Trial Outcomes & Findings for Bronchodilator Effects and Safety of Glycopyrronium Bromide (25 ug and 50 ug o.d.) in Asthma (NCT NCT03137784)

NCT ID: NCT03137784

Last Updated: 2019-01-16

Results Overview

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared to placebo in terms of trough FEV1 (mean of 23h 15 min and 23 h 45 min post -dose) following 1 week of treatment in the respective treatment period. Trough FEV1 was assessed by performing spirometry measurements in the clinic for each treatment period. For the primary efficacy variable, trough FEV1 is the mean of two measurements taken at 23h 15 min and 23h 45 min post dose.

Recruitment status

COMPLETED

Study phase

PHASE2/PHASE3

Target enrollment

148 participants

Primary outcome timeframe

Following 1 week of treatment

Results posted on

2019-01-16

Participant Flow

Participant milestones

Participant milestones
Measure
1(NVA237 50 ug/NVA237 25 ug/Placebo)
Treatment sequence: NVA 237 50 ug, 25 ug and placebo
2(NVA237 50 ug/Placebo/NVA237 25 ug)
Treatment sequence: NVA 237 50 ug, placebo and 25 ug
3 (NVA237 25 ug/NVA237 50 ug/Placebo)
Treatment sequence: NVA237 25 ug, 50 ug and placebo
4 (NVA237 25 ug/Placebo/NVA237 50 ug)
Treatment sequence: NVA 237 25 ug, placebo and 50 ug
5 (Placebo/NVA237 50 ug/ NVA237 25 ug)
Treatment sequence: Placebo, NVA237 50 ug and 25 ug
6 (Placebo/ NVA237 25 ug/NVA237 50 ug)
Treatment sequence: placebo, NVA237 25 ug and 50 ug
Overall Study
STARTED
24
25
25
24
25
25
Overall Study
COMPLETED
22
24
25
24
24
25
Overall Study
NOT COMPLETED
2
1
0
0
1
0

Reasons for withdrawal

Reasons for withdrawal
Measure
1(NVA237 50 ug/NVA237 25 ug/Placebo)
Treatment sequence: NVA 237 50 ug, 25 ug and placebo
2(NVA237 50 ug/Placebo/NVA237 25 ug)
Treatment sequence: NVA 237 50 ug, placebo and 25 ug
3 (NVA237 25 ug/NVA237 50 ug/Placebo)
Treatment sequence: NVA237 25 ug, 50 ug and placebo
4 (NVA237 25 ug/Placebo/NVA237 50 ug)
Treatment sequence: NVA 237 25 ug, placebo and 50 ug
5 (Placebo/NVA237 50 ug/ NVA237 25 ug)
Treatment sequence: Placebo, NVA237 50 ug and 25 ug
6 (Placebo/ NVA237 25 ug/NVA237 50 ug)
Treatment sequence: placebo, NVA237 25 ug and 50 ug
Overall Study
Adverse Event
1
1
0
0
0
0
Overall Study
Subject/guardian decision
1
0
0
0
0
0
Overall Study
Non-compliance with study treatment
0
0
0
0
1
0

Baseline Characteristics

Bronchodilator Effects and Safety of Glycopyrronium Bromide (25 ug and 50 ug o.d.) in Asthma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Participants
n=148 Participants
All participants randomized to one of six treatment sequences
Age, Continuous
47.3 Years
STANDARD_DEVIATION 11.8 • n=5 Participants
Sex: Female, Male
Female
75 Participants
n=5 Participants
Sex: Female, Male
Male
73 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
16 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
12 Participants
n=5 Participants
Race (NIH/OMB)
White
120 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence.

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared to placebo in terms of trough FEV1 (mean of 23h 15 min and 23 h 45 min post -dose) following 1 week of treatment in the respective treatment period. Trough FEV1 was assessed by performing spirometry measurements in the clinic for each treatment period. For the primary efficacy variable, trough FEV1 is the mean of two measurements taken at 23h 15 min and 23h 45 min post dose.

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Trough FEV1 After One Week of Treatment, Point Estimate
2.392 Liters
Standard Error 0.0249
2.392 Liters
Standard Error 0.0250
2.303 Liters
Standard Error 0.0247

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence.

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Standardized FEV1 AUC following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day (AUC 5min-1h)

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
FEV1 AUC (5 Min-1 h) After One Week of Treatment
2.489 Liters
Standard Error 0.0226
2.492 Liters
Standard Error 0.0228
2.324 Liters
Standard Error 0.0227

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence.

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Standardized FEV1 AUC following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day (AUC 5min-4h)

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
FEV1 AUC (5 Min-4 h) After One Week of Treatment
2.522 Liters
Standard Error 0.0223
2.525 Liters
Standard Error 0.0224
2.346 Liters
Standard Error 0.0223

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence.

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Standardized FEV1 AUC following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time over an entire day AUC (5 min - 23 h 45 min)

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
FEV1 AUC (5 Min - 23 h 45 Min) After One Week of Treatment
2.443 Liters
Standard Error 0.0226
2.450 Liters
Standard Error 0.0227
2.304 Liters
Standard Error 0.0226

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of Peak FEV1 following 1 week of treatment in the respective treatment period. FEV1 was measured with spirometry conducted according to internationally accepted standards. The peak effect following 1 week of treatment was defined as the maximum FEV1 during the first 4 hour on that day.

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Peak FEV1 During 4 Hours Post-dose After 1 Week of Treatment
2.621 Liters
Standard Error 0.0228
2.630 Liters
Standard Error 0.0229
2.457 Liters
Standard Error 0.0228

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of FVC following 1 week of treatment in respective treatment period. Trough Forced Vital Capacity (FVC) following 7 Days. FVC is the amount of air which can be forcibly exhaled from the lungs after taking the deepest breath possible. FVC was assessed via spirometry

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Trough Forced Vital Capacity (FVC) After 1 Week of Treatment
3.509 Liters
Standard Error 0.0268
3.530 Liters
Standard Error 0.0269
3.472 Liters
Standard Error 0.0267

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence

To evaluate the bronchodilator effects of NVA237 (25 ug and 50 ug) compared with placebo in terms of FEV1/FVC ratio following 1 week of treatment in respective treatment period

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Percent Change From Baseline in FEV1/FVC Ratio
0.018 Percent change
Standard Deviation 0.0421
0.016 Percent change
Standard Deviation 0.0438
0.003 Percent change
Standard Deviation 0.0398

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence

A Peak Expiratory Flow (PEF) meter was distributed to patients at Visit 1, to be used to measure PEF twice-daily as directed. During the Screening and Treatment Periods, PEF was measured in the morning and evening every day. the morning PEF was performed within 15 minutes after waking, and the evening PEF approximately 12 hours later. Patients were encouraged to perform morning and evening PEF measurements before the use of any LABA or rescue medication. The highest of 3 values was recorded as the daily personal best. The personal best was used to calculate the mean morning PEF and mean evening PEF value

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Mean Morning Peak Expiratory Flow (PEF) Following the 1-week Treatment Period
395.09 L/min
Standard Error 2.948
393.87 L/min
Standard Error 2.962
369.58 L/min
Standard Error 2.958

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence

A Peak Expiratory Flow (PEF) meter was distributed to patients at Visit 1, to be used to measure PEF twice-daily as directed. During the Screening and Treatment Periods, PEF was measured in the morning and evening every day. the morning PEF was performed within 15 minutes after waking, and the evening PEF approximately 12 hours later. Patients were encouraged to perform morning and evening PEF measurements before the use of any LABA or rescue medication. The highest of 3 values was recorded as the daily personal best. The personal best was used to calculate the mean morning PEF and mean evening PEF value collected between assessment Visits. LS Mean of change from baseline in mean morning PEF is calculated with the ANCOVA model using treatment, stratification group, dosing schedule, gender, center grouping, smoking status, and baseline mean morning PEF as covariates

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Mean Evening Peak Expiratory Flow Rate (PEF) Following 1-week Treatment
409.66 L/min
Standard Error 2.928
408.08 L/min
Standard Error 2.934
378.72 L/min
Standard Error 2.949

SECONDARY outcome

Timeframe: Following 1 week of treatment

Population: The Full Analysis Set (FAS) consisted of all patients in the randomized Set (RAN) who received at least one dose of study medication. Following the intent-to-treat principle, patients in the FAS were analyzed according to the treatment they were randomized to in the assigned treatment sequence

A day with no rescue medication use is defined from the diary data as any day where the patient recorded no rescue medicine use during the previous 12 hours. daytime and nighttime (combined) number of puffs is defined as the average of the respective number of puffs.

Outcome measures

Outcome measures
Measure
NVA237 50 ug
n=147 Participants
NVA237 50 g capsule
NVA237 25 ug
n=146 Participants
NVA237 25 μg capsule
Placebo
n=146 Participants
Placebo
Mean Daily Number of Puffs of Rescue Medication During 1 Week of Treatment
0.98 Puffs/day
Standard Error 0.094
1.02 Puffs/day
Standard Error 0.094
1.13 Puffs/day
Standard Error 0.094

Adverse Events

NVA237 50 ug

Serious events: 1 serious events
Other events: 10 other events
Deaths: 0 deaths

NVA237 25 ug

Serious events: 1 serious events
Other events: 11 other events
Deaths: 1 deaths

Placebo

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

Serious adverse events

Serious adverse events
Measure
NVA237 50 ug
n=147 participants at risk
NVA237 50 ug capsule
NVA237 25 ug
n=146 participants at risk
NVA237 25 ug capsule
Placebo
n=146 participants at risk
Placebo
Musculoskeletal and connective tissue disorders
Patellofemoral pain syndrome
0.68%
1/147 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description
Psychiatric disorders
Completed suicide
0.00%
0/147 • Following 1 week of treatment
AE additional description
0.68%
1/146 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description

Other adverse events

Other adverse events
Measure
NVA237 50 ug
n=147 participants at risk
NVA237 50 ug capsule
NVA237 25 ug
n=146 participants at risk
NVA237 25 ug capsule
Placebo
n=146 participants at risk
Placebo
Infections and infestations
Nasopharyngitis
1.4%
2/147 • Following 1 week of treatment
AE additional description
0.68%
1/146 • Following 1 week of treatment
AE additional description
2.1%
3/146 • Following 1 week of treatment
AE additional description
Infections and infestations
Upper respiratory tract infection
0.68%
1/147 • Following 1 week of treatment
AE additional description
2.1%
3/146 • Following 1 week of treatment
AE additional description
0.68%
1/146 • Following 1 week of treatment
AE additional description
Injury, poisoning and procedural complications
Muscle strain
0.68%
1/147 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
Nervous system disorders
Dizziness
0.68%
1/147 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
Nervous system disorders
Headache
3.4%
5/147 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
Respiratory, thoracic and mediastinal disorders
Asthma
0.00%
0/147 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description
Respiratory, thoracic and mediastinal disorders
Oropharyngeal pain
0.68%
1/147 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
0.00%
0/146 • Following 1 week of treatment
AE additional description
Skin and subcutaneous tissue disorders
Dermatitis contact
0.00%
0/147 • Following 1 week of treatment
AE additional description
1.4%
2/146 • Following 1 week of treatment
AE additional description
0.68%
1/146 • Following 1 week of treatment
AE additional description

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 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