Pulmonary Disease, Chronic ObstructivePhase 2NCT04072887
Dose-range Finding Efficacy and Safety Study for QBW251 in COPD Patients
A Phase 2 study testing QBW251 and COPD maintenance background therapy in people with Pulmonary Disease, Chronic Obstructive, run by Novartis Pharmaceuticals at 148 sites in 26 countries.
Trial summary
This clinical study was designed to support the dose selection for future studies by evaluating efficacy and safety of different QBW251 doses in Chronic obstructive pulmonary disease (COPD) patients with chronic bronchitis and a history of exacerbations, compared to placebo, when added to a triple inhaled therapy of… Read more about this study
- Who is it for?
- Ages 40 years and older
- Conditions the study is for
- Pulmonary Disease, Chronic Obstructive
- What is being tested?
- QBW251 and COPD maintenance background therapy
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 974 participants
- Where
- 148 sitesin 26 countries
- Study dates
- 12 Sep 2019to 1 Feb 2022
- Phase
- Phase 2
- 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 40 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male and female COPD patients aged ≥40 years, who have signed an Informed Consent Form prior to initiation of any study-related procedure.
- Current or ex-smokers who have a smoking history of at least 10 pack years.
- Patients who have been treated with a triple combination of LABA/LAMA/ICS for the last 3 months prior to screening.
- Patients featuring chronic bronchitis
Who cannot join
- Patients who have had a COPD exacerbation that required treatment with antibiotics and/or oral corticosteroids and/or hospitalization, or a respiratory tract infection in the 4 weeks prior to screening, or between screening and randomization.
- Patients with any documented history of asthma, or with an onset of chronic respiratory symptoms, including a COPD diagnosis, prior to age 40 years.
- Patients with a body mass index (BMI) of more than 40 kg/m2.
- Use of other investigational drugs (approved or unapproved) within 30 days or 5 half-lives prior to screening, or until the expected pharmacodynamic effect has returned to baseline (e.g., biologics), whichever is longer; or longer if required by local regulations.
- Pregnant or nursing (lactating) women, and women of childbearing potential not willing to use acceptable effective methods of contraception during study participation.
Trial locations and contacts
148 sites in 26 countries.
148 sites in 26 countries
Japan29 sites
Novartis Investigative Site
Asahikawa, Hokkaido, 070-8644
Novartis Investigative Site
Chuo Ku, Tokyo, 104-0031
Novartis Investigative Site
Chuo-ku, Tokyo, 103-0003
Novartis Investigative Site
Chuo-ku, Tokyo, 103-0028
Novartis Investigative Site
Fukuoka, Fukuoka, 811-1394
Novartis Investigative Site
Fukuoka, Fukuoka, 819-8555
Novartis Investigative Site
Kasuga, Fukuoka, 816-0813
Novartis Investigative Site
Kawachi-Nagano, Osaka, 586-8521
Novartis Investigative Site
Kawasaki, Kanagawa, 210-0852
Novartis Investigative Site
Kishiwada, Osaka, 596-8501
Novartis Investigative Site
Kodaira, Tokyo, 187-0024
Novartis Investigative Site
Koga, Fukuoka, 811 3195
Novartis Investigative Site
Matsusaka, Mie-ken, 515-8544
Novartis Investigative Site
Mizunami, Gifu, 509 6134
Novartis Investigative Site
Nagoya, Aichi-ken, 457 8510
Novartis Investigative Site
Nagoya, Aichi-ken, 457-8511
Novartis Investigative Site
Naka-gun, Ibaraki, 319-1113
Novartis Investigative Site
Osaka, 531-0073
Novartis Investigative Site
Sagamihara, Kanagawa, 252-0392
Novartis Investigative Site
Sapporo, Hokkaido, 062-8618
Novartis Investigative Site
Sendai, Miyagi, 983 8520
Novartis Investigative Site
Setagaya-ku, Tokyo, 158-8531
Novartis Investigative Site
Setagaya-Ku, Tokyo, 157-0072
Novartis Investigative Site
Shinagawa, Tokyo, 140-8522
Novartis Investigative Site
Toshima Ku, Tokyo, 170 0003
Novartis Investigative Site
Toyonaka, Osaka, 560-8552
Novartis Investigative Site
Yamagata, Yamagata, 990-8533
Novartis Investigative Site
Yanagawa, Fukuoka, 832-0059
Novartis Investigative Site
Yokohama, Kanagawa, 223-0059
United States25 sites
Novartis Investigative Site
Andalusia, Alabama, 36420
Novartis Investigative Site
Charlotte, North Carolina, 28207
Novartis Investigative Site
Columbus, Ohio, 43215
Novartis Investigative Site
Crowley, Louisiana, 70526
Novartis Investigative Site
Edina, Minnesota, 55435
Novartis Investigative Site
El Paso, Texas, 79903
Novartis Investigative Site
Florence, Kentucky, 41042
Novartis Investigative Site
Gastonia, North Carolina, 28054
Novartis Investigative Site
Houston, Texas, 77030
Novartis Investigative Site
Livonia, Michigan, 48152
Novartis Investigative Site
Los Angeles, California, 90025
Novartis Investigative Site
McKinney, Texas, 75069
Novartis Investigative Site
Medford, Oregon, 97504
Novartis Investigative Site
Midlothian, Virginia, 23114
Novartis Investigative Site
Minneapolis, Minnesota, 55407
Novartis Investigative Site
New Orleans, Louisiana, 70115
Novartis Investigative Site
Omaha, Nebraska, 68134
Novartis Investigative Site
Ormond Beach, Florida, 32174
Novartis Investigative Site
Saint Charles, Missouri, 63301
Novartis Investigative Site
Sarasota, Florida, 34233
Novartis Investigative Site
Shelby, North Carolina, 28150
Novartis Investigative Site
St Louis, Missouri, 63141
Novartis Investigative Site
Westminster, California, 92683
Novartis Investigative Site
Winter Park, Florida, 32789
Novartis Investigative Site
Zachary, Louisiana, 70791
Germany14 sites
Novartis Investigative Site
Berlin, 10119
Novartis Investigative Site
Berlin, 12157
Novartis Investigative Site
Berlin, 12159
Novartis Investigative Site
Frankfurt, 60596
Novartis Investigative Site
Halle, 06108
Novartis Investigative Site
Hamburg, 20354
Novartis Investigative Site
Landsberg, 86899
Novartis Investigative Site
Leipzig, 04207
Novartis Investigative Site
Leipzig, D-04299
Novartis Investigative Site
Leipzig, D-04347
Novartis Investigative Site
Mainz, 55131
Novartis Investigative Site
Marburg, 35037
Novartis Investigative Site
Mittweida, 09648
Novartis Investigative Site
Witten, 58452
Argentina10 sites
Novartis Investigative Site
Berazategui, Buenos Aires, 1888
Novartis Investigative Site
Ciudad Autonoma de Bs As, C1425FVH
Novartis Investigative Site
Concepción del Uruguay, Entre Ríos Province, 3260
Novartis Investigative Site
Mar del Plata, Buenos Aires, 7600
Novartis Investigative Site
Mendoza, 5500
Novartis Investigative Site
Mendoza, M5500CBA
Novartis Investigative Site
Rosario, Santa Fe Province, S2000AII
Novartis Investigative Site
Rosario, Santa Fe Province, S2000DBS
Novartis Investigative Site
Salta, 4000
Novartis Investigative Site
Santa Fe, S3000FIL
Slovakia7 sites
Novartis Investigative Site
Bardejov, Slovak Republic, 085 01
Novartis Investigative Site
Bojnice, Slovak Republic, 972 01
Novartis Investigative Site
Humenné, Slovak Republic, 066 01
Novartis Investigative Site
Poprad, 058 01
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Prešov, 080 01
Novartis Investigative Site
Spišská Nová Ves, 052 01
Novartis Investigative Site
Vyšné Hágy, 5984
Hungary5 sites
Novartis Investigative Site
Budapest, 1106
Novartis Investigative Site
Gödöllő, 2100
Novartis Investigative Site
Komárom, 2900
Novartis Investigative Site
Makó, 6900
Novartis Investigative Site
Pécs, 7635
Philippines5 sites
Novartis Investigative Site
Bulacan, 3020
Novartis Investigative Site
Iloilo City, Iloilo, 5000
Novartis Investigative Site
Iloilo City, 5000
Novartis Investigative Site
Lipa City, Batangas, 4217
Novartis Investigative Site
Manila, 1000
Australia4 sites
Novartis Investigative Site
Clayton, Victoria, 3168
Novartis Investigative Site
Footscray, Victoria, 3011
Novartis Investigative Site
South Brisbane, Queensland, 4101
Novartis Investigative Site
Spearwood, Western Australia, 6163
Czechia4 sites
Novartis Investigative Site
Liberec, Czech Republic, 460 05
Novartis Investigative Site
Ostrava Poruba, Czech Republic, 708 68
Novartis Investigative Site
Teplice, Czech Republic, 415 01
Novartis Investigative Site
Varnsdorf, 40747
France4 sites
Novartis Investigative Site
Lyon, 69317
Novartis Investigative Site
Montpellier, Herault, 34059
Novartis Investigative Site
Pessac, 33604
Novartis Investigative Site
Reims, 51092
Thailand4 sites
Novartis Investigative Site
Bangkok, 10330
Novartis Investigative Site
Bangkok, 10400
Novartis Investigative Site
Khon Kaen, THA, 40002
Novartis Investigative Site
Songkhla, Hat Yai, 90110
Austria3 sites
Novartis Investigative Site
Feldbach, 8330
Novartis Investigative Site
Grieskirchen, 4710
Novartis Investigative Site
Thalheim bei Wels, 4600
Belgium3 sites
Novartis Investigative Site
Erpent, 5100
Novartis Investigative Site
Leuven, 3000
Novartis Investigative Site
Liège, 4000
Canada3 sites
Novartis Investigative Site
Saint-Charles-Borromée, Quebec, J6E 2B4
Novartis Investigative Site
Sainte-Foy, Quebec, G1V 4G5
Novartis Investigative Site
Sherwood Park, Alberta, T8H 0N2
Denmark3 sites
Novartis Investigative Site
Aalborg, DK 9000
Novartis Investigative Site
Copenhagen, DK-2400
Novartis Investigative Site
Hvidovre, 2650
Guatemala3 sites
Novartis Investigative Site
Guatemala City, GTM, 01010
Novartis Investigative Site
Guatemala City, GTM, 01011
Novartis Investigative Site
Guatemala City, 01011
Italy3 sites
Novartis Investigative Site
Genova, GE, 16132
Novartis Investigative Site
Negrar, VR, 37024
Novartis Investigative Site
Siena, SI, 53100
Poland3 sites
Novartis Investigative Site
Grudziądz, 86-300
Novartis Investigative Site
Katowice, 40-648
Novartis Investigative Site
Zawadzkie, 47-120
South Korea3 sites
Novartis Investigative Site
Daegu, 705703
Novartis Investigative Site
Incheon, 21431
Novartis Investigative Site
Seoul, Seocho Gu, 06591
Spain3 sites
Novartis Investigative Site
Alzira, Valencia, 46600
Novartis Investigative Site
Girona, 17005
Novartis Investigative Site
Marbella, Andalusia, 29603
Greece2 sites
Novartis Investigative Site
Heraklion Crete, Greece, 711 10
Novartis Investigative Site
Thessaloniki, GR, 570 10
Hong Kong2 sites
Novartis Investigative Site
New Territories, Hong Kong
Novartis Investigative Site
Pokfulam, Hong Kong
Netherlands2 sites
Novartis Investigative Site
Eindhoven, 5623 EJ
Novartis Investigative Site
Harderwijk, 3840 AC
Turkey (Türkiye)2 sites
Novartis Investigative Site
Adana, 01330
Novartis Investigative Site
Mersin, 33079
About this study
Official title: A 24-week Multi-center, Double-blind, Placebo Controlled Dose-range Finding Study to Investigate the Efficacy and Safety of Oral QBW251 in COPD Patients on Triple Inhaled Therapy (LABA / LAMA / ICS)
This clinical study was designed to support the dose selection for future studies by evaluating efficacy and safety of different QBW251 doses in Chronic obstructive pulmonary disease (COPD) patients with chronic bronchitis and a history of exacerbations, compared to placebo, when added to a triple inhaled therapy of LABA, LAMA and ICS.
Read the detailed description
This study used a 6 treatment arm, parallel-group, randomized, double-blind study design. 974 male and female COPD patients were randomized into the trial. The study consisted of four distinct study periods:
- Screening (Weeks -3 to -2): Participants underwent a screening period of 1 week where were assessed for eligibility and tapered off disallowed medications.
- Run-in (Days -14 to 1): Subsequently, participants entered the run-in period of up to 2 weeks to establish baseline values for symptom assessments, to standardize the COPD background therapy (triple combination LABA/LAMA/ICS), and to complete eligibility assessments.
- Treatment (Day 1 to Week 24): Eligible participants moved into the Day 1 visit where they were stratified according to their smoking status (current or ex-smoker) and severity of airflow limitation (FEV1 ≥ 30% to < 50% and ≥ 50% to < 80%) and then randomized into 1 of 6 treatment arms with a randomization ratio of 2:2:1:1:1:2 (450 mg b.i.d., 300 mg b.i.d., 150 mg b.i.d., 75 mg b.i.d., 25 mg b.i.d., placebo). The treatment period consisted of 24 weeks, during which the participant returned to the site for regular visits (Day 1 - Week 24). QBW251 450 mg arm was discontinued early based on a pre-defined pharmacokinetic exposure stopping rule.
- Follow-up (Weeks 25-28): Upon completion of the treatment period, participants were followed up for safety assessments for 30 days.
- Conditions
- Pulmonary Disease, Chronic Obstructive
- Being tested
- QBW251, Placebo, COPD maintenance background therapy
- Keywords
- COPD
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
QBW251Drug
QBW251 oral capsules (450, 300, 150, 75 and 25 mg) of identical appearance to ensure blinding administered twice a day (b.i.d) for 24 weeks
PlaceboDrug
Placebo oral capsules administered twice a day for 24 weeks
COPD maintenance background therapyDrug
Combination of fluticasone furoate, vilanterol and umeclidinium bromide
| Study group | Role | What they receive |
|---|---|---|
| QBW251 450 mg | Experimental | QBW251 was orally administered 450 mg b.i.d for 24 weeks Receives: Drug: QBW251; Drug: COPD maintenance background therapy |
| QBW251 300 mg | Experimental | QBW251 was orally administered 300 mg b.i.d for 24 weeks Receives: Drug: QBW251; Drug: COPD maintenance background therapy |
| QBW251 150 mg | Experimental | QBW251 was orally administered 150 mg b.i.d for 24 weeks Receives: Drug: QBW251; Drug: COPD maintenance background therapy |
| QBW251 75 mg | Experimental | QBW251 was orally administered 75 mg b.i.d for 24 weeks Receives: Drug: QBW251; Drug: COPD maintenance background therapy |
| QBW251 25 mg | Experimental | QBW251 was orally administered 25 mg b.i.d for 24 weeks Receives: Drug: QBW251; Drug: COPD maintenance background therapy |
| Placebo | Placebo comparator | Placebo was orally administered b.i.d for 24 weeks Receives: Drug: Placebo; Drug: COPD maintenance background therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) at Week 12
The primary efficacy analysis assessed the effect of QBW251 on the absolute change from baseline in trough FEV1 in liters on Week 12. Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Baseline measurement was defined as the baseline visit pre-bronchodilator spirometry assessment.
Change from baseline in the FEV1 mean scores were analyzed using a Mixed Model for Repeated Measures (MMRM): treatment + baseline score + smoking status at screening + run-in FEV1 + airflow limitation severity + region + time interval + treatment*time interval interaction + baseline score*time interval interaction.
Measured: Baseline and Week 12
Secondary outcomes (10)
Change From Baseline in Forced Expiratory Volume in One Second (FEV1)
The primary efficacy analysis assessed the effect of QBW251 on the absolute change from baseline in trough FEV1 in liters compared to placebo on Weeks 4, 8, 16, 20 and 24. Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Baseline measurement was defined as the baseline visit pre-bronchodilator spirometry assessment. A positive trend for change from baseline in FEV1 across the dose range is considered a favorable outcome.
Measured: Baseline, weeks 4, 8, 16, 20 and 24
Change From Baseline in Evaluating Respiratory Symptoms (E-RS); Total Score
The E-RS assesses overall daily respiratory COPD symptoms (Total score) and it is derived as the sum of 11 severity items; a higher scores indicate more severe symptoms. E-RS total score has a range of 0 to 40.
Change from baseline in the E-RS Total weekly mean scores were analyzed using a Mixed Model for Repeated Measures (MMRM): treatment + baseline score + smoking status at screening + run-in E-RS + airflow limitation severity + region + time interval + treatment*time interval interaction + baseline score*time interval interaction.
The mean baseline E-RS Total score was the average of the corresponding daily scores from the run-in period.
A negative change from baseline corresponds to improvement in symptoms severity.
Measured: Baseline, weeks 12 and 24
Change From Baseline in Evaluating Respiratory Symptoms (E-RS); Cough and Sputum Score
The E-RS assesses both overall daily respiratory COPD symptoms (Total score) and specific respiratory symptoms using 3 subscales (Breathlessness, Cough \& Sputum, and Chest Symptoms). The E-RS comprises 11 severity items and higher scores indicate more severe symptoms. The Cough and Sputum subscale score has a range of 0 to 11 and was derived as the sum of items 2 - 4.
Change from baseline in the E-RS Cough and Sputum weekly mean scores were analyzed using a Mixed Model for Repeated Measures (MMRM): treatment + baseline score + smoking status at screening + run-in E-RS + airflow limitation severity + region + time interval + treatment*time interval interaction + baseline score*time interval interaction.
The mean baseline E-RS Cough \& Sputum subscale score was the average of the corresponding daily scores from the run-in period. Lower scores in the change from baseline correspond to lower symptom severity.
Measured: Baseline, weeks 12 and 24
Number of Participants With a "Better" Change in the Patient Global Impression of Severity (PGI-S) From Baseline
The PGI-S questionnaire is a patient-reported outcomes score that rates the severity of the respiratory symptoms and of cough and mucus. The change in severity scores (Better, No change and Worse) from baseline were reported at weeks 12 and 24. Thus, the number of participants with a Better change in the severity score are reported in the table below.
Measured: Baseline, weeks 12 and 24
Change From Baseline in the Cough and Sputum Assessment Questionnaire (CASA-Q)
The CASA-Q is a validated questionnaire instrument used to measure cough and sputum production, and their impact in patients COPD and/or chronic bronchitis. It contains a total of 20 items on a 5-step scale distributed in 4 domains: Cough symptoms, Cough impact, Sputum symptoms and Sputum impact. All items are rescored from 1-5 to 0-4 and then reverse scored such that better responses have higher scores. The four domains are ranged from 0-100 where higher scores associated with fewer symptoms/less impact due to cough or sputum.
Change from baseline in the CASA-Q cough and symptoms scores were analyzed using a Mixed Model for Repeated Measures (MMRM): treatment + baseline score + smoking status at screening + run-in E-RS + airflow limitation severity + region + time interval + treatment*time interval interaction + baseline score*time interval interaction.
Measured: Baseline, weeks 12 and 24
Change From Baseline in St. George's Respiratory Questionnaire (SGRQ)
SGRQ measures health impairment and contains 50 items divided into three components: Symptoms, Activity and Impacts. A score was calculated for each component and a "Total" score was also calculated. In each case the lowest possible value is zero and the highest 100. Higher values correspond to greater impairment of quality of life.
Change from baseline in the SGRQ scores were analyzed using a Mixed Model for Repeated Measures (MMRM): treatment + baseline score + smoking status at screening + baseline SGRQ score + airflow limitation severity + region + time interval + treatment*time interval interaction + baseline score*time interval interaction.
Measured: Baseline, weeks 12 and 24
Minimum Plasma Concentration (Cmin) for QBW251
Venous whole blood samples were collected for pharmacokinetics characterization. Cmin was measured pre dose at all visits and was summarized using descriptive statistics. All concentrations below the lower limit of quantification (LLOQ) were treated as zero.
Measured: Pre-dose on Days 15, 29, 57, 85, 113, 141 and 169
Maximum Plasma Concentration (Cmax) for QBW251
Venous whole blood samples were collected for pharmacokinetics characterization. Cmax was calculated from plasma concentration data using non-compartmental methods and summarized using descriptive statistics. Cmax was measured in the samples taken at 3 hours post-dose with the exception of the participants included in the Serial PK set on Days 1 and 15 for whom all samples (1, 2, 4, 6, and 8 hours post-dose) were taken into consideration for the measurement of Cmax. All concentrations below the lower limit of quantification (LLOQ) were treated as zero.
Measured: Days 1, 15 and 169
Maximum Plasma Concentration (Cmax) for QBW251 in Serial PK Set
Venous whole blood samples were collected for pharmacokinetics characterization. Cmax was calculated from plasma concentration data using non-compartmental methods and summarized using descriptive statistics. All concentrations below the lower limit of quantification (LLOQ) were treated as zero.
Measured: 1, 2, 4, 6, and 8 hours post-dose on Days 1 and 15
Area Under the Curve From Time 0 to 24 Hours (AUC0-24h) of QBW251 in Serial PK Set
Venous whole blood samples were collected for pharmacokinetics characterization. AUC0-24h was calculated from plasma concentration-time data using non-compartmental methods and summarized using descriptive statistics. All concentrations below the lower limit of quantification (LLOQ) were treated as zero.
Measured: 1, 2, 4, 6, and 8 hours post-dose on Days 1 and 15
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Aug 2019
- Study start12 Sep 2019
- Primary completion8 Oct 2021
- Study completion1 Feb 2022
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.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Pulmonary Disease, Chronic ObstructiveStudies 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 974 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
- NCT04072887
- Sponsor's protocol ID
- CQBW251B2201
- Other IDs
- 2018-003197-28, 2018
- Status last verified
- Apr 2023
- First submitted
- 7 Aug 2019
- Last updated
- 28 Apr 2023
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- 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
Publications
Martinez FJ, Criner GJ, Gessner C, Jandl M, Scherbovsky F, Shinkai M, Siler TM, Vogelmeier CF, Voves R, Wedzicha JA, Bartels C, Bottoli I, Byiers S, Cardenas P, Eckert JH, Gutzwiller FS, Knorr B, Kothari M, Parlikar R, Tanase AM, Franssen FME. Icenticaftor, a CFTR Potentiator, in COPD: A Multicenter, Parallel-Group, Double-Blind Clinical Trial. Am J Respir Crit Care Med. 2023 Aug 15;208(4):417-427. doi: 10.1164/rccm.202303-0458OC.
PubMed 37411039
Study at a glance
From the registry record, last updated by the sponsor on 28 Apr 2023. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A 24-week Multi-center, Double-blind, Placebo Controlled Dose-range Finding Study to Investigate the Efficacy and Safety of Oral QBW251 in COPD Patients on Triple Inhaled Therapy (LABA / LAMA / ICS)
- ClinicalTrials.gov ID
- NCT04072887
- Acronym / sponsor ID
- CQBW251B2201
- Conditions
- Pulmonary Disease, Chronic Obstructive
- Keywords
- COPD
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 974 participants (actual)
- Lead sponsor
- Novartis PharmaceuticalsIndustry (pharma, biotech, devices)
- Study start
- 12 Sep 2019 (actual)
- Primary completion
- 8 Oct 2021 (actual)
- Study completion
- 1 Feb 2022 (actual)
- First posted
- 28 Aug 2019 (actual)
- Results
- Posted 28 Apr 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This clinical study was designed to support the dose selection for future studies by evaluating efficacy and safety of different QBW251 doses in Chronic obstructive pulmonary disease (COPD) patients with chronic bronchitis and a history of exacerbations, compared to placebo, when added to a triple inhaled therapy of LABA, LAMA and ICS.
Detailed description
This study used a 6 treatment arm, parallel-group, randomized, double-blind study design. 974 male and female COPD patients were randomized into the trial. The study consisted of four distinct study periods:
- Screening (Weeks -3 to -2): Participants underwent a screening period of 1 week where were assessed for eligibility and tapered off disallowed medications.
- Run-in (Days -14 to 1): Subsequently, participants entered the run-in period of up to 2 weeks to establish baseline values for symptom assessments, to standardize the COPD background therapy (triple combination LABA/LAMA/ICS), and to complete eligibility assessments.
- Treatment (Day 1 to Week 24): Eligible participants moved into the Day 1 visit where they were stratified according to their smoking status (current or ex-smoker) and severity of airflow limitation (FEV1 ≥ 30% to < 50% and ≥ 50% to < 80%) and then randomized into 1 of 6 treatment arms with a randomization ratio of 2:2:1:1:1:2 (450 mg b.i.d., 300 mg b.i.d., 150 mg b.i.d., 75 mg b.i.d., 25 mg b.i.d., placebo). The treatment period consisted of 24 weeks, during which the participant returned to the site for regular visits (Day 1 - Week 24). QBW251 450 mg arm was discontinued early based on a pre-defined pharmacokinetic exposure stopping rule.
- Follow-up (Weeks 25-28): Upon completion of the treatment period, participants were followed up for safety assessments for 30 days.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| QBW251 450 mg | Experimental | Drug: QBW251, Drug: COPD maintenance background therapyQBW251 was orally administered 450 mg b.i.d for 24 weeks |
| QBW251 300 mg | Experimental | Drug: QBW251, Drug: COPD maintenance background therapyQBW251 was orally administered 300 mg b.i.d for 24 weeks |
| QBW251 150 mg | Experimental | Drug: QBW251, Drug: COPD maintenance background therapyQBW251 was orally administered 150 mg b.i.d for 24 weeks |
| QBW251 75 mg | Experimental | Drug: QBW251, Drug: COPD maintenance background therapyQBW251 was orally administered 75 mg b.i.d for 24 weeks |
| QBW251 25 mg | Experimental | Drug: QBW251, Drug: COPD maintenance background therapyQBW251 was orally administered 25 mg b.i.d for 24 weeks |
| Placebo | Placebo comparator | Drug: Placebo, Drug: COPD maintenance background therapyPlacebo was orally administered b.i.d for 24 weeks |
Who may qualify
- Ages
- 40 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Male and female COPD patients aged ≥40 years, who have signed an Informed Consent Form prior to initiation of any study-related procedure.
- Current or ex-smokers who have a smoking history of at least 10 pack years.
- Patients who have been treated with a triple combination of LABA/LAMA/ICS for the last 3 months prior to screening.
- Patients featuring chronic bronchitis
Key exclusion criteria (5 listed)
- Patients who have had a COPD exacerbation that required treatment with antibiotics and/or oral corticosteroids and/or hospitalization, or a respiratory tract infection in the 4 weeks prior to screening, or between screening and randomization.
- Patients with any documented history of asthma, or with an onset of chronic respiratory symptoms, including a COPD diagnosis, prior to age 40 years.
- Patients with a body mass index (BMI) of more than 40 kg/m2.
- Use of other investigational drugs (approved or unapproved) within 30 days or 5 half-lives prior to screening, or until the expected pharmacodynamic effect has returned to baseline (e.g., biologics), whichever is longer; or longer if required by local regulations.
- Pregnant or nursing (lactating) women, and women of childbearing potential not willing to use acceptable effective methods of contraception during study participation.
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 |
|---|---|---|
| QBW251QBW251 oral capsules (450, 300, 150, 75 and 25 mg) of identical appearance to ensure blinding administered twice a day (b.i.d) for 24 weeks | Drug | QBW251 150 mg, QBW251 25 mg, QBW251 300 mg, QBW251 450 mg, QBW251 75 mg |
| PlaceboPlacebo oral capsules administered twice a day for 24 weeks | Drug | Placebo |
| COPD maintenance background therapyCombination of fluticasone furoate, vilanterol and umeclidinium bromide | Drug | Placebo, QBW251 150 mg, QBW251 25 mg, QBW251 300 mg, QBW251 450 mg, QBW251 75 mg |
Primary outcome
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) at Week 12
Time frame: Baseline and Week 12
The primary efficacy analysis assessed the effect of QBW251 on the absolute change from baseline in trough FEV1 in liters on Week 12. Forced Expiratory Volume in one second (FEV1) is calculated as the volume of air forcibly exhaled in one second as measured by a spirometer. Baseline measurement was defined as the baseline visit pre-bronchodilator spirometry assessment. Change from baseline in the FEV1 mean scores were analyzed using a Mixed Model for Repeated Measures (MMRM): treatment + baseline score + smoking status at screening + run-in FEV1 + airflow limitation severity + region + time interval + treatment*time interval interaction + baseline score*time interval interaction.
10 secondary outcomes
Change From Baseline in Forced Expiratory Volume in One Second (FEV1)
Time frame: Baseline, weeks 4, 8, 16, 20 and 24
Change From Baseline in Evaluating Respiratory Symptoms (E-RS); Total Score
Time frame: Baseline, weeks 12 and 24
Change From Baseline in Evaluating Respiratory Symptoms (E-RS); Cough and Sputum Score
Time frame: Baseline, weeks 12 and 24
Number of Participants With a "Better" Change in the Patient Global Impression of Severity (PGI-S) From Baseline
Time frame: Baseline, weeks 12 and 24
Change From Baseline in the Cough and Sputum Assessment Questionnaire (CASA-Q)
Time frame: Baseline, weeks 12 and 24
Change From Baseline in St. George's Respiratory Questionnaire (SGRQ)
Time frame: Baseline, weeks 12 and 24
Minimum Plasma Concentration (Cmin) for QBW251
Time frame: Pre-dose on Days 15, 29, 57, 85, 113, 141 and 169
Maximum Plasma Concentration (Cmax) for QBW251
Time frame: Days 1, 15 and 169
Maximum Plasma Concentration (Cmax) for QBW251 in Serial PK Set
Time frame: 1, 2, 4, 6, and 8 hours post-dose on Days 1 and 15
Area Under the Curve From Time 0 to 24 Hours (AUC0-24h) of QBW251 in Serial PK Set
Time frame: 1, 2, 4, 6, and 8 hours post-dose on Days 1 and 15
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Apr 2023.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37411039Martinez FJ, Criner GJ, Gessner C, Jandl M, Scherbovsky F, Shinkai M, Siler TM, Vogelmeier CF, Voves R, Wedzicha JA, Bartels C, Bottoli I, Byiers S, Cardenas P, Eckert JH, Gutzwiller FS, Knorr B, Kothari M, Parlikar R, Tanase AM, Franssen FME. Icenticaftor, a CFTR Potentiator, in COPD: A Multicenter, Parallel-Group, Double-Blind Clinical Trial. Am J Respir Crit Care Med. 2023 Aug 15;208(4):417-427. doi: 10.1164/rccm.202303-0458OC.
- 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.
148 sites in 26 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing QBW251 and COPD maintenance background therapy in people with Pulmonary Disease, Chronic Obstructive, run by Novartis Pharmaceuticals at 148 sites in 26 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 4 inclusion and 5 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: finished, as of the sponsor's last update on 28 Apr 2023. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 148 sites in Japan, United States, Germany, Argentina, Slovakia and 21 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 28 Apr 2023). 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?
Change From Baseline in Forced Expiratory Volume in One Second (FEV1) at Week 12 (time frame: Baseline and Week 12). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04072887, which also lists 1 linked publication.
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 28 Apr 2023.