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This study will assess of the efficacy and safety of a once-daily, 50µg inhalation of NVA237 in moderate to severe chronic obstructive pulmonary disease (COPD) patients over 26 weeks treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NVA237 | Experimental | NVA237 50 µg once daily delivered via a single dose dry powder inhaler |
|
| Placebo | Placebo Comparator | Placebo once daily delivered via a single dose dry powder inhaler |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NVA237 | Drug | Delivered via a single dose dry powder inhaler |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Trough Forced Expiratory Volume in One Second (FEV1) | Baseline FEV1 was defined as the average of the -45 min and -15 min FEV1 values taken on day 1 prior to the first dose of study medication. Trough FEV1 was defined as the mean of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. FEV1 was measured using central spirometry according to ATS/ERS standardization. Trough FEV1 was analyzed using a MIXED model for the full analysis set population. The model contained treatment as a fixed effect with the baseline FEV1 measurement, FEV1 prior to inhalation of short acting bronchodilator, FEV1 45 min post inhalation of short acting bronchodilator and baseline inhaled corticosteroids (ICS) use as covariates. | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Transition Dyspnea Index (TDI) Score | Dyspnea was measured at baseline using the Baseline Dyspnea Index (BDI) and during the treatment period using the TDI, which captures changes from baseline. The BDI and TDI each have three domains: functional impairment, magnitude of task and magnitude of effort, and each domain scored from -3 (major deterioration) to +3 (major improvement), giving an overall score of -9 to +9. A negative score indicates deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. |
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Inclusion Criteria:
Exclusion Criteria:
Other protocol-defined inclusion/exclusion criteria may apply.
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| Name | Affiliation | Role |
|---|---|---|
| Novartis Pharmaceuticals | Novartis Pharmaceuticals | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Novartis Investigative Site | Beijing | Beijing Municipality | 100023 | China | ||
| Novartis Investigative Site |
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Participants were randomized in a 2: 1 ration to NVA237 and Placebo, respectively.
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| ID | Title | Description |
|---|---|---|
| FG000 | NVA237 | NVA237 50 µg once daily delivered via a single dose dry powder inhaler |
| FG001 | Placebo | Placebo once daily delivered via a single dose dry powder inhaler |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Placebo |
| Drug |
Delivered via a single dose dry powder inhaler |
|
| Baseline, week 12, week 26 |
| Change From Baseline in Daily Rescue Medication Use (Number of Puffs) | The participant recorded the rescue medication taken in an electronic diary between visits and in the spirometry device during study visits. Daytime and nighttime rescue medication use (number of puffs) over 26 weeks was analyzed. | Baseline, 26 weeks |
| 24h Trough FEV1 | Trough FEV1 was defined as the mean of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. This was measured using central spirometry according to ATS/ERS standardization. This was analyzed using the same MIXED model as specified for the primary analysis. | Day 1, Week 26 |
| FEV1 and Forced Vital Capacity (FVC) | FEV1 and FVC were measured using central spirometry according to ATS/ERS standardization. Both were analyzed using the same MIXED model as specified for the primary analysis. | Day 1 at 5, 15, 30 minutes (min) and 1 hour (h) post dose; days 2, 86, 184 at 23 (h) 15 min and 23 h 45 min post dose; days 29, 85, 183 at -45 and -15 min pre-dose and 5, 15, and 30 min post dose |
| Peak FEV1 | Peak FEV1 was defined as the maximum FEV1 0-4 h post-dose. Peak Fev1 was measured at 45min and 15min pre-dose and up to 4h post dose at day 1, week 12 and week 26, using central spirometry according to ATS/ERS standardization. It was analyzed using the same MIXED model as specified for the primary analysis. | Day 1, week 12, week 26 |
| Standardized FEV1 Area Under the Curve (AUC(5 Min-4 h)) Post-dose | The standardized (with respect to time) AUC for FEV1 was calculated between 5 min and 4h post morning dose at day 1, week 12 and week 26. The AUC (5 min-4 h) for FEV1 at each visit was analyzed using the same MIXED model as specified for the primary analysis. | Day 1, week 12, week 26 |
| Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Symptoms (Cough, Wheezing, Shortness of Breath, Sputum Volume, Sputum Color and Night Time Awakenings) | In an electronic diary, the participant responded to 6 questions twice daily to report on the degree of symptoms over the past 12 hours of the morning and evening. The questions covered the participant's degree of overall symptoms, and degrees of individual symptoms of coughing, wheezing, amount of sputum, color of sputum and breathlessness. Each question scored from 0 to 3 where 0 represented no symptom present and 3 represented the worst degree of that symptom. A negative change in symptom score indicates improvement. | Baseline, 26 weeks |
| Time to First Moderate or Severe COPD Exacerbation | A COPD exacerbation was defined as a worsening of the following two or more major symptoms for at least 2 consecutive days:1) dyspnea; 2) sputum volume; 3) sputum purulence; or defined as a worsening of any 1 major symptom together with an increase in any 1 of the following minor symptoms for at least 2 consecutive days: 1) sore throat; 2) colds (nasal discharge and/or nasal congestion); 3) fever without other cause; 4) cough; 5) wheeze. COPD exacerbations were recorded in the patient diary and other source documents. | 26 weeks |
| Number of Moderate and Severe COPD Exacerbations | COPD exacerbations were recorded in the patient diary and other source documents. The rate of COPD exacerbations during the 26 week treatment period was analyzed using a generalized linear model assuming a negative binomial distribution. | 26 weeks |
| The Total Score of the St George's Respiratory Questionnaire (SGRQ) | SGRQ is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity and impacts. The lowest possible score is zero and the highest possible score is 100. Higher scores correspond to greater impairment in quality of life. The health-related quality of life was measured using SGRQ. It was completed by the participant at the investigators site. | Week 12, week 26 |
| Beijing |
| Beijing Municipality |
| 100730 |
| China |
| Novartis Investigative Site | Nanning | Guangxi | 530021 | China |
| Novartis Investigative Site | Shijiazhuang | Hebei | 050000 | China |
| Novartis Investigative Site | Changsha | Hunan | 410011 | China |
| Novartis Investigative Site | Nanjing | Jiangsu | China |
| Novartis Investigative Site | Suzhou | Jiangsu | 215004 | China |
| Novartis Investigative Site | Nanchang | Jiangxi | 330006 | China |
| Novartis Investigative Site | Shengyang | Liaoning | 110016 | China |
| Novartis Investigative Site | Shanghai | Shanghai Municipality | 200433 | China |
| Novartis Investigative Site | Xi’an | Shanxi | 710032 | China |
| Novartis Investigative Site | Chengdu | Sichuan | 610041 | China |
| Novartis Investigative Site | Beijing | 100029 | China |
| Novartis Investigative Site | Beijing | 100730 | China |
| Novartis Investigative Site | Chongqing | 400037 | China |
| Novartis Investigative Site | Chongqing | 400038 | China |
| Novartis Investigative Site | Chongqing | 400042 | China |
| Novartis Investigative Site | Guangzhou | 510080 | China |
| Novartis Investigative Site | Shanghai | 200025 | China |
| Novartis Investigative Site | Shanghai | 200032 | China |
| Novartis Investigative Site | Tianjin | 300052 | China |
| Novartis Investigative Site | Dehli | New Delhi | 110063 | India |
| Novartis Investigative Site | Coimbatore | Tamil Nadu | 641 045. | India |
| Novartis Investigative Site | Bulacan | Philippines | 3020 | Philippines |
| Novartis Investigative Site | Manila | Philippines | 1000 | Philippines |
| Novartis Investigative Site | Las Piñas | 1740 | Philippines |
| Novartis Investigative Site | Quezon City | 1100 | Philippines |
| Novartis Investigative Site | Seoul | Seoul | 130-709 | South Korea |
| Novartis Investigative Site | Seoul | Seoul | 150-713 | South Korea |
| Novartis Investigative Site | Daejeon | 301-804 | South Korea |
| Novartis Investigative Site | Incheon | 403-010 | South Korea |
| Novartis Investigative Site | Seoul | 137-701 | South Korea |
| Safety Set |
|
| Full Analysis Set (FAS) |
|
| FAS, Serial Spirometry Subgroup |
|
| COMPLETED |
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| NOT COMPLETED |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | NVA237 | NVA237 50 µg once daily delivered via a single dose dry powder inhaler |
| BG001 | Placebo | Placebo once daily delivered via a single dose dry powder inhaler |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Trough Forced Expiratory Volume in One Second (FEV1) | Baseline FEV1 was defined as the average of the -45 min and -15 min FEV1 values taken on day 1 prior to the first dose of study medication. Trough FEV1 was defined as the mean of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. FEV1 was measured using central spirometry according to ATS/ERS standardization. Trough FEV1 was analyzed using a MIXED model for the full analysis set population. The model contained treatment as a fixed effect with the baseline FEV1 measurement, FEV1 prior to inhalation of short acting bronchodilator, FEV1 45 min post inhalation of short acting bronchodilator and baseline inhaled corticosteroids (ICS) use as covariates. | The number of participants considered for the analysis was from the full analysis set (randomized participants who received at least one dose of study medication). However, participants analyzed had both baseline and week 12 values. | Posted | Least Squares Mean | Standard Error | Liters | 12 weeks |
|
|
| ||||||||||||||||||||||||||||
| Secondary | Transition Dyspnea Index (TDI) Score | Dyspnea was measured at baseline using the Baseline Dyspnea Index (BDI) and during the treatment period using the TDI, which captures changes from baseline. The BDI and TDI each have three domains: functional impairment, magnitude of task and magnitude of effort, and each domain scored from -3 (major deterioration) to +3 (major improvement), giving an overall score of -9 to +9. A negative score indicates deterioration from baseline. A TDI focal score of 1 is considered to be a clinically significant improvement from baseline. | The number of participants considered for the analysis was from the full analysis set (randomized participants who received at least one dose of study medication). However, for a given time frame, analyzed participants had values at both baseline and the corresponding time frame, i.e. week 12 or week 26. | Posted | Least Squares Mean | Standard Error | score | Baseline, week 12, week 26 |
|
| |||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Daily Rescue Medication Use (Number of Puffs) | The participant recorded the rescue medication taken in an electronic diary between visits and in the spirometry device during study visits. Daytime and nighttime rescue medication use (number of puffs) over 26 weeks was analyzed. | Full Analysis Set: The full analysis set included all randomized participants who received at least one dose of study medication. | Posted | Least Squares Mean | Standard Error | Number of puffs | Baseline, 26 weeks |
|
| |||||||||||||||||||||||||||||
| Secondary | 24h Trough FEV1 | Trough FEV1 was defined as the mean of the post-dose 23 h 15 min and the 23 h 45 min FEV1 values. This was measured using central spirometry according to ATS/ERS standardization. This was analyzed using the same MIXED model as specified for the primary analysis. | The number of participants considered for the analysis was from the full analysis set (randomized participants who received at least one dose of study medication). However, for a given time frame, analyzed participants had values at both baseline and the corresponding time frame, i.e. day 1 or week 26. | Posted | Least Squares Mean | Standard Error | Liters | Day 1, Week 26 |
|
| |||||||||||||||||||||||||||||
| Secondary | FEV1 and Forced Vital Capacity (FVC) | FEV1 and FVC were measured using central spirometry according to ATS/ERS standardization. Both were analyzed using the same MIXED model as specified for the primary analysis. | The number of participants considered for the analysis was from the full analysis set (randomized participants who received at least one dose of study medication). However, for a given time frame, analyzed participants had values at both baseline and the corresponding time frame, e.g. day 1, 5 min; day 1, 15 min, etc.. | Posted | Least Squares Mean | Standard Error | Liters | Day 1 at 5, 15, 30 minutes (min) and 1 hour (h) post dose; days 2, 86, 184 at 23 (h) 15 min and 23 h 45 min post dose; days 29, 85, 183 at -45 and -15 min pre-dose and 5, 15, and 30 min post dose |
|
| |||||||||||||||||||||||||||||
| Secondary | Peak FEV1 | Peak FEV1 was defined as the maximum FEV1 0-4 h post-dose. Peak Fev1 was measured at 45min and 15min pre-dose and up to 4h post dose at day 1, week 12 and week 26, using central spirometry according to ATS/ERS standardization. It was analyzed using the same MIXED model as specified for the primary analysis. | The number of participants considered for the analysis was from a Serial Spirometry subgroup of the full analysis set where N = 134 and 58, respectively. However, analyzed participants had values at both baseline and the corresponding time frame, i.e. day 1, week 12 or week 26. | Posted | Least Squares Mean | Standard Error | Liters | Day 1, week 12, week 26 |
|
| |||||||||||||||||||||||||||||
| Secondary | Standardized FEV1 Area Under the Curve (AUC(5 Min-4 h)) Post-dose | The standardized (with respect to time) AUC for FEV1 was calculated between 5 min and 4h post morning dose at day 1, week 12 and week 26. The AUC (5 min-4 h) for FEV1 at each visit was analyzed using the same MIXED model as specified for the primary analysis. | The number of participants considered for the analysis was from a Serial Spirometry subgroup of the full analysis set where N = 134 and 58, respectively. However, analyzed participants had values at both baseline and the corresponding time frame, i.e. day 1, week 12 or week 26. | Posted | Least Squares Mean | Standard Error | Liters | Day 1, week 12, week 26 |
|
| |||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Chronic Obstructive Pulmonary Disease (COPD) Symptoms (Cough, Wheezing, Shortness of Breath, Sputum Volume, Sputum Color and Night Time Awakenings) | In an electronic diary, the participant responded to 6 questions twice daily to report on the degree of symptoms over the past 12 hours of the morning and evening. The questions covered the participant's degree of overall symptoms, and degrees of individual symptoms of coughing, wheezing, amount of sputum, color of sputum and breathlessness. Each question scored from 0 to 3 where 0 represented no symptom present and 3 represented the worst degree of that symptom. A negative change in symptom score indicates improvement. | The number of participants considered for the analysis was from the full analysis set (randomized participants who received at least one dose of study medication). However, for a given symptom category, analyzed participants had both baseline and week 26 values. | Posted | Least Squares Mean | Standard Error | score | Baseline, 26 weeks |
| ||||||||||||||||||||||||||||||
| Secondary | Time to First Moderate or Severe COPD Exacerbation | A COPD exacerbation was defined as a worsening of the following two or more major symptoms for at least 2 consecutive days:1) dyspnea; 2) sputum volume; 3) sputum purulence; or defined as a worsening of any 1 major symptom together with an increase in any 1 of the following minor symptoms for at least 2 consecutive days: 1) sore throat; 2) colds (nasal discharge and/or nasal congestion); 3) fever without other cause; 4) cough; 5) wheeze. COPD exacerbations were recorded in the patient diary and other source documents. | Full Analysis Set: The full analysis set included all randomized patients who received at least one dose of study medication. | Posted | Median | Full Range | Days | 26 weeks |
|
| |||||||||||||||||||||||||||||
| Secondary | Number of Moderate and Severe COPD Exacerbations | COPD exacerbations were recorded in the patient diary and other source documents. The rate of COPD exacerbations during the 26 week treatment period was analyzed using a generalized linear model assuming a negative binomial distribution. | Full Analysis Set: The full analysis set included all randomized patients who received at least one dose of study medication. | Posted | Mean | Standard Deviation | Number of exacerbations | 26 weeks |
|
| |||||||||||||||||||||||||||||
| Secondary | The Total Score of the St George's Respiratory Questionnaire (SGRQ) | SGRQ is a health related quality of life questionnaire consisting of 51 items in three components: symptoms, activity and impacts. The lowest possible score is zero and the highest possible score is 100. Higher scores correspond to greater impairment in quality of life. The health-related quality of life was measured using SGRQ. It was completed by the participant at the investigators site. | The number of participants considered for the analysis was from the full analysis set (randomized participants who received at least one dose of study medication). However, for a given time frame, analyzed participants had values at both baseline and the corresponding time frame, i.e. week 12 or week 26. | Posted | Least Squares Mean | Standard Error | Score | Week 12, week 26 |
|
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | NVA237 | NVA237 50 µg once daily delivered via a single dose dry powder inhaler | 17 | 305 | 81 | 305 | ||
| EG001 | Placebo | Placebo once daily delivered via a single dose dry powder inhaler | 14 | 154 | 48 | 154 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Angina pectoris | Cardiac disorders | 16.0 | Systematic Assessment |
| |
| Cardiac failure | Cardiac disorders | 16.0 | Systematic Assessment |
| |
| Cor pulmonale chronic | Cardiac disorders | 16.0 | Systematic Assessment |
| |
| Ventricular extrasystoles | Cardiac disorders | 16.0 | Systematic Assessment |
| |
| Lower gastrointestinal haemorrhage | Gastrointestinal disorders | 16.0 | Systematic Assessment |
| |
| Pancreatitis acute | Gastrointestinal disorders | 16.0 | Systematic Assessment |
| |
| Upper gastrointestinal haemorrhage | Gastrointestinal disorders | 16.0 | Systematic Assessment |
| |
| Death | General disorders | 16.0 | Systematic Assessment |
| |
| Lower respiratory tract infection | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Lung infection | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Oral candidiasis | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Pneumonia | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Viral infection | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Hypokalaemia | Metabolism and nutrition disorders | 16.0 | Systematic Assessment |
| |
| Hypoproteinaemia | Metabolism and nutrition disorders | 16.0 | Systematic Assessment |
| |
| Dupuytren's contracture | Musculoskeletal and connective tissue disorders | 16.0 | Systematic Assessment |
| |
| Intervertebral disc protrusion | Musculoskeletal and connective tissue disorders | 16.0 | Systematic Assessment |
| |
| Lung neoplasm malignant | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | 16.0 | Systematic Assessment |
| |
| Cerebral arteriosclerosis | Nervous system disorders | 16.0 | Systematic Assessment |
| |
| Thalamus haemorrhage | Nervous system disorders | 16.0 | Systematic Assessment |
| |
| Calculus ureteric | Renal and urinary disorders | 16.0 | Systematic Assessment |
| |
| Acute respiratory distress syndrome | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Bronchitis chronic | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Chronic obstructive pulmonary disease | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Cough | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Interstitial lung disease | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Pleurisy | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Respiratory failure | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
| |
| Shock | Vascular disorders | 16.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharyngitis | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | 16.0 | Systematic Assessment |
| |
| Chronic obstructive pulmonary disease | Respiratory, thoracic and mediastinal disorders | 16.0 | Systematic Assessment |
|
The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (i.e., data from all sites) in the clinical trial or disclosure of trial results in their entirety.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Novartis | 862-778-8300 |
| ID | Term |
|---|---|
| D029424 | Pulmonary Disease, Chronic Obstructive |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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Not provided
| ID | Term |
|---|---|
| D006024 | Glycopyrrolate |
| ID | Term |
|---|---|
| D000644 | Quaternary Ammonium Compounds |
| D000588 | Amines |
| D009930 | Organic Chemicals |
| D009861 | Onium Compounds |
| D011759 | Pyrrolidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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