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Efficacy and Safety of QGE031versus Placebo and Omalizumab in Patients Aged 18-75 Years With Asthma

A Multi-center, Randomized, Double-blind, Placebo and Active-controlled Study With Exploratory Dose-ranging to Investigate the Efficacy and Safety of 16 Weeks Treatment With Subcutaneous (s.c.) QGE031 in Asthma Patients Not Adequately Controlled With High-dose Inhaled Corticosteroids and Long Acting β2-agonists

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01716754
Enrollment
471
Registered
2012-10-30
Start date
2012-12-31
Completion date
2016-01-31
Last updated
2017-08-11

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

Conditions

Asthma

Keywords

asthma, asthma control, allergy, atopic, IgE, double-blind, placebo, omalizumab

Brief summary

This study assessed the effect on asthma control of different dose levels and regimens of QGE031 in asthma patients that are inadequately controlled with inhaled steroid and beta-2 agonist medication. Safety was assessed also. Comparison was to placebo and omalizumab. Information from this study was planned to support the design of future studies.

Interventions

DRUGQGE031

QGE031 was supplied as 120 mg liquid in vial per 1 mL

DRUGOmalizumab

Omalizumab was supplied as 150 mg lyophilisate in vial

DRUGPlacebo

Placebo to QGE031 and Omalizumab was supplied as QGE031 0 mg in vial per 1 mL

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

Key Inclusion Criteria: * A diagnosis of allergic asthma , uncontrolled on current medication. * History of at least 1 asthma exacerbation during the last 1 year * Forced Expiratory Volume in one second (FEV1) of ≥ 40% and ≤ 80% of the predicted normal value; reversibility following administration of bronchodilator must also be demonstrated (historical positive reversibility or bronchoprovocation result can be used). Key

Exclusion criteria

* Baseline IgE levels or body weight outside the omalizumab dosing table. * Use of tobacco products within the previous 6 months (Social occasional smokers may be included). * Recent asthma attack/exacerbation or asthma worsening/ respiratory infection.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of QGE031 Participants With Clinically Important Improvement of <= -0.5 in the Asthma Control Questionnaire 7 (ACQ-7) Score Compared to PlaceboWeek 16The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7.

Secondary

MeasureTime frameDescription
Percentage of Participants With a Change From Baseline in ACQ-7 Score Less Than -1.1Week 16The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7.
Change From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreBaseline, Week 16, Week 28The AQLQ is a 32-item disease specific questionnaire designed to measure functional impairments that are most important to participants with asthma. The 32 items in the AQLQ were divided into four domain-specific scores and a total score as follows: Activity limitations = Mean of Items 1, 2, 3, 4, 5, 11, 19, 25, 28, 31, 32 (11 items); Symptoms = Mean of Items 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 29, 30 (12 items); Emotional function = Mean of Items 7, 13, 15, 21, 27 (5 items); Environmental stimuli = Mean of Items 9, 17, 23, 26 (4 items); and Overall Score = Mean of Items 1 to 32 (32 items). Each item of the AQLQ was equally weighted and scored along a 7-point scale, where 1 indicates maximal impairment and 7 indicates no impairment. Thus, higher scores indicate better asthma-related quality of life. The mean overall score ranged from 1 to 7. A positive change from baseline indicates improvement.
Change From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationBaseline, Week 16Participants recorded their use of rescue medication into an electronic diary (eDiary). A negative change from baseline indicates improvement.
Change From Baseline in ACQ-7 ScoreBaseline, Weeks 4, 8, 12, 16 and 28The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7. A negative change from baseline indicates improvement.

Countries

Argentina, Canada, Czechia, Finland, France, Germany, Guatemala, Hungary, India, Israel, Italy, Mexico, Panama, Poland, Portugal, Romania, Russia, Singapore, Slovakia, South Africa, South Korea, Turkey (Türkiye), United Kingdom, United States

Participant flow

Recruitment details

A total of 471 participants were randomized to one of the 14 treatment groups. Of these, 5 participants did not receive study treatment. Therefore, the full analysis set (FAS) and safety set included 466 participants.

Pre-assignment details

The treatment arms for QGE031 and placebo were pooled into high dose QGE031 (240 mg q2w, 240 mg q4w, 180 mg q2w and 120 q2w), low dose QGE031 (36 mg q2w and 18 mg 2qw) and Placebo Total (all QGE031 placebo and Omalizumab placebo arms).

Participants by arm

ArmCount
QGE031 High Dose
Participants received QGE031 240 mg q2w, 240 mg q4w, 180 mg q2w or 120 mg q2w.
199
QGE031 Low Dose
Participants received QGE031 36 mg q2w or 18 mg q2w.
40
Omalizumab
Participants received omalizumab as per locally approved dosing table q2w or q4w.
135
Placebo Total
Participants received matching placebo to QGE031 or Omalizumab.
97
Total471

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyAdverse Event4221
Overall StudyDeath0001
Overall StudyLost to Follow-up1001
Overall StudyNon-compliance with study treatment0010
Overall StudyPhysician Decision1000
Overall StudyProtocol deviation0272
Overall StudyWithdrawal by Subject5043

Baseline characteristics

CharacteristicQGE031 High DoseQGE031 Low DoseOmalizumabPlacebo TotalTotal
Age, Continuous47.6 Years
STANDARD_DEVIATION 13.86
46.0 Years
STANDARD_DEVIATION 12.38
46.8 Years
STANDARD_DEVIATION 13.35
48.6 Years
STANDARD_DEVIATION 12.8
47.4 Years
STANDARD_DEVIATION 13.36
Sex: Female, Male
Female
113 Participants20 Participants92 Participants63 Participants288 Participants
Sex: Female, Male
Male
86 Participants20 Participants43 Participants34 Participants183 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
91 / 19917 / 4043 / 13135 / 96
serious
Total, serious adverse events
9 / 1993 / 401 / 1315 / 96

Outcome results

Primary

Percentage of QGE031 Participants With Clinically Important Improvement of <= -0.5 in the Asthma Control Questionnaire 7 (ACQ-7) Score Compared to Placebo

The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7.

Time frame: Week 16

Population: The full analysis set (FAS) for the QGE031 240 mg q2w, placebo to QGE031 240 mg q2w and Omalizumab groups (n=120,49,131) was considered for the analysis. Only participants who had week 16 values were analyzed. The FAS included randomized participants who received at least one dose of study drug.

ArmMeasureValue (NUMBER)
QGE031 240 mg q2wPercentage of QGE031 Participants With Clinically Important Improvement of <= -0.5 in the Asthma Control Questionnaire 7 (ACQ-7) Score Compared to Placebo63.16 Percentage of participants
Placebo to QGE031 240 mg q2wPercentage of QGE031 Participants With Clinically Important Improvement of <= -0.5 in the Asthma Control Questionnaire 7 (ACQ-7) Score Compared to Placebo70.21 Percentage of participants
OmalizumabPercentage of QGE031 Participants With Clinically Important Improvement of <= -0.5 in the Asthma Control Questionnaire 7 (ACQ-7) Score Compared to Placebo69.17 Percentage of participants
p-value: 0.57695% CI: [0.35, 1.78]Regression, Logistic
p-value: 0.55695% CI: [0.46, 1.52]Regression, Logistic
Secondary

Change From Baseline in ACQ-7 Score

The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7. A negative change from baseline indicates improvement.

Time frame: Baseline, Weeks 4, 8, 12, 16 and 28

Population: The FAS for the QGE031 240 mg q2w, placebo to QGE031 240 mg q2w and Omalizumab groups (n=120,49,131) was considered for the analysis. Participants who had values at both baseline and the post baseline time point were analyzed for that post baseline time point. The FAS included randomized participants who received at least one dose of study drug.

ArmMeasureGroupValue (MEAN)Dispersion
QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 4 (n=115,46,122)-0.51 Score on a scaleStandard Deviation 0.709
QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 8 (n=110,46,122)-0.68 Score on a scaleStandard Deviation 0.678
QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 12 (n=110,46,118)-0.78 Score on a scaleStandard Deviation 0.738
QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 28 (n112,47,115)-0.62 Score on a scaleStandard Deviation 0.81
QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 16 (n=114,48,120)-0.75 Score on a scaleStandard Deviation 0.817
Placebo to QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 8 (n=110,46,122)-0.62 Score on a scaleStandard Deviation 0.735
Placebo to QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 16 (n=114,48,120)-0.79 Score on a scaleStandard Deviation 0.733
Placebo to QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 12 (n=110,46,118)-0.71 Score on a scaleStandard Deviation 0.724
Placebo to QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 28 (n112,47,115)-0.63 Score on a scaleStandard Deviation 0.744
Placebo to QGE031 240 mg q2wChange From Baseline in ACQ-7 ScoreWeek 4 (n=115,46,122)-0.48 Score on a scaleStandard Deviation 0.834
OmalizumabChange From Baseline in ACQ-7 ScoreWeek 28 (n112,47,115)-0.59 Score on a scaleStandard Deviation 0.842
OmalizumabChange From Baseline in ACQ-7 ScoreWeek 12 (n=110,46,118)-0.83 Score on a scaleStandard Deviation 0.737
OmalizumabChange From Baseline in ACQ-7 ScoreWeek 8 (n=110,46,122)-0.78 Score on a scaleStandard Deviation 0.687
OmalizumabChange From Baseline in ACQ-7 ScoreWeek 16 (n=114,48,120)-0.89 Score on a scaleStandard Deviation 0.734
OmalizumabChange From Baseline in ACQ-7 ScoreWeek 4 (n=115,46,122)-0.60 Score on a scaleStandard Deviation 0.705
Secondary

Change From Baseline in Asthma Quality of Life Questionnaire (AQLQ) Score

The AQLQ is a 32-item disease specific questionnaire designed to measure functional impairments that are most important to participants with asthma. The 32 items in the AQLQ were divided into four domain-specific scores and a total score as follows: Activity limitations = Mean of Items 1, 2, 3, 4, 5, 11, 19, 25, 28, 31, 32 (11 items); Symptoms = Mean of Items 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 29, 30 (12 items); Emotional function = Mean of Items 7, 13, 15, 21, 27 (5 items); Environmental stimuli = Mean of Items 9, 17, 23, 26 (4 items); and Overall Score = Mean of Items 1 to 32 (32 items). Each item of the AQLQ was equally weighted and scored along a 7-point scale, where 1 indicates maximal impairment and 7 indicates no impairment. Thus, higher scores indicate better asthma-related quality of life. The mean overall score ranged from 1 to 7. A positive change from baseline indicates improvement.

Time frame: Baseline, Week 16, Week 28

Population: The FAS for the QGE031 240 mg q2w, placebo to QGE031 240 mg q2w and Omalizumab groups (n=120,49,131) was considered for the analysis. Participants who had values at both baseline and the post baseline time point were analyzed for that post baseline time point. The FAS included randomized participants who received at least one dose of study drug.

ArmMeasureGroupValue (MEAN)Dispersion
QGE031 240 mg q2wChange From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreWeek 16 (n=114,48,122)0.53 Score on a scaleStandard Deviation 0.878
QGE031 240 mg q2wChange From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreWeek 28 (n=114,47,121)0.44 Score on a scaleStandard Deviation 0.899
Placebo to QGE031 240 mg q2wChange From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreWeek 16 (n=114,48,122)0.66 Score on a scaleStandard Deviation 0.624
Placebo to QGE031 240 mg q2wChange From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreWeek 28 (n=114,47,121)0.63 Score on a scaleStandard Deviation 0.826
OmalizumabChange From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreWeek 16 (n=114,48,122)0.79 Score on a scaleStandard Deviation 0.853
OmalizumabChange From Baseline in Asthma Quality of Life Questionnaire (AQLQ) ScoreWeek 28 (n=114,47,121)0.48 Score on a scaleStandard Deviation 0.871
Secondary

Change From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue Medication

Participants recorded their use of rescue medication into an electronic diary (eDiary). A negative change from baseline indicates improvement.

Time frame: Baseline, Week 16

Population: The full analysis set (FAS) for the QGE031 240 mg q2w, placebo to QGE031 240 mg q2w and Omalizumab groups (n=120,49,131) was considered for the analysis. Only participants who had both baseline and week 16 values were analyzed. The FAS included randomized participants who received at least one dose of study drug.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QGE031 240 mg q2wChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationOverall-0.56 Number of puffsStandard Error 0.145
QGE031 240 mg q2wChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationEvening-0.31 Number of puffsStandard Error 0.082
QGE031 240 mg q2wChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationMorning-0.28 Number of puffsStandard Error 0.072
Placebo to QGE031 240 mg q2wChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationEvening-0.33 Number of puffsStandard Error 0.126
Placebo to QGE031 240 mg q2wChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationMorning-0.34 Number of puffsStandard Error 0.113
Placebo to QGE031 240 mg q2wChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationOverall-0.64 Number of puffsStandard Error 0.226
OmalizumabChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationMorning-0.39 Number of puffsStandard Error 0.073
OmalizumabChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationOverall-0.73 Number of puffsStandard Error 0.148
OmalizumabChange From Baseline in Mean Number of Puffs of Morning, Evening and Total Daily Asthma Rescue MedicationEvening-0.33 Number of puffsStandard Error 0.084
Comparison: Morningp-value: 0.604Repeated measures mixed model
Comparison: Morningp-value: 0.26Repeated measures mixed model
Comparison: Eveningp-value: 0.937Repeated measures mixed model
Comparison: Eveningp-value: 0.88Repeated measures mixed model
Comparison: Overall dailyp-value: 0.762Repeated measures mixed model
Comparison: Overall dailyp-value: 0.408Repeated measures mixed model
Secondary

Percentage of Participants With a Change From Baseline in ACQ-7 Score Less Than -1.1

The ACQ-7 measures asthma symptom control and consisted of 7 items: 5 on symptom assessment, 1 on rescue bronchodilator use and 1 on airway caliber (FEV1 % predicted). All 7 questions of the ACQ were equally weighted. Items 1-6 scored along a 7-point response scale, where 0 = good controlled and 6 = poor controlled. The 7th item on % predicted FEV1 (pre-bronchodilator) was scored by clinic staff on a 7-point scale (0 - \> 95%; 1 - 90-95%; 2 - 80-89%; 3 - 70-79%; 4 - 60-69%; 5 - 50-59%; 6 - \< 50%). The average score of the 7 questions was calculated as the sum of scores divided by the number of questions that were answered by the participants, as long as there were at least 6 questions answered and the missing items were neither question 1 nor question 7.

Time frame: Week 16

Population: The full analysis set (FAS) for the QGE031 240 mg q2w, placebo to QGE031 240 mg q2w and Omalizumab groups (n=120,49,131) was considered for the analysis. Only participants who had week 16 values were analyzed. The FAS included randomized participants who received at least one dose of study drug.

ArmMeasureValue (NUMBER)
QGE031 240 mg q2wPercentage of Participants With a Change From Baseline in ACQ-7 Score Less Than -1.140.35 Percentage of participants
Placebo to QGE031 240 mg q2wPercentage of Participants With a Change From Baseline in ACQ-7 Score Less Than -1.134.04 Percentage of participants
OmalizumabPercentage of Participants With a Change From Baseline in ACQ-7 Score Less Than -1.136.67 Percentage of participants
p-value: 0.48395% CI: [0.61, 2.86]Regression, Logistic
p-value: 0.26195% CI: [0.79, 2.44]Regression, Logistic

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