Trial Outcomes & Findings for Long Term Safety and Tolerability of QVA149 Versus Tiotropium in Japanese Patients With Chronic Obstructive Pulmonary Disease (COPD) (NCT NCT01285492)

NCT ID: NCT01285492

Last Updated: 2013-12-27

Results Overview

An AE was the appearance or worsening of any undesirable sign, symptom, or medical condition occurring after starting the study drug even if the event was not considered to be related to study drug. Study drug includes the investigational drug under evaluation and the comparator drug or placebo that was given during any phase of the study. Adverse events starting on or after the time of the first inhalation of study drug were classified as a treatment emergent adverse event.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

160 participants

Primary outcome timeframe

52 weeks

Results posted on

2013-12-27

Participant Flow

121 patients were randomized to the QVA149 group; however, demographics was on safety set and excluded 2 patients who did not take study drug

There was a pre-screening visit where informed consent was obtained and current COPD medications reviewed and in suitable patients, if necessary, arrangements were made to adjust prohibited COPD therapy to allowable COPD therapy. The interval between Visit 2 and 3 was a 7-days run-in period used to assess eligibility and to collect baseline values.

Participant milestones

Participant milestones
Measure
QVA149
QVA149 110/50 μg o.d. (once a day)
Tiotropium
tiotropium 18 μg o.d.
Overall Study
STARTED
121
39
Overall Study
Safety Set (for Demographics)
119
39
Overall Study
COMPLETED
104
38
Overall Study
NOT COMPLETED
17
1

Reasons for withdrawal

Reasons for withdrawal
Measure
QVA149
QVA149 110/50 μg o.d. (once a day)
Tiotropium
tiotropium 18 μg o.d.
Overall Study
Adverse Event
11
0
Overall Study
Protocol Violation
3
0
Overall Study
Withdrawal by Subject
2
1
Overall Study
Death
1
0

Baseline Characteristics

Long Term Safety and Tolerability of QVA149 Versus Tiotropium in Japanese Patients With Chronic Obstructive Pulmonary Disease (COPD)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Total
n=158 Participants
Total of all reporting groups
Age, Continuous
69.3 years
STANDARD_DEVIATION 6.79 • n=5 Participants
69.4 years
STANDARD_DEVIATION 6.90 • n=7 Participants
69.3 years
STANDARD_DEVIATION 6.80 • n=5 Participants
Sex: Female, Male
Female
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants
Sex: Female, Male
Male
114 Participants
n=5 Participants
37 Participants
n=7 Participants
151 Participants
n=5 Participants
Baseline Weight
60.38 kg
STANDARD_DEVIATION 9.613 • n=5 Participants
61.44 kg
STANDARD_DEVIATION 8.788 • n=7 Participants
60.64 kg
STANDARD_DEVIATION 9.400 • n=5 Participants
Baseline Height
164.4 cm
STANDARD_DEVIATION 7.08 • n=5 Participants
163.3 cm
STANDARD_DEVIATION 6.38 • n=7 Participants
164.1 cm
STANDARD_DEVIATION 6.91 • n=5 Participants
Baseline Body Mass Index
22.31 kg/m^2
STANDARD_DEVIATION 3.067 • n=5 Participants
23.02 kg/m^2
STANDARD_DEVIATION 2.919 • n=7 Participants
22.49 kg/m^2
STANDARD_DEVIATION 3.037 • n=5 Participants

PRIMARY outcome

Timeframe: 52 weeks

Population: The safety set included all patients who received at least one dose of study drug.

An AE was the appearance or worsening of any undesirable sign, symptom, or medical condition occurring after starting the study drug even if the event was not considered to be related to study drug. Study drug includes the investigational drug under evaluation and the comparator drug or placebo that was given during any phase of the study. Adverse events starting on or after the time of the first inhalation of study drug were classified as a treatment emergent adverse event.

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) or Death
Adverse Events (AEs)
101 Participants
28 Participants
Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) or Death
Serious Advers Events (SAEs)
19 Participants
2 Participants
Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) or Death
Death
1 Participants
0 Participants

SECONDARY outcome

Timeframe: 52 weeks

Population: The safety set included all patients who received at least one dose of study drug.

Clinically notable hematology values were: hemoglobin - male \<11.5g/dL, female \<9.5 g/dL; hematocrit - male \<37%, female \<32%; white cell count - \<2800µL or \>16000µL; platelets - \<7.5 10\*4/µL or \>70.0 10\*4/µL

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
Platelets < 7.5 (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
Hemoglobin: male (n = 113, 36)
3 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
Hemoglobin: female (n = 5, 2)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
Hematocrit: male (n = 113, 36)
6 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
Hematocrit: female (n = 5, 2)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
White Cell Count < 2800 (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
White Cell Count > 2800 (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Hematology Values at Any Timepoint Over the Whole Treatment Period
Platelets > 70.0 (n = 118, 38)
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 52 weeks

Population: The safety set included all patients who received at least one dose of study drug.

Clinically notable biochemistry values were: total protein - \<4.0 g/dL or \>9.5 g/dL; albumin \<2.5 g/dL; bilirubin (total) \>1.9 mg/dL; BUN \>27 mg/dL; creatinine \>1.99 mg/dL; AST \>3 x ULN U/L; ALT \>3 x ULN U/L; ALP \>3 x ULN U/L; y-GTP \>3 x ULN U/L; sodium \<125 mEq/L or \>160 mEq/L; potassium \<3.0 mEq/L or \>6.0 mEq/L; glucose \<51.0 mg/dL or \>180.0 mg/dL

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
glucose >180.0 mg/dL (n = 118, 38)
7 Participants
3 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
Total protein - <4.0 g/dL (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
Total protein - > 9.5 g/dL (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
albumin <2.5 g/dL (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
bilirubin (total) >1.9 mg/dL (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
BUN >27 mg/dL (n = 118, 38)
1 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
creatinine >1.99 mg/dL (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
AST >3 x ULN U/L (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
ALT >3 x ULN U/L (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
ALP >3 x ULN U/L (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
y-GTP >3 x ULN (n = 118, 38)
2 Participants
2 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
sodium <125 mEq/L (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
sodium >160 mEq/L (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
potassium <3.0 mEq/ (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
potassium >6.0 mEq/ (n = 118, 38)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Biochemistry Values at Any Time-point Over the Treatment Period
glucose <51.0 mg/dL (n = 118, 38)
0 Participants
0 Participants

SECONDARY outcome

Timeframe: 52 weeks

Population: The safety set included all patients who received at least one dose of study drug.

Clinically notable vital sign values were: pulse rate - low, \<40 bpm or \<=50 bpm and decrease from baseline \>=15bpm; pulse rate high, \>130 bpm or \>=120bpm and increase from baseline \>=15 bpm. Systolic blood pressure - low, \<75 mmHg or \<=90 mmHg and decrease from baseline \>=20 mmHg; high, \>200 mmHg or \>=180 mmHg and increase from baseline \>=20 mmHg. Diastolic blood pressure - low, \<40 mmHg or \<=50 mmHg and decrease from baseline \>=15 mmHg; high, \>115 mmHg or \>=105 mmHg and increase from baseline \>=15 mmHg.

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Pulse rate: low
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Pulse rate: high
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Pulse rate: low or high
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Systolic blood pressure - low
4 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Systolic blood pressure - high
0 Participants
1 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Systolic blood pressure - low or high
4 Participants
1 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Diastolic blood pressure - low
3 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Diastolic blood pressure - high
2 Participants
1 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Vital Signs Values at Any Time-point Over the Whole Treatment Period
Diastolic blood pressure - low or high
5 Participants
1 Participants

SECONDARY outcome

Timeframe: 52 weeks

Population: The safety set included all patients who received at least one dose of study drug.

Clinically notable change from baseline was an increase from baseline of 30 or greater milliseconds (ms).

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Number of Patients With Newly Occurring or Worsening Clinically Notable Fridericia's QTc Values at Any Time-point Over the Whole Treatment Period
Males: QTc > 450 ms (n = 111, 36)
6 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Fridericia's QTc Values at Any Time-point Over the Whole Treatment Period
Females: QTc > 470 ms (n = 5, 2)
0 Participants
0 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Fridericia's QTc Values at Any Time-point Over the Whole Treatment Period
Increase from baseline 30 to 60 ms (n = 116, 38)
12 Participants
3 Participants
Number of Patients With Newly Occurring or Worsening Clinically Notable Fridericia's QTc Values at Any Time-point Over the Whole Treatment Period
Increase from baseline > 60 ms (n = 116, 38)
1 Participants
0 Participants

SECONDARY outcome

Timeframe: Weeks 3, 6, 12, 24, 36, 52

Population: Full Analysis Set (FAS) included all randomized patients who received at least one dose of study drug.

Pre-dose FEV1 is defined as the average of the measurements at 45 and 15 min pre-dose. Baseline is defined as the pre-dose FEV1 value on Day 1 (Week 1).

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Change in Pre-dose Forced Expiratory Volume in One Second (FEV1) From Baseline
Week 3 (117, 38)
0.206 Litres
Standard Deviation 0.1534
0.093 Litres
Standard Deviation 0.0977
Change in Pre-dose Forced Expiratory Volume in One Second (FEV1) From Baseline
Week 6 (115, 38)
0.202 Litres
Standard Deviation 0.1668
0.083 Litres
Standard Deviation 0.1201
Change in Pre-dose Forced Expiratory Volume in One Second (FEV1) From Baseline
Week 12 (113, 38)
0.209 Litres
Standard Deviation 0.1725
0.139 Litres
Standard Deviation 0.1562
Change in Pre-dose Forced Expiratory Volume in One Second (FEV1) From Baseline
Week 24 (113, 37)
0.198 Litres
Standard Deviation 0.1735
0.115 Litres
Standard Deviation 0.1400
Change in Pre-dose Forced Expiratory Volume in One Second (FEV1) From Baseline
Week 36 (105, 37)
0.182 Litres
Standard Deviation 0.1619
0.082 Litres
Standard Deviation 0.1465
Change in Pre-dose Forced Expiratory Volume in One Second (FEV1) From Baseline
Week 52 (104, 37)
0.189 Litres
Standard Deviation 0.1762
0.052 Litres
Standard Deviation 0.1688

SECONDARY outcome

Timeframe: Weeks 3, 6, 12, 24, 36, 52

Population: Full Analysis Set (FAS) included all randomized patients who received at least one dose of study drug.

Pre-dose FVC is defined as the average of the measurements at 45 and 15 min pre-dose. Baseline is defined as the pre-dose FVC value on Day 1 (Week 1).

Outcome measures

Outcome measures
Measure
QVA149
n=119 Participants
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 Participants
tiotropium 18 μg o.d.
Change in Pre-dose Forced Vital Capacity (FVC) From Baseline
Week 24 (113, 37)
0.330 Litres
Standard Deviation 0.3248
0.206 Litres
Standard Deviation 0.2367
Change in Pre-dose Forced Vital Capacity (FVC) From Baseline
Week 3 (117, 38)
0.314 Litres
Standard Deviation 0.2882
0.213 Litres
Standard Deviation 0.2369
Change in Pre-dose Forced Vital Capacity (FVC) From Baseline
Week 6 (115, 38)
0.310 Litres
Standard Deviation 0.3178
0.173 Litres
Standard Deviation 0.2162
Change in Pre-dose Forced Vital Capacity (FVC) From Baseline
Week 12 (113, 38)
0.335 Litres
Standard Deviation 0.2948
0.279 Litres
Standard Deviation 0.2942
Change in Pre-dose Forced Vital Capacity (FVC) From Baseline
Week 36 (105, 37)
0.264 Litres
Standard Deviation 0.2706
0.167 Litres
Standard Deviation 0.2438
Change in Pre-dose Forced Vital Capacity (FVC) From Baseline
Week 52 (104, 37)
0.261 Litres
Standard Deviation 0.3047
0.112 Litres
Standard Deviation 0.2462

Adverse Events

QVA149

Serious events: 19 serious events
Other events: 66 other events
Deaths: 0 deaths

Tiotropium

Serious events: 2 serious events
Other events: 23 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
QVA149
n=119 participants at risk
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 participants at risk
tiotropium 18 μg o.d.
Congenital, familial and genetic disorders
Arrhythmogenic right ventricular dysplasia
0.84%
1/119
0.00%
0/39
Gastrointestinal disorders
Colonic polyp
2.5%
3/119
0.00%
0/39
Hepatobiliary disorders
Bile duct stone
1.7%
2/119
0.00%
0/39
Hepatobiliary disorders
Cholangitis
0.84%
1/119
0.00%
0/39
Immune system disorders
Anaphylactic shock
0.84%
1/119
0.00%
0/39
Infections and infestations
Bronchopneumonia
0.84%
1/119
0.00%
0/39
Infections and infestations
Cellulitis
0.84%
1/119
0.00%
0/39
Infections and infestations
Lower respiratory tract infection
0.84%
1/119
0.00%
0/39
Infections and infestations
Pneumonia
1.7%
2/119
0.00%
0/39
Injury, poisoning and procedural complications
Femoral neck fracture
0.84%
1/119
2.6%
1/39
Metabolism and nutrition disorders
Dehydration
0.84%
1/119
0.00%
0/39
Musculoskeletal and connective tissue disorders
Intervertebral disc protrusion
0.84%
1/119
0.00%
0/39
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Lung neoplasm malignant
0.84%
1/119
0.00%
0/39
Nervous system disorders
Cerebral infarction
0.84%
1/119
0.00%
0/39
Nervous system disorders
Thrombotic cerebral infarction
0.84%
1/119
0.00%
0/39
Renal and urinary disorders
Urinary retention
0.84%
1/119
0.00%
0/39
Reproductive system and breast disorders
Benign prostatic hyperplasia
0.84%
1/119
0.00%
0/39
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
3.4%
4/119
0.00%
0/39
Respiratory, thoracic and mediastinal disorders
Hypoxia
0.84%
1/119
0.00%
0/39
Respiratory, thoracic and mediastinal disorders
Pneumothorax
0.00%
0/119
2.6%
1/39
Respiratory, thoracic and mediastinal disorders
Respiratory failure
0.84%
1/119
0.00%
0/39

Other adverse events

Other adverse events
Measure
QVA149
n=119 participants at risk
QVA149 110/50 μg once a day (o.d)
Tiotropium
n=39 participants at risk
tiotropium 18 μg o.d.
Gastrointestinal disorders
Diarrhoea
2.5%
3/119
5.1%
2/39
Gastrointestinal disorders
Gastritis
0.00%
0/119
5.1%
2/39
Infections and infestations
Bronchitis
4.2%
5/119
7.7%
3/39
Infections and infestations
Influenza
1.7%
2/119
5.1%
2/39
Infections and infestations
Nasopharyngitis
33.6%
40/119
30.8%
12/39
Infections and infestations
Pharyngitis
4.2%
5/119
2.6%
1/39
Infections and infestations
Pneumonia
5.9%
7/119
2.6%
1/39
Infections and infestations
Upper respiratory tract infection
7.6%
9/119
15.4%
6/39
Injury, poisoning and procedural complications
Rib fracture
0.00%
0/119
7.7%
3/39
Investigations
Blood alkaline phosphatase increased
0.00%
0/119
5.1%
2/39
Musculoskeletal and connective tissue disorders
Back pain
5.0%
6/119
2.6%
1/39
Nervous system disorders
Headache
3.4%
4/119
2.6%
1/39
Psychiatric disorders
Insomnia
3.4%
4/119
5.1%
2/39
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
24.4%
29/119
20.5%
8/39
Respiratory, thoracic and mediastinal disorders
Dysphonia
4.2%
5/119
2.6%
1/39
Skin and subcutaneous tissue disorders
Rash
1.7%
2/119
5.1%
2/39

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 862-778-8300

Results disclosure agreements

  • Principal investigator is a sponsor employee The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of pooled data (i.e.,data from all sites) in clinical trial or disclosure of trial results in their entirety.
  • Publication restrictions are in place

Restriction type: OTHER