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    Clinical Trial Results:
    A randomized, double-blind, 12-week treatment, parallel-group study to evaluate the efficacy and safety of QMF149(150 μg/160 μg o.d.) compared with salmeterol xinafoate/fluticasone propionate (50 μg/500 μg b.i.d.) in patients with chronic obstructive pulmonary disease. Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com/CtrdWeb/home.novfor complete trial results.

    Summary
    EudraCT number
    2012-001172-12
    Trial protocol
    HU   GR   BG   BE   SE   FI   PL   ES   DK  
    Global end of trial date
    25 Sep 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    07 Jul 2018
    First version publication date
    07 Jul 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CQMF149F2202
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01636076
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH-4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Scientific contact
    Clinical Disclosure Office, Novartis Pharma AG, 41 613241111,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    25 Sep 2013
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    25 Sep 2013
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Sep 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to demonstrate QMF149 (150/160 μg, od) delivered via Concept1 device is at least non- inferior to salmeterol xinafoate/fluticasone propionate (50/500 μg bid) delivered via Accuhaler® in terms of trough FEV1 after 12 weeks of treatment. Trough refers to the mean of FEV1 at 23 h 10 min and 23 h 45 min after the morning dose.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and the International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines. All the local regulatory requirements pertinent to safety of trial subjects were also followed during the conduct of the trial. At the start of Screening (Visit 1), all patients were provided with a short acting β2-agonist (salbutamol or albuterol) which they were instructed to use throughout the study as rescue medication. Nebulized salbutamol was not allowed as rescue medication throughout the entire trial.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    02 Nov 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 31
    Country: Number of subjects enrolled
    Belgium: 11
    Country: Number of subjects enrolled
    Bulgaria: 53
    Country: Number of subjects enrolled
    Denmark: 35
    Country: Number of subjects enrolled
    Finland: 14
    Country: Number of subjects enrolled
    Germany: 62
    Country: Number of subjects enrolled
    Greece: 34
    Country: Number of subjects enrolled
    Hong Kong: 4
    Country: Number of subjects enrolled
    Hungary: 66
    Country: Number of subjects enrolled
    Israel: 68
    Country: Number of subjects enrolled
    Malaysia: 13
    Country: Number of subjects enrolled
    Poland: 86
    Country: Number of subjects enrolled
    Romania: 14
    Country: Number of subjects enrolled
    South Africa: 64
    Country: Number of subjects enrolled
    Spain: 4
    Country: Number of subjects enrolled
    Sweden: 33
    Country: Number of subjects enrolled
    Thailand: 37
    Worldwide total number of subjects
    629
    EEA total number of subjects
    412
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    350
    From 65 to 84 years
    278
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at 117 centres in 18 countries

    Pre-assignment
    Screening details
    982 patients screened, 629 patients randomized

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    QMF149
    Arm description
    QMF149 (Indacaterol acetate/Mometasone furoate) 150/160 µg o.d. delivered via Concept1 device
    Arm type
    Experimental

    Investigational medicinal product name
    QMF 149
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for nebuliser suspension
    Routes of administration
    Inhalation use
    Dosage and administration details
    QMF149 was supplied to the investigators by Novartis Drug Supply Management (DSM) as dry powder FDC formulation at dose strengths of Indacaterol acetate/Mometasone furoate 150/160 μg. QMF149 was administered once daily in the morning via Concept1 device as a single dose dry powder inhaler (SDDPI).

    Arm title
    Salmeterol xinafoate/fluticasone propionate
    Arm description
    Salmeterol xinafoate/fluticasone propionate 50/500 µg b.i.d, delivered via Accuhaler®
    Arm type
    Active comparator

    Investigational medicinal product name
    xinafoate/fluticasone propionate
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for nebuliser suspension
    Routes of administration
    Inhalation use
    Dosage and administration details
    Salmeterol xinafoate/fluticasone propionate as dry powder of 50/500 μg dose strengths were locally sourced. Salmeterol xinafoate/fluticasone propionate 50/500 μg bid, delivered via Accuhaler®.

    Number of subjects in period 1
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Started
    316
    313
    Completed
    299
    288
    Not completed
    17
    25
         Consent withdrawn by subject
    7
    10
         Physician decision
    1
    1
         Adverse event, non-fatal
    6
    11
         Non-compliance with study treatment
    1
    1
         Terminated by sponsor
    1
    1
         Lost to follow-up
    1
    -
         Lack of efficacy
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    QMF149
    Reporting group description
    QMF149 (Indacaterol acetate/Mometasone furoate) 150/160 µg o.d. delivered via Concept1 device

    Reporting group title
    Salmeterol xinafoate/fluticasone propionate
    Reporting group description
    Salmeterol xinafoate/fluticasone propionate 50/500 µg b.i.d, delivered via Accuhaler®

    Reporting group values
    QMF149 Salmeterol xinafoate/fluticasone propionate Total
    Number of subjects
    316 313 629
    Age categorical
    Units: Subjects
        Adults (18 - <65 )
    173 177 350
        adults (65 - <85)
    142 136 278
        adults (>=85)
    1 0 1
    Age Continuous |
    Units: years
        arithmetic mean (standard deviation)
    64.8 ( 7.74 ) 64.1 ( 7.89 ) -
    Gender, Male/Female
    Units: Participants
        Male
    233 227 460
        Female
    83 86 169

    End points

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    End points reporting groups
    Reporting group title
    QMF149
    Reporting group description
    QMF149 (Indacaterol acetate/Mometasone furoate) 150/160 µg o.d. delivered via Concept1 device

    Reporting group title
    Salmeterol xinafoate/fluticasone propionate
    Reporting group description
    Salmeterol xinafoate/fluticasone propionate 50/500 µg b.i.d, delivered via Accuhaler®

    Primary: Mixed Model for Repeated Measures (MMRM): Between-treatment comparisons for trough FEV1 (L) on Day 85

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    End point title
    Mixed Model for Repeated Measures (MMRM): Between-treatment comparisons for trough FEV1 (L) on Day 85
    End point description
    Spirometry is conducted according to the global standard. Trough FEV1 is defined as the average of the 23 hour 10 minute and 23 hour 45 minute post dose FEV1 readings.
    End point type
    Primary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Liters
    least squares mean (standard error)
        Full analysis set (n=291,282)
    1.27 ( 0.0124 )
    1.215 ( 0.0124 )
        Per protocol set (n=259,251)
    1.277 ( 0.0136 )
    1.228 ( 0.0137 )
    Statistical analysis title
    Mixed Model for Repeated Measures
    Comparison groups
    QMF149 v Salmeterol xinafoate/fluticasone propionate
    Number of subjects included in analysis
    629
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.001
    Method
    Mixed models analysis
    Parameter type
    Mean difference (net)
    Point estimate
    0.056
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.0277
         upper limit
    0.0833
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.0142

    Secondary: Trough FEV1 after first dose and after 4 and 12 weeks of treatment

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    End point title
    Trough FEV1 after first dose and after 4 and 12 weeks of treatment
    End point description
    Spirometry is conducted according to the global standard. FEV1 is measured at pre-dose and post dose up to 1 hours on Day 1 and Day 28; 24 hours post-dose on Day 29 and 85. In a subset of approximately 60 patients, FEV1 is measured up to 20 hours postdose on Day 28 and Day 84.
    End point type
    Secondary
    End point timeframe
    Day 1 and Day 85
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Liters
    arithmetic mean (standard error)
        Baseline Day 2 (n=286, 302)
    1.147 ( 0.0237 )
    1.167 ( 0.0264 )
        Day 2 (n=286, 302)
    1.216 ( 0.0106 )
    1.243 ( 0.0104 )
        Baseline Day 29 (n=293, 296)
    1.148 ( 0.0236 )
    1.178 ( 0.0266 )
        Day 29 (n=293,296)
    1.277 ( 0.0119 )
    1.247 ( 0.0119 )
        Day 84 baseline (n=289,287)
    1.144 ( 0.024 )
    1.187 ( 0.0267 )
        Day 84 (n=289,287)
    1.269 ( 0.0139 )
    1.208 ( 0.0139 )
    No statistical analyses for this end point

    Secondary: Mixed Model for Repeated Measures (MMRM): Between-treatment comparisons for FEV1 (L), by visit and timepoint

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    End point title
    Mixed Model for Repeated Measures (MMRM): Between-treatment comparisons for FEV1 (L), by visit and timepoint
    End point description
    Within treatment LS Mean
    End point type
    Secondary
    End point timeframe
    Day 1 through day 85
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: liter
    least squares mean (standard error)
        Absolute Value Day 1/5min (n=290,298)
    1.254 ( 0.0069 )
    1.198 ( 0.0068 )
        Absolute Value Day 1/30 min (n=294,306)
    1.281 ( 0.0079 )
    1.25 ( 0.0087 )
        Absolute Value Day 1/60min (n=300,303)
    1.281 ( 0.0087 )
    1.256 ( 0.0087 )
        Absolute Value Day 2/ 23 hr 10 min (n=288,295)
    1.213 ( 0.0108 )
    1.239 ( 0.0107 )
        Absolute Value Day 2/ 23 hr 45 min (n=297,305)
    1.215 ( 0.0106 )
    1.244 ( 0.0105 )
        Absolute Value Day 28/ -50min (n=288,295)
    1.265 ( 0.0132 )
    1.287 ( 0.0139 )
        Absolute Value Day 28/ -15min (n=292,290)
    1.287 ( 0.0132 )
    1.235 ( 0.014 )
        Absolute Value Day 28/ 5min (n=290,289)
    1.329 ( 0.0113 )
    1.268 ( 0.0113 )
        Absolute Value Day 28/ 30min (n=293,290)
    1.352 ( 0.0118 )
    1.298 ( 0.0118 )
        Absolute Value Day 28/ 60min (n=292,290)
    1.353 ( 0.0123 )
    1.298 ( 0.0122 )
        Absolute Value Day 29/ 23 hr 10 min (n=285,292)
    1.269 ( 0.0118 )
    1.242 ( 0.0117 )
        Absolute Value Day 29/ 23 hr 45 min (n=290,295)
    1.281 ( 0.0123 )
    1.254 ( 0.0122 )
        Absolute Value Day 84/ -50 min (n=286,278)
    1.259 ( 0.014 )
    1.195 ( 0.0141 )
        Absolute Value Day 84/ -15 min (n=282,285)
    1.282 ( 0.0146 )
    1.222 ( 0.0147 )
        Absolute Value Day 84/ 5 min (n=280,279)
    1.336 ( 0.0128 )
    1.243 ( 0.0128 )
        Absolute Value Day 84/ 30 min (n=286,280)
    1.352 ( 0.0124 )
    1.277 ( 0.0124 )
        Absolute Value Day 84/ 60 min (n=287,281)
    1.351 ( 0.0128 )
    1.283 ( 0.0128 )
        Absolute Value Day 84/ 23 hr 10 min (n=292,291)
    1.264 ( 0.0125 )
    1.212 ( 0.0125 )
        Absolute Value Day 84/ 23 hr 45 min (n=291,285)
    1.273 ( 0.0125 )
    1.221 ( 0.0126 )
    No statistical analyses for this end point

    Secondary: Forced vital capacity (FVC) at each timepoint

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    End point title
    Forced vital capacity (FVC) at each timepoint
    End point description
    Spirometry is conducted according to the global standard. FVC is measured at pre-dose and post dose up to 4 hour on Day 1, Day 28, and Day 84, at post dose 12 hour, 23 hour 10 minute and 23 hour 45 minutes on Day 2 and Day 29, and at pre-dose 50 min and 15 min on Day 2, Day 28, and Day 84.
    End point type
    Secondary
    End point timeframe
    Day 1, Day 2, Day 28, Day , Day 29, Day 84, Day 85
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: liters
    arithmetic mean (standard deviation)
        Baseline (n=316,313)
    2.46 ( 0.6969 )
    2.481 ( 0.7209 )
        Day 1/ 5 min (n=299,298) Change
    0.179 ( 0.2165 )
    0.06 ( 0.1404 )
        Day 1/ 30 min (n=302,306) Change
    0.207 ( 0.2279 )
    0.129 ( 0.1953 )
        Day 1/ 60 min (n=308,303) Change
    0.222 ( 0.2472 )
    0.152 ( 0.2287 )
        Day 1/ 4 hr (n=302,297) Change
    0.217 ( 0.2847 )
    0.183 ( 0.2611 )
        Day 2/ 23hr 10 min (n=297,296) Change
    0.089 ( 0.2518 )
    0.092 ( 0.2896 )
        Day 2/ 23hr 45 min (n=307,306) Change
    0.083 ( 0.2583 )
    0.092 ( 0.2815 )
        Day 28 / -50 min (n=295,296) Change
    0.132 ( 0.2806 )
    0.068 ( 0.2814 )
        Day 28 / -15 min (n=300,291) Change
    0.161 ( 0.309 )
    0.072 ( 0.2892 )
        Day 28 / 5 min (n=297,290) Change
    0.238 ( 0.3163 )
    0.122 ( 0.3068 )
        Day 28 / 30 min (n=301,291) Change
    0.263 ( 0.3169 )
    0.168 ( 0.3166 )
        Day 28 / 60 min (n=299,292) Change
    0.279 ( 0.3261 )
    0.189 ( 0.335 )
        Day 29 / 23hr 10 min (n=293,293) Change
    0.121 ( 0.2955 )
    0.084 ( 0.2817 )
        Day 29 /23hr 45 min (n=299,296) Change
    0.133 ( 0.3132 )
    0.097 ( 0.2965 )
        Day 84 / -50min (n=295,279) Change
    0.125 ( 0.2979 )
    0.019 ( 0.357 )
        Day 84 /-15 min (n=291,286) Change
    0.144 ( 0.3234 )
    0.049 ( 0.3519 )
        Day 84 / 5 min (n=288,290) Change
    0.229 ( 0.337 )
    0.076 ( 0.3729 )
        Day 84 /30 min (n=295,281) Change
    0.255 ( 0.3344 )
    0.12 ( 0.3537 )
        Day 84 / 60 min (n=296,282) Change
    0.272 ( 0.3295 )
    0.159 ( 0.3648 )
        Day 85 / 23 hr 10 min (n=302,292) Change
    0.113 ( 0.3132 )
    0.022 ( 0.3482 )
        Day 85 / 23 hr 45 min (n=301,286) Change
    0.126 ( 0.3206 )
    0.035 ( 0.362 )
    No statistical analyses for this end point

    Secondary: FEV1/FVC at each timepoint

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    End point title
    FEV1/FVC at each timepoint
    End point description
    Spirometry is conducted according to the global standard. FEV1/FVC is measured at pre-dose and post dose up to 4 hour on Day 1, Day 28, and Day 84, at post dose 12 hour, 23 hour 10 minute and 23 hour 45 minutes on Day 2 and Day 29, and at pre-dose 50 min and 15 min on Day 2, Day 28, and Day 84.
    End point type
    Secondary
    End point timeframe
    Day 1, Day 2, Day 28, Day , Day 29, Day 84, Day 85
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: FEV1/ FVC (%)
    arithmetic mean (standard deviation)
        Baseline (n=316, 313)
    46.786 ( 10.0306 )
    46.859 ( 10.0392 )
        Day 1 / 5 min (n=299, 298) change
    0.488 ( 2.9633 )
    0.047 ( 2.1366 )
        Day 1 / 30 min (n=302,306) change
    0.955 ( 3.0166 )
    0.879 ( 2.7281 )
        Day 1 / 60 min (n=308,303) change
    1.112 ( 3.1413 )
    1.182 ( 3.0612 )
        Day 1 / 4 hr (n=302, 297) change
    1.045 ( 3.3917 )
    1.397 ( 3.2407 )
        Day 2 / 23 Hr 10 min (n=297,296) change
    0.503 ( 3.345 )
    1.042 ( 3.2074 )
        Day 2 / 23 Hr 45 min (n=307,306) change
    0.583 ( 3.4552 )
    1.319 ( 3.1977 )
        Day 28 / -50 min (n=295,296) change
    1.463 ( 3.7864 )
    1.14 ( 3.89 )
        Day 28 / -15 min (n=300,291) change
    1.837 ( 3.9769 )
    1.495 ( 3.7597 )
        Day 28 / 5 min (n=297,290) change
    1.951 ( 4.0512 )
    1.581 ( 4.006 )
        Day 28 / 30 min (n=301,291) change
    2.296 ( 4.4904 )
    1.873 ( 4.2723 )
        Day 28 / 60 min (n=299,292) change
    2.525 ( 4.3228 )
    2.06 ( 4.4398 )
        Day 28 / 4 hr (n=44,45) change
    4.034 ( 5.2622 )
    2.322 ( 4.0257 )
        Day 28 / 11hr 10 min (n=47,44) change
    2.553 ( 4.026 )
    1.909 ( 3.9389 )
        Day 28 / 11hr 45 min (n=43,42) change
    2.791 ( 4.1708 )
    2.476 ( 4.3978 )
        Day 28 / 16 hr (n=40,41) change
    2.25 ( 3.4006 )
    2.305 ( 4.3111 )
        Day 28 / 20 hr (n=43,44) change
    2.535 ( 3.5379 )
    2.25 ( 3.9935 )
        Day 29 / 23 hr 10 min (n=293,293) change
    1.771 ( 4.073 )
    1.319 ( 3.82 )
        Day 29 / 23 hr 45 min (n=299,296) change
    2 ( 4.0562 )
    1.566 ( 3.9704 )
        Day 84 / -50 min (n=295,279) change
    1.449 ( 4.1145 )
    1.068 ( 4.1776 )
        Day 84 / -15 min (n=291,286) change
    2.155 ( 4.0673 )
    1.584 ( 4.3278 )
        Day 84 / 5 min (n=288,280) change
    2.332 ( 4.1032 )
    1.796 ( 4.231 )
        Day 84 / 30 min (n=295,281) change
    2.42 ( 4.3561 )
    2.062 ( 4.3941 )
        Day 84 / 60 min (n=296,282) change
    2.571 ( 4.4128 )
    2.067 ( 4.3512 )
        Day 84 / 4 hr (n=45,44) change
    2.389 ( 3.7079 )
    2.682 ( 4.3269 )
        Day 84 / 11hr 10 min (n=45,43) change
    1.944 ( 4.0833 )
    2.105 ( 3.8754 )
        Day 84 / 11 hr 45 min (n=39,39) change
    2.538 ( 3.7895 )
    2.295 ( 4.1147 )
        Day 84 / 16 hr (n=41,39) change
    1.415 ( 4.0588 )
    1.962 ( 3.6981 )
        Day 84 / 20 hr (n=44,43) change
    2.364 ( 4.0539 )
    1.837 ( 3.7713 )
        Day 84 / 23 hr 10 min (n=302,292) change
    1.856 ( 4.4315 )
    1.414 ( 4.0356 )
        Day 84 / 23 hr 45 min (n=301,286) change
    2.098 ( 4.3676 )
    1.593 ( 4.211 )
    No statistical analyses for this end point

    Secondary: FEV1 (L) on Day 1 between-treatment comparisons of AUC (5min – 4h)

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    End point title
    FEV1 (L) on Day 1 between-treatment comparisons of AUC (5min – 4h)
    End point description
    Spirometry is conducted according to the global standard. FEV1 AUC (5 min-4 h), Scheduled (not actual) time points are to be used. The standardized AUC(5 min – 4 h) for FEV1 will be summarized by treatment. LS mean is within treatment
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Liters / hour
    least squares mean (standard error)
        Day 1 baseline (n=303,311)
    1.142 ( 0.0233 )
    1.169 ( 0.0259 )
        Day 1 post (n=303,311)
    1.277 ( 0.0086 )
    1.26 ( 0.0085 )
    No statistical analyses for this end point

    Secondary: FEV1 AUC (5 min-4 h),

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    End point title
    FEV1 AUC (5 min-4 h),
    End point description
    Spirometry is conducted according to the global standard. FEV1 AUC (5 min-4 h), (5 min-24 h) is measured after the first dose on Day 1 and on Day 28 and Day 84 in a subset of approximately 60 patients. Scheduled (not actual) time points are to be used. The interpretation of FEV1 at time 0 is the baseline value at the randomization visit and the latest pre-dose value (-50 min or -15 min) at subsequent visits. The standardized AUC(5 min – 4 h) for FEV1 will be summarized by treatment. The same will be repeated for standardized AUC for FEV1 between 5 min and 24 hours post morning dose.
    End point type
    Secondary
    End point timeframe
    Day 1(Baseline), Day 28, Day 84
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    50
    50
    Units: Liters
    least squares mean (standard error)
        Day 1 baseline (n=46,47)
    1.302 ( 0.0278 )
    1.331 ( 0.0282 )
        Day 28 (n=45,46)
    1.41 ( 0.0353 )
    1.355 ( 0.0355 )
        Day 84 (n=44,46)
    1.387 ( 0.0401 )
    1.372 ( 0.0401 )
    No statistical analyses for this end point

    Secondary: Mixed Model for Repeated Measures (MMRM): Between-treatment comparisons for AUC (5 min – 23 h 45 min) for FEV1 (L) on Day 28 and Day 84 (Full analysis set, 24-h profiling subgroup)

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    End point title
    Mixed Model for Repeated Measures (MMRM): Between-treatment comparisons for AUC (5 min – 23 h 45 min) for FEV1 (L) on Day 28 and Day 84 (Full analysis set, 24-h profiling subgroup)
    End point description
    Spirometry is conducted according to the global standard. FEV1 AUC (5 min-4 h), (5 min-24 h) is measured after the first dose on Day 1 and on Day 28 and Day 84 in a subset of approximately 60 patients. Scheduled (not actual) time points are to be used. The interpretation of FEV1 at time 0 is the baseline value at the randomization visit and the latest pre-dose value (-50 min or -15 min) at subsequent visits. The standardized AUC(5 min – 4 h) for FEV1 will be summarized by treatment. The same will be repeated for standardized AUC for FEV1 between 5 min and 24 hours post morning dose.
    End point type
    Secondary
    End point timeframe
    Day 28, Day 84
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    50
    50
    Units: Liter/hour
    least squares mean (standard error)
        Day 28 (n=45,46)
    1.352 ( 0.0428 )
    1.298 ( 0.0431 )
        Day 85 (n=47,47)
    1.317 ( 0.0454 )
    1.303 ( 0.0459 )
    No statistical analyses for this end point

    Secondary: The usage of rescue medication (short acting β2-agonist)

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    End point title
    The usage of rescue medication (short acting β2-agonist)
    End point description
    Participants record the number of puffs of rescue medication taken in the previous 12 hours each morning and evening throughout the 12 week treatment period.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Number of puffs
    least squares mean (standard error)
        Daily Change Weeks 1-12 (n-281,274)
    -1.064 ( 0.1615 )
    -0.593 ( 0.1621 )
        Daytime Change Weeks 1-12 (n=276-272)
    -0.625 ( 0.1021 )
    -0.3 ( 0.1026 )
        Nighttime Change Weeks 1-12 (n=281,271)
    -0.452 ( 0.0748 )
    -0.308 ( 0.0751 )
    No statistical analyses for this end point

    Secondary: % of days with no rescue medication use

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    End point title
    % of days with no rescue medication use
    End point description
    Participants record the number of puffs of rescue medication taken in the previous 12 hours each morning and evening throughout the 12 week treatment period. % days shows the difference between groups in the frequency of the need for rescue medication
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    281
    274
    Units: % of days
        number (not applicable)
    8.796
    2.538
    No statistical analyses for this end point

    Secondary: Patient reported outcome measures: SGRQ (St. George’s Respiratory Questionnaire)

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    End point title
    Patient reported outcome measures: SGRQ (St. George’s Respiratory Questionnaire)
    End point description
    A Total and three component scores are calculated: Symptoms; Activity; Impacts. Each component of the questionnaire is scored separately:The score for each component is calculated separately by dividing the summed weights by the maximum possible weight for that component and expressing the result as a percentage: Score = 100 x Summed weights from all positive items in that component divided by Sum of weights for all items in that component The Total score is calculated in similar way: Score = 100 x Summed weights from all positive items in the questionnaire divided by Sum of weights for all items in the questionnaire Sum of maximum possible weights for each component and Total: Symptoms 566.2 Activity 982.9 Impacts 1652.8 Total (sum of maximum for all three components) 3201.9 The proportion of patients who achieve a clinically important improvement from baseline of at least 4 units in the total SGRQ will be analyzed. The higher the score the more symptoms of disease are present.
    End point type
    Secondary
    End point timeframe
    4 and 12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Total Score
    arithmetic mean (standard deviation)
        Baseline (n=314, 308)
    43.05 ( 18.515 )
    42.28 ( 17.941 )
        Day 28 Baseline (n=304,295)
    42.87 ( 18.392 )
    42.47 ( 18.051 )
        Day 28 Post (n=304,295)
    40.95 ( 18.527 )
    42.18 ( 18.101 )
        Day 28 Change (n=304,295)
    -1.92 ( 11.383 )
    -0.29 ( 12.145 )
        Day 84 Baseline (n=297,284)
    42.57 ( 18.322 )
    42.03 ( 18.099 )
        Day 84 Post (n=297,284)
    39.81 ( 19.057 )
    41.01 ( 18.553 )
        Day 84 Change (n=297,284)
    -2.76 ( 13.062 )
    -1.02 ( 12.178 )
    No statistical analyses for this end point

    Secondary: Analysis of the proportion of subjects with a clinically important improvement of >=1 point in the TDI (Transitional Dyspnoea Index) focal score by visit

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    End point title
    Analysis of the proportion of subjects with a clinically important improvement of >=1 point in the TDI (Transitional Dyspnoea Index) focal score by visit
    End point description
    A TDI focal score of ≥1 is considered to be a clinically important improvement from baseline. Analysis of the proportion of subjects with a clinically important improvement of >=1 point in the TDI focal score, by visit
    End point type
    Secondary
    End point timeframe
    4 and 12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: (% patient) showing clinical improvement
    number (not applicable)
        Day 28 Change from baseline (n=291,294)
    43.3
    40.5
        Day 84 Change from baseline (n=287,283)
    52.6
    45.9
    No statistical analyses for this end point

    Secondary: Patient reported outcome measures: COPD Assessment Test

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    End point title
    Patient reported outcome measures: COPD Assessment Test
    End point description
    It consists of eight items, each presented as a semantic 6-point differential scale, providing a total score out of 40. A higher score indicates a worse health status. Scores of 0 - 10, 11 - 20, 21 - 30 and 31 - 40 represent a mild, moderate, severe or very severe clinical impact of COPD upon the patient.
    End point type
    Secondary
    End point timeframe
    Baseline, 4 and 12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Baseline (n= 311,308)
    16.3 ( 7.6 )
    16.2 ( 7.48 )
        Day 28 baseline (n=303,298)
    16.2 ( 7.58 )
    16.2 ( 7.48 )
        Day 28 Post (n=303,298)
    15.8 ( 7.63 )
    16.8 ( 7.75 )
        Day 28 Change (n=303,298)
    -0.4 ( 5.56 )
    0.6 ( 4.94 )
        Day 84 Baseline (n=295,285)
    15.9 ( 7.54 )
    16.1 ( 8.38 )
        Day 84 Post (n=295,285)
    15.5 ( 7.56 )
    16.3 ( 8.38 )
        Day 84 change (n=295,285)
    -0.4 ( 5.77 )
    0.2 ( 5.84 )
    No statistical analyses for this end point

    Secondary: Patient reported outcome measures: Medical Outcome Study (MOS) sleep scale

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    End point title
    Patient reported outcome measures: Medical Outcome Study (MOS) sleep scale
    End point description
    MOS Consists of 12 items to measure 6 sleep dimensions: initiation (time to fall asleep), quantity (hours of sleep each night), maintenance , respiratory problems, perceived adequacy, somnolence (the last 4 items reported using a 6- item Likert scale ranging from “All of the time” to “None of the time”). The time frame for the responses is “the past 4 weeks.” Each patient reported outcome is measured at the start of study treatment and after 4 and 12 weeks of treatment. Score range. The range for the 12-item version is 12–71.
    End point type
    Secondary
    End point timeframe
    Baseline, 4 and 12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    302
    296
    Units: Units on a scale
    arithmetic mean (standard deviation)
        Sleep disturbance Baseline (n=299,295)
    49.6423 ( 8.50059 )
    49.9292 ( 8.5133 )
        Sleep disturbance Day 28 Baseline (n=290,285)
    49.6833 ( 8.57069 )
    49.7616 ( 8.49307 )
        Sleep disturbance Day 28 post (n=290,285)
    50.9323 ( 8.9254 )
    50.0858 ( 8.7711 )
        Sleep disturbance Day 28 change (n=290,285)
    1.249 ( 5.67591 )
    0.3242 ( 6.63156 )
        Sleep disturbance Day 84 Baseline (n=283,274)
    49.7622 ( 8.611 )
    49.6634 ( 8.41228 )
        Sleep disturbance Day 84 Post (n=283,274)
    50.7508 ( 9.22016 )
    50.238 ( 9.07204 )
        Sleep disturbance Day 84 Change (n=283,274)
    0.9887 ( 6.52972 )
    0.5745 ( 6.45362 )
        Sleep snoring Baseline (n=299,295)
    48.8815 ( 9.32313 )
    49.8895 ( 9.18885 )
        Sleep snoring Day 28 Baseline (n=290,285)
    48.8234 ( 9.40239 )
    49.7733 ( 9.2303 )
        Sleep snoring Day 28 Post (n=290,285)
    49.3476 ( 9.37744 )
    49.5067 ( 9.39012 )
        Sleep snoring Day 28 change(n=290,285)
    0.5241 ( 6.70023 )
    -0.2667 ( 7.06825 )
        Sleep snoring Day 84 Baseline (n=283,274)
    48.8414 ( 9.29113 )
    49.6385 ( 9.19681 )
        Sleep snoring Day 84 post (n=283,274)
    49.4591 ( 9.29113 )
    49.6108 ( 9.51632 )
        Sleep snoring Day 84 change (n=283,274)
    0.6177 ( 7.42456 )
    -0.0277 ( 8.266668 )
        Sleep shortness of breath Baseline (n=302,295)
    44.5221 ( 13.28329 )
    45.4259 ( 11.5156 )
        Sleep shortness of breath D 28 Bseline(n=293,285)
    44.6348 ( 13.1571 )
    45.3292 ( 11.48556 )
        Sleep shortness of breath D 28 post (n=293,285)
    45.8814 ( 11.85664 )
    45.5774 ( 11.65379 )
        Sleep shortness of breath D 28 change (n=293,285)
    1.2466 ( 12.21272 )
    0.2481 ( 11.44262 )
        Sleep shortness of breath D 84 Bseline (n=287,274)
    44.8645 ( 12.99605 )
    45.318 ( 11.37006 )
        Sleep shortness of breath D 84 post (n=287,274)
    45.7676 ( 13.20151 )
    45.7049 ( 11.8491 )
        Sleep shortness of breath D 84 change (n=287,274)
    0.9031 ( 12.11351 )
    0.387 ( 10.97093 )
        Sleep adequacy baseline (n=300,295)
    54.9999 ( 9.85865 )
    54.9725 ( 9.41704 )
        Sleep adequacy baseline D 28 (n=291,285)
    55.0531 ( 9.80609 )
    55.0679 ( 9.30955 )
        Sleep adequacy Post D 28 (n=291,285)
    55.2032 ( 10.04281 )
    54.8296 ( 10.21011 )
        Sleep adequacy Change D 28 (n=291,285)
    0.1501 ( 9.8392 )
    -0.2383 ( 9.2125 )
        Sleep adequacy baseline D 84 (n=284,274)
    55.2125 ( 9.81055 )
    55.1084 ( 9.20723 )
        Sleep adequacy Post D 84 (n=284,274)
    55.2467 ( 10.00283 )
    54.5424 ( 9.96705 )
        Sleep adequacy change D 84 (n=284,274)
    0.0342 ( 8.81793 )
    -0.5659 ( 8.578 )
        Sleep somnolence baseline (n=302,296)
    47.6646 ( 9.56376 )
    49.1709 ( 9.56807 )
        Sleep somnolence baseline D28 (n=290,285)
    47.8711 ( 9.4894 )
    49.1092 ( 9.58808 )
        Sleep somnolence post D28 (n=290,285)
    48.4429 ( 9.93046 )
    48.6761 ( 10.1785 )
        Sleep somnolence change D28 (n=290,285)
    0.5718 ( 7.91162 )
    -0.4331 ( 8.67719 )
        Sleep somnolence baseline D84 (n=284,274)
    47.7821 ( 9.53639 )
    48.9335 ( 9.55603 )
        Sleep somnolence post D84 (n=284,274)
    48.2568 ( 10.36223 )
    49.0461 ( 9.54132 )
        Sleep somnolence change D84 (n=284,274)
    0.4747 ( 8.11292 )
    0.1126 ( 7.83662 )
        Sleep Index 1 Baseline (n=300,295)
    50.4795 ( 9.72203 )
    50.8382 ( 9.16082 )
        Sleep Index 1 Baseline D28 (n=290,285)
    50.6034 ( 9.67464 )
    50.7911 ( 9.13425 )
        Sleep Index 1 Post D28 (n=290,285)
    51.4799 ( 9.86137 )
    50.7836 ( 10.02742 )
        Sleep Index 1 Change D28 (n=290,285)
    0.8764 ( 7.0396 )
    -0.0074 ( 7.73909 )
        Sleep Index 1 Baseline D84 (n=284,274)
    50.7327 ( 9.64776 )
    50.6951 ( 9.09626 )
        Sleep Index 1 Post D84 (n=284,274)
    51.359 ( 10.16584 )
    50.9888 ( 9.54642 )
        Sleep Index 1 Change D84 (n=284,274)
    0.6263 ( 7.22742 )
    0.2938 ( 7.08082 )
        Sleep Index 2 baseline (n=299,295)
    50.461 ( 9.14154 )
    51.0701 ( 8.62899 )
        Sleep Index 2 baseline D 28 (n=289,285)
    50.572 ( 9.15508 )
    50.9923 ( 8.60656 )
        Sleep Index 2 Post D 28 (n=289,285)
    51.5578 ( 9.43365 )
    51.0116 ( 9.33837 )
        Sleep Index 2 Change D 28 (n=289,285)
    0.9858 ( 6.00711 )
    0.0193 ( 6.99119 )
        Sleep Index 2 Baseline D 84 (n=283,274)
    50.688 ( 9.16092 )
    50.8848 ( 8.58893 )
        Sleep Index 2 Post D 84 (n=283,274)
    51.4615 ( 9.79518 )
    51.1511 ( 9.09673 )
        Sleep Index 2 Change D 84 (n=283,274)
    0.7735 ( 6.66709 )
    0.2663 ( 6.29393 )
        Sleep quantity Baseline (n=301,295)
    6.5565 ( 1.44169 )
    6.6203 ( 1.34895 )
        Sleep quantity Baseline D28(n=292,285)
    6.5702 ( 1.44879 )
    6.6351 ( 1.35775 )
        Sleep quantity Post D28(n=292,285)
    6.5717 ( 1.54708 )
    6.6246 ( 1.463566 )
        Sleep quantity Change D28(n=292,285)
    0.0015 ( 1.0739 )
    -0.0105 ( 1.10691 )
        Sleep quantity Baseline D84(n=285,274)
    6.5456 ( 1.42402 )
    6.6496 ( 1.345 )
        Sleep quantity Post D84(n=285,274)
    6.5561 ( 1.4378 )
    6.6569 ( 1.37648 )
        Sleep quantity Change D84(n=285,274)
    0.0105 ( 1.1227 )
    0.0073 ( 1.18906 )
    No statistical analyses for this end point

    Secondary: Summary Statistics of COPD Exacerbations over12 weeks as defined by Chronic Pulmonary Disease Tool (EXACT)

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    End point title
    Summary Statistics of COPD Exacerbations over12 weeks as defined by Chronic Pulmonary Disease Tool (EXACT)
    End point description
    The EXACT is a 14-item electronic questionnaire designed to detect the frequency, severity, and duration of exacerbations in patients with COPD.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: COPD exacerbation per participant
        arithmetic mean (standard deviation)
    0.2 ( 0.49 )
    0.3 ( 0.56 )
    No statistical analyses for this end point

    Secondary: Time to first COPD exacerbation

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    End point title
    Time to first COPD exacerbation
    End point description
    Time-to-event variables will be analyzed by the Kaplan-Meier estimates and the stratified Cox proportional hazard model by smoking status and COPD severity. The model will include treatment and country as factors, and FEV1 prior to inhalation and FEV1 15 min post inhalation of salbutamol/albuterol as covariates. The reported measure will detail the percentage of participants that were event free of a specified event.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Percentage of participants event free
    number (confidence interval)
        Mild COPD exacerbation
    99.3 (98.4 to 100)
    98.7 (97.4 to 100)
        Moderate COPD exacerbation
    94.5 (92 to 97.1)
    88.5 (84.9 to 92.1)
        Severe COPD exacerbation
    98 (96.5 to 99.6)
    98.3 (96.9 to 99.8)
        Moderate or Severe COPD exacerbation
    92.9 (89.9 to 95.7)
    86.8 (82.9 to 90.6)
        Any( mild, moderate,severe)
    92.2 (89.2 to 95.2)
    85.8 (81.9 to 89.8)
    No statistical analyses for this end point

    Secondary: Annual rate of COPD exacerbations

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    End point title
    Annual rate of COPD exacerbations
    End point description
    Time-to-event variables will be analyzed by the Kaplan-Meier estimates and the stratified Cox proportional hazard model by smoking status and COPD severity. The model will include treatment and country as factors, and FEV1 prior to inhalation and FEV1 15 min post inhalation of salbutamol/albuterol as covariates.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: COPD Exacerbations per year
    number (confidence interval)
        Model based estimates
    0.354 (0.221 to 0.5663)
    0.659 (0.4523 to 0.9592)
        Actual rate exacerbations per year
    0.39 (-99999.9 to 99999.9)
    0.73 (-99999.9 to 99999.9)
    No statistical analyses for this end point

    Secondary: Duration (in days) of COPD exacerbations

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    End point title
    Duration (in days) of COPD exacerbations
    End point description
    Duration and number of the COPD exacerbation will be analyzed by the negative binomial regression model including treatment, country, smoking status, and COPD severity as factors and FEV1 prior to inhalation and FEV1 15 min post inhalation of salbutamol/albuterol as covariates.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Days
        arithmetic mean (standard deviation)
    1.4 ( 6.59 )
    2 ( 6.28 )
    No statistical analyses for this end point

    Secondary: Percentage of patients exacerbation free at 12 weeks

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    End point title
    Percentage of patients exacerbation free at 12 weeks
    End point description
    Time-to-event variables will be analyzed by the Kaplan-Meier estimates and the stratified Cox proportional hazard model by smoking status and COPD severity. The model will include treatment and country as factors, and FEV1 prior to inhalation and FEV1 15 min post inhalation of salbutamol/albuterol as covariates. The reported measure will detail the percentage of participants that were event free of a specified event.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Percentage of participants
        number (not applicable)
    92.4
    85.9
    No statistical analyses for this end point

    Secondary: Time (in days) to permanent study discontinuation due to COPD exacerbation

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    End point title
    Time (in days) to permanent study discontinuation due to COPD exacerbation
    End point description
    Time-to-event variables will be analyzed by the Kaplan-Meier estimates and the stratified Cox proportional hazard model by smoking status and COPD severity. The model will include treatment and country as factors, and FEV1 prior to inhalation and FEV1 15 min post inhalation of salbutamol/albuterol as covariates.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316 [1]
    313 [2]
    Units: Days
        median (inter-quartile range (Q1-Q3))
    9999.9 (-99999.9 to 99999.9)
    9999.9 (-99999.9 to 99999.9)
    Notes
    [1] - number of observations is too small to project time to event
    [2] - number of observations is too small to project time to event
    No statistical analyses for this end point

    Secondary: The percentage of patients who permanently discontinued due to COPD exacerbation

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    End point title
    The percentage of patients who permanently discontinued due to COPD exacerbation
    End point description
    Time-to-event variables will be analyzed by the Kaplan-Meier estimates and the stratified Cox proportional hazard model by smoking status and COPD severity. The model will include treatment and country as factors, and FEV1 prior to inhalation and FEV1 15 min post inhalation of salbutamol/albuterol as covariates.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: Percentage participants
        number (not applicable)
    0.6
    1.6
    No statistical analyses for this end point

    Secondary: Total amount (in doses) of systemic corticosteroid used to treat COPD exacerbation during the 12 week treatment period

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    End point title
    Total amount (in doses) of systemic corticosteroid used to treat COPD exacerbation during the 12 week treatment period
    End point description
    Total amount (in doses) of systemic corticosteroid used to treat COPD exacerbation will be summarized descriptively by treatment group per each systemic corticosteroid.
    End point type
    Secondary
    End point timeframe
    12 weeks
    End point values
    QMF149 Salmeterol xinafoate/fluticasone propionate
    Number of subjects analysed
    316
    313
    Units: (Prednisolone dose equivalents) mg
    arithmetic mean (standard deviation)
        IM Hydrocortisone (mg) (n=1,0)
    100 ( 0 )
    0 ( 0 )
        IV dexamethasone (mg) (n=0,1)
    0 ( 0 )
    4 ( 0 )
        IV Hydrocortisone (mg) (n=0,1)
    0 ( 0 )
    100 ( 0 )
        IV Hydrocortisone sodium succinate (mg) (n=2,0)
    400 ( 282.843 )
    0 ( 0 )
        IV methylprenisolone sodium succinate(mg)(n=1,0)
    250 ( 0 )
    0 ( 0 )
        IV methylprenisolone sodium succinate(ug)(n=0,1)
    0 ( 0 )
    80 ( 0 )
        IV prednisolone (mg) (n=0,1)
    0 ( 0 )
    250 ( 0 )
        Oral Budesonide (mg) (n=0,1)
    0 ( 0 )
    20 ( 0 )
        Oral methylprenisolone (mg) (n=7,13)
    16.57 ( 11.414 )
    20.31 ( 9.586 )
        Oral prednisolone (mg) (n=8,28)
    24.38 ( 9.52 )
    23.93 ( 13.06 )
        Oral prednisone (mg) (n=8,16)
    31.25 ( 11.26 )
    25.31 ( 11.176 )
        Oral prednisone (ug) (n=0,1)
    0 ( 0 )
    10 ( 0 )
        Inhalation budesonide (mL)(n=0,1)
    0 ( 0 )
    0.5 ( 0 )
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse events are collected from First Patient First Visit (FPFV) until Last Patient Last Visit (LPLV). All adverse events reported in this record are from date of First Patient First Treatment until Last Patient Last Visit
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    SALM/FLUT
    Reporting group description
    SALM/FLUT

    Reporting group title
    QMF149
    Reporting group description
    QMF149

    Serious adverse events
    SALM/FLUT QMF149
    Total subjects affected by serious adverse events
         subjects affected / exposed
    19 / 313 (6.07%)
    10 / 316 (3.16%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Investigations
    ELECTROCARDIOGRAM T WAVE INVERSION
         subjects affected / exposed
    2 / 313 (0.64%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    PLEURAL MESOTHELIOMA MALIGNANT
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    UPPER LIMB FRACTURE
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    ATRIAL FIBRILLATION
         subjects affected / exposed
    2 / 313 (0.64%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    1 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CORONARY ARTERY DISEASE
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    INTRACRANIAL ANEURYSM
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    TEMPORAL LOBE EPILEPSY
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    TENSION HEADACHE
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    MALAISE
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    COLITIS
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    ABDOMINAL PAIN
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    DIARRHOEA
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    GASTRIC ULCER HAEMORRHAGE
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    HAEMATOCHEZIA
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SMALL INTESTINAL OBSTRUCTION
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hepatobiliary disorders
    CHOLECYSTITIS
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    ATELECTASIS
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    CHRONIC OBSTRUCTIVE PULMONARY DISEASE
         subjects affected / exposed
    5 / 313 (1.60%)
    6 / 316 (1.90%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 8
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    COUGH
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    HAEMATURIA
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    OSTEOARTHRITIS
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    LOBAR PNEUMONIA
         subjects affected / exposed
    1 / 313 (0.32%)
    0 / 316 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    INCISION SITE INFECTION
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    PNEUMONIA
         subjects affected / exposed
    0 / 313 (0.00%)
    2 / 316 (0.63%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    UPPER RESPIRATORY TRACT INFECTION
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    SPUTUM PURULENT
         subjects affected / exposed
    0 / 313 (0.00%)
    1 / 316 (0.32%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    SALM/FLUT QMF149
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    43 / 313 (13.74%)
    19 / 316 (6.01%)
    Respiratory, thoracic and mediastinal disorders
    CHRONIC OBSTRUCTIVE PULMONARY DISEASE
         subjects affected / exposed
    43 / 313 (13.74%)
    19 / 316 (6.01%)
         occurrences all number
    49
    21

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Due to EudraCT system limitations, which EMA is aware of, data using 999 as data points in this record are not an accurate representation of the clinical trial results. Please use https://www.novctrd.com/CtrdWeb/home.novfor complete trial results.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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