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AsthmaPhase 3XPERTTNCT04206761

Investigating the Effects of QVM149 on MRI Ventilation Defects

A Phase 3 study testing QVM149 and High Dose Dual Therapy (ICS/LABA) in people with Asthma, run by Dr. Grace Parraga at 1 site in Canada.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

The purpose of this study is to compare treatment with QVM149, an inhaler that contains three types of asthma medications compared to an inhaler that contains two types of asthma medications. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Asthma
What is being tested?
QVM149 and High Dose Dual Therapy (ICS/LABA)
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteCanada
Study dates
1 Dec 2021to 1 Dec 2022
Phase
Phase 3
Are there results?
None posted in the registry

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 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent must be directly obtained from legally competent participants before any study- related assessment is performed.
  • Male and female adult participant ≥ 18 years of age and ≤ 80 years of age.
  • Participants with a confirmed clinical diagnosis of asthma by a respirologist for a period of at least 6 months prior to Visit 101.
  • Participants who demonstrate reversibility in FEV1 by one of :
  • Increase in forced expiratory volume in one second (FEV1) of ≥ 12% and 200 ml 15 to 30 minutes after administration of 400μg salbutamol at Visit 101
  • Documented increase in FEV1 of ≥ 12% and 200 ml 15 to 30 minutes after administration of 400μg salbutamol in past 24 months
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  • Documented increase in FEV1 of ≥ 12% and 200 ml after treatment for asthma (e.g. treatment with ICS) in past 24 months
  • Documented positive methacholine challenge in past 24 months
  • Participants who have used high dose dual therapy (ICS/LABA) for asthma for at least 3 months and at a stable dose equivalent to high dose ICS for at least 1 month prior to Visit 101 (please refer to Table 1-1 for ICS dosages).
  • Participants with visually obvious MRI ventilation defects at Visit 102.
  • Pre-bronchodilator FEV1 of < 85% of the predicted normal value for the participant after withholding bronchodilators prior to spirometry at Visit 101.

Who cannot join

  • Participants meeting contraindications for undergoing an MRI such as participants with MRI-sensitive implants, tattoos with MRI-sensitive dye and severe claustrophobia.
  • Currently smoking or vaping any substance (e.g. nicotine, cannabis) at Visit 101 or within 12 months of visit 101.
  • Ex-smoker of nicotine or cannabis with a smoking history of ≥ 10 pack years or 20 joint years (Note: 1 pack is equivalent to 20 cigarettes. 10 pack years = 1 pack /day x 10 yrs., or ½ pack/day x 20 yrs. 1 joint year is equivalent to 1 joint/day x 1 year)
  • Participants diagnosed with Chronic Obstructive Pulmonary Disease (COPD). Diagnoses of asthma- COPD overlap syndrome may be eligible.
  • Participants who have had an asthma attack/exacerbation requiring systemic steroids, hospitalization and/or emergency room visit within 6 weeks of Visit 101 or a respiratory tract infection requiring antibiotics within 4 weeks prior to Visit 101. If participants experience an asthma attack/exacerbation requiring systemic steroids or hospitalization or emergency room visit between Visit 101 and Visit 201, they will be withdrawn from the study but may be re-screened 4 weeks after recovery from the exacerbation.
  • Participants treated with a LAMA for asthma within 3 months prior to Visit 101.
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  • Participants with narrow-angle glaucoma, symptomatic benign prostatic hyperplasia (BPH) or bladder- neck obstruction or severe renal impairment or urinary retention. BPH participants who are stable on treatment can be considered.
  • Participants with a history of chronic lung diseases other than asthma, including (but not limited to) sarcoidosis, interstitial lung disease, cystic fibrosis, clinically significant bronchiectasis and active tuberculosis.
  • Use of other investigational drugs within 30 days (e.g. small molecules) / or until the expected pharmacodynamic effect has returned to baseline (e.g. biologics), whichever is longer.
  • History of hypersensitivity to any of the study treatments or its excipients or to other drugs of similar chemical classes.
  • Participants with paroxysmal (e.g., intermittent) atrial fibrillation are excluded. Participants 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, digoxin or ablation therapy) for at least 6 months may be considered for inclusion. In such participants, atrial fibrillation must be present at Visit 101 with a resting ventricular rate < 100/min.
  • Participants with a history of myocardial infarction within 12 months prior to Visit 101.
  • Concomitant use of agents known to prolong the QT interval unless it can be discontinued for the duration of study. Decisions about the discontinuation of such agents will be made between the Qualified Investigator and participant.
  • Participants 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). These participants may not be rescreened.
  • Participants with a history of lactose intolerance and hypersensitivity to any of the study drugs or its excipients, or to similar drugs within the class including untoward reactions to sympathomimetic amines or inhaled medication or any component thereof.
  • Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive human chorionic gonadotropin (hCG) laboratory test.
  • Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using highly effective methods of contraception during dosing of study treatment and follow-up period. Highly effective contraception methods include:
  • True sexual abstinence with male partner(s) (when this is in line with the preferred and usual lifestyle of the participant). Periodic abstinence (e.g., calendar, ovulation, symptom-thermal, post ovulation methods) and withdrawal are not acceptable methods of contraception.
  • Female sterilization (have had surgical tubal ligation, bilateral oophorectomy with or without hysterectomy), total hysterectomy or tubal ligation at least six weeks before taking study treatment. In case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow up hormone level assessment.
  • Vasectomized male partner(s) (at least 6 months prior to Visit 101).
  • Use hormonal contraception with failure rate <1% (e.g. oral contraceptive pill, Depo-Provera™ injections, Erva Patch™ or Nuvaring™).
  • Placement of an MRI safe intrauterine device (IUD) or intrauterine system (IUS).
  • In case of use of hormonal contraception, women should have been stable on the same pharmacological agent for a minimum of 3 months before Visit 101. Women are considered post-menopausal and not of child-bearing potential if they have had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g. age appropriate, history of vasomotor symptoms) or have had surgical bilateral oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks ago. In the case of oophorectomy alone, only when the reproductive status of the woman has been confirmed by follow-up hormone level assessment is she considered not of childbearing potential.

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Robarts Research Insitute; The University of Western Ontario; London Health Sciences Centre

    London, Ontario, N6A 5B7

Other trials in Canada

About this study

Official title: Xenon MRI Probing vEntilation Response to Triple Therapy (QVM149)

The purpose of this study is to compare treatment with QVM149, an inhaler that contains three types of asthma medications compared to an inhaler that contains two types of asthma medications. Both inhalers contain an inhaled corticosteroid, which reduces inflammation in the lungs, and a medication that helps to open up the airways. The investigational inhaler, QVM149, contains a third medication that also works to open up the airways. The investigators will measure the difference in these two treatments with magnetic resonance imaging (MRI) using a special technique using xenon gas to show how gas spreads in the lungs. In healthy lungs, the gas fills the lungs evenly, but in unhealthy lungs, the gas may fill the lungs unevenly and they will appear patchy. The patchy areas are called ventilation defects. A CT of the chest will be done to assess the structure of the lungs. The investigators will also use lung function testing and questionnaires to evaluate the differences between these therapies.

Read the detailed description

A single site, two arm, randomized, open-label study in participants with asthma, who demonstrate visually obvious ventilation defects despite being on ICS/LABA was chosen to evaluate the capability of QVM149 150/50/160 μg once daily as compared to high dose dual therapy (ICS/LABA) to improve ventilation heterogeneity. According to the design of the study, hyperpolarized Xenon-129 (129Xe) will be used to measure ventilation defects in asthma participants as ventilation defect percent (VDP). A low-dose chest CT acquired within a few minutes of MRI will provide a way to measure both airway and parenchymal abnormalities. The selection of the QVM149 150/50/160 μg was made in order to keep the ICS dose equipotent to baseline therapy and to the active comparator arm and to directly compare the addition of a long-acting muscarinic antagonist (LAMA) versus continuing the therapy with high dose dual therapy (ICS/LABA).

This study will be a single site, two arm, randomized, open-label study with the following treatment:

  • Treatment A: 2-week treatment with Indacaterol/Glycopyrronium/Mometasone 150/50/160 μg delivered as powder in hard capsules via Breezhaler, a breath-activated device which will deliver a specific dose of medication.
  • Treatment B: 2-week treatment with high dose dual therapy (ICS/LABA) in any approved drug formulation and delivery device. (Continue receiving high dose ICS/LABA therapy at the same dose and in the same formulation as at baseline).

The study will consist of a screening/inclusion period of 1-5 days, followed by a treatment period of 14 days. The evaluation team including MRI observers will be blinded to treatment.

At Visit 101, informed consent will be obtained before any study related assessments or procedures are performed. Asthma medications and eligibility criteria will be reviewed. Furthermore, at Visit 101, safety assessments including electrocardiography (ECG), hematology, blood chemistry, urinalysis, and spirometry to test reversibility will be performed. Once the above criteria are met, participants will move on to Visit 102.

At Visit 102 all additional assessments, including MRI to detect visually obvious ventilation defects, low-dose chest CT, and Pulmonary Function Test assessments including spirometry, plethysmography, Lung Clearance Index (LCI) and Forced Oscillation Technique (FOT) will be conducted. Participants who qualify will then be randomized and entered into the 14 days treatment period and continue with the assessments according to study protocol. Participants will be supplied with open-label Indacaterol/Glycopyrronium/ Mometasone 150/50/160 μg o.d. delivered as powder in hard capsules via Breezhaler or continue with their previously prescribed high dose dual therapy (ICS/LABA) in any approved drug formulation and delivery device, which will be used during the study treatment period and stopped at Visit 201.

Upon completion of the study treatment period at Visit 201, all participants will undergo post-treatment assessments, including MRI, pre- and post-salbutamol pulmonary function testing including spirometry, plethysmography, LCI, FOT, and asthma questionnaires.

A final visit, Visit 301 will be scheduled for safety assessments. All participants will undergo vital signs, spirometry, ECG, bloodwork and urinalysis.

Conditions
Asthma
Being tested
QVM149, High Dose Dual Therapy (ICS/LABA)
Keywords
QVM149, Indacaterol, Glycopyrronium, Mometasone, Xenon, Triple Therapy
Medical subject headings
Asthma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • QVM149Drug

    Also called indacaterol acetate/glycopyrronium bromide/mometasone furoate

    QVM149 is an investigational drug consisting of 150μg indacaterol acetate, 50μg glycopyrronium bromide and 160μg mometasone furoate. The drug is delivered as powder in hard capsules via Breezhaler, a breath-activated device which will deliver a specific dose of medication

  • High Dose Dual Therapy (ICS/LABA)Drug

    High dose inhaled corticosteroid (ICS)/long-acting beta2-agonist (LABA) in any approved drug formulation and delivery device.

Study groups in NCT04206761
Study groupRoleWhat they receive
Treatment - QVM149ExperimentalParticipants will complete a two week treatment with QVM149 (indacaterol acetate/glycopyrronium bromide/mometasone furoate) 150/50/160 μg delivered as powder in hard capsules via Breezhaler, a breath-activated device which will deliver a specific dose of medication via inhalation.
Receives: Drug: QVM149
ControlActive comparatorParticipants will continue their clinically prescribed treatment with a high dose dual therapy of Inhaled Corticosteroid (ICS)/Long-Acting Beta2-Agonist (LABA) in any approved drug formulation and delivery device for the treatment period of two weeks. (Participants will continue receiving high dose ICS/LABA therapy at the same dose and in the same formulation as at baseline).
Receives: Drug: High Dose Dual Therapy (ICS/LABA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline airway function measured using 129-Xenon MRI ventilation defect percent at the end of 2 weeks of treatment with QVM149 150/50/160 μg once daily

    Change in VDP

    Measured: Day 0 and 14

  2. Difference in change from baseline airway function measured using 129-Xenon MRI ventilation defect percent after 2 weeks use of QVM149 150/50/160 μg once daily compared to high dose dual therapy (ICS/LABA)

    Difference in change in VDP

    Measured: Day 0 and 14

Secondary outcomes (26)
  1. Explore univariate correlation and linear regression of MRI ventilation defect percent and forced expiration volume in one second.

    The relationship between ventilation defect percent and forced expiration volume in one second will be assessed using univariate correlation analysis and linear regression. This information gives insight into the relationship between pulmonary function and structure.

    Measured: Day 14

  2. Explore univariate correlation and linear regression of MRI ventilation defect percent and forced vital capacity

    The relationship between ventilation defect percent and forced vital capacity will be assessed using univariate correlation analysis and linear regression. This information gives insight into the relationship between pulmonary function and structure.

    Measured: Day 14

  3. Explore univariate correlation and linear regression of MRI ventilation defect percent and lung volumes

    The relationship between ventilation defect percent and lung volumes will be assessed using univariate correlation analysis and linear regression. This information gives insight into the relationship between pulmonary function and structure.

    Measured: Day 14

  4. Explore univariate correlation and linear regression of MRI ventilation defect percent and forced oscillation technique

    The relationship between ventilation defect percent and forced oscillation technique will be assessed using univariate correlation analysis and linear regression. This information gives insight into the relationship between pulmonary function, structure and inflammation.

    Measured: Day 14

  5. Explore univariate correlation and linear regression of MRI ventilation defect percent and lung clearance index

    The relationship between ventilation defect percent and lung clearance index will be assessed using univariate correlation analysis and linear regression. This information gives insight into the relationship between pulmonary function and structure.

    Measured: Day 14

  6. Explore univariate correlation and linear regression of MRI ventilation defect percent and asthma control as measured by the Asthma Control Questionnaire

    The relationship between ventilation defect percent and asthma control, as measured by the Asthma Control Questionnaire (ACQ-6) will be assessed using a univariate correlation analysis and linear regression. The ACQ-6 is scored from 0 to 6, with higher scores indicating more uncontrolled asthma.

    Measured: Day 14

  7. Explore univariate correlation and linear regression of MRI ventilation defect percent and asthma-related quality of life as measured by the Asthma Quality of Life Questionnaire

    The relationship between ventilation defect percent and asthma-related quality of life as measured by the Asthma Quality of Life Questionnaire with Standardised Activities (AQLQ(S)) will be assessed using a univariate correlation analysis and linear regression. The AQLQ(S) is scored from 1-7, with lower scores indicating more severe impairment.

    Measured: Day 14

  8. Explore univariate correlation and linear regression of MRI ventilation defect percent and daily life and perceived well-being as measured by the St. George's Respiratory Questionnaire

    The relationship between ventilation defect percent and daily life and perceived well-being as measured by the St. George's Respiratory Questionnaire (SGRQ) will be assessed using univariate correlation analysis and linear regression. The SGRQ is scored from 0-100 with higher scores indicating more limitations.

    Measured: Day 14

  9. Change from baseline forced expiration volume in one second

    Indicator of pulmonary function

    Measured: Day 0 and 14

  10. Difference in change from baseline forced expiration volume in one second after use of QVM149 compared to high dose dual therapy.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  11. Change from baseline forced vital capacity

    Indicator of pulmonary function

    Measured: Day 0 and 14

  12. Difference in change from baseline forced vital capacity after use of QVM149 compared to high dose dual therapy.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  13. Change from baseline residual volume.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  14. Difference in change from baseline residual volume after use of QVM149 compared to high dose dual therapy.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  15. Change from baseline total lung capacity.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  16. Difference in change from baseline total lung capacity after use of QVM149 compared to high dose dual therapy.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  17. Change from baseline forced oscillation technique

    Indicator of pulmonary function and inflammation

    Measured: Day 0 and 14

  18. Difference in change from baseline forced oscillation technique after use of QVM149 compared to high dose dual therapy.

    Indicator of pulmonary function and inflammation

    Measured: Day 0 and 14

  19. Change from baseline lung clearance index

    Indicator of pulmonary function

    Measured: Day 0 and 14

  20. Difference in change from baseline lung clearance index after use of QVM149 compared to high dose dual therapy.

    Indicator of pulmonary function

    Measured: Day 0 and 14

  21. Change from baseline in asthma control

    Asthma Control Questionnaire (ACQ-6) is used to evaluate asthma control. The ACQ-6 is scored from 0 to 6, with higher scores indicating more severely uncontrolled asthma.

    Measured: Day 0 and 14

  22. Difference in change from baseline in asthma control after use of QVM149 compared to high dose dual therapy.

    Asthma Control Questionnaire (ACQ-6) is used to evaluate asthma control. The ACQ-6 is scored from 0 to 6, with higher scores indicating more severely uncontrolled asthma.

    Measured: Day 0 and 14

  23. Change from baseline in asthma-related quality of life

    Asthma Quality of Life Questionnaire with Standardised Activities (AQLQ(S)) evaluates asthma-related quality of life. The AQLQ(S) is scored from 1-7, with lower scores indicating more severe impairment.

    Measured: Day 0 and 14

  24. Difference in change from baseline in asthma-related quality of life after use of QVM149 compared to high dose dual therapy.

    Asthma Quality of Life Questionnaire with Standardised Activities (AQLQ(S)) evaluates asthma-related quality of life. The AQLQ(S) is scored from 1-7, with lower scores indicating more severe impairment.

    Measured: Day 0 and 14

  25. Change from baseline in daily life and perceived well-being as measured by the St. George's Respiratory Questionnaire

    Asthma Quality of Life Questionnaire with Standardised Activities (AQLQ(S)) evaluates asthma-related quality of life. The AQLQ(S) is scored from 1-7, with lower scores indicating more severe impairment.

    Measured: Day 0 and 14

  26. Difference in change from baseline in daily life and perceived well-being as measured by the St. George's Respiratory Questionnaire after use of QVM149 compared to high dose dual therapy.

    Asthma Quality of Life Questionnaire with Standardised Activities (AQLQ(S)) evaluates asthma-related quality of life. The AQLQ(S) is scored from 1-7, with lower scores indicating more severe impairment.

    Measured: Day 0 and 14

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Dec 2019
  2. Study start1 Dec 2021 (estimated)
  3. Primary completion1 Jul 2022 (estimated)
  4. Study completion1 Dec 2022 (estimated)

Why it stopped: issues related to Covid-19 restrictions/shutdowns

Resources

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
Model description
A single site, two arm, randomized, open-label study
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04206761
Sponsor's protocol ID
ROB0045
Acronym
XPERTT
Status last verified
Oct 2020
First submitted
17 Dec 2019
Last updated
14 Dec 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing QVM149 and High Dose Dual Therapy (ICS/LABA) in people with Asthma, run by Dr. Grace Parraga at 1 site in Canada.

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 11 inclusion and 23 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: withdrawn, as of the sponsor's last update on 14 Dec 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. 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. 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?

The study was withdrawn before enrolling participants, so there are no results.

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 airway function measured using 129-Xenon MRI ventilation defect percent at the end of 2 weeks of treatment with QVM149 150/50/160 μg once daily (time frame: Day 0 and 14). 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 14 Dec 2021.

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