search
Back to results

Efficacy and Safety of AQX-1125 in Unstable COPD (FLAGSHIP)

Primary Purpose

COPD

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
AQX-1125
Placebo
Sponsored by
Aquinox Pharmaceuticals (Canada) Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for COPD focused on measuring Exacerbation of COPD, Unstable COPD

Eligibility Criteria

40 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female aged ≥40 years at screening
  2. History of COPD for at least 18 months prior to screening, characterised by excessive sputum production
  3. Chronic productive cough for at least 3 months in each of the 2 years prior to screening (if other causes of productive cough have been excluded) and/or an exacerbation of COPD with predominantly bronchitic symptoms at enrolment
  4. At least 2 documented exacerbations during the last 18 months prior to screening.
  5. Presentation of a diagnosed acute exacerbation of COPD, or have recently (within 3 days) been discharged from hospital due to an acute exacerbation of COPD
  6. Ability to perform pulmonary function testing and with documented fixed airway obstruction determined by an FEV1 /FVC [forced vital capacity] ratio (post-bronchodilator) of <0.70 and a predicted FEV1 value of 30%-80% of normal within the 6 months prior to Visit 1.
  7. Former smoker or current smoker, both with a smoking history of at least 10 pack years

Exclusion Criteria:

  1. Diagnosis of other relevant lung disease (e.g. asthma, cystic fibrosis [CF] or significant non-CF bronchiectasis)
  2. Known alpha-1-antitrypsin deficiency
  3. Treatment with roflumilast or theophylline within 1 month prior to screening
  4. Lobar pneumonia, with current positive chest X-ray (CXR) or within the 3 months prior to screening including the presence of any new radiological infiltrate on CXR within the previous two weeks
  5. Hospitalisation for more than 7 days for current acute exacerbation, or the requirement for intubation during hospitalisation
  6. For outpatients, prior medical history indicating that previous exacerbations required >3 weeks to stabilise

Sites / Locations

  • University of Cincinnati
  • Department of Respiratory & Sleep Medicine, Westmead Hospital
  • Department of Respiratory Medicine, Odense University Hospital
  • Biomedicum Helsinki
  • Csongrád Megyei Melkasi Betegségek Szakkórháza
  • P3 Research
  • Medical University of Lodz
  • Lung and Allergy Clinic, Skåne University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AQX-1125

Placebo

Arm Description

1 x AQX-1125 capsule daily

1 x Placebo capsule daily

Outcomes

Primary Outcome Measures

The Primary Efficacy Variable Was the AAC for Daily EXACT Scores During the 12-week Treatment Period.
The primary variable (endpoint) of this study is the difference in the Area Above the Curve (AAC) for the daily EXACT score from baseline to Week 12 between subjects treated with AQX-1125 and placebo.The EXACT questionnaire is a patient reported outcome (PRO) measure designed to standardise the method for evaluating the frequency, severity and duration of acute exacerbations of COPD. The EXACT is a 14-item daily questionnaire where each item is assessed on a 5 or 6 point ordinal scale. Participants completed the EXACT questionnaire on a daily basis via an electronic diary from Day 1 (pre-dose) to Day 84 (week 12). Higher scores on the daily EXACT questionnaire indicate a more severe health state. When the post-treatment EXACT scores are lower (i.e. improved symptoms) than baseline EXACT, the AACs are positive.

Secondary Outcome Measures

Change From Baseline in COPD Assessment Tool (CAT) Score
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on the COPD Assessment Tool (CAT) score.The CAT questionnaire measures the impact of COPD on wellbeing and daily life. Participants answer 8 questions on a scale from 0 (best) to 5 (worst). The total score ranges from 0 to 40 with higher scores indicating more impact. A negative change from baseline indicates improvement. The change in total CAT score from Day 1, before taking study drug (baseline), to end of the 12 week treatment period was compared between the two treatments using an ANOVA model adjusting for treatment and region and including the baseline score as a covariate.
Analysis of the Number of COPD Exacerbations (Medically Treated Event (MTE))
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on the number of COPD exacerbations (MTE). COPD exacerbations were referred to as Medically Treated Exacerbations (MTEs) and identified as a change in symptoms and/or signs of COPD requiring prescription of one or both of: (1) Course of oral corticosteroids or (2) Antibiotic(s).
Time to First COPD Exacerbation
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on the time to first exacerbation requiring medical intervention of oral corticosteroids and/or antibiotics.
The Number of Subjects With at Least One COPD Exacerbation.
The number of subjects that presented with a COPD exacerbation during the 12 week treatment period.
Change From Baseline in FEV1
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on forced expiratory volume in 1 second [FEV1]. FEV1 was determined from post-bronchodilator spirometry testing done at clinic visits.
AQX-1125 Concentrations in Plasma (Trough Values)
The secondary objectives are to evaluate the pharmacokinetics (PK) of AQX-1125 in plasma.

Full Information

First Posted
September 21, 2013
Last Updated
May 8, 2017
Sponsor
Aquinox Pharmaceuticals (Canada) Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT01954628
Brief Title
Efficacy and Safety of AQX-1125 in Unstable COPD
Acronym
FLAGSHIP
Official Title
The FLAGSHIP Study: A 12-week Phase II Study to Evaluate the Efficacy and Safety of AQX-1125 Following Exacerbations in Patients With Chronic Obstructive Pulmonary Disease (COPD) by Targeting the SHIP1 Pathway
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
December 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Aquinox Pharmaceuticals (Canada) Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to evaluate the effect of 12 weeks of treatment with once daily administration of AQX-1125 compared to placebo in subjects following exacerbations of Chronic Obstructive Pulmonary Disease (COPD) by targeting the SHIP1 (Src Homology 2-containing Inositol-5'-Phosphatase 1) pathway.
Detailed Description
Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide. Acute exacerbations of COPD are usually treated with steroids and/or antibiotics. Currently this conventional therapy has significant side effects including osteoporosis, cataracts and suppression of the immune system (from the steroids) and increasing bacterial resistance and other side effects from the use of antibiotics. During an acute exacerbation of COPD, the inflammation in the airways increases. AQX-1125 represents a new type drug that based current data is thought decrease the inflammatory process and therefore may provide a therapeutic benefit in the treatment of COPD.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
COPD
Keywords
Exacerbation of COPD, Unstable COPD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
400 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AQX-1125
Arm Type
Experimental
Arm Description
1 x AQX-1125 capsule daily
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
1 x Placebo capsule daily
Intervention Type
Drug
Intervention Name(s)
AQX-1125
Intervention Description
Synthetic SHIP1 activator
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo control
Primary Outcome Measure Information:
Title
The Primary Efficacy Variable Was the AAC for Daily EXACT Scores During the 12-week Treatment Period.
Description
The primary variable (endpoint) of this study is the difference in the Area Above the Curve (AAC) for the daily EXACT score from baseline to Week 12 between subjects treated with AQX-1125 and placebo.The EXACT questionnaire is a patient reported outcome (PRO) measure designed to standardise the method for evaluating the frequency, severity and duration of acute exacerbations of COPD. The EXACT is a 14-item daily questionnaire where each item is assessed on a 5 or 6 point ordinal scale. Participants completed the EXACT questionnaire on a daily basis via an electronic diary from Day 1 (pre-dose) to Day 84 (week 12). Higher scores on the daily EXACT questionnaire indicate a more severe health state. When the post-treatment EXACT scores are lower (i.e. improved symptoms) than baseline EXACT, the AACs are positive.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change From Baseline in COPD Assessment Tool (CAT) Score
Description
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on the COPD Assessment Tool (CAT) score.The CAT questionnaire measures the impact of COPD on wellbeing and daily life. Participants answer 8 questions on a scale from 0 (best) to 5 (worst). The total score ranges from 0 to 40 with higher scores indicating more impact. A negative change from baseline indicates improvement. The change in total CAT score from Day 1, before taking study drug (baseline), to end of the 12 week treatment period was compared between the two treatments using an ANOVA model adjusting for treatment and region and including the baseline score as a covariate.
Time Frame
12 weeks
Title
Analysis of the Number of COPD Exacerbations (Medically Treated Event (MTE))
Description
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on the number of COPD exacerbations (MTE). COPD exacerbations were referred to as Medically Treated Exacerbations (MTEs) and identified as a change in symptoms and/or signs of COPD requiring prescription of one or both of: (1) Course of oral corticosteroids or (2) Antibiotic(s).
Time Frame
12 weeks
Title
Time to First COPD Exacerbation
Description
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on the time to first exacerbation requiring medical intervention of oral corticosteroids and/or antibiotics.
Time Frame
12 weeks
Title
The Number of Subjects With at Least One COPD Exacerbation.
Description
The number of subjects that presented with a COPD exacerbation during the 12 week treatment period.
Time Frame
12 weeks
Title
Change From Baseline in FEV1
Description
The secondary objective is to evaluate the treatment effect of once daily administrations of AQX-1125 compared to placebo over 12 weeks on forced expiratory volume in 1 second [FEV1]. FEV1 was determined from post-bronchodilator spirometry testing done at clinic visits.
Time Frame
12 weeks
Title
AQX-1125 Concentrations in Plasma (Trough Values)
Description
The secondary objectives are to evaluate the pharmacokinetics (PK) of AQX-1125 in plasma.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female aged ≥40 years at screening History of COPD for at least 18 months prior to screening, characterised by excessive sputum production Chronic productive cough for at least 3 months in each of the 2 years prior to screening (if other causes of productive cough have been excluded) and/or an exacerbation of COPD with predominantly bronchitic symptoms at enrolment At least 2 documented exacerbations during the last 18 months prior to screening. Presentation of a diagnosed acute exacerbation of COPD, or have recently (within 3 days) been discharged from hospital due to an acute exacerbation of COPD Ability to perform pulmonary function testing and with documented fixed airway obstruction determined by an FEV1 /FVC [forced vital capacity] ratio (post-bronchodilator) of <0.70 and a predicted FEV1 value of 30%-80% of normal within the 6 months prior to Visit 1. Former smoker or current smoker, both with a smoking history of at least 10 pack years Exclusion Criteria: Diagnosis of other relevant lung disease (e.g. asthma, cystic fibrosis [CF] or significant non-CF bronchiectasis) Known alpha-1-antitrypsin deficiency Treatment with roflumilast or theophylline within 1 month prior to screening Lobar pneumonia, with current positive chest X-ray (CXR) or within the 3 months prior to screening including the presence of any new radiological infiltrate on CXR within the previous two weeks Hospitalisation for more than 7 days for current acute exacerbation, or the requirement for intubation during hospitalisation For outpatients, prior medical history indicating that previous exacerbations required >3 weeks to stabilise
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephen B Shrewsbury, MD
Organizational Affiliation
Aquinox Pharmaceuticals (Canada) Inc.
Official's Role
Study Director
Facility Information:
Facility Name
University of Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45267
Country
United States
Facility Name
Department of Respiratory & Sleep Medicine, Westmead Hospital
City
Wentworthville
State/Province
New South Wales
ZIP/Postal Code
2145
Country
Australia
Facility Name
Department of Respiratory Medicine, Odense University Hospital
City
Odense
Country
Denmark
Facility Name
Biomedicum Helsinki
City
Helsinki
Country
Finland
Facility Name
Csongrád Megyei Melkasi Betegségek Szakkórháza
City
Deszk
Country
Hungary
Facility Name
P3 Research
City
Wellington
Country
New Zealand
Facility Name
Medical University of Lodz
City
Lodz
Country
Poland
Facility Name
Lung and Allergy Clinic, Skåne University Hospital
City
Lund
Country
Sweden

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
http://goldcopd.org/global-strategy-diagnosis-management-prevention-copd-2016/
Description
GOLD COPD Guidelines

Learn more about this trial

Efficacy and Safety of AQX-1125 in Unstable COPD

We'll reach out to this number within 24 hrs