- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03158311
Study to Compare QVM149 and Free Triple Combination of Salmeterol/Fluticasone + Tiotropium (ARGON)
A Multicenter, Partially-Blinded, Randomized, 24-Week, Parallel-Group, Non-Inferiority, Open-Label Active Controlled Study to Compare the Efficacy and Safety of QVM149 With a Free Triple Combination of Salmeterol/Fluticasone + Tiotropium in Patients With Uncontrolled Asthma
The purpose of this trial was to demonstrate that the efficacy of two treatment arms of the fixed-dose combination product QVM149 was non-inferior to the efficacy of the free combination arm of salmeterol/ fluticasone+ tiotropium in uncontrolled moderate to severe asthmatic patients.
The planned duration of treatment in this study was 24 weeks, followed up by a 7-day follow-up period.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study used a randomized, partially-blinded, 24-week, parallel-group, non-inferiority, open-label active controlled design. The study was partially open-label. Investigators and patients had knowledge of treatment allocation between QVM149 and/or comparator, however the QVM149 strength allocation was masked. The global sponsor team responsible for data review and analysis was blinded to all treatment allocations The study consisted of a screening period of up to 1-week, run-in period of 2-weeks, randomized treatment period of 24-weeks, and a follow-up period of 1-week.
At the screening visit, informed consent was obtained, and current and prohibited medications were reviewed. Rescue medication was provided to all patients who met the eligibility criteria and was to be used on an "as needed" basis throughout the study.
At the run-in visit, inclusion and exclusion criteria were reviewed and the patients were supplied with open-label long acting β2-adrenergic agonist/inhaled corticosteroids (LABA/ICS) salmeterol/fluticasone 50/250 μg b.i.d or 50/500 μg b.i.d to match their ICS background medication dose to be stopped at randomization visit.
All patients who met the eligibility criteria were randomized to 1 of 3 treatment arms with a randomization ratio of 1:1:1. The patients were stratified at randomization according to the ICS dose component of background ICS/LABA (medium or high dose) and region.
Treatment period visits were scheduled every 8 weeks. The study used two doses of QVM149 (high dose [150/50/160 μg] and a medium dose [150/50/80 μg] o.d. delivered via Concept1 inhaler) and a comparator treatment (salmeterol/fluticasone 50/500 μg b.i.d. delivered via Accuhaler® plus tiotropium 5 μg o.d delivered via Respimat®).
All randomized patients were contacted (by telephone) 7 days following the last dose of study medication or last visit, whichever was later, for Safety Follow-up visit.
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Bahia Blanca, Argentina, B8000JRB
- Novartis Investigative Site
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Buenos Aires, Argentina, C1125ABE
- Novartis Investigative Site
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Buenos Aires, Argentina, C1425FVH
- Novartis Investigative Site
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Buenos Aires, Argentina, 1900
- Novartis Investigative Site
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Buenos Aires, Argentina, B1646EBJ
- Novartis Investigative Site
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Ciudad Autonoma de Bs As, Argentina, C1128AAF
- Novartis Investigative Site
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Mendoza, Argentina, 5500
- Novartis Investigative Site
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Mendoza, Argentina, M5500CBA
- Novartis Investigative Site
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Mendoza, Argentina, 5501
- Novartis Investigative Site
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Salta, Argentina, 4400
- Novartis Investigative Site
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Santa Fe, Argentina, S3000FIL
- Novartis Investigative Site
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Buenos Aires
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Berazategui, Buenos Aires, Argentina, 1888
- Novartis Investigative Site
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Caba, Buenos Aires, Argentina, C1280AEB
- Novartis Investigative Site
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Caba, Buenos Aires, Argentina, C1122AAK
- Novartis Investigative Site
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Caba, Buenos Aires, Argentina, C1425BEN
- Novartis Investigative Site
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Caba, Buenos Aires, Argentina, C1414AIF
- Novartis Investigative Site
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Caba, Buenos Aires, Argentina, C1424BSF
- Novartis Investigative Site
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Florida, Buenos Aires, Argentina, B1602DQD
- Novartis Investigative Site
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Lanus, Buenos Aires, Argentina, B8000XAV
- Novartis Investigative Site
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Mar del Plata, Buenos Aires, Argentina, 7600
- Novartis Investigative Site
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Nueve de Julio, Buenos Aires, Argentina, B6500EZL
- Novartis Investigative Site
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Ranelagh, Partido De Berazate, Buenos Aires, Argentina, 1884
- Novartis Investigative Site
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Entre Rios
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Concepcion del Uruguay, Entre Rios, Argentina, 3260
- Novartis Investigative Site
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La Pampa
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Santa Rosa, La Pampa, Argentina, 6300
- Novartis Investigative Site
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Nueve De Julio
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Buenos Aires, Nueve De Julio, Argentina, B6500BWQ
- Novartis Investigative Site
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Santa Fe
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Rosario, Santa Fe, Argentina, S2000AII
- Novartis Investigative Site
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Rosario, Santa Fe, Argentina, S2000BRH
- Novartis Investigative Site
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Tucuman
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San Miguel de Tucuman, Tucuman, Argentina, 4000
- Novartis Investigative Site
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Region Metropolitana
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Santiago, Region Metropolitana, Chile, 7500692
- Novartis Investigative Site
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VII Region Del Maule
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Curico, VII Region Del Maule, Chile, 3341643
- Novartis Investigative Site
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Bogota, Colombia, 110221
- Novartis Investigative Site
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Cundinamarca
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Bogota, Cundinamarca, Colombia, 110911
- Novartis Investigative Site
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Lovosice, Czechia, 41002
- Novartis Investigative Site
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Miroslav, Czechia, 67172
- Novartis Investigative Site
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CZE
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Teplice, CZE, Czechia, 415 01
- Novartis Investigative Site
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Czech Republic
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Ostrava Poruba, Czech Republic, Czechia, 708 68
- Novartis Investigative Site
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Prague, Czech Republic, Czechia, 169 00
- Novartis Investigative Site
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Berlin, Germany, 12203
- Novartis Investigative Site
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Berlin, Germany, 13086
- Novartis Investigative Site
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Berlin, Germany, 10717
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Berlin, Germany, 13156
- Novartis Investigative Site
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Berlin, Germany, 14050
- Novartis Investigative Site
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Berlin, Germany, 10969
- Novartis Investigative Site
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Berlin, Germany, 12157
- Novartis Investigative Site
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Berlin, Germany, 12159
- Novartis Investigative Site
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Berlin, Germany, 10119
- Novartis Investigative Site
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Berlin, Germany, 13187
- Novartis Investigative Site
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Berlin, Germany, 10625
- Novartis Investigative Site
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Boehlen, Germany, 04564
- Novartis Investigative Site
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Bonn, Germany, 53123
- Novartis Investigative Site
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Darmstadt, Germany, 64283
- Novartis Investigative Site
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Dortmund, Germany, 44263
- Novartis Investigative Site
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Einbeck, Germany, 37574
- Novartis Investigative Site
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Frankfurt, Germany, 60596
- Novartis Investigative Site
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Frankfurt, Germany, 60389
- Novartis Investigative Site
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Furstenwalde, Germany, 15517
- Novartis Investigative Site
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Gelsenkirchen, Germany, 45879
- Novartis Investigative Site
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Hamburg, Germany, 20354
- Novartis Investigative Site
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Hamburg, Germany, 22335
- Novartis Investigative Site
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Hannover, Germany, 30167
- Novartis Investigative Site
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Hannover, Germany, 30173
- Novartis Investigative Site
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Leipzig, Germany, 04357
- Novartis Investigative Site
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Leipzig, Germany, 04103
- Novartis Investigative Site
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Leipzig, Germany, 04275
- Novartis Investigative Site
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Leipzig, Germany, 04157
- Novartis Investigative Site
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Lubeck, Germany, 23552
- Novartis Investigative Site
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Ludwigsburg, Germany, 71640
- Novartis Investigative Site
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Marburg, Germany, D-35037
- Novartis Investigative Site
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Marburg, Germany, 35037
- Novartis Investigative Site
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Menden, Germany, 58706
- Novartis Investigative Site
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Mittweida, Germany, 09648
- Novartis Investigative Site
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Munchen, Germany, 81241
- Novartis Investigative Site
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Potsdam, Germany, 14467
- Novartis Investigative Site
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Rudersdorf, Germany, 15562
- Novartis Investigative Site
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Schleswig, Germany, 24837
- Novartis Investigative Site
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Witten, Germany, 58452
- Novartis Investigative Site
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Niedersachsen
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Peine, Niedersachsen, Germany, 31224
- Novartis Investigative Site
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Schleswig Holstein
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Geesthacht, Schleswig Holstein, Germany, 12502
- Novartis Investigative Site
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Athens, Greece, 12462
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GR
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Athens, GR, Greece, 115 27
- Novartis Investigative Site
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Thessaloniki, GR, Greece, 570 10
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Thessaloniki, GR, Greece, 564 29
- Novartis Investigative Site
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Thessaloniki, GR, Greece, 546 03
- Novartis Investigative Site
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Balassagyarmat, Hungary, 2660
- Novartis Investigative Site
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Godollo, Hungary, 2100
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Komlo, Hungary, 7300
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Sellye, Hungary, 7960
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Siofok, Hungary, 8600
- Novartis Investigative Site
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Szarvas, Hungary, 5540
- Novartis Investigative Site
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Szeged, Hungary, 6722
- Novartis Investigative Site
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HUN
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Puspokladany, HUN, Hungary, 4150
- Novartis Investigative Site
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Andhra Pradesh
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Vijayawada, Andhra Pradesh, India, 520008
- Novartis Investigative Site
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Kerala
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Kozhikode, Kerala, India, 673008
- Novartis Investigative Site
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Maharashtra
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Nagpur, Maharashtra, India, 440019
- Novartis Investigative Site
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Pune, Maharashtra, India, 411014
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Punjab
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Mohali, Punjab, India, 160 062
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Tamil Nadu
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Coimbatore, Tamil Nadu, India, 641 045
- Novartis Investigative Site
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Vellore, Tamil Nadu, India, 632004
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Telangana
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Hyderabad, Telangana, India, 500 038
- Novartis Investigative Site
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West Bengal
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Kolkata, West Bengal, India, 700 107
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Jerusalem, Israel, 91120
- Novartis Investigative Site
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Jerusalem, Israel, 91031
- Novartis Investigative Site
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Ramat Gan, Israel, 5266202
- Novartis Investigative Site
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Rehovot, Israel, 76100
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Distrito Federal
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Mexico, Distrito Federal, Mexico, 14050
- Novartis Investigative Site
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Jalisco
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Guadalajara, Jalisco, Mexico, 44160
- Novartis Investigative Site
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Guadalajara, Jalisco, Mexico, 44100
- Novartis Investigative Site
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Cusco, Peru, 84
- Novartis Investigative Site
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Lima, Peru, 1
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Lima
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San Martin de Porres, Lima, Peru, 31
- Novartis Investigative Site
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Santiago de Surco, Lima, Peru, 33
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Katowice, Poland, 40-648
- Novartis Investigative Site
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Poznan, Poland, 60-693
- Novartis Investigative Site
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Poznan, Poland, 60-214
- Novartis Investigative Site
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Poznan, Poland, 60 823
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Izhevsk, Russian Federation, 426061
- Novartis Investigative Site
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Kemerovo, Russian Federation, 650002
- Novartis Investigative Site
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Moscow, Russian Federation, 109544
- Novartis Investigative Site
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Moscow, Russian Federation, 105275
- Novartis Investigative Site
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Moscow, Russian Federation, 123423
- Novartis Investigative Site
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Nizhny Novgorod, Russian Federation, 603018
- Novartis Investigative Site
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Novosibirsk, Russian Federation, 630102
- Novartis Investigative Site
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Saint Petersburg, Russian Federation, 197022
- Novartis Investigative Site
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Saint Petersburg, Russian Federation, 194354
- Novartis Investigative Site
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Saint Petersburg, Russian Federation, 107022
- Novartis Investigative Site
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Saint Petersburg, Russian Federation, 195271
- Novartis Investigative Site
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Saint-Petersburg, Russian Federation, 191186
- Novartis Investigative Site
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Saint-Petersburg, Russian Federation, 196143
- Novartis Investigative Site
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Saratov, Russian Federation, 410028
- Novartis Investigative Site
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Saratov, Russian Federation, 410054
- Novartis Investigative Site
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St Petersburg, Russian Federation, 193312
- Novartis Investigative Site
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Ulyanovsk, Russian Federation, 432063
- Novartis Investigative Site
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Yekaterinburg, Russian Federation, 620109
- Novartis Investigative Site
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Belgrade, Serbia, 11000
- Novartis Investigative Site
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Kragujevac, Serbia, 34000
- Novartis Investigative Site
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Nis, Serbia, 18000
- Novartis Investigative Site
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Sremska Kamenica, Serbia, 21204
- Novartis Investigative Site
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Liptovsky Mikulas, Slovakia, 031 23
- Novartis Investigative Site
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Topolcany, Slovakia, 95501
- Novartis Investigative Site
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Zilina, Slovakia, 01001
- Novartis Investigative Site
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Slovak Republic
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Bojnice, Slovak Republic, Slovakia, 972 01
- Novartis Investigative Site
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Humenne, Slovak Republic, Slovakia, 066 01
- Novartis Investigative Site
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Liptovsky Hradok, Slovak Republic, Slovakia, 033 01
- Novartis Investigative Site
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Cape Town, South Africa, 7700
- Novartis Investigative Site
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Cape Town, South Africa, 7530
- Novartis Investigative Site
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Chatsworth, South Africa, 4092
- Novartis Investigative Site
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Kempton Park, South Africa, 1619
- Novartis Investigative Site
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Pretoria, South Africa, 0183
- Novartis Investigative Site
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Durban
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Berea, Durban, South Africa, 4001
- Novartis Investigative Site
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Barcelona
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Esparraguera, Barcelona, Spain, 08292
- Novartis Investigative Site
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Cataluna
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Hostalets De Balenya, Cataluna, Spain, 08550
- Novartis Investigative Site
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Comunidad Valenciana
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Alzira, Comunidad Valenciana, Spain, 46600
- Novartis Investigative Site
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Extremadura
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Caceres, Extremadura, Spain, 10003
- Novartis Investigative Site
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Malaga
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Benalmadena, Malaga, Spain, 29639
- Novartis Investigative Site
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Kaoshiung, Taiwan, 80756
- Novartis Investigative Site
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Taichung, Taiwan, 40447
- Novartis Investigative Site
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Taipei, Taiwan, 10449
- Novartis Investigative Site
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Izmir, Turkey, 35040
- Novartis Investigative Site
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Mersin, Turkey, 33343
- Novartis Investigative Site
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Yenisehir/Izmir, Turkey, 35110
- Novartis Investigative Site
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Hanoi, Vietnam, 100000
- Novartis Investigative Site
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Ho Chi Minh, Vietnam, 700000
- Novartis Investigative Site
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VNM
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Ho Chi Minh, VNM, Vietnam, 700000
- Novartis Investigative Site
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with a diagnosis of asthma for a period of at least 6 months prior to Visit 1 with current asthma severity ≥ step 4 (GINA 2017).
- Patients who had used ICS/LABA combinations for asthma for at least 3 months and at stable medium or high dose of ICS/LABA for at least 1 month prior to Visit 1.
- Patients were required to be symptomatic at screening despite treatment with medium or high stable doses of ICS/LABA as defined by ACQ-7 score ≥ 1.5 at visits 101 and 201 (randomization visit).
- Patients with history of at least one severe asthma exacerbation which required medical care from a physician, emergency room visit (or local equivalent structure) or hospitalization in the 12 months prior to Visit 1 and required systemic corticosteroid treatment for at least 3 days including physician guided self-management treatment with oral corticosteroids as part of written asthma action plan.
- Pre-bronchodilator FEV1 of < 85 % of the predicted normal value for the patient after withholding bronchodilators prior to spirometry at both Visit 101 and Visit 201.
- Patients who demonstrated an increase in FEV1 of ≥ 12% and 200 ml.
Exclusion Criteria:
- Patients who had a smoking history of greater than 20 pack years.
- Patients diagnosed with Chronic Obstructive Pulmonary Disease (COPD).
- Patients who had an asthma attack/exacerbation requiring systemic steroids or hospitalization or emergency room visit within 6 weeks of Visit 1 (Screening).
- Patients treated with a LAMA for asthma within 3 months prior to Visit 1.
- Patients who had a respiratory tract infection or clinical significant asthma worsening as defined by Investigator within 4 weeks prior to Visit 1 or between Visit 1 and Visit 201.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: QVM149 150/50/80 μg
QVM149 150/50/80 μg o.d.
delivered via Concept1
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Indacaterol acetate / glycopyrronium bromide / mometasone furoate
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Experimental: QVM149 150/50/160 μg
QVM149 150/50/160 μg o.d.
delivered via Concept1
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Indacaterol acetate / glycopyrronium bromide / mometasone furoate
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Active Comparator: Salmeterol/fluticasone 50/500 μg plus tiotropium 5 μg
Salmeterol/fluticasone 50/500 μg b.i.d.
delivered via Accuhaler® plus tiotropium 5 μg o.d.
delivered via Respimat®
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Free triple arm of salmeterol / fluticasone plus tiotropium
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change From Baseline in Asthma Quality of Life Questionnaire (AQLQ) Total Score
Time Frame: Baseline and Week 24
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The AQLQ is a 32-item asthma specific questionnaire designed to measure functional impairments that are most important to patients with asthma, with a recall time of two weeks and each question to be answered on a 7-point scale, where 1=totally limited/problems all the time and 7= not at all limited/no problems.
It consists of 4 domains: symptoms, activity limitation, emotional funtion, and emotional stimuli.
The overall score is calculated as the mean of 32 items.
Higher AQLQ scores indicate better health-related quality of life.
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Baseline and Week 24
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change From Baseline in Trough Forced Expiratory Volume in 1 Second (FEV1)
Time Frame: Baseline, Week 8, Week 16 and Week 24
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FEV1 is the amount of air which can be forcibly exhaled from the lungs in the first second of a forced exhalation, measured through spirometry testing.
Trough FEV1 is the mean of two FEV1 values measures taken 15 minutes (min) and 45 min prior to evening dose.
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Baseline, Week 8, Week 16 and Week 24
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Change From Baseline in Asthma Control Questionnaire (ACQ-7) Total Score
Time Frame: Baseline, Week 16 and Week 24
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The ACQ-7 measured asthma symptom control and consists of 7 items: 5 on symptom assessment, 1 on rescue medication use and 1 on airway calibre (FEV1 % predicted).
All seven items are scored on a 7-point Likert scale, with 0 indicating total control and 6 indicating poor control.
The questions are equally weighted and the total score is the mean of the seven items.
Higher score indicates worst symptoms.
The first 6 questions of the ACQ-7 were completed by the participant while the last question was completed by the study investigator using data from the Master Scope spirometer.
A negative change from baseline indicates improvement in lung function.
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Baseline, Week 16 and Week 24
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Change From Baseline in AQLQ Total Score
Time Frame: Baseline and Week 16
|
The AQLQ is a 32-item asthma specific questionnaire designed to measure functional impairments that are most important to patients with asthma, with a recall time of two weeks and each question to be answered on a 7-point scale, where 1=totally limited/problems all the time and 7= not at all limited/no problems.
It consists of 4 domains: symptoms, activity limitation, emotional function and environmental stimuli.
The overall score is calculated as the mean of 32 items.
Higher AQLQ scores indicate better health-related quality of life.
|
Baseline and Week 16
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Percentage of Patients Achieving the Minimally Clinically Important Difference (MCID) Decrease From Baseline ACQ-7 ≥ 0.5
Time Frame: Baseline and Week 24
|
The ACQ-7 measured asthma symptom control and consists of 7 items: 5 on symptom assessment, 1 on rescue medication use and 1 on airway calibre (FEV1 % predicted).
All seven items are scored on a 7-point Likert scale, with 0 indicating total control and 6 indicating poor control.
The questions are equally weighted and the total score is the mean of the seven items.
Higher score indicates worst symptoms.
The first 6 questions of the ACQ-7 were completed by the participant while the last question was completed by the study investigator using data from the Master Scope spirometer.
A negative change from baseline indicates improvement in lung function.
Decrease of ACQ-7 score of at least 0.5 from baseline was considered clinically meaningful.
|
Baseline and Week 24
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Percentage of Patients Achieving the Minimally Clinically Important Difference (MCID) Change From Baseline AQLQ ≥ 0.5
Time Frame: Baseline and Week 24
|
The AQLQ is a 32-item asthma specific questionnaire designed to measure functional impairments that are most important to patients with asthma, with a recall time of two weeks and each question to be answered on a 7-point scale, where 1=totally limited/problems all the time and 7= not at all limited/no problems.
It consists of 4 domains: symptoms, activity limitation, emotional function and environmental stimuli.
The overall score is calculated as the mean of 32 items.
Higher AQLQ scores indicate better health-related quality of life.
An improvement of 0.5 points in AQLQ score is considered to be the minimally clinically important difference in asthma.
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Baseline and Week 24
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Change From Baseline in Forced Vital Capacity (FVC)
Time Frame: Baseline, Week 8, Week 16 and Week 24
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FVC is the total volume of air exhaled during a expiratory maneuvre.
It was assessed by performing a spirometry assessment.
|
Baseline, Week 8, Week 16 and Week 24
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Change From Baseline in Forced Expiratory Flow Between 25% and 75% of Forced Vital Capacity (FEF25-75)
Time Frame: Baseline, Week 8, Week 16 and Week 24
|
Forced expiratory flow during the mid (25 - 75%) portion of the FVC.
It was assessed by performing spirometric assessment.
|
Baseline, Week 8, Week 16 and Week 24
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Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Respiratory Tract Diseases
- Immune System Diseases
- Lung Diseases
- Hypersensitivity, Immediate
- Bronchial Diseases
- Lung Diseases, Obstructive
- Respiratory Hypersensitivity
- Hypersensitivity
- Asthma
- Physiological Effects of Drugs
- Adrenergic Agents
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Parasympatholytics
- Autonomic Agents
- Peripheral Nervous System Agents
- Cholinergic Antagonists
- Cholinergic Agents
- Anti-Inflammatory Agents
- Adrenergic Agonists
- Dermatologic Agents
- Bronchodilator Agents
- Anti-Asthmatic Agents
- Respiratory System Agents
- Anti-Allergic Agents
- Adrenergic beta-2 Receptor Agonists
- Adrenergic beta-Agonists
- Fluticasone
- Salmeterol Xinafoate
- Tiotropium Bromide
Other Study ID Numbers
- CQVM149B2306
- 2017-000136-34 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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Novartis PharmaceuticalsCompletedAsthmaGermany, Belgium, India, Romania, South Africa, Croatia, Estonia, Russian Federation, Netherlands, Israel, Thailand, Lebanon, Canada, Philippines, Poland, Slovakia, United Kingdom, China, Latvia, Italy, Argentina, Greece, Mexico, Austria and more
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Novartis PharmaceuticalsCompletedAsthmaGermany, Netherlands, United Kingdom, China, Romania, Bulgaria
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University Medical Center GroningenNovartisCompleted
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Dr. Grace ParragaNovartis PharmaceuticalsWithdrawn