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    Clinical Trial Results:
    An open label, multicenter, extension study to evaluate the long-term safety of QGE031 240 mg s.c. given every 4 weeks for 52 weeks in Chronic Spontaneous Urticaria patients who completed study CQGE031C2201

    Summary
    EudraCT number
    2015-003636-13
    Trial protocol
    DE   ES   GR   GB  
    Global end of trial date
    02 May 2019

    Results information
    Results version number
    v4(current)
    This version publication date
    30 Jul 2023
    First version publication date
    15 May 2020
    Other versions
    v1 , v2 , v3
    Version creation reason
    • Correction of full data set
    Corrected Safety presentation

    Trial information

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    Trial identification
    Sponsor protocol code
    CQGE031C2201E1
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02649218
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 6132411111, novartis.email@novartis.com
    Scientific contact
    Study Lead, Novartis Pharmaceuticals, 1 8627788300, novartis.email@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
    16 Jan 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    02 May 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    02 May 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study was to assess the long-term safety of ligelizumab in adult CSU subjects who completed the core Study C2201 using the following evaluations: Incidence and severity of non-serious and serious adverse events including any events of special interest Changes in vital signs, laboratory assessments, and electrocardiograms (ECGs)
    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
    24 May 2016
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 26
    Country: Number of subjects enrolled
    Canada: 14
    Country: Number of subjects enrolled
    Germany: 35
    Country: Number of subjects enrolled
    Greece: 4
    Country: Number of subjects enrolled
    Japan: 25
    Country: Number of subjects enrolled
    Russian Federation: 22
    Country: Number of subjects enrolled
    Spain: 30
    Country: Number of subjects enrolled
    Taiwan: 24
    Country: Number of subjects enrolled
    United Kingdom: 1
    Country: Number of subjects enrolled
    United States: 45
    Worldwide total number of subjects
    226
    EEA total number of subjects
    70
    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)
    211
    From 65 to 84 years
    15
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Of the subjects who completed core study (NCT02477332) that were eligible for extension study, 237 were screened; 226 were enrolled to open-label treatment epoch; 201 (88.9%) completed treatment epoch; 209 (92.5%) entered the post-treatment follow-up epoch and 152 (67.3%) completed the post-treatment follow-up epoch

    Pre-assignment
    Screening details
    226 who completed core study (NCT02477332) enrolled in this extension https://clinicaltrials.gov/ct2/show/NCT02477332?term=cqge031c2201&draw=2&rank=2

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    Study was not blinded. Randomization/treatment assignment data from the core Study C2201 was not unblinded to the extension study sites until the core Study C2201 was fully completed.

    Arms
    Arm title
    Ligelizumab
    Arm description
    QGE031 240 mg s.c. q4w x 13 treatments
    Arm type
    Experimental

    Investigational medicinal product name
    Ligelizumab
    Investigational medicinal product code
    QGE031
    Other name
    Pharmaceutical forms
    Injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    QGE031 240 mg s.c. q4w x 13 treatments

    Number of subjects in period 1
    Ligelizumab
    Started
    226
    Completed
    201
    Not completed
    25
         Physician decision
    1
         Consent withdrawn by subject
    2
         Adverse event, non-fatal
    8
         Pregnancy
    3
         Lack of efficacy
    8
         Protocol deviation
    3

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Ligelizumab
    Reporting group description
    QGE031 240 mg s.c. q4w x 13 treatments

    Reporting group values
    Ligelizumab Total
    Number of subjects
    226 226
    Age Categorical
    Units: participants
        <65 years
    211 211
        >= 65 years
    15 15
    Age Continuous
    age
    Units: years
        arithmetic mean (standard deviation)
    44.5 ± 12.69 -
    Sex/Gender, Customized
    75.2% of participants were female, 24.8% were male
    Units: Percentage of Participants
        Female
    170 170
        Male
    56 56
    Race/Ethnicity, Customized
    22.6% Asian, 1.3% Black, 72.1% White, 0.4% Native American, 0.9% Unknown, 2.7% Other
    Units: Subjects
        Asian
    51 51
        Black or African American
    3 3
        White
    163 163
        American Indian or Alaska Native
    1 1
        Unknown
    2 2
        Other
    6 6
    Subject analysis sets

    Subject analysis set title
    Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Safety Set: All 226 subjects who received at least one dose of study drug during this open-label study were included.

    Subject analysis sets values
    Safety Set
    Number of subjects
    226
    Age Categorical
    Units: participants
        <65 years
    211
        >= 65 years
    15
    Age Continuous
    age
    Units: years
        arithmetic mean (standard deviation)
    44.5 ± 12.69
    Sex/Gender, Customized
    75.2% of participants were female, 24.8% were male
    Units: Percentage of Participants
        Female
    170
        Male
    56
    Race/Ethnicity, Customized
    22.6% Asian, 1.3% Black, 72.1% White, 0.4% Native American, 0.9% Unknown, 2.7% Other
    Units: Subjects
        Asian
    51
        Black or African American
    3
        White
    163
        American Indian or Alaska Native
    1
        Unknown
    2
        Other
    6

    End points

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    End points reporting groups
    Reporting group title
    Ligelizumab
    Reporting group description
    QGE031 240 mg s.c. q4w x 13 treatments

    Subject analysis set title
    Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Safety Set: All 226 subjects who received at least one dose of study drug during this open-label study were included.

    Primary: Number of participants with at least one treatment emergent adverse event (AE)

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    End point title
    Number of participants with at least one treatment emergent adverse event (AE) [1]
    End point description
    The primary objective of this study was to assess the long-term safety of one-year treatment of QGE031 in adult Chronic Spontaneous Urticaria (CSU) patients who completed the core study CQGE031C2201 using the following evaluations: number of participants with treatment emergent AEs of non-serious and serious nature including any events of special interest. No statistical analysis was planned for this primary outcome.
    End point type
    Primary
    End point timeframe
    Within 16 weeks after Week 48
    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 stats analysis were planned
    End point values
    Ligelizumab
    Number of subjects analysed
    226
    Units: Participants
    190
    No statistical analyses for this end point

    Secondary: Time to UAS7 > 6 for subjects having achieved UAS7 ≤ 6 at the end of the treatment period

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    End point title
    Time to UAS7 > 6 for subjects having achieved UAS7 ≤ 6 at the end of the treatment period
    End point description
    The secondary objective of this study was to assess the long-term efficacy of QGE031 in adult CSU patients who completed the CQGE031C2201 study using the following evaluations: Sustained remission defined as maintaining (Urticaria Activity Score) UAS7 ≤ 6 over 48 weeks post-treatment follow up epoch among the participants achieving remission at the end of treatment epoch.
    End point type
    Secondary
    End point timeframe
    Up to 48 weeks after Week 52
    End point values
    Ligelizumab
    Number of subjects analysed
    226
    Units: Median number of weeks to event
    21
    No statistical analyses for this end point

    Secondary: Number and proportion of participants who achieved UAS7≤ 6

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    End point title
    Number and proportion of participants who achieved UAS7≤ 6
    End point description
    Summary of subjects with UAS7 ≤ 6. The long term efficacy of one-year treatment of ligelizumab 240 mg s.c. q4w is assessed by number and proportion of participants who achieved well controlled disease (UAS7≤ 6) at end of the treatment period (Week 52) and end of follow up period (Week 100). Proportion of participants who achieved UAS7≤ 6: Baseline 0.44%, Week 52 61.06%, 28.32%
    End point type
    Secondary
    End point timeframe
    Baseline, Week 52, Week 100
    End point values
    Ligelizumab Safety Set
    Number of subjects analysed
    226
    Units: Participants
        Baseline
    1
    1
        Week 52
    138
    138
        Week 100
    64
    64
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Within 16 weeks after Week 48
    Adverse event reporting additional description
    Adverse Events (AEs) are any untoward sign or symptom that occurs during the study treatment
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    QGE031 240 mg q4w (TEAE)
    Reporting group description
    QGE031 240 mg q4w (TEAE)

    Reporting group title
    QGE031 240 mg q4w (non-TEAE)
    Reporting group description
    QGE031 240 mg q4w (non-TEAE)

    Serious adverse events
    QGE031 240 mg q4w (TEAE) QGE031 240 mg q4w (non-TEAE)
    Total subjects affected by serious adverse events
         subjects affected / exposed
    15 / 226 (6.64%)
    6 / 226 (2.65%)
         number of deaths (all causes)
    1
    0
         number of deaths resulting from adverse events
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Basal cell carcinoma
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cervix carcinoma stage 0
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pancreatic neoplasm
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypotension
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Abortion spontaneous
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Non-cardiac chest pain
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Immune system disorders
    Hypersensitivity
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Mental status changes
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Blood pressure increased
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Ligament rupture
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tendon rupture
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Angina pectoris
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Supraventricular tachycardia
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolic encephalopathy
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Presyncope
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Toxic encephalopathy
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Vertigo
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Colitis
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhoids
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mouth cyst
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholecystitis
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystitis chronic
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Urticaria
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Acute kidney injury
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Foot deformity
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Complicated appendicitis
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Localised infection
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    0 / 226 (0.00%)
    1 / 226 (0.44%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypocalcaemia
         subjects affected / exposed
    1 / 226 (0.44%)
    0 / 226 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    QGE031 240 mg q4w (TEAE) QGE031 240 mg q4w (non-TEAE)
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    133 / 226 (58.85%)
    38 / 226 (16.81%)
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    12 / 226 (5.31%)
    1 / 226 (0.44%)
         occurrences all number
    14
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    29 / 226 (12.83%)
    2 / 226 (0.88%)
         occurrences all number
    47
    3
    General disorders and administration site conditions
    Injection site erythema
         subjects affected / exposed
    13 / 226 (5.75%)
    0 / 226 (0.00%)
         occurrences all number
    33
    0
    Skin and subcutaneous tissue disorders
    Urticaria
         subjects affected / exposed
    23 / 226 (10.18%)
    18 / 226 (7.96%)
         occurrences all number
    37
    24
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    12 / 226 (5.31%)
    1 / 226 (0.44%)
         occurrences all number
    13
    1
    Back pain
         subjects affected / exposed
    16 / 226 (7.08%)
    2 / 226 (0.88%)
         occurrences all number
    16
    3
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    57 / 226 (25.22%)
    10 / 226 (4.42%)
         occurrences all number
    94
    13
    Sinusitis
         subjects affected / exposed
    13 / 226 (5.75%)
    2 / 226 (0.88%)
         occurrences all number
    13
    2
    Upper respiratory tract infection
         subjects affected / exposed
    23 / 226 (10.18%)
    3 / 226 (1.33%)
         occurrences all number
    38
    3
    Urinary tract infection
         subjects affected / exposed
    12 / 226 (5.31%)
    3 / 226 (1.33%)
         occurrences all number
    13
    3

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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.
    None reported
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