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epinephrine

Phase 3

Asthma | Small molecule | Respiratory |Amphastar Pharmaceuticals, Inc.|Last Updated: Sep 25, 2018

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindACTIVE_CONTROLLEDBiomarker
Total Trials3
Total Enrollment420
FDA Designations
No designations recorded
Clinical Trials (3)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01357642Epinephrine Inhalation Aerosol USP: For Evaluation Of Efficacy And Safety In Asthma PatientsPHASE3 COMPLETED 373Jul 1, 2011Dec 1, 2011Mar 11, 201633 United States
NCT01188577Epinephrine Inhalation Aerosol USP, a HFA-MDI Study for Assessment of PharmacokineticsPHASE1 COMPLETED 23Aug 1, 2010Jan 1, 2011Jul 25, 20171 United States
NCT01143051Pharmacokinetics (PK) Study of Epinephrine Inhalation Aerosol in Healthy VolunteersPHASE1 COMPLETED 24Jan 1, 2010Jun 1, 2010Sep 25, 20181 United States
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Study Endpoints
Primary Endpoints
Change in Area Under the Curve (AUC) versus placebo
at 5, 30, 60, 120, 180, 240, and 360 minutes post-dose

Serial FEV1 measurements to demonstrate the mean AUC of change in percent FEV1 from same-day baseline of E004 (Treatment T; Epinephrine-HFA) versus Placebo-HFA (Treatment P) is the primary efficacy endpoint.

Baseline Concentration (C0) of Total Epinephrine
0 to 30 minutes prior to dosing

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at Baseline (prior to dosing) in each treatment period following a specified washout period (3-14 days), and were analyzed using an established analysis method. Baseline concentration (C0) is the concentration of epinephrine measured in the plasma at this time point.

Peak Concentration (Cmax) of Total Epinephrine From Time Zero to 6 Hours Post-dose
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 2, 5, 7.5, 10, 12.5, 15, 20, 25, 30, 45, 60, 90, 120, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Peak (maximum) concentration (Cmax) is the highest concentration of epinephrine measured in plasma during the treatment period.

Area Under the Curve From Time Zero to 6 Hours Post-dose (AUC[0-6]) for Total Epinephrine
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 2, 5, 7.5, 10, 12.5, 15, 20, 25, 30, 45, 60, 90, 120, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Area under the curve from time zero to 6 hours post-dose (AUC\[0-6\]) was calculated using the trapezoidal rule.

Time to Reach Peak Concentration (Tmax) for Total Epinephrine
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 2, 5, 7.5, 10, 12.5, 15, 20, 25, 30, 45, 60, 90, 120, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Tmax is the amount of time it takes for epinephrine to reach peak concentration in plasma during the treatment period.

Half-life (t1/2) of Total Epinephrine
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 2, 5, 7.5, 10, 12.5, 15, 20, 25, 30, 45, 60, 90, 120, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Half-life (t1/2) is the amount of time it takes for epinephrine to decrease to half the peak concentration in plasma during the treatment period.

Concentration vs. Time for Total Epinephrine From Time Zero to 6 Hours Post-dose
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 2, 5, 7.5, 10, 12.5, 15, 20, 25, 30, 45, 60, 90, 120, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method.

Baseline Concentration (C0) of Labeled Epinephrine Total Epinephrine
0 to 30 minutes prior to dosing

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at Baseline (prior to dosing) in each treatment period following a specified washout period (3-14 days), and were analyzed using an established analysis method. Baseline concentration (C0) is the concentration of epinephrine measured in the plasma at this time point.

Area Under the Curve From Time Zero to 6 Hours Post-dose (AUC[0-6])
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Area under the curve from time zero to 6 hours post-dose (AUC\[0-6\]) was calculated using the trapezoidal rule.

Peak Concentration (Cmax) for Total Epinephrine From Time Zero to 6 Hours Post-dose
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Peak (maximum) concentration (Cmax) is the highest concentration of epinephrine measured in plasma during the treatment period.

Half-life (t1/2) for Total Epinephrine
Pre-dose to 6 hours post-dose

Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Half-life (t1/2) is the amount of time it takes for epinephrine decrease to half the peak concentration in plasma during the treatment period.

Secondary Endpoints
Monitor vital signs
2, 10, 20, 60, and 360 min after dosing
Cardiac rhythm
at baseline, 2, 10, 20, and 60 min post-dose
Blood glucose and potassium
baseline, and at 15 and 120 min post-dose
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Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Arm TEXPERIMENTALArm T is the experimental treatment arm consisting of 2 x 125 mcg/inhalations of E004, QID, with 4-6 hr intervals
Arm PPLACEBO_COMPARATORPlacebo comparator as 2×Placebo QID, with 4-6 hr intervals
Arm AACTIVE_COMPARATORActive comparator, Primatene Mist, 2×220 mcg/inhalation, QID, with 4-6 hr intervals
Epinephrine Inhalation Aerosol, HFAEXPERIMENTALExperimental treatment of 10 inhalations of 125 mcg epinephrine base propelled by HFA 134a
Epinephrine Inhalation Aerosol, CFCACTIVE_COMPARATOREpinephrine Inhalation Aerosol, CFC propelled, 220 mcg/inhalation , 10 inhalations
Treatment CACTIVE_COMPARATORActive comparator arm utilizing marketed Primatene Mist with CFC propellant at the labeled dose.
Treatment 1EXPERIMENTALT1 is HFA propelled epinephrine inhalation aerosol 125 mcg/inhalation
Treatment 2EXPERIMENTALHFA propelled epinephrine inhalation aerosol, 160 mcg/inhalation
Interventions
NameTypeDescription
Epinephrine inhalation aerosolDRUGEpinephrine inhalation aerosol, 125 mcg/inhalation, 2 inhalations QID at 4 - 6 hour intervals
PlaceboDRUGPlacebo for epinephrine inhalation aerosol, formulation without epinephrine
Epinephrine Inhalation Aerosol, HFADRUG10 inhalations of epinephrine inhalation aerosol, 125 mcg/inhalation
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Eligibility Criteria
Age Range12 Years — 75 Years
SexALL
Healthy VolunteersNo
Study Sites33

Inclusion Criteria: * Patients with documented asthma, requiring inhaled epinephrine or beta 2-agonist treatment. * No significant changes in asthma therapy and no asthma-related hospitalization or emergency visits, within 4 weeks prior to Screening * Can tolerate withholding treatment with inhaled...

Countries:United States
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