Clinical Trial Results:
A randomized, double blind, placebo controlled study to assess the safety, tolerability, pharmacokinetics and efficacy of multiple doses of QBW251 in patients with COPD
Summary
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EudraCT number |
2014-001530-28 |
Trial protocol |
PL |
Global end of trial date |
23 Jan 2017
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Results information
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Results version number |
v1(current) |
This version publication date |
03 Feb 2018
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First version publication date |
03 Feb 2018
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
CQBW251X2201
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02449018 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Novartis Pharma AG
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Sponsor organisation address |
CH-4002, Basel, Switzerland,
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Public contact |
Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
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Scientific contact |
Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
23 Jan 2017
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
23 Jan 2017
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To assess the efficacy of a 28-day QBW251 treatment course on small airway function in current and
prior smokers with chronic bronchitis and COPD
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Protection of trial subjects |
The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
30 Apr 2015
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Poland: 3
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Country: Number of subjects enrolled |
United States: 89
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Worldwide total number of subjects |
92
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EEA total number of subjects |
3
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
47
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From 65 to 84 years |
45
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85 years and over |
0
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Recruitment
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Recruitment details |
- | |||||||||||||||||||||||||||
Pre-assignment
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Screening details |
Patients completed a single-blind placebo controlled Run-in period (14 days: Day −14 to Day −1) after confirmation of eligibility, which included visits at Day −14 and at Baseline (Day −1). | |||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | |||||||||||||||||||||||||||
Roles blinded |
Subject, Investigator | |||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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QBW251 | |||||||||||||||||||||||||||
Arm description |
QBW251 (28 day treatment period) and placebo (42 days, run-in and wash-out periods) | |||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||
Investigational medicinal product name |
CQBW251
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Investigational medicinal product code |
QBW251
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Other name |
QBW251
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Pharmaceutical forms |
Capsule, hard
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Routes of administration |
Oral use
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Dosage and administration details |
25 mg hard gelatin capsule
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Investigational medicinal product name |
QBW251X
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Investigational medicinal product code |
QBW251
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Other name |
QBW251
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Pharmaceutical forms |
Capsule, hard
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Routes of administration |
Oral use
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Dosage and administration details |
100 mg hard gelatin capsule
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Arm title
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Placebo | |||||||||||||||||||||||||||
Arm description |
Placebo (70 days, run-in, treatment and wash-out periods) | |||||||||||||||||||||||||||
Arm type |
Placebo | |||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
Placebo
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Pharmaceutical forms |
Capsule, hard
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Routes of administration |
Oral use
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Dosage and administration details |
Placebo 0mg
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Baseline characteristics reporting groups
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Reporting group title |
QBW251
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Reporting group description |
QBW251 (28 day treatment period) and placebo (42 days, run-in and wash-out periods) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Placebo (70 days, run-in, treatment and wash-out periods) | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
QBW251
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Reporting group description |
QBW251 (28 day treatment period) and placebo (42 days, run-in and wash-out periods) | ||
Reporting group title |
Placebo
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Reporting group description |
Placebo (70 days, run-in, treatment and wash-out periods) |
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End point title |
Change from Baseline in Lung Clearance Index (LCI) | ||||||||||||
End point description |
Change from baseline to Day 29 in LCI as measured by multiple breath nitrogen washout (MBNW) technique. MBNW is the time taken to wash out nitrogen while breathing 100% oxygen.
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End point type |
Primary
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End point timeframe |
Day 29
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Statistical analysis title |
Absolute change from baseline | ||||||||||||
Comparison groups |
QBW251 v Placebo
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Number of subjects included in analysis |
74
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Analysis specification |
Pre-specified
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Analysis type |
superiority | ||||||||||||
P-value |
= 0.13 | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Mean difference (net) | ||||||||||||
Point estimate |
0.28
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Confidence interval |
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level |
90% | ||||||||||||
sides |
2-sided
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lower limit |
-0.24 | ||||||||||||
upper limit |
0.79 | ||||||||||||
Variability estimate |
Standard deviation
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Dispersion value |
0.31
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End point title |
Change From Baseline in FEV1 pre-bronchodilator | ||||||||||||
End point description |
Change From Baseline to Day 29 in FEV1 will be measured by spirometer before bronchodilator administration. Forced Expiratory Volume in 1 Second (FEV1) is the amount of air that can be exhaled in 1 second. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability.
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in FEV1 post-bronchodilator | ||||||||||||
End point description |
Change From Baseline to Day 29 in FEV1 will be measured by spirometer after bronchodilator administration. Forced Expiratory Volume in 1 Second (FEV1) is the amount of air that can be exhaled in 1 second. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability.
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in FVC pre bronchodilator | ||||||||||||
End point description |
Change From Baseline to Day 29 in FVC will be measured by spirometer before bronchodilator administration. Forced Vital Capacity (FVC) is the maximum amount of air a person can expel from the lungs after a maximum inhalation. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability. Forced vital capacity (FVC) as a measure of lung function, measured before bronchodilator
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in FVC post- bronchodilator | ||||||||||||
End point description |
Change From Baseline to Day 29 in FVC will be measured by spirometer after bronchodilator administration. Forced Vital Capacity (FVC) is the maximum amount of air a person can expel from the lungs after a maximum inhalation. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability. Forced vital capacity (FVC) as a measure of lung function, measured after bronchodilator
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in TLC | ||||||||||||
End point description |
Change From Baseline to Day 29 in TLC will be measured by spirometry. Total lung capacity (TLC) is the volume in the lungs at maximal inflation. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability.
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in RV | ||||||||||||
End point description |
Change From Baseline to Day 29 in RV will be measured by spirometry. Residual volume (RV) is the volume of air remaining in the lungs after a maximal exhalation. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability.
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in FRC | ||||||||||||
End point description |
Change From Baseline to Day 29 in FRC will be measured by spirometry. Functional residual capacity (FRC) is the volume in the lungs at the end-expiratory position. All spirometry calibrations and evaluations will follow the recommendations of the American Thoracic Society / European Respiratory Society guidelines for acceptability.
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Change From Baseline in DLCO | ||||||||||||
End point description |
Diffusing capacity of the lung for carbon monoxide (DLCO) is the extent to which oxygen passes from the lung to the blood.
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End point type |
Secondary
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End point timeframe |
Day 29
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No statistical analyses for this end point |
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End point title |
Plasma concentration of QBW251 by TMax [1] | ||||||||||||
End point description |
Tmax is the time to reach the maximum concentration after drug administration.
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End point type |
Secondary
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End point timeframe |
Day 1, Day 28
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Notes [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No stats analysis for this outcome measure |
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No statistical analyses for this end point |
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End point title |
Plasma concentration of QBW251 by CMax [2] | ||||||||||||
End point description |
Cmax is the observed maximum plasma concentration following drug administration.
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End point type |
Secondary
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End point timeframe |
Day 1, Day 28
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Notes [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No stats analysis for this outcome measure |
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No statistical analyses for this end point |
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End point title |
Plasma concentration of QBW251 by AUClast [3] | ||||||||||||
End point description |
AUClast is the area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration.
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End point type |
Secondary
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End point timeframe |
Day 1, Day 28
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Notes [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No stats analysis for this outcome measure |
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No statistical analyses for this end point |
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End point title |
Plasma concentration of QBW251 by AUC0-12h | ||||||||||||
End point description |
AUC 0-12h is the area under the plasma concentration-time curve from time zero to 12 hours.
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End point type |
Secondary
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End point timeframe |
Day 1, Day 28
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Notes [4] - analysis AUClast was not calculated up to 12 hours after dosing So this data is not available. [5] - analysis AUClast was not calculated up to 12 hours after dosing So this data is not available. |
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
19.1
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Reporting groups
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Reporting group title |
Placebo
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Reporting group description |
Placebo | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
QBW251 300 mg bid
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Reporting group description |
QBW251 300 mg bid | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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01 Mar 2015 |
The purpose was to clarify multiple requirements related to the
chest HRCT study component. HRCT was utilized as a screening measurement as well as a mechanism to quantify air trapping for comparative efficacy purposes in this study.
Experience in ongoing sponsor trials revealed that historical scans are unlikely to adhere to the imaging requirements of this study. Therefore, the use of historical HRCT scans for the
purpose of air trapping quantification was removed, except in the instance that a patient was re-screened for this study. The specific quantitative thresholds used to determine evidence of
air trapping and emphysema extent was removed from the radiologic eligibility criteria and only a qualitative description remained. |
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01 Jul 2015 |
The purpose was to modify the dose of QBW251, changing from
the original dose of 450 mg bid to 300 mg bid. At the time of the protocol amendment, 4 patients were randomized to 450 mg bid (drug/placebo). |
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01 Feb 2016 |
The purpose was to discontinue the collection and analysis of
EPCs. EPC cellular biomarkers were collected as an exploratory objective to evaluate
vascular remodeling in COPD patients. Results from the analysis of 136 EPC samples from a total of 44 patients showed that blood leukocyte populations and EPCs could not be identified properly because of staining failure and quality issue of the reagents. Based on this data, cellular biomarkers were removed as an exploratory biomarker assessment |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |