Study to Compare the Pharmacokinetics of Mometasone Furoate Alone and in Combination With Indacaterol in Patients ≥ 6 to < 12 Years Old With Asthma
Condition: Asthma
MeSH terms: Asthma
Intervention: Mometasone furoate; QMF149; Standard of Care (Soc)
Intervention description: Single inhaled dose of 100 µg mometasone furoate (MF) administered via Twisthaler® on Day 1; Single inhaled dose of QMF149 (75/40 µg indacaterol acetate/MF fixed dose combination) administered via Concept 1 device on Day 6-9; Asthma therapy: budesonide and salbutamol being the most frequently used (excluding MF and indacaterol acetate)
Intervention MeSH terms: Mometasone Furoate
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Intervention model: Single Group Assignment
Intervention model description: Single-sequence crossover study
Masking: None (Open Label)
Masking description: Open label
Enrollment: 24.0
Sex: All
Minimum age: 6 Years
Maximum age: 11 Years
Healthy volunteers: No
Keywords: QMF149; mometasone furoate; indacaterol; pediatric; asthma; PK

Summary:

      This clinical study was designed to assess the pharmacokinetics, safety and tolerability of
      single inhaled doses of mometasone furoate (MF) when administered alone via MF Twisthaler®
      (TH) or as an indacaterol acetate/MF fixed dose combination (QMF149) via the Concept 1 (C1)
      device in pediatric asthma patients.
    

Eligibility criteria:

        Inclusion Criteria:

          1. Male and female children ≥ 6 years and < 12 years at the time of study entry.

          2. Written informed consent by parent(s)/legal guardian(s) for the pediatric patient and
             assent by the pediatric patient (depending on local requirements) must be obtained
             before any study-specific assessment is performed.

          3. Confirmed documented diagnosis of asthma, as defined by national or international
             asthma guidelines for at least 6 months prior to study enrollment.

          4. Patients using low dose ICS as asthma controller therapy for at least 4 weeks prior to
             first treatment.

          5. Patients who are familiar with the use of an inhaler device.

          6. Patients must be able to comply with the Study Visit Assessment Schedule which
             includes approximately 7 hours on two occasions, and agree to blood draws as
             scheduled.

          7. Parents/ legal guardian must be willing and able to attend study visits and assist the
             child with the procedures outlined in the protocol

        Exclusion Criteria:

          1. Use of other investigational drugs within 5 half-lives of enrollment, or [within 30
             days (for small molecules) /until the expected PD effect has returned to baseline (for
             biologics)], whichever is longer.

          2. Patients with weight < 17kg at screening.

          3. Patients currently taking MF products for any reason at least 7 days prior to Day 1.
             Patients can enroll if MF was discontinued at least 7 days prior to Day 1 and MF is
             substituted with a different steroid during entire study duration to avoid its
             potential impact on PK assessment. These MF products include inhalation, topical
             and/or nasal spray formulations.

          4. Patients on medium- and high- dose ICS or any dose ICS/LABA combination.

          5. Patients taking maintenance controller therapy (eg LABAs and theophylline) within 4
             weeks of screening or during the study. LTRAs are permitted provided that patients
             have been on a stable dose for 4 weeks prior to screening. Patients using short-acting
             bronchodilators on occasional basis as rescue medication can enroll, however, these
             medications must be withheld at least 8 hours prior to study dosing visits and during
             PK sampling.

          6. Contraindicated for treatment with, or having a history of reactions/hypersensitivity
             to any of the following inhaled drugs, drugs of a similar class, or any component
             there of:

               -  Adrenoreceptor agonist agent Lactose or any of the other excipients of the study
                  drug (including patients with history of galactose intolerance, lactase
                  deficiency or glucose-galactose malabsorption)

               -  Corticosteroids

               -  Indacaterol and/or MF

          7. History of chronic lung disease other than asthma within 3 months of first treatment
             visit (Day 1), cystic fibrosis, mycobacterial or other infection (including active
             SARS-CoV-2, tuberculosis or atypical mycobacterial disease).

          8. History of active bacterial, viral or fungal infection (including SARS-CoV-2) within 6
             weeks of first treatment visit (Day 1).

          9. Patients who have had an asthma attack/exacerbation requiring systemic steroids or
             hospitalization or emergency room visit within 6 weeks of first treatment visit (Day
             1).

         10. Patients who, in the opinion of the investigator, are not able to comply with study
             treatment or who have any medical or mental disorder, situation, or diagnosis, which
             could interfere with the proper completion of the study protocol requirements or pose
             a safety risk while participating in the study.

         11. Parent/guardian has a history of psychiatric disease, intellectual deficiency,
             substance abuse, or other condition (e.g. inability to read, comprehend and write)
             which will limit the validity of consent for their child to participate in this study.

         12. Hemoglobin levels outside normal ranges at screening.

         13. Any surgical or medical condition which might significantly alter the absorption,
             distribution, metabolism, or excretion of drugs, or which may jeopardize the patient
             in case of participation in the study.

         14. Patients who have a clinically significant ECG abnormality or clinically significant
             abnormal lab values reported at Screening Visit.

         15. Patients with a history of long QT syndrome or whose corrected QT interval (QTc)
             measured at Screening Visit (Fridericia method) is prolonged (≥ 450 msec for males and
             females 6 - 12 years old).

         16. Use of any prescription drugs, herbal supplements, prescribed medicinal use of
             cannabis/marijuana, within four weeks prior to initial dosing, and/or over-the-counter
             (OTC) medication, dietary supplements within two weeks prior to initial dosing. If
             needed, (i.e. an incidental and limited need) paracetamol/acetaminophen is acceptable,
             but must be documented in the Concomitant medications / Significant non-drug therapies
             page of the CRF.

         17. History of malignancy of any organ system, treated or untreated, within the past 5
             years, regardless of whether there is evidence of local recurrence or metastases.

         18. Patient is an immediate family member of the participating investigator,
             sub-investigator, study coordinator, or employee of the participating investigator.

         19. Pregnant or nursing (lactating) females.

         20. Inability to properly train in the use of the In-Check DIAL® at screening (at the
             investigator's discretion).

         21. Inability to properly train in the use of the Twisthaler® or Concept 1 Breezhaler®
             prior to dosing (at the investigator's discretion).

         22. History of paradoxical bronchospasm in response to inhaled medicines.

         23. Patients receiving any medications in the classes specified in protocol Table 6-2
             unless they undergo the required washout period prior to Day 1.

         24. Patients who are sexually active.