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    Clinical Trial Results:
    A multi-center, proof-of-mechanism study of multiple, oral doses of fevipiprant (QAW039) in COPD patients with eosinophilia

    Summary
    EudraCT number
    2018-004267-32
    Trial protocol
    GB   BE   DE   ES  
    Global end of trial date
    16 Jan 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Jan 2021
    First version publication date
    20 Jan 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CQAW039E12201
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03810183
    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, Novartis.email@novartis.com
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111, 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?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    16 Jan 2020
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    The primary purpose of the proof-of-mechanism study was to determine whether fevipiprant (QAW039), when administered to chronic obstructive pulmonary disease (COPD) patients with eosinophilic airway inflammation on standard of care therapy, reduced the burden of sputum eosinophilia. Data from other trials did not confirm efficacy of fevipiprant and did not warrant the continuation of treatment in this study. As a result, this study was terminated early.
    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. Regarding rescue medication, the site was permitted to provide short-acting beta2 agonist to each subject, in accordance with local SmPC, for use prior to spirometry, sputum induction and/or as rescue medication.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    21 May 2019
    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
    Germany: 6
    Country: Number of subjects enrolled
    United Kingdom: 3
    Worldwide total number of subjects
    9
    EEA total number of subjects
    9
    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)
    4
    From 65 to 84 years
    5
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Participants took part in 4 investigative sites in 2 countries (Germany and United Kingdom).

    Pre-assignment
    Screening details
    Participants were randomized 3:2 to active (QAW039 450 mg orally daily) vs. placebo arms. Randomization was stratified by current smoking status (current vs. ex-smoker).

    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, Carer

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    QAW039 450 mg
    Arm description
    QAW039 (fevipiprant) 450 mg once daily for 6 weeks administered orally as a tablet.
    Arm type
    Experimental

    Investigational medicinal product name
    Fevipiprant
    Investigational medicinal product code
    QAW039
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    QAW039 (fevipiprant) 450 mg once daily for 6 weeks

    Arm title
    Placebo
    Arm description
    Placebo once daily for 6 weeks administered orally as a tablet.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo once daily for 6 weeks

    Number of subjects in period 1
    QAW039 450 mg Placebo
    Started
    6
    3
    Completed
    4
    2
    Not completed
    2
    1
         Study terminated by Sponsor
    2
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    QAW039 450 mg
    Reporting group description
    QAW039 (fevipiprant) 450 mg once daily for 6 weeks administered orally as a tablet.

    Reporting group title
    Placebo
    Reporting group description
    Placebo once daily for 6 weeks administered orally as a tablet.

    Reporting group values
    QAW039 450 mg Placebo Total
    Number of subjects
    6 3 9
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    3 1 4
        From 65-84 years
    3 2 5
        85 years and over
    0 0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    63.5 ± 9.71 67.3 ± 6.35 -
    Sex: Female, Male
    Units: Participants
        Female
    1 1 2
        Male
    5 2 7
    Race/Ethnicity, Customized
    Units: Subjects
        Asian
    0 1 1
        White
    6 2 8

    End points

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    End points reporting groups
    Reporting group title
    QAW039 450 mg
    Reporting group description
    QAW039 (fevipiprant) 450 mg once daily for 6 weeks administered orally as a tablet.

    Reporting group title
    Placebo
    Reporting group description
    Placebo once daily for 6 weeks administered orally as a tablet.

    Primary: Change from baseline in sputum eosinophil percentage based on log-10 transformed scale at Week 6

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    End point title
    Change from baseline in sputum eosinophil percentage based on log-10 transformed scale at Week 6 [1]
    End point description
    Sputum eosinophil percentage of the total cell count was obtained from induced sputum samples. Sputum was processed to include preparation of slides for differential cellular count. As sputum eosinophil percentage has been found to follow a log-normal distribution, the analysis of this outcome measure was based on log10-transformed scale. The baseline measurement was defined as sputum eosinophil percentage prior to the first dosing (on log10-transformed scale).
    End point type
    Primary
    End point timeframe
    Baseline, Week 6
    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: Due to the limited sample size caused by early termination of the study, only descriptive statistics could be calculated.
    End point values
    QAW039 450 mg Placebo
    Number of subjects analysed
    3
    2
    Units: Percentage
        arithmetic mean (standard deviation)
    -0.43373 ± 0.39740
    -0.06689 ± 0.43094
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were collected from first dose of study treatment until last dose plus 30 days, up to a maximum of 72 days.
    Adverse event reporting additional description
    Any signs or symptoms that occurs during study treatment plus the 30 days post treatment.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22.0
    Reporting groups
    Reporting group title
    QAW039 450mg
    Reporting group description
    QAW039 450mg

    Reporting group title
    Placebo
    Reporting group description
    Placebo

    Reporting group title
    Total
    Reporting group description
    Total

    Serious adverse events
    QAW039 450mg Placebo Total
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 6 (0.00%)
    0 / 3 (0.00%)
    0 / 9 (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: 0%
    Non-serious adverse events
    QAW039 450mg Placebo Total
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    4 / 6 (66.67%)
    2 / 3 (66.67%)
    6 / 9 (66.67%)
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 3 (33.33%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    1
    Foot fracture
         subjects affected / exposed
    1 / 6 (16.67%)
    1 / 3 (33.33%)
    2 / 9 (22.22%)
         occurrences all number
    1
    1
    2
    Joint injury
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 3 (33.33%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    1
    Vascular disorders
    Orthostatic hypotension
         subjects affected / exposed
    0 / 6 (0.00%)
    1 / 3 (33.33%)
    1 / 9 (11.11%)
         occurrences all number
    0
    1
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 3 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    1
    0
    1
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 3 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    1
    0
    1
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 3 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    1
    0
    1
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    1 / 6 (16.67%)
    0 / 3 (0.00%)
    1 / 9 (11.11%)
         occurrences all number
    1
    0
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Apr 2019
    The section for specific liver event and laboratory test trigger definitions and follow-up requirements was updated to reflect the change that ALT or AST ≥ 3 × ULN should be the trigger for discontinuation of study treatment (changed from ALT or AST ≥ 5 × ULN). Other liver events and triggers made redundant due to this change were deleted.
    05 Nov 2019
    Due to natural variation in blood eosinophils, inclusion criteria 7 (circulating eosinophils must be ≥ 300 cells/μL blood) was updated to add a three month window prior to the screening visit for the subject to meet the inclusion criteria. To facilitate the collection of blood eosinophil data prior to full screening, an optional pre-screen visit/hematology collection was added to the study design, scheduled from 3 months to the day prior to the screening visit. Exclusion criteria linked to safety was updated to require that they had to be met at both the screening and baseline visits, to align with the assessment schedule. The addition of a hematology sample on Day 21 allowed the stopping criteria related to white blood cells levels to be checked during the treatment period and for full interpretation of the ILC (innate lymphoid cell) data. Changes to the visit windows for each visit in the screening period were made to give greater flexibility to the site and subject for scheduling purposes, while maintaining the maximum screening window.

    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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    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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