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Comparison of Safety and Efficacy of the Combination Product QVA149A Against the Concurrent Administration of the Individual Components, QAB149 and NVA237, in Patients With Chronic Obstructive Pulmonary Disease (COPD)

A Study to Compare the Efficacy and Safety of Once Daily QVA149 Versus the Once Daily Concurrent Administration of QAB149 Plus NVA237 in Patients With Moderate to Severe Chronic Obstructive Pulmonary Disease

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01529632
Acronym
BEACON
Enrollment
193
Registered
2012-02-09
Start date
2012-05-31
Completion date
2012-12-31
Last updated
2014-02-12

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Obstructive Pulmonary Disease

Keywords

chronic obstructive pulmonary disease, COPD, QVA149, QAB149, NVA237, indacaterol, glycopyrronium bromide

Brief summary

The study assessed the safety and efficacy of the fixed combination product QVA149 versus the component products QAB149 and NVA237, administered concurrently, in patients that have moderate to severe chronic obstructive pulmonary disease (COPD).

Detailed description

The study assessed the safety and efficacy of the fixed combination product QVA149 versus the component products QAB149 and NVA237, administered concurrently, in patients that have moderate to severe chronic obstructive pulmonary disease (COPD).

Interventions

DRUGQVA149

QVA149 110/50 ug supplied as capsules in blister packs for inhalation via SDDPI, once daily

DRUGNVA237

NVA237 50 ug supplied as capsules in blister packs for inhalation via SDDPI, once daily

DRUGQAB149

QAB149 150 ug supplied as capsules in blister packs for inhalation via SDDPI , once daily

DRUGPlacebo

Placebo capsules provided in blister packs for inhalation via SDDPI, once daily

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Healthy volunteers
No

Inclusion criteria

* Male or female adults aged ≥ 40 yrs * Smoking history of at least 10 pack years * Diagnosis of COPD (moderate to severe as classified by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines, 2010) * Post-bronchodilator FEV1 \< 80% and ≥ 30% of the predicted normal value and post-bronchodilator FEV1/FVC (forced vital capacity) \< 70%

Exclusion criteria

* Patients who have had a respiratory tract infection within 4 weeks prior to Visit 1 * Patients with concomitant pulmonary disease * Patients with a history of asthma * Any patient with lung cancer or a history of lung cancer * Patients with a history of certain cardiovascular co-morbid conditions * Patients with a known history and diagnosis of alpha-1 antitrypsin deficiency * Patients in the active phase of a supervised pulmonary rehabilitation program * Patients contraindicated for inhaled anticholinergic agents and β2 agonists Other protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Trough Forced Expiratory Volume in 1 Second (FEV1) After 28 Days of Blinded TreatmentDay 29Spirometry was conducted according to internationally accepted standards. Trough FEV1 is defined as the average of the 23 hour 15 minute and 23 hour 45 minute post-dose FEV1 readings measured at day 29, after 28 days of treatment. Mixed model: Trough FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country.

Secondary

MeasureTime frameDescription
Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 280, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose at Day 28Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 28 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country.
Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-dose5 min - 4 hr at Days 1 and 28Spirometry was conducted according to internationally accepted standards. Peak FEV1 is the maximum FEV1 recorded in the period between 5 minutes and 4 hours post dose. Analysis of Covariance was carried out with a mixed model that used (period) baseline, defined as the value of FEV1 measured prior to the first study drug intake in the period, as a covariate.
Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 10, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose at Day 1Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 1 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country.
Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of TreatmentBaseline and 28 daysThe number of puffs of rescue medication taken in the previous 12 hours was recorded in the Patient Diary in the morning and evening. The total number of puffs of rescue medication per day over the whole active treatment period was calculated and divided by the total number of days with non-missing rescue data to derive the mean daily number of puffs of rescue medication taken for the patient. If the number of puffs was missing for part of the day (either morning or evening) then a half day was used in the denominator.
Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of Treatment28 daysThe mean total symptom scores and mean individual symptom scores for the patient were calculated for the whole study period. The mean change from baseline in the total scores and in the individual scores were summarized by treatment and were analyzed for the percentage of 'nights with no nighttime awakenings'. The symptom variables for the whole active treatment period was analyzed using the similar MIXED model as for the primary endpoint, with the baseline FEV1 term being replaced by the respective baseline symptom variables.
Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28-45 min, -15 min predose, 5 min, 30 min, 1 hr, 2hr, 3hr and 4 hr post-dose on Day 28Time course of Forced Expiratory Volume in 1 second (FEV1) was measured at -45 min, -15 min predose, 5 min, 30 min, 1 hr, 2hr, 3hr and 4 hr post-dose on Day 28. FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation.

Countries

Austria, Denmark, Netherlands, Norway, Sweden

Participant flow

Recruitment details

193 patients were randomized, with 187 of those completing the study. A total of 6 patients discontinued from the study.

Pre-assignment details

Open-label, active QAB149 and NVA237 were administered during a 14-day period prior to randomization in order to stabilize patients and standardize baseline lung function. The patients were then randomized to either the fixed dose combination or free combination arms of blinded treatment in a 1:1 ratio and received study drug for 28 days.

Participants by arm

ArmCount
QVA149
QVA149 plus placebo once daily for 28 days.
90
QAB149 + NVA237
Indacaterol (QAB149) plus glycopyrronium bromide (NVA237) once daily for 28 days.
103
Total193

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdministrative problem21
Overall StudyAdverse Event11
Overall StudyProtocol Violation01

Baseline characteristics

CharacteristicQVA149QAB149 + NVA237Total
Age, Continuous65.6 years
STANDARD_DEVIATION 7.28
64.2 years
STANDARD_DEVIATION 7.4
64.9 years
STANDARD_DEVIATION 7.36
Sex: Female, Male
Female
32 Participants44 Participants76 Participants
Sex: Female, Male
Male
58 Participants59 Participants117 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
20 / 9012 / 103
serious
Total, serious adverse events
4 / 906 / 103

Outcome results

Primary

Trough Forced Expiratory Volume in 1 Second (FEV1) After 28 Days of Blinded Treatment

Spirometry was conducted according to internationally accepted standards. Trough FEV1 is defined as the average of the 23 hour 15 minute and 23 hour 45 minute post-dose FEV1 readings measured at day 29, after 28 days of treatment. Mixed model: Trough FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country.

Time frame: Day 29

Population: The Per Protocol Set includes the Full analysis Set patients with available data and without any major protocol deviations or criteria causing exclusion.~Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Trough Forced Expiratory Volume in 1 Second (FEV1) After 28 Days of Blinded Treatment1.459 LitersStandard Error 0.0196
QAB149 + NVA237Trough Forced Expiratory Volume in 1 Second (FEV1) After 28 Days of Blinded Treatment1.465 LitersStandard Error 0.018
Secondary

Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of Treatment

The mean total symptom scores and mean individual symptom scores for the patient were calculated for the whole study period. The mean change from baseline in the total scores and in the individual scores were summarized by treatment and were analyzed for the percentage of 'nights with no nighttime awakenings'. The symptom variables for the whole active treatment period was analyzed using the similar MIXED model as for the primary endpoint, with the baseline FEV1 term being replaced by the respective baseline symptom variables.

Time frame: 28 days

Population: The Modified per protocol set (PPS) was defined post-DBL and included all patients with available data and without any major protocol deviations or criteria or GCP finding causing exclusion. Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
QVA149Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of TreatmentBaseline (day 1)6.2 percentage of daysStandard Deviation 16.54
QVA149Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of TreatmentAfter 28 days of treatment9.3 percentage of daysStandard Deviation 23.69
QAB149 + NVA237Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of TreatmentBaseline (day 1)3.9 percentage of daysStandard Deviation 10.44
QAB149 + NVA237Change From Baseline in Percentage of Days With 'no Daytime Symptoms' Over 28 Days of TreatmentAfter 28 days of treatment6.0 percentage of daysStandard Deviation 15.85
Secondary

Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of Treatment

The number of puffs of rescue medication taken in the previous 12 hours was recorded in the Patient Diary in the morning and evening. The total number of puffs of rescue medication per day over the whole active treatment period was calculated and divided by the total number of days with non-missing rescue data to derive the mean daily number of puffs of rescue medication taken for the patient. If the number of puffs was missing for part of the day (either morning or evening) then a half day was used in the denominator.

Time frame: Baseline and 28 days

Population: The Per Protocol Set includes the Full analysis Set patients with available data and without any major protocol deviations or criteria causing exclusion.~Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureGroupValue (MEAN)Dispersion
QVA149Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of TreatmentBaseline (day 1)2.24 puffsStandard Deviation 2.437
QVA149Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of Treatment28 days after treatment1.85 puffsStandard Deviation 2.283
QAB149 + NVA237Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of TreatmentBaseline (day 1)2.04 puffsStandard Deviation 2.585
QAB149 + NVA237Change From Baseline in the Mean Daily, (Daytime and Nighttime Combined) Number of Puffs of Rescue Medication Used Over 28 Days of Treatment28 days after treatment1.70 puffsStandard Deviation 2.338
Secondary

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 1

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 1 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country.

Time frame: 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose at Day 1

Population: The Per Protocol Set includes the Full analysis Set patients with available data and without any major protocol deviations or criteria causing exclusion.~Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 11.597 LitersStandard Error 0.0125
QAB149 + NVA237Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 11.573 LitersStandard Error 0.0114
Secondary

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 28

Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4h at Day 28 was measured via spirometry conducted according to internationally accepted standards. Measurements were made at 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose. The standardized AUC FEV1 was calculated as the sum of trapezoids divided by the length of time. Mixed model used: AUC FEV1 = treatment + baseline FEV1 + FEV1 reversibility components + baseline smoking status + baseline ICS use + country + center (country) + error. Center was included as a random effect nested within country.

Time frame: 0, 5, 15, and 30 minutes; and 1, 2, 3 and 4 hours post-dose at Day 28

Population: The Per Protocol Set includes the Full analysis Set patients with available data and without any major protocol deviations or criteria causing exclusion.~Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 281.575 LitersStandard Error 0.02
QAB149 + NVA237Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) 0-4 Hours at Day 281.587 LitersStandard Error 0.0184
Secondary

Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-dose

Spirometry was conducted according to internationally accepted standards. Peak FEV1 is the maximum FEV1 recorded in the period between 5 minutes and 4 hours post dose. Analysis of Covariance was carried out with a mixed model that used (period) baseline, defined as the value of FEV1 measured prior to the first study drug intake in the period, as a covariate.

Time frame: 5 min - 4 hr at Days 1 and 28

Population: The Per Protocol Set includes the Full analysis Set patients with available data and without any major protocol deviations or criteria causing exclusion.~Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-doseDay 1 (n=83, 97)1.668 LitersStandard Error 0.0132
QVA149Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-doseDay 28 (n= 80, 92)1.643 LitersStandard Error 0.021
QAB149 + NVA237Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-doseDay 1 (n=83, 97)1.646 LitersStandard Error 0.012
QAB149 + NVA237Peak Forced Expiratory Volume in 1 Second (FEV1) on Days 1 and 28 Post-doseDay 28 (n= 80, 92)1.654 LitersStandard Error 0.0194
Secondary

Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28

Time course of Forced Expiratory Volume in 1 second (FEV1) was measured at -45 min, -15 min predose, 5 min, 30 min, 1 hr, 2hr, 3hr and 4 hr post-dose on Day 28. FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation.

Time frame: -45 min, -15 min predose, 5 min, 30 min, 1 hr, 2hr, 3hr and 4 hr post-dose on Day 28

Population: The Per Protocol Set includes the Full analysis Set patients with available data and without any major protocol deviations or criteria causing exclusion. Patients were analyzed according to the treatment to which they were randomized.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28-45 min predose (n=76,90)1.452 LitersStandard Error 0.0197
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28-15 predose (n=72,87)1.449 LitersStandard Error 0.0239
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 285 min postdose (n=76,89)1.491 LitersStandard Error 0.0222
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 2830 min postdose (n=76,88)1.529 LitersStandard Error 0.0181
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 281 hour postdose (n=77,90)1.584 LitersStandard Error 0.0204
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 282 hours postdose (n=77,90)1.601 LitersStandard Error 0.0219
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 283 hours postdose (n=78,91)1.576 LitersStandard Error 0.0211
QVA149Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 284 hours postdose (n=77,84)1.554 LitersStandard Error 0.0236
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 284 hours postdose (n=77,84)1.556 LitersStandard Error 0.0228
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28-45 min predose (n=76,90)1.460 LitersStandard Error 0.0184
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 281 hour postdose (n=77,90)1.604 LitersStandard Error 0.0189
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 28-15 predose (n=72,87)1.430 LitersStandard Error 0.0227
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 283 hours postdose (n=78,91)1.587 LitersStandard Error 0.0195
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 285 min postdose (n=76,89)1.514 LitersStandard Error 0.0206
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 282 hours postdose (n=77,90)1.624 LitersStandard Error 0.0203
QAB149 + NVA237Time Course of Forced Expiratory Volume in One Second (FEV1) (Pre-dose to 4 Hours Post Dose) on Day 2830 min postdose (n=76,88)1.544 LitersStandard Error 0.0166

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026