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QVA149

Phase 3

Chronic Obstructive Pulmonary Disease (COPD) | Small molecule | Respiratory |Novartis AG|Last Updated: Jun 15, 2016

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindPLACEBO_CONTROLLEDDMCBiomarker
Total Trials7
Total Enrollment8,328
FDA Designations
No designations recorded
Clinical Trials (7)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT01782326QVA vs. Salmeterol/Fluticasone, 52-week Exacerbation Study, FLAME (EFfect of Indacaterol Glycopyronium Vs Fluticasone Salmeterol on COPD Exacerbations)PHASE3 COMPLETED 3,362Jul 1, 2013Sep 1, 2015May 16, 2016499 Argentina, Austria +41
NCT01712516A 12-week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled Study to Assess the Efficacy, Safety, and Tolerability of Indacaterol Maleate / Glycopyrronium Bromide in COPD Patients With Moderate to Severe Airflow LimitationPHASE3 COMPLETED 1,001Dec 1, 2012Feb 1, 2014Jul 15, 201595 United States, Colombia +7
NCT01727141A 12 Week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled Study to Assess the Efficacy, Safety, and Tolerability of Indacaterol Maleate / Glycopyrronium Bromide in COPD Patients With Moderate to Severe Airflow Limitation.PHASE3 COMPLETED 1,042Nov 1, 2012Feb 1, 2014Mar 29, 2016143 United States, Canada +6
NCT01610037Comparison of Long-term Safety of the Combination Product QVA149A Against Placebo and Standard of Care Treatment in Chronic Obstructive Pulmonary Disease Patients With Moderate to Severe Airflow LimitationPHASE3 COMPLETED 1,215Oct 1, 2012Feb 1, 2015Jun 15, 2016116 Argentina, Colombia +15
NCT01682863A Multi-centre Randomized Double Blind 52-week Study to Assess the Safety of QVA149 Compared to QAB149 in Patients With COPD Who Have Moderate to Severe Airflow LimitationPHASE3 COMPLETED 614Oct 1, 2012Jun 1, 2014Mar 30, 201686 United States, Bulgaria +5
NCT01574651The Effect of QVA149 on Health Related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease (COPD)PHASE3 COMPLETED 934May 1, 2012Apr 1, 2013May 22, 2014144 Germany
NCT01285492Long Term Safety and Tolerability of QVA149 Versus Tiotropium in Japanese Patients With Chronic Obstructive Pulmonary Disease (COPD)PHASE3 COMPLETED 160Jan 1, 2011Sep 1, 2012Dec 27, 201335 Japan
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Study Endpoints
Primary Endpoints
Rate of COPD Exacerbations
52 weeks

COPD exacerbations starting between first dose and one day after last treatment are included. COPD exacerbations that occurred within 7 days of each other are collapsed as one event. Estimates are from a generalized linear model assuming a negative binomial distribution with terms for treatment, baseline total symptom score, baseline COPD exacerbation history (i.e. number of COPD exacerbations during the past 12 months prior to study), smoking status at screening, ICS use at screening, airflow limitation severity, and region. As the offset variable log(exposure time in years) was used.

Primary: Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))
baseline (BL), 12 weeks

Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction. Missing values of FEV1 AUC0-12 at Day 1 and Week 12 will not imputed. The trapezoidal rule was used to calculate FEV1 AUC and then normalized to the length of time.

Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))
baseline (BL), 12 Weeks

Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction. Missing values of FEV1 AUC0-12 at Day 1 and Week 12 will not imputed. The trapezoidal rule was used to calculate FEV1 AUC and then normalized to the length of time.

Number of Patients With Serious Adverse Events
Week 52

The overall rate of serious adverse events reported from initiation through 30 days post last dose.

Number of Patients With Adverse Events, Serious Adverse Events, and Death
56 weeks

The overall rate of adverse events reported from initiation through 30 days post last dose.

St. George's Respiratory Questionnaire (SGRQ-C) Total Score After 26 Weeks of Treatment (Non-inferiority Analysis).
Baseline, week 26

SGRQ is a health related quality of life questionnaire consisting of 40 items in three areas: symptoms (respiratory symptoms and severity), activity (activities that cause or are limited by breathlessness) and impacts (social functioning and psychological disturbances due to airway disease). The total score is 0 to 100 with a higher score indicating poorer health status. For patients who completed the study but with missing SGRQ-C during treatment, the missing SGRQ-C were replaced by the last observation carried forward (LOCF). Symptom scores were expected to improve over treatment, therefore the replacement of missing values with earlier measurements did not result in overoptimistic imputation and this procedure could be regarded as conservative.

Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) or Death
52 weeks

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.

Secondary Endpoints
Time to First COPD Exacerbation.
52 weeks
Rate of Moderate to Severe COPD Exacerbations.
52 weeks
Time to First Moderate to Severe COPD Exacerbation.
52 weeks.
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Study Design & Arms
AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
QVA149EXPERIMENTALQVA149 (110/50 μg) once daily
Long acting B2 agonist (LABA) and inhaled corticosteroid (ICS)ACTIVE_COMPARATORSalmeterol/fluticasone (50/500μg) b.i.d
QAB149ACTIVE_COMPARATOR27.5 ug b.i.d.
NVA237ACTIVE_COMPARATOR12.5 ug b.i.d.
PlaceboPLACEBO_COMPARATORb.i.d.
TiotropiumACTIVE_COMPARATOR -
QVA149 dose 1EXPERIMENTALQVA149 27.5/12.5 μg capsules
QVA149 dose 2EXPERIMENTALQVA149 27.5/25 μg capsules
QVA149 plus placebo to tiotropium and placebo to formoterolEXPERIMENTALQVA149 110/50µg, once daily for inhalation use plus placebo to tiotropium, once daily for inhalation use and placebo to formoterol, twice daily for inhalation use.
Tiotropium plus Formoterol and placebo to QVA149ACTIVE_COMPARATORTiotropium 18µg, once daily for inhalation use plus Formoterol 12µg, twice daily for inhalation use and placebo to QVA149, once daily for inhalation use.
Interventions
NameTypeDescription
QVA149DRUGQVA149 will be supplied in a capsule form in blister packs for use in the Novartis Concept 1 SDDPI.
Long acting B2 agonist (LABA) and inhaled corticosteroid (ICS)DRUGSalmeterol/fluticasone dry inhalation powder delivered via the Accuhaler device.
QAB149DRUGQAB149 was supplied in capsule form in blister packs for use in the Novartis Concept1 SDDPI.
NVA237DRUGNVA237 was supplied in capsule form in blister packs for use in the Novartis Concept1 SDDPI.
PlaceboDRUGPlacebo was supplied in capsule form in blister packs for use in the Novartis Concept1 SDDPI.
TiotropiumDRUGTiotropium 18 µg will be supplied as capsules in blister packs for once daily inhalation using the HandiHaler SDDPI
Placebo to tiotropiumDRUGPlacebo to tiotropium capsules daily (q.d.) for inhalation, delivered via proprietary inhaler (Handihaler®). Placebo tiotropium inhalation capsules were matched in size and color to tiotropium 18 μg q.d. inhalation capsules
Placebo to formoterolDRUGPlacebo to formoterol capsules twice daily (b.i.d) delivered via Aerolizer® device. Placebo formoterol inhalation capsules were equally matched in size, shape and color to formoterol 12 μg b.i.d. inhalation capsules.
FormoterolDRUGFormoterol 12µg, twice daily is administered via the manufacturer's proprietary inhalation device.
Placebo to QVA149DRUGPlacebo to QVA149 is administered via a single-dose dry powder inhaler. Placebo QVA149 inhalation capsules were equally matched in size, shape and color to QVA149 110/50 μg q.d. inhalation capsules
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Eligibility Criteria
Age Range40 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites499

Inclusion Criteria: * Written informed consent must be obtained before any assessment is performed * Male or female adults aged ≥40 years * Patients with stable Chronic Obstructive Pulmonary Disease ( COPD) according to the current GOLD strategy (GOLD 2011) * Current or ex-smokers who have a smokin...

Countries:ArgentinaAustriaBelgiumBulgariaCanadaChileChinaColombiaCroatiaCzechiaDenmarkEstoniaFinlandFranceGermanyGreeceGuatemalaHong KongHungaryIcelandIndiaItalyJapanLatviaLithuaniaMexicoNetherlandsNorwayPhilippinesPolandPortugalRomaniaRussiaSerbiaSlovakiaSouth AfricaSouth KoreaSpainSwedenTaiwanThailandTurkey (Türkiye)United KingdomUnited StatesEgyptPanamaSloveniaUkraineVietnamIsraelPuerto Rico
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