Trial Outcomes & Findings for A Randomized, Multicenter, Open-label, Parallel-group, 12-week Study to Assess the Efficacy and Safety of Switching From Tiotropium to QVA149 (Indacaterol Maleate/Glycopyrronium Bromide) in Symptomatic Mild to Moderate COPD Patients (NCT NCT02566031)

NCT ID: NCT02566031

Last Updated: 2019-09-23

Results Overview

Spirometry was performed according to internationally accepted standards. Trough FEV1 is defined as the mean of 45 minute and 15 minute pre-dose values.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

379 participants

Primary outcome timeframe

Week 12

Results posted on

2019-09-23

Participant Flow

Participant milestones

Participant milestones
Measure
Indacaterol and Glycopyrronium (QVA149)
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Overall Study
STARTED
189
190
Overall Study
COMPLETED
169
178
Overall Study
NOT COMPLETED
20
12

Reasons for withdrawal

Reasons for withdrawal
Measure
Indacaterol and Glycopyrronium (QVA149)
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Overall Study
Patient/guardian decision
14
7
Overall Study
Protocol deviation
2
3
Overall Study
Adverse Event
3
1
Overall Study
Lost to Follow-up
1
1

Baseline Characteristics

A Randomized, Multicenter, Open-label, Parallel-group, 12-week Study to Assess the Efficacy and Safety of Switching From Tiotropium to QVA149 (Indacaterol Maleate/Glycopyrronium Bromide) in Symptomatic Mild to Moderate COPD Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Indacaterol and Glycopyrronium (QVA149)
n=189 Participants
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=190 Participants
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Total
n=379 Participants
Total of all reporting groups
Age, Continuous
69.2 Years
STANDARD_DEVIATION 8.08 • n=5 Participants
69.0 Years
STANDARD_DEVIATION 7.54 • n=7 Participants
69.1 Years
STANDARD_DEVIATION 7.81 • n=5 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
7 Participants
n=7 Participants
10 Participants
n=5 Participants
Sex: Female, Male
Male
186 Participants
n=5 Participants
183 Participants
n=7 Participants
369 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
189 Participants
n=5 Participants
190 Participants
n=7 Participants
379 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Week 12

Population: The full analysis set (FAS) consisted of all randomized patients who received at least one dose of study treatment and have at least one evaluable post-baseline assessment. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization

Spirometry was performed according to internationally accepted standards. Trough FEV1 is defined as the mean of 45 minute and 15 minute pre-dose values.

Outcome measures

Outcome measures
Measure
Indacaterol and Glycopyrronium (QVA149)
n=177 Participants
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=184 Participants
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Trough Forced Expiratory Volume In One Second (FEV1) After 12 Weeks of Treatment
0.0668 Liters
Standard Deviation 0.18097
0.0090 Liters
Standard Deviation 0.18487

SECONDARY outcome

Timeframe: mean of 45 min and 15 min pre-dose week 4

Population: The full analysis set (FAS) consisted of all randomized patients who received at least one dose of study treatment and have at least one evaluable post-baseline assessment. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization

Spirometry was performed according to internationally accepted standards. Trough FEV1 was defined as the mean of 45 minute and 15 minute pre-dose values.

Outcome measures

Outcome measures
Measure
Indacaterol and Glycopyrronium (QVA149)
n=177 Participants
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=184 Participants
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Trough Forced Expiratory Volume In One Second (FEV1) After 4 Weeks of Treatment
-45min
0.087 Liters
Standard Deviation 0.2386
0.026 Liters
Standard Deviation 0.1626
Trough Forced Expiratory Volume In One Second (FEV1) After 4 Weeks of Treatment
-15min
0.077 Liters
Standard Deviation 0.2298
0.024 Liters
Standard Deviation 0.1567

SECONDARY outcome

Timeframe: Week 12

Population: The full analysis set (FAS) consisted of all randomized patients who received at least one dose of study treatment and have at least one evaluable post-baseline assessment. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization

A trained assessor interviewed the patient and graded the degree of impairment due to dyspnea (difficulty breathing). TDI focal score is based on three domains: functional impairment, magnitude of task and magnitude of effort and captures changes from baseline. TDI captures changes from baseline, each domain is scored from -3=major deterioration to 3=major improvement to give an overall TDI focal score of -9 to 9. Higher numbers indicate a better score.

Outcome measures

Outcome measures
Measure
Indacaterol and Glycopyrronium (QVA149)
n=177 Participants
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=184 Participants
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Baseline Transitional Dyspnea Index (TDI) Focal Score
0.77 Score
Standard Deviation 1.735
0.61 Score
Standard Deviation 1.534

SECONDARY outcome

Timeframe: Week 12

Population: The full analysis set (FAS) consisted of all randomized patients who received at least one dose of study treatment and have at least one evaluable post-baseline assessment. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization

Total score of COPD Assessment Test (CAT) will be measured at week 12. This questionnaire is completed by the patient. The score ranges from 0-40 where higher scores represent worse health status. Mild: Score = 0 - 10, Moderate: Score = 11 - 20, Severe: Score = 21 - 30, Very Severe: Score = 31 - 40. The CAT total score was the sum of 8 item scores (each ranging from 0 to 5). If 1 or 2 items were missing, they were replaced with the mean of the completed items. If 3 or more items were missing, the CAT total score was set missing

Outcome measures

Outcome measures
Measure
Indacaterol and Glycopyrronium (QVA149)
n=177 Participants
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=184 Participants
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)
Mild
62 Number of participants
54 Number of participants
Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)
Moderate
92 Number of participants
101 Number of participants
Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)
Severe
15 Number of participants
22 Number of participants
Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)
Very severe
0 Number of participants
1 Number of participants
Number of Participants With Change From Baseline on Total Score of COPD Assessment Test (CAT)
Missing
8 Number of participants
6 Number of participants

SECONDARY outcome

Timeframe: Week 12

Population: The full analysis set (FAS) consisted of all randomized patients who received at least one dose of study treatment and have at least one evaluable post-baseline assessment. Following the intent-to-treat principle, patients were analyzed according to the treatment they were assigned to at randomization

The total number of puffs of rescue medication used over the last 24 hours will be recorded in the patient diary in the morning. The total number of puffs of rescue medication per day over the full 12 weeks will be calculated and divided by the total number of days with non-missing rescue medication data to derive the mean daily number of puffs of rescue medication taken for the patient. The mean daily number of puffs of rescue medication used over 12 weeks will be summarized by treatments

Outcome measures

Outcome measures
Measure
Indacaterol and Glycopyrronium (QVA149)
n=177 Participants
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=184 Participants
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Daily Rescue Medication Use (Number of Puffs)
1.7 Puffs/day
Standard Deviation 0.92
1.8 Puffs/day
Standard Deviation 1.28

Adverse Events

Indacaterol and Glycopyrronium (QVA149

Serious events: 8 serious events
Other events: 12 other events
Deaths: 0 deaths

Tiotropium

Serious events: 3 serious events
Other events: 9 other events
Deaths: 0 deaths

Total

Serious events: 11 serious events
Other events: 21 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Indacaterol and Glycopyrronium (QVA149
n=189 participants at risk
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=188 participants at risk
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Total
n=377 participants at risk
Total
Cardiac disorders
Angina pectoris
0.53%
1/189 • 12 Weeks
0.00%
0/188 • 12 Weeks
0.27%
1/377 • 12 Weeks
Infections and infestations
Pneumonia
1.1%
2/189 • 12 Weeks
0.00%
0/188 • 12 Weeks
0.53%
2/377 • 12 Weeks
Injury, poisoning and procedural complications
Femoral neck fracture
0.53%
1/189 • 12 Weeks
0.00%
0/188 • 12 Weeks
0.27%
1/377 • 12 Weeks
Injury, poisoning and procedural complications
Fracture
0.00%
0/189 • 12 Weeks
0.53%
1/188 • 12 Weeks
0.27%
1/377 • 12 Weeks
Injury, poisoning and procedural complications
Rib fracture
0.00%
0/189 • 12 Weeks
0.53%
1/188 • 12 Weeks
0.27%
1/377 • 12 Weeks
Nervous system disorders
Carotid artery stenosis
0.53%
1/189 • 12 Weeks
0.00%
0/188 • 12 Weeks
0.27%
1/377 • 12 Weeks
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
1.6%
3/189 • 12 Weeks
0.53%
1/188 • 12 Weeks
1.1%
4/377 • 12 Weeks

Other adverse events

Other adverse events
Measure
Indacaterol and Glycopyrronium (QVA149
n=189 participants at risk
QVA149 110/50 μg capsules for inhalation delivered once daily via single-dose dry powder inhaler (SDPPI) for 12 weeks
Tiotropium
n=188 participants at risk
Tiotropium 18 μg capsules for inhalation delivered once daily via HandiHaler® device for 12 weeks
Total
n=377 participants at risk
Total
Respiratory, thoracic and mediastinal disorders
Chronic obstructive pulmonary disease
6.3%
12/189 • 12 Weeks
4.8%
9/188 • 12 Weeks
5.6%
21/377 • 12 Weeks

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 8627788300

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 the pooled data (i.e., data from all sites) in the clinical trial or disclosure of trial results in their entirety
  • Publication restrictions are in place

Restriction type: OTHER