Novartis' fifth QVA149 (indacaterol maleate/glycopyrronium bromide) phase III study, SPARK, met its primary endpoint of a reduced rate of moderate-to-severe COPD exacerbations compared to glycopyrronium bromide (Seebri Breezhaler).
SPARK is the final study intended for initial regulatory filings of QVA149 in Europe and Japan, which are expected in Q4 2012. US filing of QVA149 is expected at the end of 2014. To date, the first five studies of the IGNITE QVA149 phase III clinical trials programme have all met their primary endpoints of efficacy, safety, exercise endurance, and reduction of exacerbations.
"We are very pleased that SPARK showed a reduction of exacerbations, further demonstrating that QVA149 could improve the lives of patients with COPD," said Tim Wright, head of development, Novartis Pharmaceuticals. "We are looking forward to filing QVA149 initially in Europe and Japan, which will bring us another step closer to providing a full range of innovative COPD medicines to help physicians select the right treatment for the right patient at the right time."
SPARK met its primary endpoint by demonstrating that patients treated with once-daily (QD) investigational QVA149 for 64 weeks demonstrated a clinically meaningful and statistically significant lower rate of moderate-to-severe COPD exacerbations compared to patients treated with QD glycopyrronium 50 mcg (p=0.038). The study also showed that the rate of moderate-to-severe exacerbations was numerically lower (p=0.096) in patients on QVA149 compared to open-label (OL) tiotropium 18 mcg.
A further analysis of the data demonstrated that QVA149 was statistically significantly more effective in reducing the overall rate of all exacerbations (mild, moderate and severe) compared to glycopyrronium 50 mcg (p=0.001) and OL tiotropium 18 mcg (p=0.002). The adverse event (AE) profile of QVA149 was similar to both glycopyrronium 50 mcg and OL tiotropium 18 mcg.
The management of COPD exacerbations is important to both patients and physicians, as exacerbations can impose a significant burden of morbidity, mortality, reduced quality of life and healthcare costs. Frequent exacerbations are linked to an accelerated decline in lung function and patients are also known to have a poorer quality of life. Admissions to hospital due to exacerbations are increasing and patients with more severe underlying disease account for around 70% of the direct medical costs of COPD.
SPARK was a 64-week, multi-center, randomized, double-blind, parallel-group, active controlled study designed to evaluate the effect of QVA149 (indacaterol maleate 110 mcg/glycopyrronium 50 mcg) QD versus glycopyrronium 50 mcg and QD OL tiotropium 18 mcg on moderate-to-severe COPD exacerbations in 2,224 patients with severe to very severe COPD.
QVA149 is an investigational inhaled, once-daily, fixed-dose combination of the long-acting beta2-adrenergicagonist (LABA) indacaterol maleate, and the investigational long-acting muscarinic antagonist (LAMA) glycopyrronium bromide, being investigated for the treatment of COPD in the phase III IGNITE clinical trial programme. IGNITE is one of the largest international clinical trial programmes in COPD comprising 10 studies in total with more than 7,000 patients across 42 countries. The first five studies (ILLUMINATE, SHINE, BRIGHT, ENLIGHTEN, SPARK) have already completed in 2012 with three additional studies (BLAZE, ARISE, BEACON) expected to complete by the end of the year. The studies are designed to investigate efficacy, safety and tolerability, exercise endurance, exacerbations, breathlessness and quality of life.
Novartis is committed to addressing the unmet medical needs of COPD patients and improving their quality of life by providing innovative medicines and devices.
In addition to investigational QVA149, the Novartis COPD portfolio also includes Onbrez Breezhaler (indacaterol maleate) and glycopyrronium bromide (Seebri Breezhaler).
Onbrez Breezhaler (indacaterol maleate) is a QD LABA that is currently the only COPD treatment on the market to offer clinically relevant 24-hour bronchodilation combined with a rapid onset of action of five minutes at first dose, as demonstrated in the INERGIZE phase III trial programme. Onbrez Breezhaler has also shown significant improvement in breathlessness scores compared to placebo and OL tiotropium 18 mcg. Onbrez Breezhaler was first launched in the EU in 150 mcg and 300 mcg once-daily doses. Most recently, Novartis launched the 75 mcg once-daily dose in the US under the brand name Arcapta Neohaler. It is also available as a 150 mcg once-daily dose in Japan under the brand name Onbrez inhalation capsules.
Glycopyrronium bromide (Seebri Breezhaler) is an investigational LAMA developed as a once-daily inhaled maintenance therapy for the treatment of COPD. Phase III data from the GLOW1, 2 and 3 studies demonstrated that glycopyrronium bromide increased patients' lung function over a 24-hour period compared to placebo with a fast onset of action at first dose, and improved exercise endurance versus placebo. Glycopyrronium bromide was licensed to Novartis in April 2005 by Vectura and its co-development partner Sosei.