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A Breath of Fresh Air
                                                 How ePRO improves Asthma and Rhinoconjunctivitis clinical studies




The Time is Now
Sponsors elect to use ePRO to capture data from asthma patients primarily because of the
importance of collecting timely and frequent assessments. The LogPad’s accurate time-
stamps ensure data are entered at appropriate times according to the protocl, while its
intuitive touchscreen interface, reminder alarms and branching logic reduce respondent
burden especially during periods of dense sampling. eSense device integration further
elevates the reliability of patient data to unprecedented heights.

Whether you are implementing a diary question about the degree of breathing difficulty,
or comparing PEF and FEV1scores to baseline, PHT’s LogPad System enables higher quality
data and safer clinical research worldwide.

Behind only disorders of the Central Nervous System, the majority of PHT’s market-leading
clinical trial experience is in the Respiratory therapeutic area, a significant percentage of
which are allergy and rhinoconjunctivitis studies*:

 Clinical Trials         35
 Subjects                14,000 (includes pediatrics)                                                 eSense Device Integration
                                                                                                   Wirelessly integrated PEF meters,
 Sites                   2,100                                                                    pioneered by PHT, have become the
 By Phase                Phase II (30%) - Phase III (58%) - Phase IV (12%)                         gold standard in asthma research.
                                                                                                Subjects use the PEF meter throughout
 Questionnaires          Asthma Control Quesitonnaire (ACQ-5), Asthma Quality of                 the day, and all timestamped scores
                         Life Questionnaire (AQLQ), Rhinioconjunctivitis Quality of Life         are sent automatically to the LogPad.
                         Questionnaire (RQLQ), St. George’s Respiratory Questionnaire             This eliminates invented data, user
                         (SGRQ),Total Nasal Symptom Score (TNSS)                                error, and transcription error typical of
 Countries               Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada,       asthma and pediatric asthma trials.
                         Costa Rica, Colombia, Czech Republic, Denmark, France,
                         Germany, Hungary, Israel, Indonesia, Italy, Latvia, Mexico,                   PHT Client Case Study
                         Netherlands, New Zealand, Pakistan, Peru, Phillipines, Poland,          One sponsor allowed subjects to use
                         Portugal, Puerto Rico, Russia, Singapore, Slovakia, South Africa,       eSense integration or enter readings
                         South Korea, Spain, Sweden, Switzerland, Taiwan, Thailand,                   manually into the eDiary.
                         United Kingdom, United States
                                                                                                 As presented in a poster at the 2008
 Languages               Afrikaans, Bulgarian, Chinese (China, Singapore, Taiwan), Czech,
                                                                                                   AAAAI Annual Meeting, 86.5% of
                         Danish, Dutch, English (Australia, UK, US), Flemish, French
                                                                                                12,195 expected blows were sent to the
                         (Belgium, Canada, France), German, Hangul, Hebrew, Hindi,
                                                                                                LogPad via eSense, 12.5% were entered
                         Hungarian, Indonesian, Italian, Latvian, Malay, Polish, Portu-
                                                                                                 manually, and only 1.0% were missed.
                         guese (Brazil, Portugal), Spanish (Argentina, Costa Rica, Puerto
                         Rico, Russian, Peru, Spain, US), Swedish, Tagalog, Thai, Urdu
                                                                                                  These results demonstrate frequent
                                                                                                    voluntary use of the eSense PiKo
                                                                   * As of September, 2008
                                                                                                 provides a significant increase in data
                                                                                                reliability over antiquated paper diaries
                                                                                                   or disconnected eSource methods.
                      NDA Approval of SYBMICORT® by AstraZeneca
                      The FDA approved the use of SYBMICORT (budesonide/formoterol) in the United States based on primary efficacy
                      data captured in two LogPad trials with 1,076 patients. Data from seven LogPad studies were used to prove safety.
PHT Corporation
Asthma and Rhinoconjunctivitis




Sample Screen Shots
The LogPad System can display an infinite number of screen types and items. The following are samples of diaries used by clients in previous trials:


 Number Spinner                            Edit Check                                Numeric Scale                               Keypad




 Allows subjects to indicate dosage Enables subjects to confirm or                   Limits subjects to legible and              Helps subjects enter multi-digit
 of medication simply with a tap of clarify out-of-range responses.                  logically appropriate responses             numerical data (e.g. a PEF score)
 an arrow.                          Also provides custom instructions                (e.g. they cannot enter invented            in a familiar fashion. eSense
                                    as necessary.                                    values or write AEs in the margin).         sends these data automatically.

Recommendations and Best Practices for Asthma Diary Design
The real value of the eDiary comes in its design - from work flows and branching logic to edit checks and calculations. PHT’s PROVision science
team has unrivaled experience and expertise in designing screens and diaries to meet the specific requirements of clients and patient populations.
General recommendations and best practices for asthma diary design:

           • Ask subjects to complete two reports per day (morning and evening)
           • Record Peak Expiratory Flow values during both reports
           • Enable alerts on diaries based on specific threshold values (e.g. when a subject’s performance declines as compared to baseline)
                      • A simple message screen inside of a subject report asks subjects to clarify/confirm out-of-range responses (e.g. a
                        response of too many puffs of albuterol) and advise the subject to seek medical attention as necessary
                      • StudyWorks™ flags the data in real time for site personnel in online data summaries
                      • SafetyPRO™ email and phone alerts are sent instantly to site and medical personnel indicating that attention to, and
                        contact with, the subject is required
           • Use questionnaires completed during a screening period as randomization criteria. The LogPad can retain information from previous
             diaries and perform complex calculations integrating both past and present information. Suggested criteria include symptom
             severity and diary compliance
           • Include questionnaires under Qoltech copyrights (e.g. AQLQ, RQLQ) - they are the current benchmark for asthma questionnaires.
             Ensure they are validated with Prof. Juniper’s official approval for the particular eDiary device you will use**
           • Plan to study patients of all ages. PHT has found that children as young as six can use the LogPad effectively. For certain pediatric ages,
             consider implementing a Caregiver Module, which allows an authorized parent or guardian to enter responses on the child’s behalf
           • Employ eSense PiKo devices to transmit wireless PEF readings directly from the PiKo meter to the LogPad

                                    Learn More about ePRO and Asthma
                                    Trust your patient and questionnaire data again. Accurate timestamps and frequent sampling,
                                    enhanced by eSense device integration and best practices for patient safety monitoring, are
                                    taking asthma research to new heights. Contact PHT or review interactive product demos at the
                                    award-winning www.phtcorp.com to learn how your upcoming asthma program can benefit
                                    from improved data quality, real-time data access and more efficient trial management. PHT is
                                    the leading provider of ePRO solutions used by 90 sponsors in 360 clinical trials worldwide.

** Juniper EF, Riis B, Juniper BA. Development and validation of an electronic version of the Rhinoconjunctivitis Quality of Life Questionnaire. Allergy 2007; 62:
1091-3

                                                                 PHT Corporation                                        www.phtcorp.com
                                                                 500 Rutherford Avenue
                                                                 Boston, MA 02129, USA
                                                                 Toll-Free: 877-360-2901                                Copyright © 2008 PHT Corporation V1.0

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ePro And Asthma

  • 1. A Breath of Fresh Air How ePRO improves Asthma and Rhinoconjunctivitis clinical studies The Time is Now Sponsors elect to use ePRO to capture data from asthma patients primarily because of the importance of collecting timely and frequent assessments. The LogPad’s accurate time- stamps ensure data are entered at appropriate times according to the protocl, while its intuitive touchscreen interface, reminder alarms and branching logic reduce respondent burden especially during periods of dense sampling. eSense device integration further elevates the reliability of patient data to unprecedented heights. Whether you are implementing a diary question about the degree of breathing difficulty, or comparing PEF and FEV1scores to baseline, PHT’s LogPad System enables higher quality data and safer clinical research worldwide. Behind only disorders of the Central Nervous System, the majority of PHT’s market-leading clinical trial experience is in the Respiratory therapeutic area, a significant percentage of which are allergy and rhinoconjunctivitis studies*: Clinical Trials 35 Subjects 14,000 (includes pediatrics) eSense Device Integration Wirelessly integrated PEF meters, Sites 2,100 pioneered by PHT, have become the By Phase Phase II (30%) - Phase III (58%) - Phase IV (12%) gold standard in asthma research. Subjects use the PEF meter throughout Questionnaires Asthma Control Quesitonnaire (ACQ-5), Asthma Quality of the day, and all timestamped scores Life Questionnaire (AQLQ), Rhinioconjunctivitis Quality of Life are sent automatically to the LogPad. Questionnaire (RQLQ), St. George’s Respiratory Questionnaire This eliminates invented data, user (SGRQ),Total Nasal Symptom Score (TNSS) error, and transcription error typical of Countries Argentina, Australia, Austria, Belgium, Brazil, Bulgaria, Canada, asthma and pediatric asthma trials. Costa Rica, Colombia, Czech Republic, Denmark, France, Germany, Hungary, Israel, Indonesia, Italy, Latvia, Mexico, PHT Client Case Study Netherlands, New Zealand, Pakistan, Peru, Phillipines, Poland, One sponsor allowed subjects to use Portugal, Puerto Rico, Russia, Singapore, Slovakia, South Africa, eSense integration or enter readings South Korea, Spain, Sweden, Switzerland, Taiwan, Thailand, manually into the eDiary. United Kingdom, United States As presented in a poster at the 2008 Languages Afrikaans, Bulgarian, Chinese (China, Singapore, Taiwan), Czech, AAAAI Annual Meeting, 86.5% of Danish, Dutch, English (Australia, UK, US), Flemish, French 12,195 expected blows were sent to the (Belgium, Canada, France), German, Hangul, Hebrew, Hindi, LogPad via eSense, 12.5% were entered Hungarian, Indonesian, Italian, Latvian, Malay, Polish, Portu- manually, and only 1.0% were missed. guese (Brazil, Portugal), Spanish (Argentina, Costa Rica, Puerto Rico, Russian, Peru, Spain, US), Swedish, Tagalog, Thai, Urdu These results demonstrate frequent voluntary use of the eSense PiKo * As of September, 2008 provides a significant increase in data reliability over antiquated paper diaries or disconnected eSource methods. NDA Approval of SYBMICORT® by AstraZeneca The FDA approved the use of SYBMICORT (budesonide/formoterol) in the United States based on primary efficacy data captured in two LogPad trials with 1,076 patients. Data from seven LogPad studies were used to prove safety.
  • 2. PHT Corporation Asthma and Rhinoconjunctivitis Sample Screen Shots The LogPad System can display an infinite number of screen types and items. The following are samples of diaries used by clients in previous trials: Number Spinner Edit Check Numeric Scale Keypad Allows subjects to indicate dosage Enables subjects to confirm or Limits subjects to legible and Helps subjects enter multi-digit of medication simply with a tap of clarify out-of-range responses. logically appropriate responses numerical data (e.g. a PEF score) an arrow. Also provides custom instructions (e.g. they cannot enter invented in a familiar fashion. eSense as necessary. values or write AEs in the margin). sends these data automatically. Recommendations and Best Practices for Asthma Diary Design The real value of the eDiary comes in its design - from work flows and branching logic to edit checks and calculations. PHT’s PROVision science team has unrivaled experience and expertise in designing screens and diaries to meet the specific requirements of clients and patient populations. General recommendations and best practices for asthma diary design: • Ask subjects to complete two reports per day (morning and evening) • Record Peak Expiratory Flow values during both reports • Enable alerts on diaries based on specific threshold values (e.g. when a subject’s performance declines as compared to baseline) • A simple message screen inside of a subject report asks subjects to clarify/confirm out-of-range responses (e.g. a response of too many puffs of albuterol) and advise the subject to seek medical attention as necessary • StudyWorks™ flags the data in real time for site personnel in online data summaries • SafetyPRO™ email and phone alerts are sent instantly to site and medical personnel indicating that attention to, and contact with, the subject is required • Use questionnaires completed during a screening period as randomization criteria. The LogPad can retain information from previous diaries and perform complex calculations integrating both past and present information. Suggested criteria include symptom severity and diary compliance • Include questionnaires under Qoltech copyrights (e.g. AQLQ, RQLQ) - they are the current benchmark for asthma questionnaires. Ensure they are validated with Prof. Juniper’s official approval for the particular eDiary device you will use** • Plan to study patients of all ages. PHT has found that children as young as six can use the LogPad effectively. For certain pediatric ages, consider implementing a Caregiver Module, which allows an authorized parent or guardian to enter responses on the child’s behalf • Employ eSense PiKo devices to transmit wireless PEF readings directly from the PiKo meter to the LogPad Learn More about ePRO and Asthma Trust your patient and questionnaire data again. Accurate timestamps and frequent sampling, enhanced by eSense device integration and best practices for patient safety monitoring, are taking asthma research to new heights. Contact PHT or review interactive product demos at the award-winning www.phtcorp.com to learn how your upcoming asthma program can benefit from improved data quality, real-time data access and more efficient trial management. PHT is the leading provider of ePRO solutions used by 90 sponsors in 360 clinical trials worldwide. ** Juniper EF, Riis B, Juniper BA. Development and validation of an electronic version of the Rhinoconjunctivitis Quality of Life Questionnaire. Allergy 2007; 62: 1091-3 PHT Corporation www.phtcorp.com 500 Rutherford Avenue Boston, MA 02129, USA Toll-Free: 877-360-2901 Copyright © 2008 PHT Corporation V1.0