Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
Label indication ASMANEX ® TWISTHALER ® is indicated for the maintenance treatment of asthma as prophylactic therapy in adult and pediatric patients 4 years of age and older. Limitations of Use ASMANEX TWISTHALER is not indicated for the relief of acute bronchospasm. ASMANEX TWISTHALER is not indicated in children less than 4 years of age. FDA label
Also known as MF, QMF149
Mometasone furoate · 7 trials · 3 indications
Forced Expiratory Volume in 1 second (FEV1) is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured by spirometry.
A TEAE is any adverse event that started on or after the time of the first inhalation of study drug but not later than 7 days (30 days in the case of a SAE) after the last administration. A SAE is described as any adverse event that leads to death, is life-threatening, results in persistent or significant disability/incapacity, causes or prolongs hospitalization, results in a congenital anomaly, or any other important medical event which is medically significant.
Patients were required to record a 12 hour "reflective" score twice a day approximately 12 hours apart. For the rTNSS patients were asked to "look back" or "reflect" on their severity of nasal symptoms over the previous 12 hours. The first rating on each day was taken prior to dosing. Patients were asked to score 4 nasal symptoms (nasal congestion, runny nose, sneezing and itchy nose) on a 4 point scale ranging from 0 (no symptom) to 3 (severe symptom). The means of the 4 individual symptom scores obtained over the randomized treatment period were summed to give the mean rTNSS, which ranged from 0 to 12 with a lower score indicating less severe symptoms. Mean baseline rTNSS was calculated by summing the means of the 4 individual symptom scores obtained over the 72 hours before the randomized treatment period. Mean change from baseline was calculated as "mean baseline rTNSS" - "mean post-randomization rTNSS". A positive change from baseline in rTNSS is considered a favorable outcome.
Patients were required to record a 12 hour "reflective" score twice a day approximately 12 hours apart. For the rTNSS patients were asked to "look back" or "reflect" on their severity of nasal symptoms over the previous 12 hours. The first rating on each day was taken prior to dosing. Patients were asked to score 4 nasal symptoms (nasal congestion, runny nose, sneezing and itchy nose) on a 4 point scale ranging from 0 (no symptom) to 3 (severe symptom). The means of the 4 individual symptom scores obtained over the randomized treatment period were summed to give the mean rTNSS, which ranged from 0 to 12 with a lower score indicating less severe symptoms. Mean baseline rTNSS was calculated by summing the means of the 4 individual symptom scores obtained over the 72 hours before the randomized treatment period. Mean change from baseline was calculated as "mean baseline rTNSS" - "mean post-randomization rTNSS". A positive change from baseline in rTNSS is considered a favorable outcome.
Mometasone furoate plasma concentrations were determined by a validated liquid chromatography with tandem mass spectrometry (LC-MS/MS) method. Cmax of mometasone furoate was determined with Phoenix WinNonlin (Version 8.0 or higher). A correction factor was applied to MF pharmacokinetic parameters to consider the first-dose effect that is based on the fact that the participants in this study received a single dose from single unused (unprimed) C1 and TH devices. Unprimed devices are not coated with the formulation, and therefore may lead to lower fine particle mass (FPM) and delivered dose compared to later doses actuated from the device throughout its use time. The first-dose correction factor (FPMprimed (MF) / FPMunprimed (MF)) for MF delivered via TH was 1.26 and for MF delivered via C1 it was 1.62.
AUC0-6h of mometasone furoate was determined using non-compartment methods with Phoenix WinNonlin (Version 8.0 or higher). The linear trapezoidal rule was used for AUC0-6h calculation. A correction factor was applied to MF pharmacokinetic parameters to consider the first-dose effect that is based on the fact that the participants in this study received a single dose from single unused (unprimed) C1 and TH devices. Unprimed devices are not coated with the formulation, and therefore may lead to lower fine particle mass (FPM) and delivered dose compared to later doses actuated from the device throughout its use time. The first-dose correction factor (FPMprimed (MF) / FPMunprimed (MF)) for MF delivered via TH was 1.26 and for MF delivered via C1 it was 1.62.
Spirometry is conducted according to the global standard. Trough FEV1 is defined as the average of the 23 hour 10 minute and 23 hour 45 minute post dose FEV1 readings.
Forced Expiratory Volume in 1 second (FEV1) was measured via spirometry conducted according to internationally accepted standards. Measurements were taken on day 29 after treatment.
For FEV1 AUC(0-12h) the trapezoidal rule was applied using planned time measurements to calculate the AUC up to and including the last measurement recorded before intake of rescue medication. The AUC was standardized by dividing by the length of time for which measurements of FEV1 were included in the calculation of the AUC thus adjusting for subjects who were unable to complete the measurements during the 12-hour observation period and without inhaling rescue medication. The unit of the AUC was in L, being a weighted average of the acceptable FEV1 measurements recorded over 12 hours post dose
| Arm | Type | Description |
|---|---|---|
| QMF149 | EXPERIMENTAL | QMF149 75/40μg |
| Budesonide | ACTIVE_COMPARATOR | Budesonide 200μg o.d |
| Test | EXPERIMENTAL | Mometasone furoate 50 mcg/actuation nasal spray (Lek Pharmaceuticals) administered once daily at a dose of 200 mcg (4 actuations) for 14 days. |
| Reference | ACTIVE_COMPARATOR | Mometasone furoate (Nasonex®) 50 mcg/actuation nasal spray administered once daily at a dose of 200 mcg (4 actuations) for 14 days. |
| Placebo | PLACEBO_COMPARATOR | Placebo nasal spray administered once daily for 14 days. |
| MF followed by QMF149 | EXPERIMENTAL | Single inhaled dose of mometasone furoate on Day 1 delivered via TH inhaler followed by 4-7 days of washout. On Day 6-9, single inhaled dose of QMF149 delivered via C1 inhaler. |
| Salmeterol xinafoate/fluticasone propionate | ACTIVE_COMPARATOR | Salmeterol xinafoate/fluticasone propionate 50/500 µg b.i.d, delivered via Accuhaler® |
| Mometasone furoate 80 μg | EXPERIMENTAL | Description: Mometasone furoate (MF) 800 ug delivered via the Twisthaler® device for 2 weeks, followed by MF 200 ug delivered via the Twisthaler® device for 2 weeks or no treatment for 2 weeks, then randomized to MF 80 ug delivered via the Concept1 device for 4 weeks. |
| Mometasone furoate 200 µg | EXPERIMENTAL | Mometasone furoate (MF) 800 ug delivered via the Twisthaler® device for 2 weeks, followed by MF 200 ug delivered via the Twisthaler® device for 2 weeks or no treatment for 2 weeks, then randomized to MF 200 ug delivered via the Twisthaler® device for 4 weeks. |
| Mometasone furoate 320 µg | EXPERIMENTAL | Mometasone furoate (MF) 800 ug delivered via the Twisthaler® device for 2 weeks, followed by MF 200 ug delivered via the Twisthaler® device for 2 weeks or no treatment for 2 weeks, then randomized to MF 320 ug delivered via the Concept1 device for 4 weeks. |
| Mometasone furoate 800 µg | EXPERIMENTAL | Mometasone furoate (MF) 800 ug delivered via the Twisthaler® device for 2 weeks, followed by MF 200 ug delivered via the Twisthaler® device for 2 weeks or no treatment for 2 weeks, then randomized to MF 800 ug delivered via the Twisthaler® device for 4 weeks. |
| F12M - PL - F12D - MFF | EXPERIMENTAL | Participants received a single dose of each treatment in the following order, separated by a washout period of 6-7 days: Period 1: Formoterol fumarate 12 μg via pMDI + placebo to formoterol fumarate via DPI; Period 2: Placebo to formoterol fumarate / mometasone furoate via pMDI + placebo to formoterol fumarate via DPI; Period 3: Placebo to formoterol fumarate / mometasone furoate via pMDI + formoterol fumarate via DPI; Period 4: Formoterol fumarate / mometasone furoate 10 μg / 100 μg via pMDI + placebo to formoterol fumarate via DPI. Participants were allowed to continue their regular asthma maintenance inhaled corticosteroid medication throughout the study and were supplied with the short-acting β2-agonist (SABA) salbutamol as rescue medication. |
| F12D - F12M - MFF - PL | EXPERIMENTAL | Participants received a single dose of each treatment in the following order, separated by a washout period of 6-7 days: Period 1: Placebo to formoterol fumarate / mometasone furoate via pMDI + formoterol fumarate via DPI; Period 2: Formoterol fumarate 12 μg via pMDI + placebo to formoterol fumarate via DPI; Period 3: Formoterol fumarate / mometasone furoate 10 μg / 100 μg via pMDI + placebo to formoterol fumarate via DPI; Period 4: Placebo to formoterol fumarate / mometasone furoate via pMDI + placebo to formoterol fumarate via DPI. Participants were allowed to continue their regular asthma maintenance inhaled corticosteroid medication throughout the study and were supplied with the short-acting β2-agonist (SABA) salbutamol as rescue medication. |
| MFF - F12D - PL - F12M | EXPERIMENTAL | Participants received a single dose of each treatment in the following order, separated by a washout period of 6-7 days: Period 1: Formoterol fumarate / mometasone furoate 10 μg / 100 μg via pMDI + placebo to formoterol fumarate via DPI; Period 2: Placebo to formoterol fumarate / mometasone furoate via pMDI + formoterol fumarate via DPI; Period 3: Placebo to formoterol fumarate / mometasone furoate via pMDI + placebo to formoterol fumarate via DPI; Period 4: Formoterol fumarate 12 μg via pMDI + placebo to formoterol fumarate via DPI. Participants were allowed to continue their regular asthma maintenance inhaled corticosteroid medication throughout the study and were supplied with the short-acting β2-agonist (SABA) salbutamol as rescue medication. |
| PL - MFF - F12M - F12D | EXPERIMENTAL | Participants received a single dose of each treatment in the following order, separated by a washout period of 6-7 days: Period 1: Placebo to formoterol fumarate / mometasone furoate via pMDI + placebo to formoterol fumarate via DPI; Period 2: Formoterol fumarate / mometasone furoate 10 μg / 100 μg via pMDI + placebo to formoterol fumarate via DPI; Period 3: Formoterol fumarate 12 μg via pMDI + placebo to formoterol fumarate via DPI; Period 4: Placebo to formoterol fumarate / mometasone furoate via pMDI + formoterol fumarate via DPI. Participants were allowed to continue their regular asthma maintenance inhaled corticosteroid medication throughout the study and were supplied with the short-acting β2-agonist (SABA) salbutamol as rescue medication. |
| Name | Type | Description |
|---|---|---|
| QMF149 | DRUG | QMF149 75/40 μg o.d via Breezhaler |
| Budesonide | DRUG | Budesonide 200 μg o.d via Breezhaler |
| Mometasone furoate 50 mcg/actuation nasal spray (Lek Pharmaceuticals) | DRUG | Mometasone nasal spray administered once daily at a dose of 200 mcg (4 actuations) for 14 days. |
| Mometasone furoate (Nasonex®) 50 mcg/actuation nasal spray | DRUG | Mometasone nasal spray administered once daily at a dose of 200 mcg (4 actuations) for 14 days. |
| Placebo | DRUG | Placebo nasal spray administered once daily (4 actuations) for 14 days. |
| Mometasone furoate | DRUG | Single inhaled dose of 100 µg mometasone furoate (MF) administered via Twisthaler® on Day 1 |
| Standard of Care (Soc) | DRUG | Asthma therapy: budesonide and salbutamol being the most frequently used (excluding MF and indacaterol acetate) |
| Salmeterol | DRUG | delivered via Accuhaler® |
| Concept 1 | DEVICE | A single dose dry powder inhaler (SDDPI) |
| Twisthaler | DEVICE | A single dose dry powder inhaler (SDDPI) |
| Mometasone furoate/formoterol fumarate (MFF) | DRUG | Formoterol fumarate dihydrate / mometasone furoate combination product 10 μg / 100 μg delivered via Pressurized Metered Dose Inhaler (pMDI). One dose consisted of 2 puffs x 5 μg / 50 μg. |
| Formoterol fumarate 12 μg pMDI (F12M) | DRUG | Formoterol fumarate dihydrate 12 μg delivered via Pressurized Metered Dose Inhaler (pMDI) (1 dose = 2 puffs x 6 μg). |
| Formoterol fumarate 12 μg DPI (F12D) | DRUG | Formoterol fumarate dihydrate 12 μg delivered via Dry Powder Inhaler (DPI). |
| Placebo to F12D | DRUG | Placebo to formoterol fumarate DPI delivered via DPI |
| Placebo to F12M/MFF | DRUG | Placebo to formoterol fumarate pMDI and formoterol fumarate / mometasone furoate delivered via pMDI |
Inclusion Criteria 1. Male or female children ≥ 6 years and \<12 years in age at randomization. 2. Parents/legal guardian must be willing and able to attend study visits and assist the child with the procedures outlined in the protocol (e.g. compliance with taking study medication and completing th...
Mometasone furoate is studied for asthma and seasonal allergic rhinitis. It has been tested in adults, adolescents, and children with persistent asthma, and in patients aged 12 years and older with seasonal allergic rhinitis. It is a small molecule developed by Novartis AG.
Novartis AG, which trades under the ticker NVS, is the developer of mometasone furoate. The company has sponsored the clinical trial program for the drug across asthma and seasonal allergic rhinitis indications.
Mometasone furoate is in Phase 2 development. It is investigational and has not been approved. Three completed trials are listed, with no active trials currently. The program includes Phase 2 studies in asthma and a Phase 3 study in seasonal allergic rhinitis.
Completed trials include NCT04589663, a Phase 2 pharmacokinetic study in children aged 6 to under 12 with asthma; NCT01555151, a Phase 2 safety and efficacy study in persistent asthma; NCT01038427, a Phase 3 study in seasonal allergic rhinitis; and NCT00746330, a Phase 2 single dose study in children with persistent asthma.
Across the completed trials, 795 patients have been enrolled in total. The largest study, NCT01038427, enrolled 795 patients in seasonal allergic rhinitis, while the asthma studies ranged from 24 to 739 participants. The trials were randomized, double blind, and controlled.