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    Clinical Trial Results:
    A randomized, double-blind, double-dummy, activecontrolled,3-period complete cross-over study to assess the bronchodilator effect and safety of two doses of QVM149 compared to a fixed dose combination of salmeterol/fluticasone in patients with asthma.

    Summary
    EudraCT number
    2016-005164-34
    Trial protocol
    NL   GB   BG   RO  
    Global end of trial date
    02 Aug 2018

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Aug 2019
    First version publication date
    22 Aug 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CQVM149B2208
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03063086
    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 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 61324111, 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
    02 Aug 2018
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    02 Aug 2018
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To demonstrate superiority in peak bronchodilator effect of QVM149 at a dose of 150/50/160 μg o.d. and 150/50/80 μg once daily (o.d.) compared to a fixed-dose combination (FDC) of salmeterol/fluticasone at a dose of 50/500 μg twice daily (b.i.d.) after 3 weeks of treatment in patients with asthma. Due to EudraCT system limitations, which EMA is aware of, results of crossover studies are not accurately represented in this record. Please go to https://www.novctrd.com/CtrdWeb/home.nov for complete trial results.
    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
    31 May 2017
    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
    Bulgaria: 25
    Country: Number of subjects enrolled
    China: 8
    Country: Number of subjects enrolled
    Germany: 62
    Country: Number of subjects enrolled
    United Kingdom: 4
    Country: Number of subjects enrolled
    Netherlands: 8
    Country: Number of subjects enrolled
    Romania: 9
    Worldwide total number of subjects
    116
    EEA total number of subjects
    108
    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)
    98
    From 65 to 84 years
    18
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    114 patients were planned to be randomized to one of the six treatment sequences in an equal allocation ratio. Procedures in all treatment periods were identical. At the end of the last treatment period, the patients underwent Study Completion evaluations before they were discharged from the study site

    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
    Sequence 1 (A-B-C)
    Arm description
    QVM149 150/50/80 μg o.d; QVM149 150/50/160 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.
    Arm type
    Active comparator

    Investigational medicinal product name
    QVM149 150/50/80 μg o.d.; QVM149 150/50/160 μg o.d.; salmeterol/fluticasone FDC 50/500 μg b.i.d.
    Investigational medicinal product code
    QVM149
    Other name
    QVM149
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    oral inhalation

    Arm title
    Sequence 2(A-C-B)
    Arm description
    QVM149 150/50/80 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/160 μg o.d;
    Arm type
    Active comparator

    Investigational medicinal product name
    QVM149 150/50/80 μg o.d.; salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/160 μg o.d.;
    Investigational medicinal product code
    QVM149
    Other name
    QVM149
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    oral inhalation

    Arm title
    Sequence 3(B-C-A)
    Arm description
    QVM149 150/50/160 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/80 μg o.d
    Arm type
    Active comparator

    Investigational medicinal product name
    QVM149 150/50/160 μg o.d.; salmeterol/fluticasone FDC 50/500 μg b.i.d; QVM149 150/50/80 μg o.d.;
    Investigational medicinal product code
    QVM149
    Other name
    QVM149
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral inhalation

    Arm title
    Sequence 4(B-A-C)
    Arm description
    QVM149 150/50/160 μg o.d; QVM149 150/50/80 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d
    Arm type
    Active comparator

    Investigational medicinal product name
    QVM149 150/50/160 μg o.d; QVM149 150/50/80 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.
    Investigational medicinal product code
    QVM149
    Other name
    QVM149
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral Inhalation

    Arm title
    Sequence 5(C-A-B)
    Arm description
    salmeterol/fluticasone FDC 50/500 μg b.i.d; QVM149 150/50/80 μg o.d; QVM149 150/50/160 μg o.d
    Arm type
    Active comparator

    Investigational medicinal product name
    salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/80 μg o.d; QVM149 150/50/160 μg o.d.;
    Investigational medicinal product code
    QVM149
    Other name
    QVM149
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral Inhalation

    Arm title
    Sequence 6(C-B-A)
    Arm description
    salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/160 μg o.d; QVM149 150/50/80 μg o.d
    Arm type
    Active comparator

    Investigational medicinal product name
    salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/160 μg o.d.; QVM149 150/50/80 μg o.d
    Investigational medicinal product code
    QVM149
    Other name
    QVM149
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Inhalation use
    Dosage and administration details
    Oral Inhalation

    Number of subjects in period 1
    Sequence 1 (A-B-C) Sequence 2(A-C-B) Sequence 3(B-C-A) Sequence 4(B-A-C) Sequence 5(C-A-B) Sequence 6(C-B-A)
    Started
    19
    20
    18
    20
    20
    19
    Completed
    16
    19
    17
    17
    20
    18
    Not completed
    3
    1
    1
    3
    0
    1
         technical problems
    1
    -
    -
    -
    -
    -
         Physician decision
    -
    -
    -
    1
    -
    -
         subject/guardian decision
    1
    -
    -
    -
    -
    -
         Adverse event, non-fatal
    1
    1
    1
    1
    -
    -
         Non-compliance with study treatment
    -
    -
    -
    1
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Study
    Reporting group description
    -

    Reporting group values
    Overall Study Total
    Number of subjects
    116 116
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    0 0
        Adolescents (12-17 years)
    0 0
        Adults (18-64 years)
    98 98
        From 65-84 years
    18 18
        85 years and over
    0 0
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    49.5 ( 14 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    55 55
        Male
    61 61
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0
        Asian
    9 9
        Native Hawaiian or Other Pacific Islander
    0 0
        Black or African American
    1 1
        White
    106 106
        More than one race
    0 0
        Unknown or Not Reported
    0 0
    Subject analysis sets

    Subject analysis set title
    All participants
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All participants randomized to one of six treatment sequences

    Subject analysis set title
    QVM149 150/50/160 μg o.d.
    Subject analysis set type
    Full analysis
    Subject analysis set description
    QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d

    Subject analysis set title
    QVM149 150/50/80 μg o.d.
    Subject analysis set type
    Full analysis
    Subject analysis set description
    QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d.

    Subject analysis set title
    Salmeterol/fluticasone 50/500 μg b.i.d.
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Salmeterol/fluticasone 50/500 μg b.i.d.

    Subject analysis sets values
    All participants QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d. Salmeterol/fluticasone 50/500 μg b.i.d.
    Number of subjects
    116
    112
    115
    111
    Age categorical
    Units: Subjects
        In utero
        Preterm newborn infants (gestational age < 37 wks)
        Newborns (0-27 days)
        Infants and toddlers (28 days-23 months)
        Children (2-11 years)
        Adolescents (12-17 years)
        Adults (18-64 years)
    98
        From 65-84 years
    18
        85 years and over
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    49.5 ( 14 )
    ( )
    ( )
    ( )
    Sex: Female, Male
    Units: Subjects
        Female
    55
        Male
    61
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0
        Asian
    9
        Native Hawaiian or Other Pacific Islander
    0
        Black or African American
    1
        White
    106
        More than one race
    0
        Unknown or Not Reported
    0

    End points

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    End points reporting groups
    Reporting group title
    Sequence 1 (A-B-C)
    Reporting group description
    QVM149 150/50/80 μg o.d; QVM149 150/50/160 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.

    Reporting group title
    Sequence 2(A-C-B)
    Reporting group description
    QVM149 150/50/80 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/160 μg o.d;

    Reporting group title
    Sequence 3(B-C-A)
    Reporting group description
    QVM149 150/50/160 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/80 μg o.d

    Reporting group title
    Sequence 4(B-A-C)
    Reporting group description
    QVM149 150/50/160 μg o.d; QVM149 150/50/80 μg o.d; salmeterol/fluticasone FDC 50/500 μg b.i.d

    Reporting group title
    Sequence 5(C-A-B)
    Reporting group description
    salmeterol/fluticasone FDC 50/500 μg b.i.d; QVM149 150/50/80 μg o.d; QVM149 150/50/160 μg o.d

    Reporting group title
    Sequence 6(C-B-A)
    Reporting group description
    salmeterol/fluticasone FDC 50/500 μg b.i.d.; QVM149 150/50/160 μg o.d; QVM149 150/50/80 μg o.d

    Subject analysis set title
    All participants
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All participants randomized to one of six treatment sequences

    Subject analysis set title
    QVM149 150/50/160 μg o.d.
    Subject analysis set type
    Full analysis
    Subject analysis set description
    QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d

    Subject analysis set title
    QVM149 150/50/80 μg o.d.
    Subject analysis set type
    Full analysis
    Subject analysis set description
    QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d.

    Subject analysis set title
    Salmeterol/fluticasone 50/500 μg b.i.d.
    Subject analysis set type
    Full analysis
    Subject analysis set description
    Salmeterol/fluticasone 50/500 μg b.i.d.

    Primary: Peak FEV1 (mL) defined as the highest bronchodilatory effect on FEV1 during a period of 5 min to 4 h after the last evening dose of each treatment period

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    End point title
    Peak FEV1 (mL) defined as the highest bronchodilatory effect on FEV1 during a period of 5 min to 4 h after the last evening dose of each treatment period
    End point description
    The highest bronchodilator effect on FEV1 during a period of 5 min to 4 h after the last evening dose of each treatment period . To demonstrate superiority in peak bronchodilator effect of QVM149 at a dose of 150/50/160 μg o.d. and 150/50/80 μg o.d. compared to a FDC of salmeterol/fluticasone at a dose of 50/500 μg b.i.d. after 3 weeks of treatment in patients with asthma
    End point type
    Primary
    End point timeframe
    3 weeks
    End point values
    QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d.
    Number of subjects analysed
    112 [1]
    115 [2]
    Units: Liters
        least squares mean (confidence interval 95%)
    0.172 (0.137 to 0.208)
    0.159 (0.123 to 0.195)
    Notes
    [1] - QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [2] - QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d.
    Statistical analysis title
    Peak FEV1
    Comparison groups
    QVM149 150/50/160 μg o.d. v QVM149 150/50/80 μg o.d.
    Number of subjects included in analysis
    227
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    0.172
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.137
         upper limit
    0.208

    Secondary: Mean FEV1 over 24 h after 21 days of treatment in relation to evening dose

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    End point title
    Mean FEV1 over 24 h after 21 days of treatment in relation to evening dose
    End point description
    To evaluate the bronchodilator effect of each dose of QVM149 compared to salmeterol/fluticasone FDC after 3 weeks of treatment at -45 min, -15 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3h, 4 h, 8 h, 10 h, 11 h 55 min, 14 h, 18 h, 21 h, 23 h 15 min, 23 h 45 min.
    End point type
    Secondary
    End point timeframe
    -45 min, -15 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3h, 4 h, 8 h, 10 h, 11 h 55 min, 14 h, 18 h, 21 h, 23 h 15 min, 23 h 45 min at 3 weeks
    End point values
    QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d.
    Number of subjects analysed
    112 [3]
    115 [4]
    Units: Liters
    least squares mean (confidence interval 95%)
        -45 min
    0.1306 (0.0803 to 0.1810)
    0.0708 (0.0204 to 0.1213)
        -15 min
    0.1188 (0.0715 to 0.1660)
    0.0794 (0.0320 to 0.1269)
        5 min
    0.1376 (0.0946 to 0.1806)
    0.1143 (0.0712 to 0.1575)
        15 min
    0.1525 (0.0991 to 0.2058)
    0.0965 (0.0429 to 0.1502)
        30 min
    0.1588 (0.1160 to 0.2015)
    0.1218 (0.0789 to 0.1647)
        1 h
    0.1524 (0.1115 to 0.1933)
    0.1427 (0.1016 to 0.1838)
        2 h
    0.1790 (0.1364 to 0.2215)
    0.1752 (0.1324 to 0.2180)
        3 h
    0.1699 (0.1264 to 0.2135)
    0.1424 (0.0986 to 0.1862)
        4 h
    0.1651 (0.1172 to 0.2130)
    0.1401 (0.0920 to 0.1882)
        8 h
    0.1883 (0.1438 to 0.2328)
    0.1632 (0.1183 to 0.2080)
        10 h
    0.2091 (0.1603 to 0.2579)
    0.1887 (0.1396 to 0.2379)
        11h 55 min
    0.2201 (0.1718 to 0.2685)
    0.1800 (0.1313 to 0.2287)
        14 h
    0.1475 (0.1029 to 0.1921)
    0.1187 (0.0737 to 0.1636)
        18 h
    0.1017 (0.0577 to 0.1457)
    0.0744 (0.0300 to 0.1188)
        21 h
    0.0980 (0.0517 to 0.1442)
    0.0856 (0.0389 to 0.1322)
        23 h 15 min
    0.1289 (0.0873 to 0.1705)
    0.1096 (0.0675 to 0.1516)
        23 h 45 min
    0.1054 (0.0638 to 0.1470)
    0.0810 (0.0389 to 0.1230)
    Notes
    [3] - QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [4] - QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d.
    No statistical analyses for this end point

    Secondary: FVC over 24 h after 21 days of treatment in relation to evening dose

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    End point title
    FVC over 24 h after 21 days of treatment in relation to evening dose
    End point description
    To evaluate the bronchodilator effect of each dose of QVM149 compared to salmeterol/fluticasone FDC after 3 weeks of treatment at -45 min, -15 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3h, 4 h, 8 h, 10 h, 11 h 55 min, 14 h, 18 h, 21 h, 23 h 15 min, 23 h 45 min.
    End point type
    Secondary
    End point timeframe
    -45 min, -15 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3h, 4 h, 8 h, 10 h, 11 h 55 min, 14 h, 18 h, 21 h, 23 h 15 min, 23 h 45 min at 3 weeks
    End point values
    QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d. Salmeterol/fluticasone 50/500 μg b.i.d.
    Number of subjects analysed
    112 [5]
    115 [6]
    111 [7]
    Units: Liters
    arithmetic mean (standard deviation)
        -45min
    3.9046 ( 1.03169 )
    3.8538 ( 0.98086 )
    3.7626 ( 1.00067 )
        -15min
    3.8743 ( 1.04318 )
    3.8571 ( 0.97420 )
    3.7230 ( 0.94180 )
        5min
    3.8656 ( 0.99877 )
    3.8976 ( 1.00323 )
    3.7536 ( 0.93696 )
        15min
    3.8669 ( 0.98489 )
    3.8971 ( 0.96840 )
    3.7290 ( 0.94033 )
        30min
    3.8700 ( 0.99289 )
    3.9002 ( 0.99091 )
    3.7695 ( 0.96026 )
        1h
    3.8756 ( 0.99978 )
    3.8993 ( 0.99141 )
    3.7530 ( 0.97083 )
        2h
    3.8698 ( 0.99623 )
    3.8985 ( 0.99369 )
    3.7629 ( 0.97164 )
        3h
    3.8576 ( 0.98598 )
    3.8766 ( 0.97806 )
    3.7575 ( 0.96899 )
        4h
    3.8744 ( 0.99833 )
    3.8627 ( 0.95673 )
    3.7629 ( 0.98205 )
        8h
    3.9020 ( 0.98241 )
    3.9217 ( 0.99184 )
    3.7683 ( 1.00410 )
        10h
    3.8976 ( 0.98360 )
    3.9504 ( 0.99286 )
    3.7809 ( 0.98213 )
        11h 55min
    3.9271 ( 0.98924 )
    3.9405 ( 1.00198 )
    3.7911 ( 0.99102 )
        14h
    3.9091 ( 1.00241 )
    3.9210 ( 0.97942 )
    3.8089 ( 1.02918 )
        18h
    3.8675 ( 0.95725 )
    3.9151 ( 1.02198 )
    3.7824 ( 0.98395 )
        21h
    3.8438 ( 1.00672 )
    3.8694 ( 0.98786 )
    3.7680 ( 1.00768 )
        23h 15min
    3.7977 ( 0.97550 )
    3.8673 ( 0.99915 )
    3.7395 ( 1.01764 )
        23h 45min
    3.8034 ( 0.99036 )
    3.8603 ( 0.98502 )
    3.7431 ( 1.00668 )
    Notes
    [5] - QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [6] - QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [7] - Salmeterol/fluticasone 50/500 μg b.i.d.
    No statistical analyses for this end point

    Secondary: FEV1/FVC ratio over 24 h after 21 days of treatment in relation to evening dose

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    End point title
    FEV1/FVC ratio over 24 h after 21 days of treatment in relation to evening dose
    End point description
    To evaluate the bronchodilator effect of each dose of QVM149 compared to salmeterol/fluticasone FDC after 3 weeks of treatment at -45 min, -15 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3h, 4 h, 8 h, 10 h, 11 h 55 min, 14 h, 18 h, 21 h, 23 h 15 min, 23 h 45 min.
    End point type
    Secondary
    End point timeframe
    -45 min, -15 min, 5 min, 15 min, 30 min, 1 h, 2 h, 3h, 4 h, 8 h, 10 h, 11 h 55 min, 14 h, 18 h, 21 h, 23 h 15 min, 23 h 45 min at 3 weeks
    End point values
    QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d. Salmeterol/fluticasone 50/500 μg b.i.d.
    Number of subjects analysed
    112 [8]
    115 [9]
    111 [10]
    Units: Liters
    arithmetic mean (standard deviation)
        -45min
    0.6701 ( 0.10880 )
    0.6612 ( 0.10358 )
    0.6527 ( 0.10867 )
        -15min
    0.6707 ( 0.10646 )
    0.6669 ( 0.10422 )
    0.6539 ( 0.10526 )
        5min
    0.6788 ( 0.10300 )
    0.6754 ( 0.10370 )
    0.6563 ( 0.10639 )
        15min
    0.6873 ( 0.10126 )
    0.6778 ( 0.10734 )
    0.6560 ( 0.10823 )
        30min
    0.6878 ( 0.10137 )
    0.6844 ( 0.10699 )
    0.6573 ( 0.10552 )
        1h
    0.6900 ( 0.09764 )
    0.6895 ( 0.09940 )
    0.6632 ( 0.10403 )
        2h
    0.6939 ( 0.09629 )
    0.6932 ( 0.10073 )
    0.6647 ( 0.10413 )
        3h
    0.6968 ( 0.10159 )
    0.6890 ( 0.10052 )
    0.6634 ( 0.10436 )
        4h
    0.6897 ( 0.10060 )
    0.6879 ( 0.09733 )
    0.6605 ( 0.10419 )
        8h
    0.6842 ( 0.10782 )
    0.6802 ( 0.11349 )
    0.6492 ( 0.10814 )
        10h
    0.6916 ( 0.10550 )
    0.6858 ( 0.10468 )
    0.6489 ( 0.11155 )
        11h 55min
    0.6853 ( 0.10672 )
    0.6791 ( 0.10656 )
    0.6482 ( 0.10810 )
        14h
    0.6846 ( 0.10842 )
    0.6848 ( 0.10450 )
    0.6567 ( 0.11048 )
        18h
    0.6801 ( 0.09943 )
    0.6741 ( 0.10240 )
    0.6546 ( 0.10369 )
        21h
    0.6790 ( 0.10890 )
    0.6785 ( 0.10387 )
    0.6562 ( 0.10729 )
        23h 15min
    06821 ( 0.10386 )
    0.6791 ( 0.09986 )
    0.6548 ( 0.10423 )
        23h 45min
    0.6782 ( 0.10457 )
    0.6776 ( 0.10111 )
    0.6537 ( 0.10934 )
    Notes
    [8] - QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [9] - QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d.
    [10] - Salmeterol/fluticasone 50/500 μg b.i.d.
    No statistical analyses for this end point

    Secondary: FEV1 AUC 5 min - 1 h (Day 21) FEV1 AUC 5 min - 4 h (Day 21) and FEV1 AUC 5 min - 23 h 45 min (Day 21)

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    End point title
    FEV1 AUC 5 min - 1 h (Day 21) FEV1 AUC 5 min - 4 h (Day 21) and FEV1 AUC 5 min - 23 h 45 min (Day 21)
    End point description
    To evaluate the bronchodilator effect of each dose of QVM149 compared to salmeterol/ fluticasone FDC by measuring standardized FEV1 AUCs after 3 weeks of treatment respective period.
    End point type
    Secondary
    End point timeframe
    3 weeks
    End point values
    QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d.
    Number of subjects analysed
    112 [11]
    115 [12]
    Units: Liters
    least squares mean (confidence interval 95%)
        FEV1 AUC 5 min - 1 h
    0.160 (0.120 to 0.201)
    0.131 (0.090 to 0.172)
        FEV1 AUC 5 min - 4 h
    0.177 (0.141 to 0.213)
    0.159 (0.123 to 0.195)
        FEV1 AUC 5 min - 23 h 45 min
    0.163 (0.128 to 0.197)
    0.138 (0.103 to 0.173)
    Notes
    [11] - QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [12] - QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    No statistical analyses for this end point

    Secondary: Trough FEV1 (mL; mean of FEV1 at 23 h 15 min and 23 h 45 min post-dose)

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    End point title
    Trough FEV1 (mL; mean of FEV1 at 23 h 15 min and 23 h 45 min post-dose)
    End point description
    To evaluate post-dose trough bronchodilator effect of each dose of QVM149 compared to salmeterol/fluticasone FDC after 3 weeks of treatment in the respective treatment period.
    End point type
    Secondary
    End point timeframe
    3 weeks
    End point values
    QVM149 150/50/160 μg o.d. QVM149 150/50/80 μg o.d.
    Number of subjects analysed
    112 [13]
    115 [14]
    Units: Liters
        least squares mean (confidence interval 95%)
    0.124 (0.086 to 0.161)
    0.105 (0.067 to 0.143)
    Notes
    [13] - QVM149 150/50/160 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    [14] - QVM149 150/50/80 μg o.d. vs salmeterol/fluticasone 50/500 μg b.i.d
    Statistical analysis title
    Trough FEV1
    Comparison groups
    QVM149 150/50/160 μg o.d. v QVM149 150/50/80 μg o.d.
    Number of subjects included in analysis
    227
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    < 0.0001
    Method
    Mixed models analysis
    Parameter type
    Mean difference (final values)
    Point estimate
    0.124
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.086
         upper limit
    0.161

    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
    QVM149 150/50/160 µg o.d.
    Reporting group description
    QVM149 150/50/160 µg o.d.

    Reporting group title
    Salmeterol/fluticasone 50/500 µg b.i.d.
    Reporting group description
    Salmeterol/fluticasone 50/500 µg b.i.d.

    Reporting group title
    QVM149 150/50/80 µg o.d.
    Reporting group description
    QVM149 150/50/80 µg o.d.

    Serious adverse events
    QVM149 150/50/160 µg o.d. Salmeterol/fluticasone 50/500 µg b.i.d. QVM149 150/50/80 µg o.d.
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 112 (0.00%)
    0 / 111 (0.00%)
    0 / 115 (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: 5%
    Non-serious adverse events
    QVM149 150/50/160 µg o.d. Salmeterol/fluticasone 50/500 µg b.i.d. QVM149 150/50/80 µg o.d.
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    14 / 112 (12.50%)
    21 / 111 (18.92%)
    18 / 115 (15.65%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    10 / 112 (8.93%)
    13 / 111 (11.71%)
    10 / 115 (8.70%)
         occurrences all number
    12
    15
    11
    Respiratory, thoracic and mediastinal disorders
    Dysphonia
         subjects affected / exposed
    6 / 112 (5.36%)
    6 / 111 (5.41%)
    1 / 115 (0.87%)
         occurrences all number
    6
    6
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 112 (0.00%)
    1 / 111 (0.90%)
    0 / 115 (0.00%)
         occurrences all number
    0
    1
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    3 / 112 (2.68%)
    4 / 111 (3.60%)
    7 / 115 (6.09%)
         occurrences all number
    3
    4
    7

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    12 Jan 2018
    Modification of the inclusion criterion for duration of baseline ICS/LABA requirements from 1 year to 3 months. This was based on investigator feedback from real-world asthma populations and intended to address evolving treatment patterns, whereby patient medications are more rapidly up-titrated in response to symptoms. This would help identify previously ineligible patients who may potentially benefit from treatment with LAMA as add-on therapy to existing ICS/LABA treatment

    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, results of crossover studies are not accurately represented in this record. Please go to https://www.novctrd.com/CtrdWeb/home.nov for 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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