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Study to Compare the Efficacy and Safety of QVM149 With QMF149 in Patients With Asthma

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ClinicalTrials.gov Identifier: NCT02571777
Recruitment Status : Recruiting
First Posted : October 8, 2015
Last Update Posted : July 16, 2018
Sponsor:
Information provided by (Responsible Party):
Novartis ( Novartis Pharmaceuticals )

Brief Summary:
The purpose of the trial is to evaluate the efficacy and safety of two different doses of QVM149 (QVM149 150/50/80 μg and QVM149 150/50/160 μg via Concept1) over two respective QMF149 doses (QMF149 150/160 μg and QMF149 150/320 μg via Concept1 in poorly controlled asthmatics as determined by pulmonary function testing and effects on asthma control.

Condition or disease Intervention/treatment Phase
Asthma Drug: QVM149 Drug: QMF149 Drug: salmeterol/fluticasone Phase 3

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 2980 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multicenter, Randomized, 52-week, Double-blind, Parallelgroup, Active Controlled Study to Compare the Efficacy and Safety of QVM149 With QMF149 in Patients With Asthma
Actual Study Start Date : February 1, 2015
Estimated Primary Completion Date : June 3, 2019
Estimated Study Completion Date : June 3, 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Asthma

Arm Intervention/treatment
Experimental: QVM149 150/50/160 µg o.d.
QVM149 150/50/160 µg o.d. delivered via Concept1
Drug: QVM149
Experimental: QVM149 150/50/80 µg o.d.
QVM149 150/50/80 µg o.d. delivered via Concept1
Drug: QVM149
Active Comparator: QMF149 150/160 µg o.d.
QMF149 150/160 µg o.d. delivered via Concept1
Drug: QMF149
Active Comparator: QMF149 150/320 µg o.d.
QMF149 150/320 µg o.d. delivered via Concept1
Drug: QMF149
Active Comparator: Salmeterol/fluticasone
Salmeterol xinafoate /fluticasone propionate 50/500 µg b.i.d. delivered via Accuhaler®.
Drug: salmeterol/fluticasone



Primary Outcome Measures :
  1. Trough FEV1 [ Time Frame: 26 weeks ]
    to demonstrate superiority of either QVM149 150/50/80 µg o.d. to QMF149 150/160 µg o.d. or QVM149 150/50/160 µg o.d. to QMF149 150/320 µg o.d on through FEV1 over 26 weeks of treatment. Forced Expiratory cvolume in 1 second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing.


Secondary Outcome Measures :
  1. Trough FEV1 at week 52 [ Time Frame: 52 weeks ]
    Forced Expiratory Volume in 1 second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing.

  2. FVC at week 4 and week 12 [ Time Frame: 12 weeks ]
    FVC is the total amount of air exhaled during the FEV test.

  3. PEF over 26 and 52 weeks [ Time Frame: 52 weeks ]
    measured in the morning and evening. PEF is the peak expiratory flow, the maximum speed of expiration.

  4. ACQ-7 [ Time Frame: 26 weeks, 52 weeks ]
    ACQ is the Asthma Control Questionnaire (scoring 5 symptoms, FEV1 entered by the investigator and the rescue medication use entered by the patient) validated to evaluate different levels of asthma control

  5. % days with no symptoms (overall, at awakening and rising) [ Time Frame: 52 weeks ]
    Percentage of days with no symptoms, the percentage of days with no awakenings and the percentage of mornings with no symptoms on rising

  6. % days without rescue medication use over 26 and 52 weeks [ Time Frame: 52 weeks ]
    Percentage of days without rescue medication usage (salbutamol(albuterol) as recorded by e-diary over 26 and 52 weeks of treatment.

  7. % patients with MID ACQ>= 0,5 at week 26 and 52 [ Time Frame: 52 weeks ]
    Percentage of patients achieving the minimal important difference (MID) ACQ ≥ 0.5 at Week 26 and Week 52

  8. asthma exacerbation over 52 weeks [ Time Frame: 52 weeks ]

    To evaluate the efficacy in terms of asthma exacerbation-related parameters :

    • Time to first hospitalization for asthma exacerbation
    • Time to first asthma exacerbation by exacerbation category
    • Annual rate of asthma exacerbations excluding measurements in patients requiring chronic corticosteroid use after an exacerbation (beyond permitted steroid taper for exacerbation) by exacerbation category
    • Duration in days of asthma exacerbations by exacerbation category
    • Percentage of patients with at least one asthma exacerbation by exacerbation category
    • Time in days to permanent discontinuation of study medication due to asthma exacerbations
    • Percentage of patients who permanently discontinued study medication due to asthma exacerbations
    • Total amounts of systemic corticosteroids (in doses) used to treat asthma exacerbations.

  9. % rescue medication free days over 26 and 52 weeks [ Time Frame: 52 weeks ]
    % of rescue medication free days over 26 and 52 weeks of treatment

  10. AQLQ [ Time Frame: 52 weeks ]
    Quality of life as assessed by Asthma Quality of Life Questionnaire (AQLQ) over 52 weeks

  11. Trough FEV1 at 26 weeks comparison with salmeterol xinafoate /fluticasone propionate 50/500 µg via Accuhaler® [ Time Frame: 26 weeks ]
    In addition to the comparison QVM149 150/50/80 µg o.d. to QMF149 150/160 µg o.d. or QVM149 150/50/160 µg o.d. to QMF149 150/320 µg o.d for all above endpoints, QVM149 150/50/80 µg o.d. and QVM149 150/50/160 µg o.d. delivered via Concept1 will be compared with salmeterol xinafoate /fluticasone propionate 50/500 µg via Accuhaler® in all secondary enpoints above as well as Trough FEV1 measured after 26 weeks of treatment

  12. Asthma control as assessed by the Asthma Control Questionnaire (ACQ-7) comparison with salmeterol xinafoate /fluticasone propionate 50/500 µg via Accuhaler® [ Time Frame: 26 weeks ]
    In addition to the comparison QVM149 150/50/80 µg o.d. to QMF149 150/160 µg o.d. or QVM149 150/50/160 µg o.d. to QMF149 150/320 µg o.d for all above endpoints, QVM149 150/50/80 µg o.d. and QVM149 150/50/160 µg o.d. delivered via Concept1 will be compared with salmeterol xinafoate /fluticasone propionate 50/500 µg via Accuhaler® in all secondary enpoints and ACQ-7 at week 26

  13. Serious asthma outcome incidence and CCV events/atrial fibrilaltion [ Time Frame: 52 weeks ]
    Cumulative incidence of the composite endpoint of serious asthma outcomes (i.e. asthma-related hospitalization, asthma-related intubation, or asthma-related death) and CCV events/atrial fibrillation over 52 weeks of treatment

  14. Adverse events, vital signs, laboratory analysis and ECG [ Time Frame: 52 weeks ]
    Adverse events, vital signs, ECG and laboratory analysis (haematology, blood chemistry including glucose and potassium, urinalysis, plasma evening cortisol) and treatment discontinuation due to adverse event over 52 weeks of treatment.

  15. FEV1 at week 4 and week 12 [ Time Frame: week 12 ]
    Forced Expiratory Volume in 1 second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing.



Information from the National Library of Medicine

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


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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with a diagnosis of asthma, (GINA 2015) for a period of at least 1 year prior to Visit 1 (Screening).
  • Patients who have used medium or high dose of ICS/LABA combinations for asthma for at least 3 months and at stable medium or high doses of ICS/LABA for at least 1 month prior to Visit 1.
  • Patients must be symptomatic at screening despite treatment with mid or high stable doses of ICS/LABA. Patients with ACQ-7 score ≥ 1.5 at Visit 101 and at Visit 102 (before randomization).
  • Patients with documented history of at least one asthma exacerbation which required medical care from a physician, ER visit (or local equivalent structure) or hospitalization in the 12 months prior to Visit 1, and required systemic corticosteroid treatment.
  • Pre-bronchodilator FEV1 of < 80 % of the predicted normal value for the patient according to ATS/ERS guidelines after withholding bronchodilators at both visits 101 and 102.
  • Withholding period of bronchodilators prior to spirometry: SABA for ≥ 6 hrs, Twice daily LABA (or FDC of ICS/LABA) for ≥ 12 hrs, Once daily LABA (or FDC of ICS/LABA) for ≥ 24 hrs, SAMA for ≥ 8 hrs, Short acting xanthines for 12 hrs, Long acting xanthines for 24 hrs, .
  • Washout period of each drug should be kept as close as possible as above and should not be longer. If longer washout period is needed due to scheduling issues, please contact Novartis Medical monitor.
  • A one-time repeat of percentage predicated FEV1 (Pre-bronchodilator) at Visit 101 and/or Visit 102 is allowed in an ad-hoc visit. Repeat of Visit 101 spirometry should be done in an ad-hoc visit to be scheduled on a date that would provide sufficient time to receive confirmation from the spirometry data central reviewer of the validity of the assessment before randomization. Run-in medication should be dispensed once spirometry assessment met inclusion criteria (ATS/ERS quality criteria, FEV1 % predicted normal value, and reversibility) as per equipment
  • A one-time rescreen is allowed in case the patient fails to meet the criteria at the repeat, provided the patient returned to the required treatment as per inclusion criteria 4
  • Patients who demonstrate an increase in FEV1 of 12% and 200 mL within 30 minutes after administration of 400 µg salbutamol/360 µg albuterol (or equivalent dose) at Visit 101.All patients must perform a reversibility test at Visit 101. If reversibility is not demonstrated at Visit 101 then one of the following criteria need to be met.
  • Reversibility should be repeated once.
  • Patients may be permitted to enter the study with historical evidence of reversibility that was performed according to ATS/ERS guidelines within 2 years prior to Visit 1.
  • Alternatively, patients may be permitted to enter the study with a historical positive bronchoprovocation test that was performed within 2 years prior to Visit 1. If reversibility is not demonstrated at Visit 101 (or after repeated assessment in an ad-hoc visit) and historical evidence of reversibility/bronchoprovocation is not available (or was not performed according to the ATS/ERS guidelines patients must be screen failed
  • Spacer devices are permitted during reversibility testing only. The Investigator or delegate may decide whether or not to use a spacer for the reversibility testing

Exclusion Criteria:

  • Patients who have had an asthma attack/exacerbation requiring systemic steroids or hospitalization or emergency room visit within 6 weeks of Visit 1 (Screening). If patients experience an asthma attack/exacerbation requiring systemic steroids or hospitalization or emergency room visit between Visit 1 and Visit 102 they may be re-screened 6 weeks after recovery from the exacerbation.
  • Patients who have ever required intubation for a severe asthma attack/exacerbation.
  • Patients who have a clinical condition which is likely to be worsened by ICS administration (e.g. glaucoma, cataract and fragility fractures) who are according to investigator's medical judgment at risk participating in the study.
  • Patients treated with a LAMA for asthma within 3 months prior Visit 1 (Screening).
  • Patients with narrow-angle glaucoma, symptomatic benign prostatic hyperplasia (BPH) or bladder-neck obstruction or severe renal impairment or urinary retention. BPH patients who are stable on treatment can be considered).
  • Patients who have had a respiratory tract infection or asthma worsening as determined by investigator within 4 weeks prior to Visit 1 (Screening) or between Visit 1 and Visit 102. Patients may be re-screened 4 weeks after recovery from their respiratory tract infection or asthma worsening.
  • Patients with evidence upon visual inspection (laboratory culture is not required) of clinically significant (in the opinion of investigator) oropharyngeal candidiasis at Visit 102 or earlier, with or without treatment. Patients may be re-screened once their candidiasis has been treated and has resolved.
  • Patients with any chronic conditions affecting the upper respiratory tract (e.g. chronic sinusitis) which in the opinion of the investigator may interfere with the study evaluation or optimal participation in the study.
  • Patients with a history of chronic lung diseases other than asthma, including (but not limited to) chronic obstructive pulmonary disease, sarcoidosis, interstitial lung disease, cystic fibrosis, clinically significant bronchiectasis and active tuberculosis.
  • Patients with Type I diabetes or uncontrolled Type II diabetes.
  • Patients who, either in the judgment of the investigator or the responsible Novartis personnel, have a clinically significant condition such as (but not limited to) unstable ischemic heart disease, New York Heart Association (NYHA) Class III/IV left ventricular failure arrhythmia, uncontrolled hypertension, cerebrovascular disease, psychiatric disease, neurodegenerative diseases, or other neurological disease, uncontrolled hypo- and hyperthyroidism and other autoimmune diseases, hypokalemia, hyperadrenergic state, or ophthalmologic disorder or patients with a medical condition that might compromise patient safety or compliance, interfere with evaluation, or preclude completion of the study.
  • Patients with paroxysmal (e.g., intermittent) atrial fibrillation are excluded. Patients with persistent atrial fibrillation as defined by continuous atrial fibrillation for at least 6 months and controlled with a rate control strategy (i.e., selective beta blockers, calcium channel blocker, pacemaker placement, digoxin or ablation therapy) for at least 6 months may be considered for inclusion. In such patients, atrial fibrillation must be present at the run-in visit (Visit 101) with a resting ventricular rate < 100/min. At Visit 101 the atrial fibrillation must be confirmed by central reading.
  • Patients with a history of myocardial infarction (this should be confirmed clinically by the investigator) within the previous 12 months.
  • Concomitant use of agents known to prolong the QT interval unless it can be permanently discontinued for the duration of study
  • Patients with a history of long QT syndrome or whose QTc measured at Visit 101 (Fridericia method) is prolonged (> 450 msec for males and > 460 msec for females) and confirmed by a central assessor (these patients should not be rescreened).
  • Patients with a history of hypersensitivity to lactose, any of the study drugs or to similar drugs within the class including untoward reactions to sympathomimetic amines or inhaled medication or any component thereof.
  • Patients who have not achieved an acceptable spirometry result at Visit 101 in accordance with ATS/ERS criteria for acceptability and repeatability. A one-time repeat spirometry is allowed in an ad-hoc visit scheduled as close as possible from the first attempt (but not on the same day) if the spirometry did not qualify due to ATS/ERS criteria at Visit 101 and/or Visit 102. If the patient fails the repeat assessment, the patient may be rescreened once, provided the patient returns to the required treatment as per inclusion criteria 4.
  • Patients unable to use the Concept1 dry powder inhaler, Accuhaler or a metered dose inhaler. Spacer devices are not permitted.
  • History of alcohol or other substance abuse.
  • Patients with a known history of non-compliance to medication or who were unable or unwilling to complete a patient diary or who are unable or unwilling to use Electronic Peak Flow with e-diary device.
  • Patients who do not maintain regular day/night, waking/sleeping cycles (e.g., night shift workers).

Information from the National Library of Medicine

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

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02571777


Contacts
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Contact: Novartis Pharmaceuticals +41613241111
Contact: Novartis Pharmaceuticals +81337978748

  Show 481 Study Locations
Sponsors and Collaborators
Novartis Pharmaceuticals

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Responsible Party: Novartis Pharmaceuticals
ClinicalTrials.gov Identifier: NCT02571777     History of Changes
Other Study ID Numbers: CQVM149B2302
First Posted: October 8, 2015    Key Record Dates
Last Update Posted: July 16, 2018
Last Verified: July 2018

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Novartis ( Novartis Pharmaceuticals ):
Asthma
Additional relevant MeSH terms:
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Asthma
Bronchial Diseases
Respiratory Tract Diseases
Lung Diseases, Obstructive
Lung Diseases
Respiratory Hypersensitivity
Hypersensitivity, Immediate
Hypersensitivity
Immune System Diseases
Fluticasone
Salmeterol Xinafoate
Anti-Inflammatory Agents
Bronchodilator Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Asthmatic Agents
Respiratory System Agents
Dermatologic Agents
Anti-Allergic Agents
Adrenergic beta-2 Receptor Agonists
Adrenergic beta-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action