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NCT03287414

Study of Pharmacodynamics, Pharmacokinetics, Safety and Tolerability of VAY736 in Patients With Idiopathic Pulmonary Fibrosis

Terminated Phase 2 Results posted Last updated 18 June 2024
What this trial tests

Phase 2 trial testing VAY736 in Idiopathic Pulmonary Fibrosis in 30 participants. Terminated before completion.

Timeline
20 December 2017
Primary endpoint
25 November 2020
14 February 2022

Quick facts

Lead sponsorNovartis Pharmaceuticals
PhasePhase 2
StatusTerminated
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingquadruple
Primary purposetreatment
Enrollment30
Start date20 December 2017
Primary completion25 November 2020
Estimated completion14 February 2022
Sites16 locations across Italy, Ireland, United Kingdom, Germany, Canada, United States

Drugs / interventions tested

Conditions studied

Sponsor

Novartis Pharmaceuticals — full company profile →

Who can join

Adults 40 to 80, any sex, with Idiopathic Pulmonary Fibrosis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Change From Baseline to End of Treatment Epoch (48 Weeks of Treatment) in Forced Vital Capacity (FVC). Primary · From baseline up to 48 weeks post first dose of study treatment

FVC was defined as the maximum amount of air that an individual was able to forcibly exhale from his / her lungs after taking the deepest breath they could. Change from baseline to end of treatment epoch (48 weeks of treatment) in Forced Vital Capacity (FVC) was analyzed using a Mixed Effects Model for Repeated Measures (MMRM) and considering all assessments collected during the treatment epoch. The model included treatment and visit as fixed effects, standard of care treatment (Nintedanib, Pirfenidone, or no treatment) as factor and baseline value as a covariate, treatment-by-visit and baseli

GroupValue95% CI
VAY7360.039± 0.1116
Placebo-0.023± 0.0773
Percentage of Participants With All-cause Mortality Events Secondary · Up to 48 weeks post first dose of study treatment

All-cause mortality events were defined as deaths due to any cause. Kaplan-Meier estimates of the percentage of participants with the event of interest along with 80% two-sided confidence intervals using Greenwood's formula are provided.

GroupValue95% CI
VAY7368.32.39 – 26.92
Placebo0NA – NA
Percentage of Participants With Survival Idiopathic Pulmonary Fibrosis (IPF) -Related Mortality Events Secondary · Up to 48 weeks post first dose of study treatment

IPF-related mortality events were defined as deaths due to IPF related cause. Kaplan-Meier estimates of the percentage of participants with the event of interest along with 80% two-sided confidence intervals using Greenwood's formula are provided.

GroupValue95% CI
VAY7360NA – NA
Placebo0NA – NA
Percentage of Participants With Progression-free Survival (PFS) Events Secondary · Up to 48 weeks post first dose of study treatment

PFS events were divided into: 1) PFS1 events including progression (relative reduction in FVC ≥ 10%) or death due to all causes, and 2) PFS2 events including progression (relative reduction in FVC ≥ 10%) or death due to IPF-related causes. Kaplan-Meier estimates of the percentage of participants with the event of interest (PFS1 events or PFS2 events) along with 80% two-sided confidence intervals using Greenwood's formula are provided.

PFS1
GroupValue95% CI
VAY73661.038.22 – 84.20
Placebo31.918.04 – 52.51
PFS2
GroupValue95% CI
VAY73657.133.44 – 82.86
Placebo31.918.04 – 52.51
Percentage of Participants With Disease Progression Events Secondary · Up to 48 weeks post first dose of study treatment

The following disease progression events were considered: a) relative reduction in FVC ≥ 10%; b) relative reduction in Diffusing Capacity of the Lungs (DLCO) ≥ 15%; c) absolute reduction in Six Minute Walk Distance (6MWD) ≥ 50 m. Kaplan-Meier estimates of the percentage of participants with the event of interest along with 80% two-sided confidence intervals using Greenwood's formula are provided.

FVC
GroupValue95% CI
VAY73657.133.44 – 82.86
Placebo31.918.04 – 52.51
DLCO
GroupValue95% CI
VAY73673.846.56 – 94.24
Placebo56.138.65 – 75.10
6MWD
GroupValue95% CI
VAY73638.319.96 – 64.88
Placebo75.058.52 – 88.74
Percentage of Participants With Composite Events Secondary · Up to 48 weeks post first dose of study treatment

Composite events were defined as: 1) death (all-cause mortality), or relative reduction in FVC ≥ 10%, or relative reduction in DLCO ≥ 15%, or relative reduction in 6MWD ≥ 50 m (composite endpoint 1); and 2) Death (IPF-related mortality), or relative reduction in FVC ≥ 10%, or relative reduction in DLCO ≥ 15%, or relative reduction in 6MWD ≥ 50 m (composite endpoint 2). Kaplan-Meier estimates of the percentage of participants with the event of interest along with 80% two-sided confidence intervals using Greenwood's formula are provided.

Composite Endpoint 1
GroupValue95% CI
VAY73681.063.86 – 93.29
Placebo66.350.84 – 81.18
Composite Endpoint 2
GroupValue95% CI
VAY73679.261.07 – 92.70
Placebo66.350.84 – 81.18
Change From Baseline to End of Treatment Epoch (48 Weeks of Treatment) in Diffusing Capacity of the Lungs Secondary · From baseline up to 48 weeks post first dose of study treatment

DLCO is a measurement to assess the lungs' ability to transfer gas from inspired air to the bloodstream. DLCO was determined according to ATS guidelines. Change from baseline to end of treatment epoch (48 weeks of treatment) in diffusing capacity of the lung for carbon monoxide (DLCO) was analyzed using a Mixed Effects Model for Repeated Measures (MMRM) and considering all assessments collected during the treatment epoch. The model included treatment and visit as fixed effects, standard of care treatment (Nintedanib, Pirfenidone, or no treatment) as factor and baseline value as a covariate, tr

GroupValue95% CI
VAY736-1.954± 1.0816
Placebo-1.033± 0.7244
Change From Baseline to the End of Treatment Epoch (48 Weeks of Treatment) in 6-minute Walk Distance (6MWD) Secondary · From baseline up to 48 weeks post first dose of study treatment

A standardized 6-minute walk test (6MWT) was performed in accordance with the guidelines of the American Thoracic Society 2002. The distance walked in six minutes (6MWD) was recorded. Change from baseline to end of treatment epoch (48 weeks of treatment) in 6MWD was analyzed using a Mixed Effects Model for Repeated Measures (MMRM) and considering all assessments collected during the treatment epoch. The model included treatment and visit as fixed effects, standard of care treatment (Nintedanib, Pirfenidone, or no treatment) as factor and baseline value as a covariate, treatment-by-visit and ba

GroupValue95% CI
VAY73619.743± 53.5268
Placebo-12.479± 28.9400
Change From Baseline to the End of Treatment Epoch (48 Weeks of Treatment) in Distance Saturation Product Secondary · From baseline up to 48 weeks post first dose of study treatment

Distance saturation product is the product of distance walked and lowest oxygen saturation during the 6-min walk test. Change from baseline to end of treatment epoch (48 weeks of treatment) in distance saturation product was analyzed using a Mixed Effects Model for Repeated Measures (MMRM) and considering all assessments collected during the treatment epoch. The model included treatment and visit as fixed effects, standard of care treatment (Nintedanib, Pirfenidone, or no treatment) as factor and baseline value as a covariate, treatment-by-visit and baseline-by-visit as interaction terms. A po

GroupValue95% CI
VAY7369.746± 52.2985
Placebo-19.420± 28.3755
Change From Baseline to the End of Treatment Epoch (48 Weeks of Treatment) in Resting Oxygen Saturation Level (on Room Air) Secondary · From baseline up to 48 weeks post first dose of study treatment

Change from baseline to end of treatment epoch (48 weeks of treatment) in resting oxygen saturation (on room air) was analyzed using a Mixed Effects Model for Repeated Measures (MMRM) and considering all assessments collected during the treatment epoch. The model included treatment and visit as fixed effects, standard of care treatment (Nintedanib, Pirfenidone, or no treatment) as factor and baseline value as a covariate, treatment-by-visit and baseline-by-visit as interaction terms. A positive change from baseline indicates improvement. Baseline was defined as the last available assessment pr

GroupValue95% CI
VAY736-0.117± 1.0179
Placebo-1.887± 0.9415
Number of Participants With Positive Serum Anti-VAY736 Antibodies Secondary · Day 1, 29, 85, 169, 253 and 337

Number of participants with positive serum anti-VAY736 antibodies. A bridging ELISA method that is designed to detect the presence of anti-VAY736 antibodies in human serum was used.

Day 1
GroupValue95% CI
VAY7361
Placebo3
Day 29
GroupValue95% CI
VAY7361
Placebo2
Day 85
GroupValue95% CI
VAY7361
Placebo1
Day 169
GroupValue95% CI
VAY7360
Placebo2
Day 253
GroupValue95% CI
VAY7362
Placebo1
Day 337
GroupValue95% CI
VAY7360
Placebo0
Ctrough of VAY736 From the Serum Concentration-time Data Secondary · At pre-dose on Day 1, 29, 57, 85, 113, 141, 169, 197, 225, 253, 281, 309 and 337

The lowest serum concentration of VAY736 observed during a dosing interval at steady state (Ctrough) was determined

Day 1
GroupValue95% CI
VAY7360.00± 0.000
Day 29
GroupValue95% CI
VAY736676.79± 499.931
Day 57
GroupValue95% CI
VAY736779.89± 645.363
Day 85
GroupValue95% CI
VAY736786.63± 501.225
Day 113
GroupValue95% CI
VAY736771.88± 623.268
Day 141
GroupValue95% CI
VAY7361316.05± 877.240
Day 169
GroupValue95% CI
VAY7361019.00± 587.097
Day 197
GroupValue95% CI
VAY736985.50± 495.652

Adverse events — posted to ClinicalTrials.gov

Time frame: From baseline up to end of study, assessed up to approximately 2.4 years. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

VAY736
Serious: 5/13 (38%)
Deaths: 1/13
Placebo
Serious: 9/16 (56%)
Deaths: 0/16
Total
Serious: 14/29 (48%)
Deaths: 1/29

Serious adverse events (14 terms)

ReactionSystemVAY736PlaceboTotal
PneumoniaInfections and infestations
Myocardial infarctionCardiac disorders
Idiopathic pulmonary fibrosisRespiratory, thoracic and mediastinal disorders
Aortic valve incompetenceCardiac disorders
VertigoEar and labyrinth disorders
Retinal vein occlusionEye disorders
PancreatitisGastrointestinal disorders
BronchitisInfections and infestations
Lower respiratory tract infectionInfections and infestations
DehydrationMetabolism and nutrition disorders
Basal cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps)
Prostate cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps)
HypoxiaRespiratory, thoracic and mediastinal disorders
VasculitisVascular disorders
Other adverse events (119 terms — click to expand)

ReactionSystemVAY736PlaceboTotal
Injection site pruritusGeneral disorders
Weight decreasedInvestigations
DiarrhoeaGastrointestinal disorders
BronchitisInfections and infestations
Upper respiratory tract infectionInfections and infestations
HeadacheNervous system disorders
CoughRespiratory, thoracic and mediastinal disorders
Idiopathic pulmonary fibrosisRespiratory, thoracic and mediastinal disorders
NauseaGastrointestinal disorders
VomitingGastrointestinal disorders
FatigueGeneral disorders
Injection site erythemaGeneral disorders
Respiratory tract infectionInfections and infestations
InsomniaPsychiatric disorders
DyspepsiaGastrointestinal disorders
Injection site bruisingGeneral disorders
Lower respiratory tract infectionInfections and infestations
Viral upper respiratory tract infectionInfections and infestations
ContusionInjury, poisoning and procedural complications
Injection related reactionInjury, poisoning and procedural complications
SunburnInjury, poisoning and procedural complications
Alanine aminotransferase increasedInvestigations
Gamma-glutamyltransferase increasedInvestigations
Monocyte count increasedInvestigations
Urine protein/creatinine ratio increasedInvestigations
Pain in extremityMusculoskeletal and connective tissue disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
Nasal congestionRespiratory, thoracic and mediastinal disorders
RashSkin and subcutaneous tissue disorders
Hot flushVascular disorders
AnaemiaBlood and lymphatic system disorders
EosinophiliaBlood and lymphatic system disorders
Aortic valve incompetenceCardiac disorders
Arteriosclerosis coronary arteryCardiac disorders
PalpitationsCardiac disorders
TachycardiaCardiac disorders
Eustachian tube dysfunctionEar and labyrinth disorders
TinnitusEar and labyrinth disorders
CataractEye disorders
Corneal degenerationEye disorders

Most-reported serious reactions: Pneumonia, Myocardial infarction, Idiopathic pulmonary fibrosis, Aortic valve incompetence, Vertigo, Retinal vein occlusion, Pancreatitis, Bronchitis.

Data from ClinicalTrials.gov NCT03287414 adverse events section.

Sponsor's own description

The purpose of this study was to investigate the safety, tolerability and efficacy of VAY736 as potential therapy for the treatment of idiopathic pulmonary fibrosis (IPF).

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Idiopathic pulmonary fibrosis: Disease mechanisms and drug development.
    Spagnolo P, Kropski JA, Jones MG, Lee JS, et al · · 2021 · cited 448× · PMID 33359599 · DOI 10.1016/j.pharmthera.2020.107798
  2. Targeting fibrosis, mechanisms and cilinical trials.
    Zhao M, Wang L, Wang M, Zhou S, et al · · 2022 · cited 352× · PMID 35773269 · DOI 10.1038/s41392-022-01070-3
  3. Regulatory Immune Cells in Idiopathic Pulmonary Fibrosis: Friends or Foes?
    van Geffen C, Deißler A, Quante M, Renz H, et al · · 2021 · cited 65× · PMID 33995390 · DOI 10.3389/fimmu.2021.663203
  4. Pulmonary fibrosis from molecular mechanisms to therapeutic interventions: lessons from post-COVID-19 patients.
    Giacomelli C, Piccarducci R, Marchetti L, Romei C, et al · · 2021 · cited 48× · PMID 34687672 · DOI 10.1016/j.bcp.2021.114812
  5. Research Progress in the Molecular Mechanisms, Therapeutic Targets, and Drug Development of Idiopathic Pulmonary Fibrosis.
    Ma H, Wu X, Li Y, Xia Y. · · 2022 · cited 47× · PMID 35935869 · DOI 10.3389/fphar.2022.963054
  6. Targeting Alveolar Repair in Idiopathic Pulmonary Fibrosis.
    Ptasinski VA, Stegmayr J, Belvisi MG, Wagner DE, et al · · 2021 · cited 43× · PMID 34129811 · DOI 10.1165/rcmb.2020-0476tr
  7. Prognosticating Outcomes in Interstitial Lung Disease by Mediastinal Lymph Node Assessment. An Observational Cohort Study with Independent Validation.
    Adegunsoye A, Oldham JM, Bonham C, Hrusch C, et al · · 2019 · cited 40× · PMID 30216085 · DOI 10.1164/rccm.201804-0761oc
  8. What have we learned from basic science studies on idiopathic pulmonary fibrosis?
    Yanagihara T, Sato S, Upagupta C, Kolb M. · · 2019 · cited 37× · PMID 31511255 · DOI 10.1183/16000617.0029-2019

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Other trials of VAY736

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