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epinephrine

Phase 3

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

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLED
Total Trials3
Total Enrollment420

FDA Designations

No designations recorded

Clinical trial landscape

epinephrine · 3 trials · 4 indications

Phase 3 1Phase 1 2
NCT01357642Epinephrine Inhalation Aerosol USP: For Evaluation Of Efficacy And Safety In Asthma PatientsAsthma
COMPLETED373 Analytics
PHASE3COMPLETED
Epinephrine Inhalation Aerosol USP: For Evaluation Of Efficacy And Safety In Asthma Patients
AsthmaUnlock trial analytics

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 to 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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Frequently asked questions about epinephrine

What is epinephrine used for in asthma?

Epinephrine is an investigational small molecule being developed by Amphastar Pharmaceuticals, Inc. (AMPH) for the treatment of asthma. It is formulated as an inhalation aerosol and is currently in Phase 3 clinical development. The drug is intended to relieve asthma symptoms, including bronchospasm, wheezing, and shortness of breath.

How does epinephrine work?

Epinephrine works by acting on alpha and beta adrenergic receptors, which are part of the sympathetic nervous system. This action leads to bronchodilation, relaxing the smooth muscles of the airways and improving airflow in patients with asthma. The drug is delivered via inhalation aerosol to target the lungs directly.

Who makes epinephrine?

Epinephrine is being developed by Amphastar Pharmaceuticals, Inc., a biopharmaceutical company traded on the NASDAQ under the ticker symbol AMPH. The company is conducting clinical trials to evaluate the safety and efficacy of this inhaled epinephrine formulation for the treatment of asthma.

What phase is epinephrine in?

Epinephrine is in Phase 3 clinical development for asthma. The most advanced trial, NCT01357642, is a Phase 3 study that has been completed. This trial evaluated the efficacy and safety of epinephrine inhalation aerosol in asthma patients aged 12 years and older. The drug is not yet approved and remains investigational.

What clinical trials is epinephrine in?

Epinephrine has been studied in three clinical trials, all completed. NCT01143051 and NCT01188577 were Phase 1 pharmacokinetic studies in healthy volunteers, while NCT01357642 was a Phase 3 efficacy and safety study in asthma patients. The Phase 3 trial enrolled 373 participants and was conducted in the United States.

Is epinephrine the same as other asthma medications?

Epinephrine is a bronchodilator that has been used for decades in various forms, but this specific inhaled aerosol formulation is being developed by Amphastar. It is not the same as other common asthma medications like albuterol, which is a selective beta-2 agonist. Epinephrine acts on both alpha and beta receptors, providing a different mechanism of action.