The purpose of this study is to determine whether potentiating the cystic fibrosis transmembrane conductance regulator (CFTR) with QBW251 in patients with bronchiectasis will demonstrate clinical safety and efficacy related to improved mucociliary clearance with reduced bacterial colonization as potential drivers of airway obstruction, reduced airway inflammation, exacerbations and mucus load, improved lung function, clinical symptoms and quality of life to support further development in bronchiectasis.
This was a randomized, participant- and investigator-blinded, placebo-controlled, parallel-group study investigating the preliminary efficacy and safety of QBW251 administered orally for 12 weeks in participants with bronchiectasis. Approximately 72 subjects were planned to be randomized in a 1:1 ratio to receive either QBW251 or placebo in order to achieve 60 subjects to complete the treatment period based on the assumption of a 16% drop-out rate. However, the study was prematurely terminated due to a Novartis strategic decision. As a result, only 42 participants were randomized to either the QBW251 300 mg b.i.d group or the placebo group. The study consisted of the screening, baseline/Day 1, treatment period, and end of study assessments (EOS) visit followed by an additional post-treatment safety follow up via phone call. The total duration for each patient in the study was up to approximately 19 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
42
Novartis Investigative Site
Guangzhou, Guangdong, China
Novartis Investigative Site
Shanghai, China
Novartis Investigative Site
Frankfurt, Germany
Change From Baseline In Bacterial Load Colony-forming Units of Potentially Pathogenic Microorganisms in Sputum at Week 12
This measure reflects the amount of bacteria present in a patient's lungs.
Time frame: Baseline, 12 weeks
Number of Participants With Absence of Any Colony-forming Units of Potentially Pathogenic Bacteria Sputum
Time frame: Baseline, 12 weeks
Change From Baseline in Quality of Life Questionnaire for Bronchiectasis (QOL-B) (Respiratory Symptoms Domain)
The Quality of Life Questionnaire for Bronchiectasis (QOL-B) is a disease-specific questionnaire developed for non-cystic fibrosis bronchiectasis. It covers 8 dimensions: physical functioning, role functioning, emotional functioning, social functioning, vitality, treatment burden, health perceptions, and respiratory symptoms. Each dimension is scored separately on a scale of 0 to 100, and higher scores represent better outcomes. Only the respiratory symptoms domain score is reported for this outcome measure.
Time frame: Baseline, Days 28, 56, 84
Change From Baseline in Fibrinogen Plasma Concentration
Time frame: Baseline, 12 weeks
Change From Baseline in Daily Rescue Medication Use (Salbutamol/Albuterol)
The total number of puffs of rescue medication was divided by the total number of (full or half) days with non-missing rescue data to derive the mean daily number of puffs of rescue medication taken for the patient for the given visit interval.
Time frame: Baseline, 12 weeks
Change From Baseline in Pre-bronchodilator Forced Exploratory Volume in the First Second (FEV1)
FEV1 is the amount of air that can be forcibly exhaled from the lungs in the first second of a forced exhalation.
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Novartis Investigative Site
Hanover, Germany
Novartis Investigative Site
Mainz, Germany
Novartis Investigative Site
Barcelona, Catalonia, Spain
Novartis Investigative Site
Girona, Catalonia, Spain
Novartis Investigative Site
Leeds, West Yorkshire, United Kingdom
Novartis Investigative Site
Cambridge, United Kingdom
Novartis Investigative Site
Edinburgh, United Kingdom
...and 4 more locations
Time frame: Baseline, Days 28, 56, 84
Change From Baseline in Pre-bronchodilator Forced Vital Capacity (FVC)
Forced vital capacity (FVC) is the amount of air that can be forcibly exhaled from the lungs after taking the deepest breath possible.
Time frame: Baseline, Days 28, 56, 84
Change From Baseline in Bronchus Region Pi10
Pi10 is the square root of the wall area for an idealized airway with a luminal perimeter of 10 mm. Pi10 is the most commonly used measure of wall thickening and represents a regional estimate of the small airways across the whole lung or a particular lobe. Measured by high resolution computed tomography (HRCT).
Time frame: Baseline, 12 weeks
Change From Baseline in Region Percent Below or Equal to -856 Hounsfield Units (HU)
The region percent below or equal to -856 HU represents air trapping, which was evaluated by HRCT in the whole lung and in the regions (thirds, lobes).
Time frame: Baseline, 12 weeks
Change From Baseline in Region Air Volume
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Average Inner Area
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Average Major Inner Diameter
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Average Minor Inner Diameter
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Average Outer Area
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Average Wall Area Fraction
Wall area fraction or ratio was calculated by dividing the wall area of the corresponding segment to the total airway area. Measured by HRCT.
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Average Wall Thickness
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Wall Area Percent
Measured by HRCT
Time frame: Baseline, 12 weeks
Change From Baseline in Segment Wall Area
Measured by HRCT
Time frame: Baseline, 12 weeks
Cmax of QBW251
Maximum (peak) plasma concentration of QBW251
Time frame: 1h, 2h, 3h, 4h, 6h and 8h post-dose on Days 1 and 28, and 3h post-dose on Day 56 and Day 84
Ctrough of QBW251
Trough (pre-dose) plasma concentration of QBW251
Time frame: Pre-dose Day 1, Day 28, Day 56, Day 84
Cmax of QBW251 for a Serial PK Set
Time frame: Pre-dose, 1h, 2h, 3h, 4h, 6h and 8h post-dose on Day 1 and Day 28
Ctrough of QBW251 for a Serial PK Set
Time frame: Pre-dose, 1h, 2h, 3h, 4h, 6h and 8h post-dose on Day 1 and Day 28
AUClast of QBW251 for a Serial PK Set
Area under the concentration-time curve up to the last measurable concentration of QBW251 (AUClast)
Time frame: Pre-dose, 1h, 2h, 3h, 4h, 6h and 8h post-dose on Day 1 and Day 28
Tmax of QBW251 for a Serial PK Set
Time to reach maximum (peak) plasma concentration after single-dose administration
Time frame: Pre-dose, 1h, 2h, 3h, 4h, 6h and 8h post-dose on Day 1 and Day 28
AUC0-12h of QBW251 for a Serial PK Set
Twelve-hour AUC
Time frame: Pre-dose, 1h, 2h, 3h, 4h, 6h and 8h post-dose on Day 1 and Day 28
Tlast of QBW251 for a Serial PK Set
Tlast is the last measurable concentration sampling time.
Time frame: Pre-dose, 1h, 2h, 3h, 4h, 6h and 8h post-dose on Day 1 and Day 28