Novartis cheered by COPD trial results

pharmafile | September 3, 2012 | News story | Research and Development COPD, ERS, Novartis 

One of Novartis’ experimental respiratory drugs has proved superior in a late-stage trial to Boehringer Ingelheim and Pfizer’s existing brand Spiriva in helping patients breathe more easily.

In data presented at the European Respiratory Society (ERS) Congress, the dual-bronchodilator QVA149 was better at increasing airflow to the lungs than tiotropium, the active ingredient in Spiriva.

The investigational chronic obstructive pulmonary disease (COPD) treatment likewise demonstrated superior bronchodilation to a range of other COPD comparators, such as indacaterol and glycopyrronium, in three new studies from the IGNITE phase III programme.

QVA149 is an inhaled dry-powder fixed-dose combination medication of indacaterol maleate and glycopyrronium bromide.

SHINE, part of IGNITE, met its primary endpoint by demonstrating that once-daily QVA149 110/50 mcg improved lung function as measured by trough FEV compared to once-daily indacaterol maleate 150 mcg (+70mL above indacaterol alone; p<0.001).

It did the same against once-daily glycopyrronium 50 mcg (+90mL above glycopyrronium alone; p<0.001).

QVA149 was also more effective at improving lung function compared to OL tiotropium 18 mcg (+80mL above tiotropium; p<0.001) and placebo (+200mL; p<0.001).

Novartis’ once-daily COPD portfolio also scored in pooled data from the phase III/IV INERGIZE trial, where its Onbrez Breezhaler (indacaterol maleate) was superior to tiotropium in improving severe breathlessness symptoms.

A pooled post-hoc sub-group analysis from three studies (INVOLVE, INHANCE and INLIGHT2) showed that a 300 mcg dose was statistically significantly more effective than OL tiotropium 18 mcg at improving breathlessness in patients who were more breathless on entry to the studies.

Meanwhile Seebri Breezhaler (glycopyrronium bromide) was similar to tiotropium in demonstrating rapid, sustained bronchodilation and reduced exacerbations in data analysis from the phase III GLOW programme.

For patients taking glycopyrronium 50 mcg, the time to first moderate/severe exacerbation was significantly prolonged compared to placebo at both Week 26 (hazard ratio 0.64; p<0.001) and Week 52 (HR 0.67; p<0.001) – with comparable results in patients treated with OL tiotropium 18 mcg.

Glycopyrronium 50 mcg improved breathlessness measured by TDI (p<0.05) and health-related quality of life measured by SGRQ (p<0.001) at Weeks 26 and 52 – again similar to OL tiotropium 18 mcg compared to placebo.

“We are very excited that the Novartis data at ERS brings us one step further to delivering on the promise to provide COPD patients and physicians with a range of innovative treatments,” said David Epstein, head of Novartis Pharmaceuticals.

All products are being made available in the Breezhaler device, he added.
Encompassing chronic bronchitis and emphysema, COPD is usually caused by smoking, affects 210 million people worldwide and is predicted to be the third leading cause of death anywhere by 2020.

Although COPD treatment options are not thin on the ground, Novartis’ results will cheer the company and its investors by confirming a strong pipeline.

The COPD field currently includes Spiriva, AstraZeneca’s Symbicort and GlaxoSmithKline’s blockbuster Advair (Seretide in the UK), the biggest-selling drug in the market.

Forest Laboratories Tudorza Pressair (aclidinium bromide) is newly approved and GSK and US biopharma firm Theravance also recently submitted their investigational COPD drug Breo (Relvar in Europe) to the FDA and European authorities.

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