AsthmaPhase 3NCT03629249
Systemic Corticosteroids Avoidance Study in Severe Asthma Patients
A Phase 3 study testing QAW039 150 mg once daily and QAW039 450 mg once daily in people with Asthma, run by Novartis Pharmaceuticals at 120 sites in 21 countries.
Trial summary
The overall purpose of this study was to determine the efficacy of fevipiprant (150 mg and 450 mg once daily), compared with placebo, as add-on to standard-of-care asthma therapy, in terms of avoidance of corticosteroid use over 52 weeks. Read more about this study
- Who is it for?
- Ages 18 to 84 years
- Conditions the study is for
- Asthma
- What is being tested?
- QAW039 150 mg once daily and QAW039 450 mg once daily
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 604 participants
- Where
- 120 sitesin 21 countries
- Study dates
- 13 Dec 2018to 6 Feb 2020
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 84 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patients with a diagnosis of asthma for a period of at least 3 months prior to Screening Visit with current asthma severity step 4 or 5 (GINA 2018)
- Currently on treatment with medium or high dose ICS/LABA +/- other controller (i.e.long-acting muscarinic antagonist (LAMA), leukotriene receptor antagonist (LTRA) etc. as per GINA) for a minimum of 6 weeks prior to Screening Visit
- At screening, patients with FEV1 of ≤80% of the predicted normal value for the patient, after withholding bronchodilators at Screening Visit and beginning of Run-In Visit
- An increase of ≥12% and ≥200 ml in FEV1 approximately 10 to 15 minutes after administration of 400 mcg of salbutamol/albuterol prior to randomization (documented historical reversibility was accepted).
- Demonstration of inadequate control of asthma based on an ACQ-5 score ≥1.5 at Screening Visit and Treatment Day 1 Visit
- Documented history of at least 1 asthma exacerbation within 1 year prior to enrollment
Who cannot join
- Asthma exacerbation, within 6 weeks prior to enrollment (screening) that required SCS, hospitalization, or emergency room visit
- Chronic/maintenance use of oral corticosteroids (OCS) for asthma (total OCS use days greater than 6 months; continuously or intermittently) within the last year
- Prior use of biologics that has potential to interfere/ affect asthma disease progression, in the previous 6 months from run-in period.
- Any contraindications of SCS use e.g. diabetes, narrow angle glaucoma, or any other as defined by the treating physician
- Pregnant or nursing (lactating) women
- Use of other investigational drugs within 5 half-lives of enrollment, or [within 30 days], whichever is longer
Trial locations and contacts
120 sites in 21 countries.
120 sites in 21 countries
Germany20 sites
Novartis Investigative Site
Berlin, 10119
Novartis Investigative Site
Berlin, 10717
Novartis Investigative Site
Berlin, 10969
Novartis Investigative Site
Berlin, 12159
Novartis Investigative Site
Berlin, 12203
Novartis Investigative Site
Berlin, 13187
Novartis Investigative Site
Darmstadt, 64283
Novartis Investigative Site
Frankfurt, 60389
Novartis Investigative Site
Frankfurt, 60596
Novartis Investigative Site
Hamburg, 20354
Novartis Investigative Site
Hamburg, 22299
Novartis Investigative Site
Hanover, 30173
Novartis Investigative Site
Koblenz, North Rhine-Westphalia, 56068
Novartis Investigative Site
Landsberg, 86899
Novartis Investigative Site
Leipzig, 04103
Novartis Investigative Site
Leipzig, 04275
Novartis Investigative Site
Leipzig, 04357
Novartis Investigative Site
Mainz, 55131
Novartis Investigative Site
Marburg, 35037
Novartis Investigative Site
Witten, 58452
Argentina14 sites
Novartis Investigative Site
Buenos Aires, 1428
Novartis Investigative Site
Buenos Aires, 1900
Novartis Investigative Site
Buenos Aires, C1012AAR
Novartis Investigative Site
Buenos Aires, C1125ABE
Novartis Investigative Site
Buenos Aires, C1440BRR
Novartis Investigative Site
CABA, Buenos Aires, C1122AAK
Novartis Investigative Site
CABA, Buenos Aires, C1424BSF
Novartis Investigative Site
CABA
Novartis Investigative Site
Córdoba, X5003DCE
Novartis Investigative Site
Florida, Buenos Aires, B1602DQD
Novartis Investigative Site
Mar del Plata, Buenos Aires, 7600
Novartis Investigative Site
Rosario, Santa Fe Province, S2000DBS
Novartis Investigative Site
San Miguel de Tucumán, Tucumán Province, 4000
Novartis Investigative Site
San Miguel de Tucumán, Tucumán Province, T4000IFL
Russia12 sites
Novartis Investigative Site
Barnaul, 656045
Novartis Investigative Site
Moscow, 115478
Novartis Investigative Site
Moscow, 115682
Novartis Investigative Site
Moscow, 125993
Novartis Investigative Site
Petrozavodsk, 185019
Novartis Investigative Site
Saint Petersburg, 193312
Novartis Investigative Site
Saint Petersburg, 194325
Novartis Investigative Site
Saint Petersburg, 196143
Novartis Investigative Site
Saint Petersburg, 198260
Novartis Investigative Site
Saratov, 410012
Novartis Investigative Site
Stavropol, 355000
Novartis Investigative Site
Volgograd, 400120
Hungary10 sites
Novartis Investigative Site
Balassagyarmat, 2660
Novartis Investigative Site
Gödöllő, 2100
Novartis Investigative Site
Győr, HUN, 9024
Novartis Investigative Site
Hajdúnánás, HUN, 4080
Novartis Investigative Site
Kapuvár, HUN, 9330
Novartis Investigative Site
Nyíregyháza, H-4400
Novartis Investigative Site
Pécs, 7635
Novartis Investigative Site
Püspökladány, HUN, 4150
Novartis Investigative Site
Százhalombatta, HUN, 2440
Novartis Investigative Site
Szeged, 6722
United States9 sites
Novartis Investigative Site
Bangor, Maine, 04401
Novartis Investigative Site
Boerne, Texas, 78006
Novartis Investigative Site
Dallas, Texas, 75230
Novartis Investigative Site
McKinney, Texas, 75069
Novartis Investigative Site
Newport Beach, California, 92663
Novartis Investigative Site
The Bronx, New York, 10459
Novartis Investigative Site
Waldorf, Maryland, 20602
Novartis Investigative Site
Westminster, California, 92683
Novartis Investigative Site
Winter Park, Florida, 32789
Czechia7 sites
Novartis Investigative Site
Beroun, Czech Republic, 266 01
Novartis Investigative Site
Jindřichův Hradec, 377 01
Novartis Investigative Site
Lovosice, 41002
Novartis Investigative Site
Prague, Czech Republic, 140 46
Novartis Investigative Site
Teplice, Czech Republic, 415 01
Novartis Investigative Site
Teplice, CZE, 415 01
Novartis Investigative Site
Varnsdorf, 40747
Greece5 sites
Novartis Investigative Site
Athens, GR, 115 25
Novartis Investigative Site
Athens, GR, 115 27
Novartis Investigative Site
Heraklion Crete, Greece, 711 10
Novartis Investigative Site
Thessaloniki, GR, 564 29
Novartis Investigative Site
Thessaloniki, GR, 570 10
Slovakia5 sites
Novartis Investigative Site
Bardejov, Slovak Republic, 085 01
Novartis Investigative Site
Humenné, Slovak Republic, 066 01
Novartis Investigative Site
Levice, Slovak Republic, 934 01
Novartis Investigative Site
Spišská Nová Ves, Slovak Republic, 052 01
Novartis Investigative Site
Žilina, 010 01
Belgium4 sites
Novartis Investigative Site
Erpent, 5100
Novartis Investigative Site
Lebbeke, 9280
Novartis Investigative Site
Liège, 4000
Novartis Investigative Site
Mechelen, 2800
Colombia4 sites
Novartis Investigative Site
Bogotá, 110221
Novartis Investigative Site
Bogotá, 110231
Novartis Investigative Site
Bucaramanga
Novartis Investigative Site
Zipaquirá, Cundinamarca, 250252
France4 sites
Novartis Investigative Site
Grenoble, 38043
Novartis Investigative Site
Lyon, Rhone, 69317
Novartis Investigative Site
Montpellier, Herault, 34059
Novartis Investigative Site
Pessac, 33604
Peru4 sites
Novartis Investigative Site
Cusco, 84
Novartis Investigative Site
Lima, 1
Novartis Investigative Site
Piura
Novartis Investigative Site
San Isidro, Lima region, 27
Spain4 sites
Novartis Investigative Site
Badalona, Catalonia, 08916
Novartis Investigative Site
Madrid, 28006
Novartis Investigative Site
Marbella, Andalusia, 29603
Novartis Investigative Site
Santiago de Compostela, 15706
Bulgaria3 sites
Novartis Investigative Site
Pleven, 5800
Novartis Investigative Site
Sofia, 1407
Novartis Investigative Site
Vidin, BGR, 3703
Philippines3 sites
Novartis Investigative Site
Iloilo City, Iloilo, 5000
Novartis Investigative Site
Iloilo City, 5000
Novartis Investigative Site
Lipa City, Batangas, 4217
United Kingdom3 sites
Novartis Investigative Site
Bradford, West Yorkshire, BD9 6RJ
Novartis Investigative Site
Chertsey, Surrey, KT16 0PZ
Novartis Investigative Site
Portsmouth, Hants, PO6 3LY
Vietnam3 sites
Novartis Investigative Site
Hanoi, 100000
Novartis Investigative Site
Hanoi, 10000
Novartis Investigative Site
Ho Chi Minh City
Chile2 sites
Novartis Investigative Site
Curicó, Maule Region, 3341643
Novartis Investigative Site
Santiago, Santiago Metropolitan, 7500692
South Africa2 sites
Novartis Investigative Site
Berea, Durban, 4001
Novartis Investigative Site
Cape Town, 7925
About this study
Official title: A 52-week, Multicenter, Randomized, Double-blind, Double-dummy, Parallel-group, Placebo-controlled Study of Fevipiprant Once Daily Plus Standard-of-care (SoC) for Reduction of Systemic Corticosteroids (Oral and Parenteral) Use in Patients With Severe Asthma
The overall purpose of this study was to determine the efficacy of fevipiprant (150 mg and 450 mg once daily), compared with placebo, as add-on to standard-of-care asthma therapy, in terms of avoidance of corticosteroid use over 52 weeks.
Read the detailed description
This was a randomized, multicenter, double-blind, double-dummy, placebo-controlled, parallel-group study to determine the ability of fevipiprant (QAW039) plus standard-of-care (SoC) compared with placebo plus SoC to reduce the use of systemic corticosteroids (SCS) in patients with severe asthma. The study included:
- a Screening period of up to 2 weeks to assess eligibility;
- a Run-in period of 4 or 10 weeks to evaluate maintenance of asthma control and to collect baseline safety data. The Run-in period was 4 weeks for patients coming with high-dose ICS/LABA (inhaled corticosteroids/long-acting beta-agonist) and 10 weeks for patients switching from mid-dose to high-dose ICS/LABA as per protocol during the run-in period;
- a Treatment period of 52 weeks. Upon completion of the Run-in period, all patients who met eligibility criteria were randomized to 1 of 3 treatment groups (fevipiprant 150 mg or 450 mg or placebo once daily) in a ratio 1:1:1. Randomized patients were stratified according to their peripheral blood eosinophil count (< 250 cells/μl or ≥ 250 cells/μl);
- a Follow-up period of 2 weeks following the last dose of study drug to collect additional data for safety variables.
The main purpose of this study was to determine the efficacy of fevipiprant (150 mg and 450 mg once daily), compared with placebo, as add-on to GINA (Global Initiative for Asthma) treatment step 4 or 5 SoC asthma therapy in terms of avoidance of SCS use over 52 weeks in patients with inadequately controlled severe asthma and high eosinophil counts (eosinophil count at Visit 1 ≥250 cells/ μl) and in the overall patient population regardless of eosinophil counts.
On 16-Dec-2019 the sponsor decided to terminate study CQAW039A2323 earlier than the planned study completion. There were no safety findings with fevipiprant that contributed to this decision. The planned treatment period of 52 weeks was not completed by any patient; patients were treated for a median time of 14 weeks in each group and a maximum of up to 36 weeks.
- Conditions
- Asthma
- Being tested
- Placebo once daily, QAW039 150 mg once daily, QAW039 450 mg once daily
- Keywords
- Asthma, Bronchial Diseases, Respiratory Tract Diseases, Lung Diseases, Obstructive Lung Diseases, Respiratory Hypersensitivity, Hypersensitivity, Immune System Diseases, Fevipiprant, QAW039
- Medical subject headings
- Asthma, Bronchial Diseases, Respiratory Tract Diseases, Lung Diseases, Lung Diseases, Obstructive, Respiratory Hypersensitivity, Hypersensitivity, Immune System Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Placebo once dailyDrug
Placebo to QAW039 once daily (one tablet blinded placebo to QAW039 150 mg and one tablet blinded placebo to QAW039 450 mg).
QAW039 150 mg once dailyDrug
Also called fevipiprant 150 mg
QAW039 150 mg once daily (one tablet of blinded QAW039 150 mg to be given together with one tablet blinded placebo to QAW039 450 mg)
QAW039 450 mg once dailyDrug
Also called fevipiprant 450 mg
QAW039 450 mg once daily (one tablet of blinded QAW039 450 mg to be given together with one tablet blinded placebo to QAW039 150 mg)
| Study group | Role | What they receive |
|---|---|---|
| QAW039 150 mg | Experimental | QAW039 150 mg once daily orally Receives: Drug: QAW039 150 mg once daily |
| QAW039 450 mg | Experimental | QAW039 450 mg once daily orally Receives: Drug: QAW039 450 mg once daily |
| Placebo | Placebo comparator | Placebo to QAW039 once daily orally Receives: Drug: Placebo once daily |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Over 52 Weeks in the Overall Population
All participants were provided with prednisone/prednisolone (or equivalent) tablets that could be used according to the asthma plan along with an electronic diary (e-Diary/ePEF). Daily use of oral corticosteroids (number of tablets taken in the previous 12 hours) was recorded once in the morning and once in the evening by the subject in the eDiary/PEF device. In case of use of injectable corticosteroids during certain circumstances (eg. hospitalization) the data was collected on the eCRF (electronic case report form).
The total systemic corticosteroids (SCS) dose data was aggregated into monthly data for analysis. For the patients discontinuing treatment early, the total SCS dose for 52 weeks was obtained as annualized SCS dose. For example if patient took 120 mg for 3 months then for 12 months patient will be taking 120*12/3=480mg total SCS dose.
The mean values over 52 weeks in the overall patient population regardless of peripheral blood eosinophil counts are reported here.
Measured: 52 weeks
Total Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Over 52 Weeks in the Subpopulation of Patients With High Eosinophil Count (≥ 250 Cells/µl)
All participants were provided with prednisone/prednisolone (or equivalent) tablets that could be used according to the asthma plan along with an electronic diary (e-Diary/ePEF). Daily use of oral corticosteroids (number of tablets taken in the previous 12 hours) was recorded once in the morning and once in the evening by the subject in the eDiary/PEF device. In case of use of injectable corticosteroids during certain circumstances (eg. hospitalization) the data was collected on the eCRF (electronic case report form).
The total systemic corticosteroids (SCS) dose data was aggregated into monthly data for analysis. For the patients discontinuing treatment early, the total SCS dose for 52 weeks was obtained as annualized SCS dose. For example if patient took 120 mg for 3 months then for 12 months patient will be taking 120*12/3=480mg total SCS dose.
The mean values over 52 weeks in the subpopulation of patients with high peripheral blood eosinophil count at baseline are reported here.
Measured: 52 weeks
Secondary outcomes (7)
Change From Baseline in Daytime Symptom Scores
All participants were provided with an electronic diary (eDiary/ePEF) to record asthma symptom twice per day. Daytime asthma symptoms were assessed before bed and nighttime asthma symptoms on awakening.
The daytime asthma symptom score included 4 questions with a range of response categories for each question from 0 to 6 (0 = totally controlled; 6 = extremely poorly controlled). The questions were equally weighted and the overall score (from 0 to 6) was calculated as the average of the 4 questions with higher values indicating more asthma symptoms.
Mean values of daytime asthma symptom scores were calculated over 4-week intervals during the treatment period.
The baseline values of daytime asthma symptoms scores were defined as the average score during the run-in period.
A negative change from baseline in daytime asthma symptom score is a favorable outcome.
Measured: Baseline, up to Week 29-32
Change From Baseline in Nighttime Symptom Scores
All participants were provided with an electronic diary (eDiary/ePEF) to record asthma symptom twice per day. Daytime asthma symptoms were assessed before bed and nighttime asthma symptoms on awakening.
The nighttime asthma symptom score included 1 question with a range of response categories from 0 to 3 (0 = no awakening with asthma symptoms; 3 = awake all night).
Mean values of nighttime asthma symptom scores were calculated over 4-week intervals during the treatment period.
The baseline values of nighttime asthma symptoms scores were defined as the average score during the run-in period.
A negative change from baseline in nighttime asthma symptom score is a favorable outcome.
Measured: Baseline, up to Week 29-32
Change From Baseline in ACQ-5 Total Score up to End of Treatment Visit
The Asthma Control Questionnaire (ACQ-5) was completed by the patients at the investigator's site. Patients were asked to recall how their asthma had been during the previous week and to respond to the symptom questions on a 7-point scale (0=no impairment, 6=maximum impairment). The questions were equally weighted and the ACQ-5 score was the mean of the 5 questions and therefore between 0 (totally controlled) and 6 (severely uncontrolled).
The baseline values of ACQ-5 score were defined as the ACQ-5 scores obtained on Day 1.
A negative change from baseline in ACQ-5 score is a favorable outcome.
Measured: Baseline, up to Week 28
Change From Baseline in AQLQ+12 Total Score up to End of Treatment Visit
The Asthma Quality of Life Questionnaire (AQLQ+12) was completed by the patients at the investigator's site. The AQLQ+12 is a 32-item disease specific questionnaire designed to measure functional impairments that are most important to patients with asthma. Patients were asked to recall their experiences during the previous 2 weeks and to score each of the 32 items on a 7-point scale, where 1 indicates maximal impairment and 7 indicates no impairment. Thus, higher scores indicate better asthma-related quality of life. Each item of the AQLQ+12 was equally weighted and the overall score was the mean score of all 32 items and therefore ranged between 1 and 7.
The baseline values of AQLQ+12 score were defined as the AQLQ+12 scores obtained on Day 1.
A positive change from baseline in AQLQ+12 score is a favorable outcome.
Measured: Baseline, up to Week 28
Percentage of Patients Requiring ≥ 7.5 mg Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Per Day Continuously for at Least 30 Days
All participants were provided with prednisone/prednisolone (or equivalent) tablets that could be used according to the asthma plan along with an electronic diary (e-Diary/ePEF) to record medication use. Daily use of oral corticosteroids (the number of tablets taken in the previous 12 hours) was recorded once in the morning and once in the evening by the subject using the eDiary/PEF device. In case of use of injectable corticosteroids during certain circumstances (eg. hospitalization) the data was collected on the eCRF (electronic case report form).
The percentage of patients requiring ≥ 7.5 mg systemic corticosteroid dose in mg prednisone/prednisolone (or equivalent) per day continuously for at least 30 days within the on-treatment period is presented in this record.
Measured: Up to 36 weeks
Percentage of Patients With no Systemic Corticosteroids Use
All participants were provided with prednisone/prednisolone (or equivalent) tablets that could be used according to the asthma plan along with an electronic diary (e-Diary/ePEF) to record medication use. Daily use of oral corticosteroids (the number of tablets taken in the previous 12 hours) was recorded once in the morning and once in the evening by the subject using the eDiary/PEF device. In case of use of injectable corticosteroids during certain circumstances (eg. hospitalization) the data was collected on the eCRF (electronic case report form).
The percentage of patients with no systemic corticosteroids use up to visit on Week 36 is presented in this record.
Measured: Week 36
Percentage of Patients With Prescription of Biologic Therapy
As part of the flexible therapy, investigators were allowed to prescribe biologics approved for asthma from randomization visit onwards. Prescription of biologic therapy during the treatment period was recorded.
The proportion of patients with prescription of biologic therapy during the on-treatment period is presented in this record.
Measured: Up to 36 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Aug 2018
- Study start13 Dec 2018
- Primary completion6 Feb 2020
- Study completion6 Feb 2020
Why it stopped: Company decision
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for AsthmaStudies of the same condition, open and under way.
- More trials run by Novartis PharmaceuticalsThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 604 participants (actual)
Sponsor and investigators
- Lead sponsor
- Novartis Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03629249
- Sponsor's protocol ID
- CQAW039A2323
- Other IDs
- 2018-000212-25, 2018
- Status last verified
- Oct 2021
- First submitted
- 9 Aug 2018
- Last updated
- 11 Oct 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.
Study at a glance
From the registry record, last updated by the sponsor on 11 Oct 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 52-week, Multicenter, Randomized, Double-blind, Double-dummy, Parallel-group, Placebo-controlled Study of Fevipiprant Once Daily Plus Standard-of-care (SoC) for Reduction of Systemic Corticosteroids (Oral and Parenteral) Use in Patients With Severe Asthma
- ClinicalTrials.gov ID
- NCT03629249
- Acronym / sponsor ID
- CQAW039A2323
- Conditions
- Asthma
- Keywords
- Asthma, Bronchial Diseases, Respiratory Tract Diseases, Lung Diseases, Obstructive Lung Diseases, Respiratory Hypersensitivity, Hypersensitivity, Immune System Diseases
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- TerminatedReason stopped: Company decision
- Enrolment
- 604 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 13 Dec 2018 (actual)
- Primary completion
- 6 Feb 2020 (actual)
- Study completion
- 6 Feb 2020 (actual)
- First posted
- 14 Aug 2018 (actual)
- Results
- Posted 2 Feb 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The overall purpose of this study was to determine the efficacy of fevipiprant (150 mg and 450 mg once daily), compared with placebo, as add-on to standard-of-care asthma therapy, in terms of avoidance of corticosteroid use over 52 weeks.
Detailed description
This was a randomized, multicenter, double-blind, double-dummy, placebo-controlled, parallel-group study to determine the ability of fevipiprant (QAW039) plus standard-of-care (SoC) compared with placebo plus SoC to reduce the use of systemic corticosteroids (SCS) in patients with severe asthma. The study included:
- a Screening period of up to 2 weeks to assess eligibility;
- a Run-in period of 4 or 10 weeks to evaluate maintenance of asthma control and to collect baseline safety data. The Run-in period was 4 weeks for patients coming with high-dose ICS/LABA (inhaled corticosteroids/long-acting beta-agonist) and 10 weeks for patients switching from mid-dose to high-dose ICS/LABA as per protocol during the run-in period;
- a Treatment period of 52 weeks. Upon completion of the Run-in period, all patients who met eligibility criteria were randomized to 1 of 3 treatment groups (fevipiprant 150 mg or 450 mg or placebo once daily) in a ratio 1:1:1. Randomized patients were stratified according to their peripheral blood eosinophil count (< 250 cells/μl or ≥ 250 cells/μl);
- a Follow-up period of 2 weeks following the last dose of study drug to collect additional data for safety variables.
The main purpose of this study was to determine the efficacy of fevipiprant (150 mg and 450 mg once daily), compared with placebo, as add-on to GINA (Global Initiative for Asthma) treatment step 4 or 5 SoC asthma therapy in terms of avoidance of SCS use over 52 weeks in patients with inadequately controlled severe asthma and high eosinophil counts (eosinophil count at Visit 1 ≥250 cells/ μl) and in the overall patient population regardless of eosinophil counts.
On 16-Dec-2019 the sponsor decided to terminate study CQAW039A2323 earlier than the planned study completion. There were no safety findings with fevipiprant that contributed to this decision. The planned treatment period of 52 weeks was not completed by any patient; patients were treated for a median time of 14 weeks in each group and a maximum of up to 36 weeks.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| QAW039 150 mg | Experimental | Drug: QAW039 150 mg once dailyQAW039 150 mg once daily orally |
| QAW039 450 mg | Experimental | Drug: QAW039 450 mg once dailyQAW039 450 mg once daily orally |
| Placebo | Placebo comparator | Drug: Placebo once dailyPlacebo to QAW039 once daily orally |
Who may qualify
- Ages
- 18 to 84 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Patients with a diagnosis of asthma for a period of at least 3 months prior to Screening Visit with current asthma severity step 4 or 5 (GINA 2018)
- Currently on treatment with medium or high dose ICS/LABA +/- other controller (i.e.long-acting muscarinic antagonist (LAMA), leukotriene receptor antagonist (LTRA) etc. as per GINA) for a minimum of 6 weeks prior to Screening Visit
- At screening, patients with FEV1 of ≤80% of the predicted normal value for the patient, after withholding bronchodilators at Screening Visit and beginning of Run-In Visit
- An increase of ≥12% and ≥200 ml in FEV1 approximately 10 to 15 minutes after administration of 400 mcg of salbutamol/albuterol prior to randomization (documented historical reversibility was accepted).
- Demonstration of inadequate control of asthma based on an ACQ-5 score ≥1.5 at Screening Visit and Treatment Day 1 Visit
Key exclusion criteria (6 listed)
- Asthma exacerbation, within 6 weeks prior to enrollment (screening) that required SCS, hospitalization, or emergency room visit
- Chronic/maintenance use of oral corticosteroids (OCS) for asthma (total OCS use days greater than 6 months; continuously or intermittently) within the last year
- Prior use of biologics that has potential to interfere/ affect asthma disease progression, in the previous 6 months from run-in period.
- Any contraindications of SCS use e.g. diabetes, narrow angle glaucoma, or any other as defined by the treating physician
- Pregnant or nursing (lactating) women
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Placebo once dailyPlacebo to QAW039 once daily (one tablet blinded placebo to QAW039 150 mg and one tablet blinded placebo to QAW039 450 mg). | Drug | Placebo |
| QAW039 150 mg once dailyAlso: fevipiprant 150 mgQAW039 150 mg once daily (one tablet of blinded QAW039 150 mg to be given together with one tablet blinded placebo to QAW039 450 mg) | Drug | QAW039 150 mg |
| QAW039 450 mg once dailyAlso: fevipiprant 450 mgQAW039 450 mg once daily (one tablet of blinded QAW039 450 mg to be given together with one tablet blinded placebo to QAW039 150 mg) | Drug | QAW039 450 mg |
Primary outcome
Total Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Over 52 Weeks in the Overall Population
Time frame: 52 weeks
All participants were provided with prednisone/prednisolone (or equivalent) tablets that could be used according to the asthma plan along with an electronic diary (e-Diary/ePEF). Daily use of oral corticosteroids (number of tablets taken in the previous 12 hours) was recorded once in the morning and once in the evening by the subject in the eDiary/PEF device. In case of use of injectable corticosteroids during certain circumstances (eg. hospitalization) the data was collected on the eCRF (electronic case report form). The total systemic corticosteroids (SCS) dose data was aggregated into monthly data for analysis. For the patients discontinuing treatment early, the total SCS dose for 52 weeks was obtained as annualized SCS dose. For example if patient took 120 mg for 3 months then for 12 months patient will be taking 120*12/3=480mg total SCS dose. The mean values over 52 weeks in the overall patient population regardless of peripheral blood eosinophil counts are reported here.
Total Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Over 52 Weeks in the Subpopulation of Patients With High Eosinophil Count (≥ 250 Cells/µl)
Time frame: 52 weeks
All participants were provided with prednisone/prednisolone (or equivalent) tablets that could be used according to the asthma plan along with an electronic diary (e-Diary/ePEF). Daily use of oral corticosteroids (number of tablets taken in the previous 12 hours) was recorded once in the morning and once in the evening by the subject in the eDiary/PEF device. In case of use of injectable corticosteroids during certain circumstances (eg. hospitalization) the data was collected on the eCRF (electronic case report form). The total systemic corticosteroids (SCS) dose data was aggregated into monthly data for analysis. For the patients discontinuing treatment early, the total SCS dose for 52 weeks was obtained as annualized SCS dose. For example if patient took 120 mg for 3 months then for 12 months patient will be taking 120*12/3=480mg total SCS dose. The mean values over 52 weeks in the subpopulation of patients with high peripheral blood eosinophil count at baseline are reported here.
7 secondary outcomes
Change From Baseline in Daytime Symptom Scores
Time frame: Baseline, up to Week 29-32
Change From Baseline in Nighttime Symptom Scores
Time frame: Baseline, up to Week 29-32
Change From Baseline in ACQ-5 Total Score up to End of Treatment Visit
Time frame: Baseline, up to Week 28
Change From Baseline in AQLQ+12 Total Score up to End of Treatment Visit
Time frame: Baseline, up to Week 28
Percentage of Patients Requiring ≥ 7.5 mg Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Per Day Continuously for at Least 30 Days
Time frame: Up to 36 weeks
Percentage of Patients With no Systemic Corticosteroids Use
Time frame: Week 36
Percentage of Patients With Prescription of Biologic Therapy
Time frame: Up to 36 weeks
Results and safety
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Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Oct 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- A Plain Language Trial Summary is available on novartisclinicaltrials.comLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
120 sites in 21 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing QAW039 150 mg once daily and QAW039 450 mg once daily in people with Asthma, run by Novartis Pharmaceuticals at 120 sites in 21 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: stopped early, as of the sponsor's last update on 11 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 120 sites in Germany, Argentina, Russia, Hungary, United States and 16 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 2 Feb 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Total Systemic Corticosteroid Dose in mg Prednisone/Prednisolone or Equivalent Over 52 Weeks in the Overall Population (time frame: 52 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Oct 2021.