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    Clinical Trial Results:
    A randomized, double blind, placebo-controlled study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of multiple doses of inhaled QBW276 in patients with cystic fibrosis

    Summary
    EudraCT number
    2014-004915-35
    Trial protocol
    DE   GB  
    Global end of trial date
    04 Oct 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    02 May 2019
    First version publication date
    02 May 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CQBW276X2201
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02566044
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis PharmaAG
    Sponsor organisation address
    CH-4002, Basel, United Kingdom,
    Public contact
    Medica Information Services, Novartis Pharmaceuticals UK Limited, +44 1276698370, medinfo.uk@novartis.com
    Scientific contact
    Medica Information Services, Novartis Pharmaceuticals UK Limited, +44 1276698370, medinfo.uk@novartis.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    04 Oct 2018
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    04 Oct 2018
    Global end of trial reached?
    Yes
    Global end of trial date
    04 Oct 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Cohorts 1 and 2: To assess the safety, tolerability, and pharmacokinetics (PK) of multiple doses of inhaled QBW276 and its metabolites, over 1 or 2 weeks of treatment in patients with cystic fibrosis regardless of the underlying mutation Cohort 3: To evaluate the pharmacodynamic (PD) response to multiple doses of inhaled QBW276 in lung function (percent of predicted FEV1) over 4 weeks of treatment compared with placebo in patients with cystic fibrosis that are homozygous for the F508del mutation
    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.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    25 Sep 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 13
    Country: Number of subjects enrolled
    United States: 3
    Worldwide total number of subjects
    16
    EEA total number of subjects
    13
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    16
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    The study was terminated after completion of all randomized patients in Cohort 2 due to strategic issues. All patients completed the study prior to termination.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Cohort 1 QBW276
    Arm description
    QBW276 3mg bid
    Arm type
    Experimental

    Investigational medicinal product name
    QBW276 3mg bid
    Investigational medicinal product code
    QBW276 3mg bid
    Other name
    QBW276 3mg bid
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    1.5 mg strength capsule

    Arm title
    Cohort 2 QBW276
    Arm description
    QBW276 Dose 6 mg bid
    Arm type
    Experimental

    Investigational medicinal product name
    QBW276 Dose 6 mg bid
    Investigational medicinal product code
    QBW276 Dose 6 mg bid
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    1.5 mg strength capsule

    Arm title
    Placebo
    Arm description
    -
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Placebo
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Matching placebo

    Number of subjects in period 1
    Cohort 1 QBW276 Cohort 2 QBW276 Placebo
    Started
    6
    6
    4
    Completed
    6
    6
    4

    Baseline characteristics

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    End points

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    End points reporting groups
    Reporting group title
    Cohort 1 QBW276
    Reporting group description
    QBW276 3mg bid

    Reporting group title
    Cohort 2 QBW276
    Reporting group description
    QBW276 Dose 6 mg bid

    Reporting group title
    Placebo
    Reporting group description
    -

    Subject analysis set title
    Cohort 1 QBP545
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    formation of metabolites QBP545

    Subject analysis set title
    Cohort 1 QBV697
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    formation of metabolites QBV697

    Subject analysis set title
    Cohort 2 QBP545
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    formation of metabolites QBP545

    Subject analysis set title
    Cohort 2 QBV697
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    formation of metabolites QBV697

    Primary: Cohorts 1 and 2: Safety Assessments, incidence of Treatment-Emergent Adverse Events

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    End point title
    Cohorts 1 and 2: Safety Assessments, incidence of Treatment-Emergent Adverse Events [1]
    End point description
    Adverse events were summarized by the number of patients having any adverse event overall and presented in the safety section. Study was prematurely terminated
    End point type
    Primary
    End point timeframe
    Cohort 1: day 1-7; Cohort 2: day 1-14
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No statistical analysis for safety
    End point values
    Cohort 1 QBW276 Cohort 2 QBW276 Placebo
    Number of subjects analysed
    6
    6
    4
    Units: Participants
    6
    6
    4
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Treatment-emergent adverse events
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.0
    Reporting groups
    Reporting group title
    QBW276 3 mg bid
    Reporting group description
    QBW276 3 mg bid

    Reporting group title
    Placebo
    Reporting group description
    Placebo

    Reporting group title
    QBW276 6 mg bid
    Reporting group description
    QBW276 6 mg bid

    Serious adverse events
    QBW276 3 mg bid Placebo QBW276 6 mg bid
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    0 / 6 (0.00%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 2%
    Non-serious adverse events
    QBW276 3 mg bid Placebo QBW276 6 mg bid
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    2 / 6 (33.33%)
    0 / 4 (0.00%)
    6 / 6 (100.00%)
    Investigations
    Alanine aminotransferase increased
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Aspartate aminotransferase increased
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Blood creatine phosphokinase increased
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Blood uric acid increased
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    3 / 6 (50.00%)
         occurrences all number
    0
    0
    5
    General disorders and administration site conditions
    Feeling cold
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Mucosal dryness
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Pyrexia
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    3
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Immune system disorders
    Seasonal allergy
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Gastrointestinal disorders
    Abdominal distension
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    3
    Abdominal pain upper
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    4 / 6 (66.67%)
         occurrences all number
    0
    0
    6
    Dyspnoea
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 4 (0.00%)
    2 / 6 (33.33%)
         occurrences all number
    1
    0
    3
    Haemoptysis
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Oropharyngeal pain
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Pulmonary congestion
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Sinus congestion
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Sputum increased
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Wheezing
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Skin and subcutaneous tissue disorders
    Hyperhidrosis
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Rash papular
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Renal and urinary disorders
    Haematuria
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 4 (0.00%)
    0 / 6 (0.00%)
         occurrences all number
    1
    0
    0
    Musculoskeletal and connective tissue disorders
    Joint swelling
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Musculoskeletal chest pain
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1
    Metabolism and nutrition disorders
    Hypoglycaemia
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 4 (0.00%)
    1 / 6 (16.67%)
         occurrences all number
    0
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Nov 2015
    This amendment to the protocol was to make specific changes that address comments received from the UK MHRA on 12 Nov 2015 in response to the Sponsors clinical trial application (CTA) submission. The MHRA stated their comments were grounds for non-acceptance of the CTA and that a protocol amendment was required. The changes made to the protocol included additional detail on the duration for use of contraception after the last dose of QBW276, inclusion of the prohibited medications list within the protocol, amendments to the study stopping rules and some corrections of typographical errors. As this amendment to the protocol has occurred prior to study start, these changes did not affect the study population or study results
    01 Mar 2017
    The purpose of this amendment was to revise the Assessment Schedule to comply with Health Authority requirements that all studies must be collected and submitted in CDISC (Clinical Data Interchange Standards Consortium) compliant format. To adhere to these requirements, the protocol was amended to SDTM (Study Data Tabulation Model) format. After completing exploratory biomarker analysis in the QBW251 trials, no significant or relevant signals were detected in the biomarker assays conducted. As a result, other than aldosterone and electrolytes, the exploratory biomarker analysis was removed. In addition, some minor modifications and corrections were made throughout the document to ensure clarity and consistency. As this amendment to the protocol occurred prior to study start, these changes did not affect the study population or study results. This amendment does not affect the safety or physical or mental integrity of the subjects of the study, the scientific value of the study, or the conduct or management of the study.
    01 Aug 2017
    The purpose of this amendment was to address the request from Health Authorities to exclude patients with hypersensitivity to excipients. In addition, few minor corrections were made and missing reference for CF Quality of Life Questionnaire was added
    01 Jun 2018
    The purpose of this amendment was to remove Lung Volumes and MBNW (Multiple Breath Nitrogen Washout) assessments, and to adjust and clarify the assessment schedule, allowing more time for screening and baseline assessments in Cohort 3. The inclusion and exclusion criteria were also revised. In addition, some minor modifications and corrections were made throughout the document to ensure clarity and consistency

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com/CtrdWeb/home.novfor complete trial results.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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