Novartis Phase IIIb ARGON study meets primary endpoint in a comparison of Enerzair Breezhaler (QVM149) versus a free combination of two existing inhaled treatments in uncontrolled asthma
- Once-daily Enerzair??Breezhaler??(QVM149; IND/GLY/MF) met primary endpoint, demonstrating non-inferiority to a free combination of twice-daily Sal/Flu plus once-daily tiotropium (Tio), in improving quality of life in people with uncontrolled asthma1.
- Among secondary analyses, improvements in lung function, asthma control, health status, and a reduction in moderate exacerbations were observed with once-daily high-dose IND/GLY/MF compared to a free combination of high-dose Sal/Flu plus Tio1.
- IND/GLY/MF recently received a positive opinion from the European Medicines Agency?s Committee for Medicinal Products for Human Use (CHMP) and is currently under regulatory review in multiple countries.?
- If approved, once-daily IND/GLY/MF will be the first LABA/LAMA/ICS fixed-dose combination for patients whose asthma is uncontrolled with LABA/ICS treatment and could provide an effective and convenient alternative to the current standard-of-care regimen.
About Uncontrolled Asthma? Asthma affects an estimated 358 million people worldwide and can cause a significant personal, health and financial burden when not adequately controlled3,4. Despite current therapy, over 40% of patients with asthma at Global Initiative for Asthma (GINA) Step 3, and over 45% at GINA Steps 4 and 5 remain uncontrolled5,6. Patients with uncontrolled asthma may downplay or underestimate the severity of their disease and are at a higher risk of exacerbation, hospitalization or death7,8,9. Barriers, such as treatment mismatch, safety issues with an oral corticosteroid and ineligibility for biologics, have created an unmet medical need in asthma10,11.
About Enerzair??Breezhaler??in the EU The CHMP adopted a positive opinion recommending the approval of high-dose Enerzair??Breezhaler??(QVM149; IND/GLY/MF) 150/50/160 ?g once-daily as a maintenance treatment of asthma in adult patients not adequately controlled with a maintenance combination of a long-acting beta2-agonist (LABA) and a high dose of an inhaled corticosteroid (ICS) who experienced one or more asthma exacerbations in the previous year12. This formulation combines the bronchodilation of indacaterol acetate (a LABA) and the antimuscarinic effects of glycopyrronium bromide (a LAMA) with mometasone furoate (ICS) in a precise once-daily formulation, delivered via the dose-confirming Breezhaler??device. Glycopyrronium bromide certain use and formulation intellectual property were exclusively licensed to Novartis in April 2005 by Sosei Heptares and Vectura. Mometasone furoate is exclusively licensed to Novartis from a subsidiary of Merck & Co., Inc, Kenilworth, NJ, USA, for use in IND/GLY/MF (worldwide excluding the US).
IND/GLY/MF will be administered via the dose-confirming Breezhaler??device, which enables once-daily inhalation using a single inhaler. If approved, IND/GLY/MF will be the first asthma treatment in the EU that can be prescribed together with a digital companion; the Propeller Health app and a sensor custom-built for the Breezhaler??device. The digital companion will provide patients with inhalation confirmation, medication reminders and access to objective data that can be shared with their physician in order to help them make better therapeutic decisions. The sensor for the Breezhaler??device was developed by Propeller Health and is a CE marked Medical Device, designed and licensed to Novartis exclusively for use with the Breezhaler??inhaler worldwide. The sensor includes a microchip, a microphone, Bluetooth capabilities, an antenna and a battery. The sensor does not alter the drug delivery characteristics of the Breezhaler??inhaler itself but produces a recording of each administered dose. Based on the patient?s recorded medication usage, personalized content is presented within the app to help the patient better self-manage their asthma. About the PLATINUM Clinical Development Program The PLATINUM program, containing over 7,500 patients worldwide, is the Novartis Phase III/IIIb clinical development program supporting the development of IND/GLY/MF and IND/MF. It includes four studies: the QUARTZ study, which compared a low-dose of IND/MF with MF alone; the PALLADIUM study, which compared IND/MF with MF and salmeterol xinafoate/fluticasone propionate (Sal/Flu); the IRIDIUM study, which compared IND/GLY/MF with IND/MF and Sal/Flu; and the ARGON study, which compared IND/GLY/MF with a free combination of Sal/Flu plus tiotropium (Tio).About the ARGON study1 ARGON (NCT03158311) is a Phase IIIb, multicenter, randomized, 24-week, parallel-group, non-inferiority, open-label (blinded for the two IND/GLY/MF tested doses), active-controlled study comparing the efficacy and safety of IND/GLY/MF with a free combination of salmeterol xinafoate/fluticasone propionate (Sal/Flu) plus tiotropium (Tio) in patients with uncontrolled asthma.
The purpose of this trial was to demonstrate that the efficacy of two doses of the fixed-dose combination product IND/GLY/MF (high: 150/50/160 ?g and medium: 150/50/80 ?g) is non-inferior to the efficacy of the free combination of Sal/Flu (50/500 ?g) plus Tio (5 ?g) in patients with uncontrolled asthma. All patients were symptomatic at screening despite treatment with medium- or high- stable doses of LABA/ICS as defined by Asthma Control Questionnaire (ACQ-7) score =1.5. Approximately 1,251 male and female patients with uncontrolled asthma (aged 18 and above) were randomized 1:1:1 (approximately 417 patients in each of the treatment groups) to receive either:- IND/GLY/MF 150/50/80 ?g (once-daily)
- IND/GLY/MF 150/50/160 ?g (once-daily)
- Open label Sal/Flu 50/500 ?g (twice-daily) delivered via Diskus??plus Tio delivered via Respimat?
- To evaluate efficacy of high-dose IND/GLY/MF and medium-dose IND/GLY/MF compared with Sal/Flu plus Tio based on trough FEV1?after 24 weeks of treatment.
- To evaluate efficacy of high-dose IND/GLY/MF and medium-dose IND/GLY/MF compared with Sal/Flu plus Tio based on Asthma Quality of Life Questionnaire (AQLQ) over 24 weeks of treatment.
- To evaluate efficacy of high-dose IND/GLY/MF and medium-dose IND/GLY/MF compared with Sal/Flu plus Tio based on ACQ-7 over 24 weeks of treatment.
- To evaluate efficacy of high-dose IND/GLY/MF and medium-dose IND/GLY/MF compared with Sal/Flu plus Tio based on lung function over 24 weeks of treatment.
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Novartis Media Relations E-mail:?media.relations@novartis.comPeter Zuest Novartis Global External Communications +41 79 899 9812 (mobile) peter.zuest@novartis.com Eric Althoff Novartis US External Communications +1 646 438 4335 eric.althoff@novartis.com | Phil McNamara Global Head, Respiratory Communications +41 79 510 8756 (mobile) philip.mcnamara@novartis.com |
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