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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01126437
Registration number
NCT01126437
Ethics application status
Date submitted
6/05/2010
Date registered
19/05/2010
Date last updated
20/06/2014
Titles & IDs
Public title
Comparison of Tiotropium in the HandiHaler Versus the Respimat in Chronic Obstructive Pulmonary Disease
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Scientific title
A Randomized, Active-controlled, Double-blind, Double-dummy, Parallel Group Design, Multi-center Trial to Compare the Efficacy and Safety of 2.5 µg and 5 µg Tiotropium Inhalation Solution Delivered by the Respimat Inhaler With Tiotropium Inhalation Capsules 18 µg Delivered by the HandiHaler (TIOSPIR)
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Secondary ID [1]
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2009-015713-51
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Secondary ID [2]
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205.452
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pulmonary Disease, Chronic Obstructive
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Condition category
Condition code
Respiratory
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Chronic obstructive pulmonary disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - tiotropium 18 mcg
Treatment: Drugs - tiotropium 1.25 mcg (2 actuations/day)
Treatment: Drugs - tiotropium 2.5 mcg (2 actuations/day)
Experimental: tiotropium 2.5 mcg and placebo - Patients receive one of the active tiotropium arms daily
Active comparator: tiotropium 18 mcg and placebo - Patients receive one of the active tiotropium arms daily
Experimental: tiotropium 5 mcg and placebo - Patients receive one of the active tiotropium arms daily
Treatment: Drugs: tiotropium 18 mcg
HandiHaler
Treatment: Drugs: tiotropium 1.25 mcg (2 actuations/day)
soft mist inhaler 2 actuations=2 puffs/day
Treatment: Drugs: tiotropium 2.5 mcg (2 actuations/day)
soft mist inhaler (2 actuations=2 puffs/day)
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Time to All-Cause Mortality
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Assessment method [1]
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Number of patients with all-cause mortality
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Timepoint [1]
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Up to 3 years
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Primary outcome [2]
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Time to First COPD Exacerbation
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Assessment method [2]
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Defined as "a complex of lower respiratory events/symptoms (increase of new onset) related to the underlying COPD, with duration of three days or more, requiring a change in treatment" where a "complex of lower respiratory event/symptoms" was defined as having at least two of the following: shortness of breath, sputum production (volume), occurrence of purulent sputum, cough, wheezing, chest tightness and where "a required change in treatment" includes the following:Prescription of antibiotics and/or systemic steroids, and/or a newly prescribed maintenance respiratory medication (i.e., bronchodilators including theophyllines).
"Onset of exacerbation" was defined by the onset of first recorded symptom. The "end of exacerbation" was decided by the investigator based on clinical judgement.
Exacerbations were classified as follows:
Mild:a new prescription of maintenance bronchodilator only Moderate:antibiotics or systemic steroids without hospitalization Severe:hospitalization.
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Timepoint [2]
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Up to 3 years
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Secondary outcome [1]
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Trough FEV1 Over 120 Weeks (in a Substudy of 1370 Patients)
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Assessment method [1]
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Trough forced expiratory volume in one second (FEV1) over 120 weeks (in a substudy of 1370 patients)
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Timepoint [1]
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Up to 3 years
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Secondary outcome [2]
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Number of COPD Exacerbations
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Assessment method [2]
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The number of COPD exacerbations. COPD exacerbation defined as "a complex of lower respiratory events/symptoms (increase of new onset) related to the underlying COPD, with duration of three days or more, requiring a change in treatment" where a "complex of lower respiratory event/symptoms" was defined as having at least two of the following: shortness of breath, sputum production (volume), occurrence of purulent sputum, cough, wheezing, chest tightness and where "a required change in treatment" includes the following:Prescription of antibiotics and/or systemic steroids, and/or a newly prescribed maintenance respiratory medication (i.e., bronchodilators including theophyllines).
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Timepoint [2]
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Up to 3 years
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Secondary outcome [3]
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Time to First Hospitalization Associated With COPD Exacerbation
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Assessment method [3]
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The results presented below are for the patients with hospitalizations due to COPD exacerbations.
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Timepoint [3]
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Up to 3 years
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Secondary outcome [4]
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Number of Hospitalizations Associated With COPD Exacerbation
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Assessment method [4]
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Total number of hospitalizations associated with COPD exacerbation.
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Timepoint [4]
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Up to 3 years
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Secondary outcome [5]
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Time to First Moderate to Severe COPD Exacerbation
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Assessment method [5]
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COPD exacerbation defined as "a complex of lower respiratory events/symptoms (increase of new onset) related to the underlying COPD, with duration of three days or more, requiring a change in treatment" where a "complex of lower respiratory event/symptoms" was defined as having at least two of the following: shortness of breath, sputum production (volume), occurrence of purulent sputum, cough, wheezing, chest tightness and where "a required change in treatment" includes the following:Prescription of antibiotics and/or systemic steroids, and/or a newly prescribed maintenance respiratory medication (i.e., bronchodilators including theophyllines).
Exacerbations classified as follows:
Mild:a new prescription of maintenance bronchodilator only Moderate:antibiotics or systemic steroids without hospitalization Severe:hospitalization.
Results presented below are number of patients with moderate to severe exacerbations.
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Timepoint [5]
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Up to 3 years
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Secondary outcome [6]
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Time to Onset of First Major Adverse Cardiovascular Event (MACE)
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Assessment method [6]
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Time to onset of first major adverse cardiovascular event (MACE). MACE was defined as: Fatal event in the system organ classes of cardiac and vascular disorders, Preferred terms: sudden death, cardiac death, sudden cardiac death, Outcome events of myocardial infarction (serious and non-serious), Outcome events of stroke (serious and non-serious) and Outcome events of TIA (serious and non-serious). The results presented below are for the number of patients with MACE.
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Timepoint [6]
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Up to 3 years
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Secondary outcome [7]
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Time to Death From Major Adverse Cardiovascular Event (MACE)
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Assessment method [7]
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The results presented below are number of patients with death from MACE.
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Timepoint [7]
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Up to 3 years
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Eligibility
Key inclusion criteria
Inclusion criteria:
1. All patients must sign an informed consent consistent with International Conference on Harmonization Good Clinical Practice (ICH-GCP) guidelines prior to participation in the trial, which includes medication washout and restrictions.
2. Male or female patients 40 years of age or older.
3. Patients must be current or ex-smokers with a smoking history of =10 pack-years. (Patients who have never smoked cigarettes must be excluded)
4. All patients must have a diagnosis of COPD (P06-12085), and must meet the following criteria: Relatively stable airway obstruction with a post-bronchodilator FEV1 = 70% of predicted normal and post-bronchodilator FEV1 / FVC =70%.
Pulmonary function tests (PFTs) were conducted after the inhalation of 400 µg salbutamol / albuterol (preferred), however testing with either 200 µg salbutamol/albuterol or a combination of salbutamol / albuterol with ipratropium bromide (2 to 4 actuations) was acceptable. Other short-acting beta agonists, such as terbutaline, may have been used for the testing. The medication used for the testing was documented. Further, historical data from measurements within the past 6 months either at the site or at a referral site may have been used (see Section 6.2.1 of the CTP, located in Appendix 16.1.1). Subjects were not to have been randomized to the study without the availability of spirometry data at the actual study site.
Eligibility for PFT sub-study: For subjects participating in the spirometry sub-study, historical data may not have been used for inclusion. These subjects must have qualified in the clinic at Visit 1 after performing a baseline measurement. These subjects performed a pre-dose PFT which was followed by the administration of 400 µg salbutamol / albuterol only (no other short-acting beta agonist was allowed), followed by a post-dose PFT for qualification.
5. Able to inhale from the HandiHaler® and the Respimat® devices.
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Minimum age
40
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria:
1. Significant diseases other than COPD. A significant disease is defined as a disease or condition which, in the opinion of the investigator, may put the patient at risk because of participation in the study or may influence the patients ability to participate in the study.
2. Patients with a recent history (i.e., six months or less) of myocardial infarction.
3. Patients with any unstable or life-threatening cardiac arrhythmia requiring intervention or change in drug therapy during the last year.
4. Hospitalisation for cardiac failure (New York Heart Association (NYHA) Class III or IV) during the past year.
5. Known active tuberculosis.
6. Patients with a history of asthma, cystic fibrosis, clinically evident bronchiectasis, interstitial lung disease, or pulmonary thromboembolic disease.
7. History of thoracotomy with pulmonary resection. Subjects with a history of thoracotomy for other reasons were to have been evaluated per exclusion criterion 1.
8. Subject was planning to undergo lung transplant or lung volume reduction surgery (LVRS).
9. Malignancy for which the subject had undergone resection, radiation, chemotherapy or biological treatments within the last 5 years. Subjects with treated basal cell carcinoma were allowed.
10. Known respiratory infection or exacerbation of COPD in the 4 weeks prior to randomization.
11. Known hypersensitivity to anticholinergic drugs, lactose, benzalkonium chloride (BAC), ethylenediaminetetraacetic acid (EDTA), or any other components of the HandiHaler® or Respimat® inhalation solution delivery system.
12. Known moderate to severe renal impairment (as judged by the investigator).
13. Known narrow angle glaucoma.
14. Known significant symptomatic prostatic hyperplasia or bladder-neck obstruction. Subjects whose symptoms were controlled on treatment may have been included.
15. Use of systemic corticosteroid medication at unstable doses (i.e., less than 6 weeks on stable dose) or at doses in excess of the equivalent of 10 mg prednisolone per day.
16. Pregnant or nursing women or women of childbearing potential not using a medically approved means of contraception for at least 3 months prior to and for the duration of the trial.
17. Significant alcohol or drug abuse within the past 12 months.
18. Subjects requiring the use of supplemental oxygen therapy for > 12 hours per day.
19. Subjects who had completed a pulmonary rehabilitation program in the 6 weeks prior to the screening visit or subjects who were currently in a pulmonary rehabilitation program that was not maintained throughout the duration of the study.
20. Subjects who had taken an investigational drug within 30 days prior to the Screening Visit.
21. Previous participation (receipt of randomized treatment) in this study.
22. Subjects who were currently participating in an interventional study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/05/2010
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/05/2013
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Sample size
Target
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Accrual to date
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Final
17183
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Recruitment in Australia
Recruitment state(s)
SA,VIC,WA
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Recruitment hospital [1]
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205.452.61006 Boehringer Ingelheim Investigational Site - Adelaide
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Recruitment hospital [2]
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205.452.61002 Boehringer Ingelheim Investigational Site - Woodville
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Recruitment hospital [3]
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205.452.61004 Boehringer Ingelheim Investigational Site - Box Hill
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Recruitment hospital [4]
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205.452.61003 Boehringer Ingelheim Investigational Site - Footscray
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Recruitment hospital [5]
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205.452.61001 Boehringer Ingelheim Investigational Site - Frankston
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Recruitment hospital [6]
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205.452.61005 Boehringer Ingelheim Investigational Site - Nedlands
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Recruitment postcode(s) [1]
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- Adelaide
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Recruitment postcode(s) [2]
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- Woodville
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Recruitment postcode(s) [3]
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- Box Hill
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Recruitment postcode(s) [4]
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- Footscray
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Recruitment postcode(s) [5]
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- Frankston
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Recruitment postcode(s) [6]
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- Nedlands
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Recruitment outside Australia
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United States of America
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Alabama
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Alaska
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Arizona
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California
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Colorado
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Connecticut
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Delaware
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Florida
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Georgia
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New York
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North Carolina
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Oklahoma
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Wisconsin
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Argentina
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Capital Federal
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Argentina
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Florencio Varela
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Argentina
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Mar del Plata
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Mendoza
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Rosario
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Argentina
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San Miguel de Tucumán
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Austria
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Feldbach
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Austria
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Hallein
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Austria
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Thalheim bei Wels
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Belgium
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Godinne
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Gozée
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Halen
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Leuven
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Belgium
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Linkebeek
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Belgium
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Merksem
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Belgium
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Natoye
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Belgium
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Zichem
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Brazil
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Florianópolis
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Brazil
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Passo Fundo - RS
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Brazil
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Porto Alegre
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Brazil
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Recife
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Brazil
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Rio de Janeiro
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Brazil
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Río de Janeiro
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Brazil
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Sao Pablo
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Brazil
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Sao Paulo
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Brazil
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São Paulo
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Bulgaria
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Plovdiv
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Sofia
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Bulgaria
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Stara Zagora
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Bulgaria
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Veliko Turnovo
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Canada
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Alberta
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Canada
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British Columbia
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Canada
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Manitoba
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Canada
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New Brunswick
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Canada
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Newfoundland and Labrador
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Canada
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Ontario
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Canada
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Quebec
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Canada
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Saskatchewan
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China
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Beijing
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China
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Changchun
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China
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0
0
Changsha
Query!
Country [90]
0
0
China
Query!
State/province [90]
0
0
Chengdu
Query!
Country [91]
0
0
China
Query!
State/province [91]
0
0
Chongqing
Query!
Country [92]
0
0
China
Query!
State/province [92]
0
0
Foshan
Query!
Country [93]
0
0
China
Query!
State/province [93]
0
0
Guangzhou
Query!
Country [94]
0
0
China
Query!
State/province [94]
0
0
Haikou
Query!
Country [95]
0
0
China
Query!
State/province [95]
0
0
Hangzhou
Query!
Country [96]
0
0
China
Query!
State/province [96]
0
0
Nan Ning
Query!
Country [97]
0
0
China
Query!
State/province [97]
0
0
Nanchang
Query!
Country [98]
0
0
China
Query!
State/province [98]
0
0
Nanjing
Query!
Country [99]
0
0
China
Query!
State/province [99]
0
0
Qingdao
Query!
Country [100]
0
0
China
Query!
State/province [100]
0
0
Shanghai
Query!
Country [101]
0
0
China
Query!
State/province [101]
0
0
Shenyang
Query!
Country [102]
0
0
China
Query!
State/province [102]
0
0
Suzhou
Query!
Country [103]
0
0
China
Query!
State/province [103]
0
0
Tianjin
Query!
Country [104]
0
0
China
Query!
State/province [104]
0
0
Wuhan
Query!
Country [105]
0
0
China
Query!
State/province [105]
0
0
Xi'An
Query!
Country [106]
0
0
Colombia
Query!
State/province [106]
0
0
Bogotá
Query!
Country [107]
0
0
Colombia
Query!
State/province [107]
0
0
Medellín
Query!
Country [108]
0
0
Croatia
Query!
State/province [108]
0
0
Cakovec
Query!
Country [109]
0
0
Croatia
Query!
State/province [109]
0
0
Dubrovnik
Query!
Country [110]
0
0
Croatia
Query!
State/province [110]
0
0
Osijek
Query!
Country [111]
0
0
Croatia
Query!
State/province [111]
0
0
Rijeka
Query!
Country [112]
0
0
Croatia
Query!
State/province [112]
0
0
Sisak
Query!
Country [113]
0
0
Croatia
Query!
State/province [113]
0
0
Split
Query!
Country [114]
0
0
Croatia
Query!
State/province [114]
0
0
Zagreb
Query!
Country [115]
0
0
Denmark
Query!
State/province [115]
0
0
Aalborg
Query!
Country [116]
0
0
Denmark
Query!
State/province [116]
0
0
Aarhus C
Query!
Country [117]
0
0
Denmark
Query!
State/province [117]
0
0
Birkerød
Query!
Country [118]
0
0
Denmark
Query!
State/province [118]
0
0
Kolding
Query!
Country [119]
0
0
Denmark
Query!
State/province [119]
0
0
København NV
Query!
Country [120]
0
0
Denmark
Query!
State/province [120]
0
0
København S
Query!
Country [121]
0
0
Denmark
Query!
State/province [121]
0
0
Odense C
Query!
Country [122]
0
0
Denmark
Query!
State/province [122]
0
0
Roskilde
Query!
Country [123]
0
0
Denmark
Query!
State/province [123]
0
0
Rødovre
Query!
Country [124]
0
0
Denmark
Query!
State/province [124]
0
0
Silkeborg
Query!
Country [125]
0
0
Denmark
Query!
State/province [125]
0
0
Skive
Query!
Country [126]
0
0
Denmark
Query!
State/province [126]
0
0
Sønderborg
Query!
Country [127]
0
0
Denmark
Query!
State/province [127]
0
0
Viby
Query!
Country [128]
0
0
Denmark
Query!
State/province [128]
0
0
Værløse
Query!
Country [129]
0
0
Finland
Query!
State/province [129]
0
0
Helsinki
Query!
Country [130]
0
0
Finland
Query!
State/province [130]
0
0
Lahti
Query!
Country [131]
0
0
Finland
Query!
State/province [131]
0
0
Pori
Query!
Country [132]
0
0
Finland
Query!
State/province [132]
0
0
Porvoo
Query!
Country [133]
0
0
Finland
Query!
State/province [133]
0
0
Tammisaari
Query!
Country [134]
0
0
Finland
Query!
State/province [134]
0
0
Tampere
Query!
Country [135]
0
0
Finland
Query!
State/province [135]
0
0
Turku
Query!
Country [136]
0
0
France
Query!
State/province [136]
0
0
Albens
Query!
Country [137]
0
0
France
Query!
State/province [137]
0
0
Angers
Query!
Country [138]
0
0
France
Query!
State/province [138]
0
0
Anzin
Query!
Country [139]
0
0
France
Query!
State/province [139]
0
0
Arras
Query!
Country [140]
0
0
France
Query!
State/province [140]
0
0
Avrillé
Query!
Country [141]
0
0
France
Query!
State/province [141]
0
0
Becon les Granits
Query!
Country [142]
0
0
France
Query!
State/province [142]
0
0
Bersée
Query!
Country [143]
0
0
France
Query!
State/province [143]
0
0
Beziers
Query!
Country [144]
0
0
France
Query!
State/province [144]
0
0
Bischheim
Query!
Country [145]
0
0
France
Query!
State/province [145]
0
0
Blois
Query!
Country [146]
0
0
France
Query!
State/province [146]
0
0
Bort les Orgues
Query!
Country [147]
0
0
France
Query!
State/province [147]
0
0
Bourg des cptes
Query!
Country [148]
0
0
France
Query!
State/province [148]
0
0
Briollay
Query!
Country [149]
0
0
France
Query!
State/province [149]
0
0
Broglie
Query!
Country [150]
0
0
France
Query!
State/province [150]
0
0
Bruay La Buissiere
Query!
Country [151]
0
0
France
Query!
State/province [151]
0
0
Cannes Cedex
Query!
Country [152]
0
0
France
Query!
State/province [152]
0
0
Cannes
Query!
Country [153]
0
0
France
Query!
State/province [153]
0
0
Chamalières
Query!
Country [154]
0
0
France
Query!
State/province [154]
0
0
Chambery
Query!
Country [155]
0
0
France
Query!
State/province [155]
0
0
Chateau Renault
Query!
Country [156]
0
0
France
Query!
State/province [156]
0
0
Colombey les Belles
Query!
Country [157]
0
0
France
Query!
State/province [157]
0
0
Cournonterral
Query!
Country [158]
0
0
France
Query!
State/province [158]
0
0
Croix
Query!
Country [159]
0
0
France
Query!
State/province [159]
0
0
Dinard
Query!
Country [160]
0
0
France
Query!
State/province [160]
0
0
Donges
Query!
Country [161]
0
0
France
Query!
State/province [161]
0
0
Gambsheim
Query!
Country [162]
0
0
France
Query!
State/province [162]
0
0
Grenoble
Query!
Country [163]
0
0
France
Query!
State/province [163]
0
0
Hautmont
Query!
Country [164]
0
0
France
Query!
State/province [164]
0
0
Hinx
Query!
Country [165]
0
0
France
Query!
State/province [165]
0
0
Jarny
Query!
Country [166]
0
0
France
Query!
State/province [166]
0
0
La Bouëxière
Query!
Country [167]
0
0
France
Query!
State/province [167]
0
0
La Chapelle sur Erdre
Query!
Country [168]
0
0
France
Query!
State/province [168]
0
0
La Montagne
Query!
Country [169]
0
0
France
Query!
State/province [169]
0
0
La Riche
Query!
Country [170]
0
0
France
Query!
State/province [170]
0
0
Lambersart
Query!
Country [171]
0
0
France
Query!
State/province [171]
0
0
Levallois Perret
Query!
Country [172]
0
0
France
Query!
State/province [172]
0
0
Louvigne De bais
Query!
Country [173]
0
0
France
Query!
State/province [173]
0
0
Luynes
Query!
Country [174]
0
0
France
Query!
State/province [174]
0
0
Marcq en Baroeul
Query!
Country [175]
0
0
France
Query!
State/province [175]
0
0
Mondelange
Query!
Country [176]
0
0
France
Query!
State/province [176]
0
0
Mont de Marsan
Query!
Country [177]
0
0
France
Query!
State/province [177]
0
0
Montigny les Metz
Query!
Country [178]
0
0
France
Query!
State/province [178]
0
0
Mundolsheim
Query!
Country [179]
0
0
France
Query!
State/province [179]
0
0
Murs Erigne
Query!
Country [180]
0
0
France
Query!
State/province [180]
0
0
Nantes
Query!
Country [181]
0
0
France
Query!
State/province [181]
0
0
Nice
Query!
Country [182]
0
0
France
Query!
State/province [182]
0
0
Oignies
Query!
Country [183]
0
0
France
Query!
State/province [183]
0
0
Ollioules
Query!
Country [184]
0
0
France
Query!
State/province [184]
0
0
Orthez
Query!
Country [185]
0
0
France
Query!
State/province [185]
0
0
Parcay les Pins
Query!
Country [186]
0
0
France
Query!
State/province [186]
0
0
Paris
Query!
Country [187]
0
0
France
Query!
State/province [187]
0
0
Pont à Mousson
Query!
Country [188]
0
0
France
Query!
State/province [188]
0
0
Quarouble
Query!
Country [189]
0
0
France
Query!
State/province [189]
0
0
Reims
Query!
Country [190]
0
0
France
Query!
State/province [190]
0
0
Rosiers d'Egletons
Query!
Country [191]
0
0
France
Query!
State/province [191]
0
0
Rugles
Query!
Country [192]
0
0
France
Query!
State/province [192]
0
0
Saint Alban Leysse
Query!
Country [193]
0
0
France
Query!
State/province [193]
0
0
Saint Aulaire
Query!
Country [194]
0
0
France
Query!
State/province [194]
0
0
Saint Avertin
Query!
Country [195]
0
0
France
Query!
State/province [195]
0
0
Saint Léger des Bois
Query!
Country [196]
0
0
France
Query!
State/province [196]
0
0
Saintes
Query!
Country [197]
0
0
France
Query!
State/province [197]
0
0
Salies de Bearn
Query!
Country [198]
0
0
France
Query!
State/province [198]
0
0
Savonnières
Query!
Country [199]
0
0
France
Query!
State/province [199]
0
0
Segre
Query!
Country [200]
0
0
France
Query!
State/province [200]
0
0
Serres Casset
Query!
Country [201]
0
0
France
Query!
State/province [201]
0
0
Six Four les Plages
Query!
Country [202]
0
0
France
Query!
State/province [202]
0
0
St Jouan des Guerets
Query!
Country [203]
0
0
France
Query!
State/province [203]
0
0
St Sebastien sur Loire
Query!
Country [204]
0
0
France
Query!
State/province [204]
0
0
Strasbourg
Query!
Country [205]
0
0
France
Query!
State/province [205]
0
0
Thouars
Query!
Country [206]
0
0
France
Query!
State/province [206]
0
0
Tinténiac
Query!
Country [207]
0
0
France
Query!
State/province [207]
0
0
Toulon
Query!
Country [208]
0
0
France
Query!
State/province [208]
0
0
Tours
Query!
Country [209]
0
0
France
Query!
State/province [209]
0
0
Vendôme
Query!
Country [210]
0
0
France
Query!
State/province [210]
0
0
Vernoil
Query!
Country [211]
0
0
France
Query!
State/province [211]
0
0
Vieux Condé
Query!
Country [212]
0
0
France
Query!
State/province [212]
0
0
Vihiers
Query!
Country [213]
0
0
France
Query!
State/province [213]
0
0
Villey St Etienne
Query!
Country [214]
0
0
France
Query!
State/province [214]
0
0
Wattrelos
Query!
Country [215]
0
0
Georgia
Query!
State/province [215]
0
0
Tbilisi
Query!
Country [216]
0
0
Germany
Query!
State/province [216]
0
0
Aschaffenburg
Query!
Country [217]
0
0
Germany
Query!
State/province [217]
0
0
Augsburg
Query!
Country [218]
0
0
Germany
Query!
State/province [218]
0
0
Backnang
Query!
Country [219]
0
0
Germany
Query!
State/province [219]
0
0
Bad Kissingen
Query!
Country [220]
0
0
Germany
Query!
State/province [220]
0
0
Bad Lippspringe
Query!
Country [221]
0
0
Germany
Query!
State/province [221]
0
0
Bad Neustadt
Query!
Country [222]
0
0
Germany
Query!
State/province [222]
0
0
Bad Wörishofen
Query!
Country [223]
0
0
Germany
Query!
State/province [223]
0
0
Bamberg
Query!
Country [224]
0
0
Germany
Query!
State/province [224]
0
0
Bensheim
Query!
Country [225]
0
0
Germany
Query!
State/province [225]
0
0
Bergisch Gladbach
Query!
Country [226]
0
0
Germany
Query!
State/province [226]
0
0
Berlin
Query!
Country [227]
0
0
Germany
Query!
State/province [227]
0
0
Bonn
Query!
Country [228]
0
0
Germany
Query!
State/province [228]
0
0
Brake
Query!
Country [229]
0
0
Germany
Query!
State/province [229]
0
0
Bruchsal
Query!
Country [230]
0
0
Germany
Query!
State/province [230]
0
0
Celle
Query!
Country [231]
0
0
Germany
Query!
State/province [231]
0
0
Cottbus
Query!
Country [232]
0
0
Germany
Query!
State/province [232]
0
0
Deggendorf
Query!
Country [233]
0
0
Germany
Query!
State/province [233]
0
0
Dillingen
Query!
Country [234]
0
0
Germany
Query!
State/province [234]
0
0
Donaueschingen
Query!
Country [235]
0
0
Germany
Query!
State/province [235]
0
0
Dortmund
Query!
Country [236]
0
0
Germany
Query!
State/province [236]
0
0
Düren
Query!
Country [237]
0
0
Germany
Query!
State/province [237]
0
0
Emden
Query!
Country [238]
0
0
Germany
Query!
State/province [238]
0
0
Engelskirchen
Query!
Country [239]
0
0
Germany
Query!
State/province [239]
0
0
Ense
Query!
Country [240]
0
0
Germany
Query!
State/province [240]
0
0
Essen
Query!
Country [241]
0
0
Germany
Query!
State/province [241]
0
0
Forchheim
Query!
Country [242]
0
0
Germany
Query!
State/province [242]
0
0
Frankfurt
Query!
Country [243]
0
0
Germany
Query!
State/province [243]
0
0
Fulda
Query!
Country [244]
0
0
Germany
Query!
State/province [244]
0
0
Föhren
Query!
Country [245]
0
0
Germany
Query!
State/province [245]
0
0
Gelnhausen
Query!
Country [246]
0
0
Germany
Query!
State/province [246]
0
0
Gütersloh
Query!
Country [247]
0
0
Germany
Query!
State/province [247]
0
0
Hagen
Query!
Country [248]
0
0
Germany
Query!
State/province [248]
0
0
Hamburg
Query!
Country [249]
0
0
Germany
Query!
State/province [249]
0
0
Hannover
Query!
Country [250]
0
0
Germany
Query!
State/province [250]
0
0
Heidelberg
Query!
Country [251]
0
0
Germany
Query!
State/province [251]
0
0
Heilbronn
Query!
Country [252]
0
0
Germany
Query!
State/province [252]
0
0
Hemmingen
Query!
Country [253]
0
0
Germany
Query!
State/province [253]
0
0
Höchstädt
Query!
Country [254]
0
0
Germany
Query!
State/province [254]
0
0
Ingelheim
Query!
Country [255]
0
0
Germany
Query!
State/province [255]
0
0
Karlsruhe
Query!
Country [256]
0
0
Germany
Query!
State/province [256]
0
0
Kassel
Query!
Country [257]
0
0
Germany
Query!
State/province [257]
0
0
Kaufbeuren
Query!
Country [258]
0
0
Germany
Query!
State/province [258]
0
0
Koblenz
Query!
Country [259]
0
0
Germany
Query!
State/province [259]
0
0
Käbschütztal-Krögis
Query!
Country [260]
0
0
Germany
Query!
State/province [260]
0
0
Köln
Query!
Country [261]
0
0
Germany
Query!
State/province [261]
0
0
Landsberg am Lech
Query!
Country [262]
0
0
Germany
Query!
State/province [262]
0
0
Langen
Query!
Country [263]
0
0
Germany
Query!
State/province [263]
0
0
Leipzig
Query!
Country [264]
0
0
Germany
Query!
State/province [264]
0
0
Leonberg
Query!
Country [265]
0
0
Germany
Query!
State/province [265]
0
0
Mannheim
Query!
Country [266]
0
0
Germany
Query!
State/province [266]
0
0
Marburg
Query!
Country [267]
0
0
Germany
Query!
State/province [267]
0
0
Minden
Query!
Country [268]
0
0
Germany
Query!
State/province [268]
0
0
München
Query!
Country [269]
0
0
Germany
Query!
State/province [269]
0
0
Neumünster
Query!
Country [270]
0
0
Germany
Query!
State/province [270]
0
0
Neuruppin
Query!
Country [271]
0
0
Germany
Query!
State/province [271]
0
0
Neuwied
Query!
Country [272]
0
0
Germany
Query!
State/province [272]
0
0
Oranienburg
Query!
Country [273]
0
0
Germany
Query!
State/province [273]
0
0
Oschersleben
Query!
Country [274]
0
0
Germany
Query!
State/province [274]
0
0
Paderborn
Query!
Country [275]
0
0
Germany
Query!
State/province [275]
0
0
Potsdam
Query!
Country [276]
0
0
Germany
Query!
State/province [276]
0
0
Radebeul
Query!
Country [277]
0
0
Germany
Query!
State/province [277]
0
0
Rathenow
Query!
Country [278]
0
0
Germany
Query!
State/province [278]
0
0
Raubach
Query!
Country [279]
0
0
Germany
Query!
State/province [279]
0
0
Rehau
Query!
Country [280]
0
0
Germany
Query!
State/province [280]
0
0
Reinfeld
Query!
Country [281]
0
0
Germany
Query!
State/province [281]
0
0
Rhaunen
Query!
Country [282]
0
0
Germany
Query!
State/province [282]
0
0
Rheine
Query!
Country [283]
0
0
Germany
Query!
State/province [283]
0
0
Rodgau-Dudenhofen
Query!
Country [284]
0
0
Germany
Query!
State/province [284]
0
0
Rüsselsheim
Query!
Country [285]
0
0
Germany
Query!
State/province [285]
0
0
Saarlouis
Query!
Country [286]
0
0
Germany
Query!
State/province [286]
0
0
Schwetzingen
Query!
Country [287]
0
0
Germany
Query!
State/province [287]
0
0
Solingen
Query!
Country [288]
0
0
Germany
Query!
State/province [288]
0
0
Tübingen
Query!
Country [289]
0
0
Germany
Query!
State/province [289]
0
0
Ulm
Query!
Country [290]
0
0
Germany
Query!
State/province [290]
0
0
Wallerfing
Query!
Country [291]
0
0
Germany
Query!
State/province [291]
0
0
Wardenburg
Query!
Country [292]
0
0
Germany
Query!
State/province [292]
0
0
Warendorf
Query!
Country [293]
0
0
Germany
Query!
State/province [293]
0
0
Weinheim
Query!
Country [294]
0
0
Germany
Query!
State/province [294]
0
0
Weyhe
Query!
Country [295]
0
0
Germany
Query!
State/province [295]
0
0
Wiesloch
Query!
Country [296]
0
0
Germany
Query!
State/province [296]
0
0
Witten
Query!
Country [297]
0
0
Germany
Query!
State/province [297]
0
0
Wolfsburg
Query!
Country [298]
0
0
Germany
Query!
State/province [298]
0
0
Zerbst
Query!
Country [299]
0
0
Greece
Query!
State/province [299]
0
0
Athens
Query!
Country [300]
0
0
Greece
Query!
State/province [300]
0
0
Heraklion
Query!
Country [301]
0
0
Greece
Query!
State/province [301]
0
0
Kalamaria
Query!
Country [302]
0
0
Greece
Query!
State/province [302]
0
0
Kavala
Query!
Country [303]
0
0
Greece
Query!
State/province [303]
0
0
Lamia
Query!
Country [304]
0
0
Greece
Query!
State/province [304]
0
0
Nafplio
Query!
Country [305]
0
0
Greece
Query!
State/province [305]
0
0
Rethymno
Query!
Country [306]
0
0
Greece
Query!
State/province [306]
0
0
Serres
Query!
Country [307]
0
0
Greece
Query!
State/province [307]
0
0
Thessaloniki
Query!
Country [308]
0
0
Guatemala
Query!
State/province [308]
0
0
Guatemala
Query!
Country [309]
0
0
Guatemala
Query!
State/province [309]
0
0
Nivel 12
Query!
Country [310]
0
0
Guatemala
Query!
State/province [310]
0
0
Nivel Guatemala
Query!
Country [311]
0
0
Guatemala
Query!
State/province [311]
0
0
Quetzaltenango
Query!
Country [312]
0
0
Hungary
Query!
State/province [312]
0
0
Baja
Query!
Country [313]
0
0
Hungary
Query!
State/province [313]
0
0
Budapest
Query!
Country [314]
0
0
Hungary
Query!
State/province [314]
0
0
Debrecen
Query!
Country [315]
0
0
Hungary
Query!
State/province [315]
0
0
Deszk
Query!
Country [316]
0
0
Hungary
Query!
State/province [316]
0
0
Dombovar
Query!
Country [317]
0
0
Hungary
Query!
State/province [317]
0
0
Erd
Query!
Country [318]
0
0
Hungary
Query!
State/province [318]
0
0
Farkasgyepü
Query!
Country [319]
0
0
Hungary
Query!
State/province [319]
0
0
Györ
Query!
Country [320]
0
0
Hungary
Query!
State/province [320]
0
0
Hajduböszörmeny
Query!
Country [321]
0
0
Hungary
Query!
State/province [321]
0
0
Hodmezovasarhely
Query!
Country [322]
0
0
Hungary
Query!
State/province [322]
0
0
Kaposvar
Query!
Country [323]
0
0
Hungary
Query!
State/province [323]
0
0
Kapuvar
Query!
Country [324]
0
0
Hungary
Query!
State/province [324]
0
0
Kecskemet
Query!
Country [325]
0
0
Hungary
Query!
State/province [325]
0
0
Makó
Query!
Country [326]
0
0
Hungary
Query!
State/province [326]
0
0
Mohacs
Query!
Country [327]
0
0
Hungary
Query!
State/province [327]
0
0
Mosonmagyarovar
Query!
Country [328]
0
0
Hungary
Query!
State/province [328]
0
0
Nagykanizsa
Query!
Country [329]
0
0
Hungary
Query!
State/province [329]
0
0
Nyiregyhaza
Query!
Country [330]
0
0
Hungary
Query!
State/province [330]
0
0
Pecs
Query!
Country [331]
0
0
Hungary
Query!
State/province [331]
0
0
Siófok
Query!
Country [332]
0
0
Hungary
Query!
State/province [332]
0
0
Szarvas
Query!
Country [333]
0
0
Hungary
Query!
State/province [333]
0
0
Szeged
Query!
Country [334]
0
0
Hungary
Query!
State/province [334]
0
0
Tatabanya
Query!
Country [335]
0
0
Hungary
Query!
State/province [335]
0
0
Törökbálint
Query!
Country [336]
0
0
India
Query!
State/province [336]
0
0
Ahmedabad
Query!
Country [337]
0
0
India
Query!
State/province [337]
0
0
Chennai
Query!
Country [338]
0
0
India
Query!
State/province [338]
0
0
Coimbatore
Query!
Country [339]
0
0
India
Query!
State/province [339]
0
0
Dadar(East)
Query!
Country [340]
0
0
India
Query!
State/province [340]
0
0
Hyderabad
Query!
Country [341]
0
0
India
Query!
State/province [341]
0
0
Jaipur
Query!
Country [342]
0
0
India
Query!
State/province [342]
0
0
Karnataka
Query!
Country [343]
0
0
India
Query!
State/province [343]
0
0
Maharashtra
Query!
Country [344]
0
0
India
Query!
State/province [344]
0
0
Maharastra
Query!
Country [345]
0
0
India
Query!
State/province [345]
0
0
Punjab
Query!
Country [346]
0
0
Ireland
Query!
State/province [346]
0
0
Co. Cork
Query!
Country [347]
0
0
Ireland
Query!
State/province [347]
0
0
Co. Tipperary
Query!
Country [348]
0
0
Ireland
Query!
State/province [348]
0
0
Co. Wexford
Query!
Country [349]
0
0
Ireland
Query!
State/province [349]
0
0
Dublin 24
Query!
Country [350]
0
0
Ireland
Query!
State/province [350]
0
0
Dublin
Query!
Country [351]
0
0
Ireland
Query!
State/province [351]
0
0
Limerick
Query!
Country [352]
0
0
Ireland
Query!
State/province [352]
0
0
Offaly
Query!
Country [353]
0
0
Israel
Query!
State/province [353]
0
0
Ashkelon
Query!
Country [354]
0
0
Israel
Query!
State/province [354]
0
0
Beer Sheva
Query!
Country [355]
0
0
Israel
Query!
State/province [355]
0
0
Haifa
Query!
Country [356]
0
0
Israel
Query!
State/province [356]
0
0
Jerusalem
Query!
Country [357]
0
0
Israel
Query!
State/province [357]
0
0
Kfar Saba
Query!
Country [358]
0
0
Israel
Query!
State/province [358]
0
0
Petach Tikva
Query!
Country [359]
0
0
Israel
Query!
State/province [359]
0
0
Rehovot
Query!
Country [360]
0
0
Israel
Query!
State/province [360]
0
0
Tel-Aviv
Query!
Country [361]
0
0
Italy
Query!
State/province [361]
0
0
Arenzano (ge)
Query!
Country [362]
0
0
Italy
Query!
State/province [362]
0
0
Ascoli Piceno
Query!
Country [363]
0
0
Italy
Query!
State/province [363]
0
0
Avellino
Query!
Country [364]
0
0
Italy
Query!
State/province [364]
0
0
Benevento
Query!
Country [365]
0
0
Italy
Query!
State/province [365]
0
0
Brescia
Query!
Country [366]
0
0
Italy
Query!
State/province [366]
0
0
Busto Arsizio (va)
Query!
Country [367]
0
0
Italy
Query!
State/province [367]
0
0
Cagliari
Query!
Country [368]
0
0
Italy
Query!
State/province [368]
0
0
Catanzaro
Query!
Country [369]
0
0
Italy
Query!
State/province [369]
0
0
Chieti Scalo
Query!
Country [370]
0
0
Italy
Query!
State/province [370]
0
0
Firenze
Query!
Country [371]
0
0
Italy
Query!
State/province [371]
0
0
Monza
Query!
Country [372]
0
0
Italy
Query!
State/province [372]
0
0
Napoli
Query!
Country [373]
0
0
Italy
Query!
State/province [373]
0
0
Orbassano (to)
Query!
Country [374]
0
0
Italy
Query!
State/province [374]
0
0
Palermo
Query!
Country [375]
0
0
Italy
Query!
State/province [375]
0
0
Parma
Query!
Country [376]
0
0
Italy
Query!
State/province [376]
0
0
Perugia
Query!
Country [377]
0
0
Italy
Query!
State/province [377]
0
0
Prato
Query!
Country [378]
0
0
Italy
Query!
State/province [378]
0
0
Reggio Emilia
Query!
Country [379]
0
0
Italy
Query!
State/province [379]
0
0
Roma
Query!
Country [380]
0
0
Italy
Query!
State/province [380]
0
0
Treviso
Query!
Country [381]
0
0
Korea, Republic of
Query!
State/province [381]
0
0
Bucheon
Query!
Country [382]
0
0
Korea, Republic of
Query!
State/province [382]
0
0
Busan
Query!
Country [383]
0
0
Korea, Republic of
Query!
State/province [383]
0
0
Daegu
Query!
Country [384]
0
0
Korea, Republic of
Query!
State/province [384]
0
0
Daejoen
Query!
Country [385]
0
0
Korea, Republic of
Query!
State/province [385]
0
0
Gangwon-Do
Query!
Country [386]
0
0
Korea, Republic of
Query!
State/province [386]
0
0
Goyang
Query!
Country [387]
0
0
Korea, Republic of
Query!
State/province [387]
0
0
Gwangju
Query!
Country [388]
0
0
Korea, Republic of
Query!
State/province [388]
0
0
Incheon
Query!
Country [389]
0
0
Korea, Republic of
Query!
State/province [389]
0
0
Jeonju
Query!
Country [390]
0
0
Korea, Republic of
Query!
State/province [390]
0
0
Seoul
Query!
Country [391]
0
0
Korea, Republic of
Query!
State/province [391]
0
0
Uijeongbu
Query!
Country [392]
0
0
Latvia
Query!
State/province [392]
0
0
Daugavpils
Query!
Country [393]
0
0
Latvia
Query!
State/province [393]
0
0
Kraslava
Query!
Country [394]
0
0
Latvia
Query!
State/province [394]
0
0
Riga
Query!
Country [395]
0
0
Latvia
Query!
State/province [395]
0
0
Talsi
Query!
Country [396]
0
0
Latvia
Query!
State/province [396]
0
0
Valmiera
Query!
Country [397]
0
0
Lithuania
Query!
State/province [397]
0
0
Alytus
Query!
Country [398]
0
0
Lithuania
Query!
State/province [398]
0
0
Kaunas
Query!
Country [399]
0
0
Lithuania
Query!
State/province [399]
0
0
Klaipeda
Query!
Country [400]
0
0
Lithuania
Query!
State/province [400]
0
0
Siauliai
Query!
Country [401]
0
0
Lithuania
Query!
State/province [401]
0
0
Utena
Query!
Country [402]
0
0
Lithuania
Query!
State/province [402]
0
0
Vilnius
Query!
Country [403]
0
0
Malaysia
Query!
State/province [403]
0
0
Johor Bahru
Query!
Country [404]
0
0
Malaysia
Query!
State/province [404]
0
0
Kuala Lumpur
Query!
Country [405]
0
0
Malaysia
Query!
State/province [405]
0
0
Pahang
Query!
Country [406]
0
0
Malaysia
Query!
State/province [406]
0
0
Sarawak
Query!
Country [407]
0
0
Malaysia
Query!
State/province [407]
0
0
Selangor
Query!
Country [408]
0
0
Malaysia
Query!
State/province [408]
0
0
Terengganu
Query!
Country [409]
0
0
Mexico
Query!
State/province [409]
0
0
Aguascalientes
Query!
Country [410]
0
0
Mexico
Query!
State/province [410]
0
0
Distrito Federal
Query!
Country [411]
0
0
Mexico
Query!
State/province [411]
0
0
Guadalajara
Query!
Country [412]
0
0
Mexico
Query!
State/province [412]
0
0
Monte Rey
Query!
Country [413]
0
0
Mexico
Query!
State/province [413]
0
0
México
Query!
Country [414]
0
0
Mexico
Query!
State/province [414]
0
0
Zona Río
Query!
Country [415]
0
0
Netherlands
Query!
State/province [415]
0
0
Almere
Query!
Country [416]
0
0
Netherlands
Query!
State/province [416]
0
0
Andijk
Query!
Country [417]
0
0
Netherlands
Query!
State/province [417]
0
0
Beek En Donk
Query!
Country [418]
0
0
Netherlands
Query!
State/province [418]
0
0
Beek
Query!
Country [419]
0
0
Netherlands
Query!
State/province [419]
0
0
Ermelo
Query!
Country [420]
0
0
Netherlands
Query!
State/province [420]
0
0
Hoogwoud
Query!
Country [421]
0
0
Netherlands
Query!
State/province [421]
0
0
Nijverdal
Query!
Country [422]
0
0
Netherlands
Query!
State/province [422]
0
0
Oude Pekela
Query!
Country [423]
0
0
Netherlands
Query!
State/province [423]
0
0
Roelofarendsveen
Query!
Country [424]
0
0
New Zealand
Query!
State/province [424]
0
0
Christchurch
Query!
Country [425]
0
0
New Zealand
Query!
State/province [425]
0
0
Dunedin
Query!
Country [426]
0
0
New Zealand
Query!
State/province [426]
0
0
Newtown Wellington NZ
Query!
Country [427]
0
0
New Zealand
Query!
State/province [427]
0
0
Tauranga
Query!
Country [428]
0
0
Norway
Query!
State/province [428]
0
0
Drammen
Query!
Country [429]
0
0
Norway
Query!
State/province [429]
0
0
Fredrikstad
Query!
Country [430]
0
0
Norway
Query!
State/province [430]
0
0
Hønefoss
Query!
Country [431]
0
0
Norway
Query!
State/province [431]
0
0
Kløfta
Query!
Country [432]
0
0
Norway
Query!
State/province [432]
0
0
Kolbjørnsvik
Query!
Country [433]
0
0
Norway
Query!
State/province [433]
0
0
Løvenstad
Query!
Country [434]
0
0
Norway
Query!
State/province [434]
0
0
Oslo
Query!
Country [435]
0
0
Norway
Query!
State/province [435]
0
0
Sandvika
Query!
Country [436]
0
0
Norway
Query!
State/province [436]
0
0
Svelvik
Query!
Country [437]
0
0
Norway
Query!
State/province [437]
0
0
Trollåsen
Query!
Country [438]
0
0
Panama
Query!
State/province [438]
0
0
Carrasquilla
Query!
Country [439]
0
0
Panama
Query!
State/province [439]
0
0
Marbella
Query!
Country [440]
0
0
Peru
Query!
State/province [440]
0
0
Bellavista
Query!
Country [441]
0
0
Peru
Query!
State/province [441]
0
0
Cusco
Query!
Country [442]
0
0
Peru
Query!
State/province [442]
0
0
Jesús Maria
Query!
Country [443]
0
0
Peru
Query!
State/province [443]
0
0
Jesús María
Query!
Country [444]
0
0
Peru
Query!
State/province [444]
0
0
Lima
Query!
Country [445]
0
0
Peru
Query!
State/province [445]
0
0
San Isidro
Query!
Country [446]
0
0
Peru
Query!
State/province [446]
0
0
San Martin de Porres
Query!
Country [447]
0
0
Philippines
Query!
State/province [447]
0
0
Cavite City
Query!
Country [448]
0
0
Philippines
Query!
State/province [448]
0
0
Davao City
Query!
Country [449]
0
0
Philippines
Query!
State/province [449]
0
0
Iloilo City
Query!
Country [450]
0
0
Philippines
Query!
State/province [450]
0
0
Manila
Query!
Country [451]
0
0
Philippines
Query!
State/province [451]
0
0
Quezon City
Query!
Country [452]
0
0
Poland
Query!
State/province [452]
0
0
Babice
Query!
Country [453]
0
0
Poland
Query!
State/province [453]
0
0
Bialystok
Query!
Country [454]
0
0
Poland
Query!
State/province [454]
0
0
Bydgoszcz
Query!
Country [455]
0
0
Poland
Query!
State/province [455]
0
0
Checiny
Query!
Country [456]
0
0
Poland
Query!
State/province [456]
0
0
Gdansk
Query!
Country [457]
0
0
Poland
Query!
State/province [457]
0
0
Gdynia
Query!
Country [458]
0
0
Poland
Query!
State/province [458]
0
0
Gorzow Wlkp
Query!
Country [459]
0
0
Poland
Query!
State/province [459]
0
0
Ilawa
Query!
Country [460]
0
0
Poland
Query!
State/province [460]
0
0
Katowice
Query!
Country [461]
0
0
Poland
Query!
State/province [461]
0
0
Krakow
Query!
Country [462]
0
0
Poland
Query!
State/province [462]
0
0
Libiaz
Query!
Country [463]
0
0
Poland
Query!
State/province [463]
0
0
Lodz
Query!
Country [464]
0
0
Poland
Query!
State/province [464]
0
0
Olsztyn
Query!
Country [465]
0
0
Poland
Query!
State/province [465]
0
0
Ostrow Wielkopolska
Query!
Country [466]
0
0
Poland
Query!
State/province [466]
0
0
Piaseczno
Query!
Country [467]
0
0
Poland
Query!
State/province [467]
0
0
Poznan
Query!
Country [468]
0
0
Poland
Query!
State/province [468]
0
0
Rokietnica
Query!
Country [469]
0
0
Poland
Query!
State/province [469]
0
0
Skierniewice
Query!
Country [470]
0
0
Poland
Query!
State/province [470]
0
0
Slawkow
Query!
Country [471]
0
0
Poland
Query!
State/province [471]
0
0
Szczecin
Query!
Country [472]
0
0
Poland
Query!
State/province [472]
0
0
Tarnow
Query!
Country [473]
0
0
Poland
Query!
State/province [473]
0
0
Tczew
Query!
Country [474]
0
0
Poland
Query!
State/province [474]
0
0
Torun
Query!
Country [475]
0
0
Poland
Query!
State/province [475]
0
0
Tranow
Query!
Country [476]
0
0
Poland
Query!
State/province [476]
0
0
Turek
Query!
Country [477]
0
0
Poland
Query!
State/province [477]
0
0
Warsaw
Query!
Country [478]
0
0
Poland
Query!
State/province [478]
0
0
Warszawa
Query!
Country [479]
0
0
Poland
Query!
State/province [479]
0
0
Wolomin
Query!
Country [480]
0
0
Poland
Query!
State/province [480]
0
0
Wroclaw
Query!
Country [481]
0
0
Poland
Query!
State/province [481]
0
0
Zakopane
Query!
Country [482]
0
0
Portugal
Query!
State/province [482]
0
0
Amadora
Query!
Country [483]
0
0
Portugal
Query!
State/province [483]
0
0
Coimbra
Query!
Country [484]
0
0
Portugal
Query!
State/province [484]
0
0
Lisboa
Query!
Country [485]
0
0
Portugal
Query!
State/province [485]
0
0
Matosinhos
Query!
Country [486]
0
0
Portugal
Query!
State/province [486]
0
0
Penafiel
Query!
Country [487]
0
0
Portugal
Query!
State/province [487]
0
0
Vila Nova de Gaia
Query!
Country [488]
0
0
Portugal
Query!
State/province [488]
0
0
Viseu
Query!
Country [489]
0
0
Puerto Rico
Query!
State/province [489]
0
0
Ponce
Query!
Country [490]
0
0
Puerto Rico
Query!
State/province [490]
0
0
San Juan
Query!
Country [491]
0
0
Romania
Query!
State/province [491]
0
0
Brasov
Query!
Country [492]
0
0
Romania
Query!
State/province [492]
0
0
Bucharest
Query!
Country [493]
0
0
Romania
Query!
State/province [493]
0
0
Bucuresti
Query!
Country [494]
0
0
Romania
Query!
State/province [494]
0
0
Constanta
Query!
Country [495]
0
0
Romania
Query!
State/province [495]
0
0
Craiova
Query!
Country [496]
0
0
Russian Federation
Query!
State/province [496]
0
0
Arkhangelsk
Query!
Country [497]
0
0
Russian Federation
Query!
State/province [497]
0
0
Barnaul
Query!
Country [498]
0
0
Russian Federation
Query!
State/province [498]
0
0
Chelyabinsk
Query!
Country [499]
0
0
Russian Federation
Query!
State/province [499]
0
0
Ekaterinburg
Query!
Country [500]
0
0
Russian Federation
Query!
State/province [500]
0
0
Gatchina (Leningradskaya oblast)
Query!
Country [501]
0
0
Russian Federation
Query!
State/province [501]
0
0
Irkutsk
Query!
Country [502]
0
0
Russian Federation
Query!
State/province [502]
0
0
Ivanovo
Query!
Country [503]
0
0
Russian Federation
Query!
State/province [503]
0
0
Kaliningrad
Query!
Country [504]
0
0
Russian Federation
Query!
State/province [504]
0
0
Kazan
Query!
Country [505]
0
0
Russian Federation
Query!
State/province [505]
0
0
Kemerovo
Query!
Country [506]
0
0
Russian Federation
Query!
State/province [506]
0
0
Kirov
Query!
Country [507]
0
0
Russian Federation
Query!
State/province [507]
0
0
Krasnodar
Query!
Country [508]
0
0
Russian Federation
Query!
State/province [508]
0
0
Moscow
Query!
Country [509]
0
0
Russian Federation
Query!
State/province [509]
0
0
Murmansk
Query!
Country [510]
0
0
Russian Federation
Query!
State/province [510]
0
0
Nizhniy Novgorod
Query!
Country [511]
0
0
Russian Federation
Query!
State/province [511]
0
0
Nizhny Novgorod
Query!
Country [512]
0
0
Russian Federation
Query!
State/province [512]
0
0
Novosibirsk
Query!
Country [513]
0
0
Russian Federation
Query!
State/province [513]
0
0
Penza
Query!
Country [514]
0
0
Russian Federation
Query!
State/province [514]
0
0
Pskov
Query!
Country [515]
0
0
Russian Federation
Query!
State/province [515]
0
0
Rostov-na-Donu
Query!
Country [516]
0
0
Russian Federation
Query!
State/province [516]
0
0
Rostov-on-Don
Query!
Country [517]
0
0
Russian Federation
Query!
State/province [517]
0
0
Ryazan
Query!
Country [518]
0
0
Russian Federation
Query!
State/province [518]
0
0
Samara
Query!
Country [519]
0
0
Russian Federation
Query!
State/province [519]
0
0
Saratov
Query!
Country [520]
0
0
Russian Federation
Query!
State/province [520]
0
0
St. Petersburg
Query!
Country [521]
0
0
Russian Federation
Query!
State/province [521]
0
0
Tomsk
Query!
Country [522]
0
0
Russian Federation
Query!
State/province [522]
0
0
Velikiy Novgorod
Query!
Country [523]
0
0
Russian Federation
Query!
State/province [523]
0
0
Yaroslavl
Query!
Country [524]
0
0
Serbia
Query!
State/province [524]
0
0
Belgrade
Query!
Country [525]
0
0
Serbia
Query!
State/province [525]
0
0
Kragujevac
Query!
Country [526]
0
0
Serbia
Query!
State/province [526]
0
0
Nis
Query!
Country [527]
0
0
Serbia
Query!
State/province [527]
0
0
Sremska Kamenica
Query!
Country [528]
0
0
Slovakia
Query!
State/province [528]
0
0
Bardejov
Query!
Country [529]
0
0
Slovakia
Query!
State/province [529]
0
0
Bratislava
Query!
Country [530]
0
0
Slovakia
Query!
State/province [530]
0
0
Humenne
Query!
Country [531]
0
0
Slovakia
Query!
State/province [531]
0
0
Kosice
Query!
Country [532]
0
0
Slovakia
Query!
State/province [532]
0
0
Levice
Query!
Country [533]
0
0
Slovakia
Query!
State/province [533]
0
0
Martin
Query!
Country [534]
0
0
Slovakia
Query!
State/province [534]
0
0
Poprad
Query!
Country [535]
0
0
Slovakia
Query!
State/province [535]
0
0
Presov
Query!
Country [536]
0
0
Slovakia
Query!
State/province [536]
0
0
Rimavska Sobota
Query!
Country [537]
0
0
Slovakia
Query!
State/province [537]
0
0
Spisska Nova Ves
Query!
Country [538]
0
0
Slovakia
Query!
State/province [538]
0
0
Sturovo
Query!
Country [539]
0
0
South Africa
Query!
State/province [539]
0
0
Amanzimtoti
Query!
Country [540]
0
0
South Africa
Query!
State/province [540]
0
0
Bellville
Query!
Country [541]
0
0
South Africa
Query!
State/province [541]
0
0
Bloemfontein
Query!
Country [542]
0
0
South Africa
Query!
State/province [542]
0
0
Cape Town
Query!
Country [543]
0
0
South Africa
Query!
State/province [543]
0
0
Centurion
Query!
Country [544]
0
0
South Africa
Query!
State/province [544]
0
0
Durban
Query!
Country [545]
0
0
South Africa
Query!
State/province [545]
0
0
Johannesburg
Query!
Country [546]
0
0
South Africa
Query!
State/province [546]
0
0
Pretoria
Query!
Country [547]
0
0
South Africa
Query!
State/province [547]
0
0
Somerset West
Query!
Country [548]
0
0
Spain
Query!
State/province [548]
0
0
Badajoz
Query!
Country [549]
0
0
Spain
Query!
State/province [549]
0
0
Badalona (Barcelona)
Query!
Country [550]
0
0
Spain
Query!
State/province [550]
0
0
Barcelona
Query!
Country [551]
0
0
Spain
Query!
State/province [551]
0
0
Centelles
Query!
Country [552]
0
0
Spain
Query!
State/province [552]
0
0
Cáceres
Query!
Country [553]
0
0
Spain
Query!
State/province [553]
0
0
Elda
Query!
Country [554]
0
0
Spain
Query!
State/province [554]
0
0
Hospitalet de Llobregat
Query!
Country [555]
0
0
Spain
Query!
State/province [555]
0
0
Lugo
Query!
Country [556]
0
0
Spain
Query!
State/province [556]
0
0
Madrid
Query!
Country [557]
0
0
Spain
Query!
State/province [557]
0
0
Málaga
Query!
Country [558]
0
0
Spain
Query!
State/province [558]
0
0
Mérida
Query!
Country [559]
0
0
Spain
Query!
State/province [559]
0
0
Plasencia
Query!
Country [560]
0
0
Spain
Query!
State/province [560]
0
0
Pozuelo de Alarcón
Query!
Country [561]
0
0
Spain
Query!
State/province [561]
0
0
San Juan de Alicante
Query!
Country [562]
0
0
Spain
Query!
State/province [562]
0
0
Santander
Query!
Country [563]
0
0
Spain
Query!
State/province [563]
0
0
Terrassa (Barcelona)
Query!
Country [564]
0
0
Spain
Query!
State/province [564]
0
0
Torrevieja
Query!
Country [565]
0
0
Spain
Query!
State/province [565]
0
0
Valencia
Query!
Country [566]
0
0
Spain
Query!
State/province [566]
0
0
Valladolid
Query!
Country [567]
0
0
Spain
Query!
State/province [567]
0
0
Vic (Barcelona)
Query!
Country [568]
0
0
Spain
Query!
State/province [568]
0
0
Vilanova i la Geltrú
Query!
Country [569]
0
0
Spain
Query!
State/province [569]
0
0
Zaragoza
Query!
Country [570]
0
0
Sweden
Query!
State/province [570]
0
0
Brämhult
Query!
Country [571]
0
0
Sweden
Query!
State/province [571]
0
0
Eksjö
Query!
Country [572]
0
0
Sweden
Query!
State/province [572]
0
0
Gullspång
Query!
Country [573]
0
0
Sweden
Query!
State/province [573]
0
0
Göteborg
Query!
Country [574]
0
0
Sweden
Query!
State/province [574]
0
0
Höllviken
Query!
Country [575]
0
0
Sweden
Query!
State/province [575]
0
0
Järfälla
Query!
Country [576]
0
0
Sweden
Query!
State/province [576]
0
0
Kil
Query!
Country [577]
0
0
Sweden
Query!
State/province [577]
0
0
Lidingö
Query!
Country [578]
0
0
Sweden
Query!
State/province [578]
0
0
Luleå
Query!
Country [579]
0
0
Sweden
Query!
State/province [579]
0
0
Sigtuna
Query!
Country [580]
0
0
Sweden
Query!
State/province [580]
0
0
Solna
Query!
Country [581]
0
0
Sweden
Query!
State/province [581]
0
0
Uddevalla
Query!
Country [582]
0
0
Sweden
Query!
State/province [582]
0
0
Örebro
Query!
Country [583]
0
0
Switzerland
Query!
State/province [583]
0
0
Ascona
Query!
Country [584]
0
0
Switzerland
Query!
State/province [584]
0
0
Basel
Query!
Country [585]
0
0
Switzerland
Query!
State/province [585]
0
0
Bern
Query!
Country [586]
0
0
Switzerland
Query!
State/province [586]
0
0
Glarus
Query!
Country [587]
0
0
Switzerland
Query!
State/province [587]
0
0
Gossau
Query!
Country [588]
0
0
Switzerland
Query!
State/province [588]
0
0
Liestal
Query!
Country [589]
0
0
Switzerland
Query!
State/province [589]
0
0
Locarno
Query!
Country [590]
0
0
Switzerland
Query!
State/province [590]
0
0
Lugano
Query!
Country [591]
0
0
Switzerland
Query!
State/province [591]
0
0
Spiez
Query!
Country [592]
0
0
Switzerland
Query!
State/province [592]
0
0
St. Gallen
Query!
Country [593]
0
0
Switzerland
Query!
State/province [593]
0
0
Zürich
Query!
Country [594]
0
0
Taiwan
Query!
State/province [594]
0
0
Changhua
Query!
Country [595]
0
0
Taiwan
Query!
State/province [595]
0
0
Chia-Yi
Query!
Country [596]
0
0
Taiwan
Query!
State/province [596]
0
0
Kaohsiung City
Query!
Country [597]
0
0
Taiwan
Query!
State/province [597]
0
0
Kaohsiung
Query!
Country [598]
0
0
Taiwan
Query!
State/province [598]
0
0
New Taipei
Query!
Country [599]
0
0
Taiwan
Query!
State/province [599]
0
0
Taichung
Query!
Country [600]
0
0
Taiwan
Query!
State/province [600]
0
0
Tainan
Query!
Country [601]
0
0
Taiwan
Query!
State/province [601]
0
0
Taipei
Query!
Country [602]
0
0
Taiwan
Query!
State/province [602]
0
0
Taoyuan County
Query!
Country [603]
0
0
Thailand
Query!
State/province [603]
0
0
Chiang Mai
Query!
Country [604]
0
0
Thailand
Query!
State/province [604]
0
0
Hatyai, Songkhla
Query!
Country [605]
0
0
Thailand
Query!
State/province [605]
0
0
Khon Kaen
Query!
Country [606]
0
0
Thailand
Query!
State/province [606]
0
0
Muang, Phitsanulok
Query!
Country [607]
0
0
Thailand
Query!
State/province [607]
0
0
Nonthaburi
Query!
Country [608]
0
0
Tunisia
Query!
State/province [608]
0
0
Ariana
Query!
Country [609]
0
0
Tunisia
Query!
State/province [609]
0
0
Mahdia
Query!
Country [610]
0
0
Tunisia
Query!
State/province [610]
0
0
Monastir
Query!
Country [611]
0
0
Tunisia
Query!
State/province [611]
0
0
Nabeul
Query!
Country [612]
0
0
Tunisia
Query!
State/province [612]
0
0
Tunis
Query!
Country [613]
0
0
Turkey
Query!
State/province [613]
0
0
Adana
Query!
Country [614]
0
0
Turkey
Query!
State/province [614]
0
0
Ankara
Query!
Country [615]
0
0
Turkey
Query!
State/province [615]
0
0
Antalya
Query!
Country [616]
0
0
Turkey
Query!
State/province [616]
0
0
Aydin
Query!
Country [617]
0
0
Turkey
Query!
State/province [617]
0
0
Bolu
Query!
Country [618]
0
0
Turkey
Query!
State/province [618]
0
0
Edirne
Query!
Country [619]
0
0
Turkey
Query!
State/province [619]
0
0
Erzurum
Query!
Country [620]
0
0
Turkey
Query!
State/province [620]
0
0
Hatay
Query!
Country [621]
0
0
Turkey
Query!
State/province [621]
0
0
Istanbul
Query!
Country [622]
0
0
Turkey
Query!
State/province [622]
0
0
Izmir
Query!
Country [623]
0
0
Turkey
Query!
State/province [623]
0
0
Malatya
Query!
Country [624]
0
0
Ukraine
Query!
State/province [624]
0
0
Crimea
Query!
Country [625]
0
0
Ukraine
Query!
State/province [625]
0
0
Dnipropetrovks
Query!
Country [626]
0
0
Ukraine
Query!
State/province [626]
0
0
Dnipropetrovsk
Query!
Country [627]
0
0
Ukraine
Query!
State/province [627]
0
0
Dnyepropyetrovsk
Query!
Country [628]
0
0
Ukraine
Query!
State/province [628]
0
0
Donetsk
Query!
Country [629]
0
0
Ukraine
Query!
State/province [629]
0
0
Ivano-Frankivsk
Query!
Country [630]
0
0
Ukraine
Query!
State/province [630]
0
0
Kharkiv
Query!
Country [631]
0
0
Ukraine
Query!
State/province [631]
0
0
Kharkov
Query!
Country [632]
0
0
Ukraine
Query!
State/province [632]
0
0
Kiev
Query!
Country [633]
0
0
Ukraine
Query!
State/province [633]
0
0
Nikolayev
Query!
Country [634]
0
0
Ukraine
Query!
State/province [634]
0
0
Odesa
Query!
Country [635]
0
0
Ukraine
Query!
State/province [635]
0
0
Odessa
Query!
Country [636]
0
0
Ukraine
Query!
State/province [636]
0
0
Simferopol
Query!
Country [637]
0
0
Ukraine
Query!
State/province [637]
0
0
Vinnytsya
Query!
Country [638]
0
0
Ukraine
Query!
State/province [638]
0
0
Zaporizhzhya
Query!
Country [639]
0
0
United Kingdom
Query!
State/province [639]
0
0
Atherstone
Query!
Country [640]
0
0
United Kingdom
Query!
State/province [640]
0
0
Burbage
Query!
Country [641]
0
0
United Kingdom
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State/province [641]
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Chertsey
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Country [642]
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United Kingdom
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State/province [642]
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Chesterfield
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Country [643]
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United Kingdom
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State/province [643]
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Coventry
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Country [644]
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United Kingdom
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State/province [644]
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Exeter
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Country [645]
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United Kingdom
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State/province [645]
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Fowey
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Country [646]
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United Kingdom
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State/province [646]
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Frome
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Country [647]
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United Kingdom
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State/province [647]
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Leamington Spa
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Country [648]
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United Kingdom
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State/province [648]
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St Just, Penzance
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Boehringer Ingelheim
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
Direct comparison studies of the tiotropium HandiHaler® 18 µg and Respimat® 5 µg formulations have been limited to 4-week crossover studies. Therefore, prospective data from a trial of adequate size and duration is required to establish that compared to tiotropium HandiHaler®, tiotropium Respimat® will have (a) similar effects on safety and (b) similar or superior effects on exacerbations.
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Trial website
https://clinicaltrials.gov/study/NCT01126437
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Trial related presentations / publications
Wise RA, Calverley PM, Carter K, Clerisme-Beaty E, Metzdorf N, Anzueto A. Seasonal variations in exacerbations and deaths in patients with COPD during the TIOSPIR(R) trial. Int J Chron Obstruct Pulmon Dis. 2018 Feb 14;13:605-616. doi: 10.2147/COPD.S148393. eCollection 2018. Calverley PMA, Mueller A, Fowler A, Metzdorf N, Wise RA. The Effect of Defining Chronic Obstructive Pulmonary Disease by the Lower Limit of Normal of FEV1/FVC Ratio in Tiotropium Safety and Performance in Respimat Participants. Ann Am Thorac Soc. 2018 Feb;15(2):200-208. doi: 10.1513/AnnalsATS.201703-194OC. Dahl R, Calverley PM, Anzueto A, Metzdorf N, Fowler A, Mueller A, Wise R, Dusser D. Safety and efficacy of tiotropium in patients switching from HandiHaler to Respimat in the TIOSPIR trial. BMJ Open. 2015 Dec 29;5(12):e009015. doi: 10.1136/bmjopen-2015-009015. Anzueto A, Wise R, Calverley P, Dusser D, Tang W, Metzdorf N, Dahl R. The Tiotropium Safety and Performance in Respimat(R) (TIOSPIR(R)) Trial: Spirometry Outcomes. Respir Res. 2015 Sep 15;16(1):107. doi: 10.1186/s12931-015-0269-4. Wise RA, Anzueto A, Cotton D, Dahl R, Devins T, Disse B, Dusser D, Joseph E, Kattenbeck S, Koenen-Bergmann M, Pledger G, Calverley P; TIOSPIR Investigators. Tiotropium Respimat inhaler and the risk of death in COPD. N Engl J Med. 2013 Oct 17;369(16):1491-501. doi: 10.1056/NEJMoa1303342. Epub 2013 Aug 30.
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Public notes
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Contacts
Principal investigator
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Boehringer Ingelheim
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Boehringer Ingelheim
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Contact person for public queries
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT01126437
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