E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with COPD, with moderate to severe airflow limitation and a smoking history of at least 10 pack years. |
|
E.1.1.1 | Medical condition in easily understood language |
Patients with COPD and a smoking history |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 15.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10010952 |
E.1.2 | Term | COPD |
E.1.2 | System Organ Class | 100000004855 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To demonstrate the superiority of QVA149 as compared to fluticasone/salmeterol in COPD patients with moderate to severe airflow limitation in terms of standardized FEV1 AUC0-12h at 12 weeks of treatment. |
|
E.2.2 | Secondary objectives of the trial |
To evaluate the effect of QVA149 as compared to fluticasone/salmeterol in COPD patients with moderate to severe airflow limitation in terms of:
Lung function:
-Trough FEV1 at Day 1 and Week 12 (mean of 23 h 15 min and 23 h 45
min post morning dose)
-Pre-dose trough FEV1 at Week 12 (mean of 15 min and 45 min pre
morning dose)
-Peak FEV1 within 4 hours post dose at Day 1 and Week 12
-AUC0-4h at Day 1 and Week 12
-FEV1 and FVC by time point at Day 1 and Week 12
The level of breathlessness experienced by the patients evaluated using Transition Dyspnea Index (TDI) at Week 12
The change in health status, based on total score of the St George’s Respiratory Questionnaire (SGRQ) at Week 12 as compared to baseline
The mean change from baseline in daily number of puffs of rescue medication at Week 12
For more Secondary objectives, please refer to the protocol. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Patients who have signed an Informed Consent Form prior to initiation of any study-related procedure
- Male and female adults aged ≥40 years
- Patients with stable COPD according to the current GOLD strategy (GOLD 2011)
- Patients with airflow limitation indicated by a post-bronchodilator FEV1 ≥ 30% and < 80% of the predicted normal, and a post-bronchodilator
FEV1/FVC < 0.7 at run-in (Visit 101)
- Current or ex-smokers who have a smoking history of at least 10 pack years (e.g., 10 pack years = 1 pack/day x 10 years, or ½ pack/day x 20 years). An ex-smoker may be defined as a subject who has not smoked for ≥ 6 months at screening
- Patients with an mMRC grade 2 or greater at Visit 101 |
|
E.4 | Principal exclusion criteria |
1. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive hCG (human Chorionic Gonadotropin) laboratory test.
2. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant, unless they are using effective methods of contraception during dosing of study treatment. Effective contraception methods include:
• Total abstinence when this is in line with the preferred and usual lifestyle of the
subject (periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation
methods) and withdrawal are not acceptable methods of contraception).
• Female sterilization defined as surgical hysterectomy, bilateral oophorectomy, or
tubal ligation at least six weeks before taking the study treatment (Single
oophorectomy does not meet the definition of female sterilization).
• Male sterilization (at least 6 months prior to screening). For female subjects on the
study, the vasectomized male partner should be the sole partner for that subject.
• Barrier methods of contraception: Condom or Occlusive cap (diaphragm or
cervical/vault caps) with spermicidal foam/gel/film/cream/vaginal suppository.
• Use of oral, injected or implanted hormonal methods of contraception or other forms
of hormonal contraception that have comparable efficacy (failure rate <1%), for
example hormone vaginal ring or transdermal hormone contraception. In case of use
of oral contraception women should have been stable on the same pill for a minimum
of 3 months before taking study treatment.
• Placement of an intrauterine device (IUD) or intrauterine system (IUS).
Women are considered post-menopausal and not of child bearing potential if they have
had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile
(e.g. age appropriate, history of vasomotor symptoms) or have had surgical bilateral
oophorectomy (with or without hysterectomy) or tubal ligation at least six weeks ago. In
the case of oophorectomy alone, only when the reproductive status of the woman has been
confirmed by follow up hormone level assessment is she considered not of child bearing
potential
3. Patients with Type I or uncontrolled Type II diabetes.
4. Patients with a history of long QT syndrome or whose QTc measured at Visit 101
(Fridericia method) is prolonged (>450 ms for males and females) and confirmed by a
central laboratory. These patients should not be re-screened.
5. Patients who have a clinically significant ECG abnormality at Visit 101 or Visit 102.
These patients should not be re-screened.
6. Patients who have a clinically significant laboratory abnormality at Visit 101.
7. Patients with a body mass index (BMI) of more than 40 kg/m2.
8. Patients who have clinically significant renal, cardiovascular (such as but not limited to
unstable ischemic heart disease, NYHA Class III/IV left ventricular failure, myocardial
infarction), arrhythmia (see below for patients with atrial fibrillation), neurological,
endocrine, immunological, psychiatric, gastrointestinal, hepatic, or hematological
abnormalities which could interfere with the assessment of the efficacy and safety of the
study treatment.
For more exclusion criteria, please refer to the protocol. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
|
E.5.2 | Secondary end point(s) |
• Lung function:
• Trough FEV1 at Day 1 and Week 12 (mean of 23 h 15 min and 23 h 45 min post morning dose)
• Pre-dose trough FEV1 at Week 12 (mean of 15 min and 45 min pre morning dose)
• Peak FEV1 within 4 hours post dose at Day 1 and Week 12
• AUC0-4h at Day 1 and Week 12
• FEV1 and FVC bytime point at Day 1 and Week 12
• The level of breathlessness experienced by the patients evaluated using Transition Dyspnea Index (TDI) at Week 12
• The change in health status, based on total score of the St George’s Respiratory Questionnaire (SGRQ) at Week 12 as compared to baseline
• The mean change from baseline in daily number of puffs of rescue medication at Week 12
• Symptoms reported at Week 12 using the patient electronic diary
• COPD assessment test (CAT) at Week 12
• Safety and tolerability (electrocardiograms (ECGs), laboratory tests, vital signs and
adverse events including COPD exacerbations and oral candidiasis) over 12 weeks of
treatment. |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
- Tolerability
- Modified Medical Research Council (mMRC) dyspnea scale |
|
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 31 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Austria |
Ecuador |
Germany |
United States |
|
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 9 |