of nintedanib in plasma at steady state on Day 729 and Cpre,ss,365 represents the pre-dose plasma concentration of nintedanib in plasma at steady state on Day 365. At day 365, values only for Nintedanib 50 qd group are presented as no values reported for other groups and at day 729, values are presented for all group except for Nintedanib 50 qd group as no values reported for it.


Enrollment: 432
Study Start Date: August 2007
Primary Completion Date: June 2010 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: dose 1
low dose BIBF1120 once daily
Drug: low dose BIBF1120 once daily
low dose BIBF1120 once daily
Experimental: dose 2
low dose BIBF 1120 twice daily
Drug: low dose BIBF 1120 twice daily
low dose BIBF 1120 twice daily
Experimental: dose 3
intermediate dose BIBF 1120 twice daily
Drug: intermediate dose BIBF 1120 twice daily
intermediate dose BIBF 1120 twice daily
Experimental: dose 4
high dose BIBF 1120 twice daily
Drug: high dose BIBF 1120 twice daily
high dose BIBF 1120 twice daily
Placebo Comparator: placebo
placebo
Drug: placebo
placebo

  Eligibility

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   40 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Patient >40 years
  2. Written informed consent signed prior to entry into the study
  3. IPF diagnosed (according to ATS / ERS criteria) less than 5 years prior to screening visit.
  4. HRCT within 12 months of randomisation and biopsy (the latter if needed to fulfil ATS/ERS criteria) centrally reviewed and consistent with diagnosis.
  5. FVC>50 % of predicted value

    Predicted normal values will be calculated according to ESCS (R94-1408):

    Males :

    FVC predicted (L) = 5.76 x height (meters)- 0.026 x age (years) -4.34

    Females :

    FVC predicted (L) = 4.43 x height (meters)- 0.026 x age (years) -2.89

  6. Single breath DLCO (corrected for Hb) 30 - 79% inclusive of predicted .

    Different sites may use different prediction formulas, based on the method used to measure DLco. In any case, the method used must be in compliance with the ATS/ERS guideline on DLCO measurements (R06-2002), and the prediction formula appropriate for that method. Raw data (gas mixture, equation used for prediction of normal, further adjustments made if so) must be traced.

    Adjustment for haemoglobin (R06-2002):

    Males :

    DLCO predicted for Hb = DLCO predicted x (1.7Hb/[10.22+Hb])

    Females :

    DLCO predicted for Hb = DLCO predicted x (1.7Hb/[9.38+Hb]) where Hb is expressed in g/dL-1

  7. PaO2 >= 55 mmHg (sea level to 1500 m) or 50 mmHg (above 1500 m) room air

Exclusion Criteria:

  1. AST, ALT > 1.5 x ULN ;
  2. Bilirubin > 1.5 x ULN
  3. Relevant airways obstruction
  4. Continuous oxygen supplementation at randomisation (defined as > 15 hours supplemental oxygen per day).
  5. Active infection at screening or randomisation.
  6. Neutrophils < 1500 / mm3
  7. International normalised ratio (INR) > 1.5 and/or Partial thromboplastin time (PTT) > 1.5 x ULN ;
  8. Platelets < 100 000 /mL
  9. Haemoglobin < 9.0 g/dL
  10. In the opinion of the Investigator, patient is likely to have lung transplantation during study
  11. Life expectancy for disease other than IPF < 2.5 years (Investigator assessment).
  12. Other disease that may interfere with testing procedures or in judgement of Investigator may interfere with trial participation or may put the patient at risk when participating to this trial.

    • Myocardial infarction during the previous 6 months
    • Unstable angina during the previous month
  13. Other investigational therapy received within 8 weeks prior to screening visit.
  14. Pregnant women or women who are breast feeding or of child bearing potential not using a highly effective method of birth control for at least one month prior to enrolment.
  15. Sexually active males not committing to using condoms during the course of the study (except if their partner is not of childbearing potential).
  16. Known or suspected active alcohol or drug abuse.
  17. Bleeding risk : Known inherited predisposition to bleeding, patients who require full-dose anticoagulation, Patients who require full-dose antiplatelet therapy, History of hemorrhagic CNS event within 12 months prior to screening , Any of the following within 3 months prior to screening : Gross / frank haemoptysis or haematuria, Active gastro-intestinal bleeding or ulcers, Major injury or surgery
  18. Thrombotic risk
  19. Surgical procedures planned to occur during trial period.
  20. Coagulopathy
  21. Uncontrolled systemic arterial hypertension
  22. known hypersensitivity to lactose or any component of the study medication
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00514683


  Show 92 Study Locations
Sponsors and Collaborators
Boehringer Ingelheim
Investigators
Study Chair: Boehringer Ingelheim Boehringer Ingelheim
  More Information

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Boehringer Ingelheim, Study Chair, Boehringer Ingelheim
ClinicalTrials.gov Identifier: NCT00514683     History of Changes
Other Study ID Numbers: 1199.30
First Submitted: August 9, 2007
First Posted: August 10, 2007
Results First Submitted: November 14, 2014
Results First Posted: January 6, 2015
Last Update Posted: January 6, 2015
Last Verified: January 2015

Additional relevant MeSH terms:
Fibrosis
Pulmonary Fibrosis
Idiopathic Pulmonary Fibrosis
Idiopathic Interstitial Pneumonias
Pathologic Processes
Lung Diseases
Respiratory Tract Diseases
Lung Diseases, Interstitial
Nintedanib
Antineoplastic Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action