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    Clinical Trial Results:
    A randomized, multi-center, double-blind, doubledummy, parallel group study to evaluate the efficacy and safety of umeclidinium/vilanterol compared with fluticasone propionate/salmeterol over 12 weeks in subjects with COPD.

    Summary
    EudraCT number
    2012-002156-16
    Trial protocol
    RO  
    Global end of trial date
    09 Jan 2014

    Results information
    Results version number
    v1(current)
    This version publication date
    27 Apr 2016
    First version publication date
    01 May 2015
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    DB2114951
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01879410
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    GlaxoSmithKline
    Sponsor organisation address
    980 Great West Road, Brentford, Middlesex, United Kingdom,
    Public contact
    GSK Response Center, GlaxoSmithKline, 1 866-435-7343,
    Scientific contact
    GSK Response Center, GlaxoSmithKline, 1 866-435-7343,
    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
    13 Mar 2014
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    09 Jan 2014
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Compare the efficacy and safety of UMEC/VI Inhalation Powder (62.5/25 µg oncedaily) with fluticasone propionate/salmeterol (250/50 µg twice-daily) over 12 weeks in subjects with COPD who have a history of infrequent COPD exacerbations
    Protection of trial subjects
    Several measures were taken to protect trials participants: these included adverse event monitoring throughout the study, frequent clinic visits (approximately every 4 weeks) to monitor participant status, exclusion of participants with clinically significant and uncontrolled medical conditions and/or ECG findings, and use of treatment arms where all participants received pharmacologic treatment that was appropriate for the disease and disease severity under study. Fluticasone propionate/salmeterol combination inhalation powder is a marketed product and was administered according to the local label. Fluticasone propionate/salmeterol has an acceptable safety profile for use. This conclusion is supported by the results of previously performed clinical studies and post-marketing experience (see local label). All participants were on active treatment.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    13 Jun 2013
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Chile: 100
    Country: Number of subjects enrolled
    Mexico: 50
    Country: Number of subjects enrolled
    Russian Federation: 269
    Country: Number of subjects enrolled
    South Africa: 110
    Country: Number of subjects enrolled
    United States: 232
    Country: Number of subjects enrolled
    Norway: 70
    Country: Number of subjects enrolled
    Romania: 135
    Worldwide total number of subjects
    966
    EEA total number of subjects
    205
    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)
    518
    From 65 to 84 years
    438
    85 years and over
    10

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A total of 700 participants (par.) representing the enrolled participants, were randomized to study treatment. Of these, 697 comprised the Intent-to-Treat Population (participants randomized to treatment who received >=1 dose of randomized study medication in the treatment period).

    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, Monitor, Data analyst, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    UMEC/VI 62.5/25 µg
    Arm description
    Participants received umeclidinium bromide/vilanterol (UMEC/VI) 62.5/25 micrograms (µg) once daily (QD) in the morning via a dry powder inhaler (DPI) and placebo in the morning and evening via a separate DPI for 12 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    Umeclidinium bromide/ vilanterol
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Respiratory use
    Dosage and administration details
    62.5/25 µg once-daily via dry powder inhaler

    Arm title
    FSC 250/50 µg
    Arm description
    Participants received fluticasone propionate/salmeterol (FSC) 250/50 µg twice daily (BID) in the morning and evening via a DPI and placebo in the morning via a separate DPI for 12 weeks.
    Arm type
    Active comparator

    Investigational medicinal product name
    fluticasone propionate/salmeterol Inhalation Powder
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Inhalation powder
    Routes of administration
    Respiratory use
    Dosage and administration details
    250/50 µg twice-daily via dry powder inhaler

    Number of subjects in period 1 [1]
    UMEC/VI 62.5/25 µg FSC 250/50 µg
    Started
    349
    348
    Completed
    326
    312
    Not completed
    23
    36
         Adverse event, serious fatal
    2
    3
         Consent withdrawn by subject
    7
    8
         Adverse event, non-fatal
    7
    11
         Lost to follow-up
    2
    1
         Lack of efficacy
    4
    6
         Protocol deviation
    1
    7
    Notes
    [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same.
    Justification: Although 966 participants were enrolled in the trial worldwide, only 700 were randomized to treatment. Of these, 697 participants comprised the Intent-to-Treat Population (participants randomized to treatment who received >=1 dose of randomized study medication in the treatment period).

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    UMEC/VI 62.5/25 µg
    Reporting group description
    Participants received umeclidinium bromide/vilanterol (UMEC/VI) 62.5/25 micrograms (µg) once daily (QD) in the morning via a dry powder inhaler (DPI) and placebo in the morning and evening via a separate DPI for 12 weeks.

    Reporting group title
    FSC 250/50 µg
    Reporting group description
    Participants received fluticasone propionate/salmeterol (FSC) 250/50 µg twice daily (BID) in the morning and evening via a DPI and placebo in the morning via a separate DPI for 12 weeks.

    Reporting group values
    UMEC/VI 62.5/25 µg FSC 250/50 µg Total
    Number of subjects
    349 348 697
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    63.2 ( 8.57 ) 64 ( 8.53 ) -
    Gender categorical
    Units: Subjects
        Female
    85 84 169
        Male
    264 264 528
    Race
    Units: Subjects
        African American/African Heritage
    18 13 31
        American Indian or Alaska Native
    7 2 9
        Asian
    4 2 6
        Native Hawaiian or other Pacific Islander
    0 0 0
        White
    317 326 643
        American Indian or Alaska Native & White
    3 5 8

    End points

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    End points reporting groups
    Reporting group title
    UMEC/VI 62.5/25 µg
    Reporting group description
    Participants received umeclidinium bromide/vilanterol (UMEC/VI) 62.5/25 micrograms (µg) once daily (QD) in the morning via a dry powder inhaler (DPI) and placebo in the morning and evening via a separate DPI for 12 weeks.

    Reporting group title
    FSC 250/50 µg
    Reporting group description
    Participants received fluticasone propionate/salmeterol (FSC) 250/50 µg twice daily (BID) in the morning and evening via a DPI and placebo in the morning via a separate DPI for 12 weeks.

    Primary: Change from Baseline (BL) in 0 to 24 hour weighted mean forced expiratory volume over 1 second (FEV1) at Day 84

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    End point title
    Change from Baseline (BL) in 0 to 24 hour weighted mean forced expiratory volume over 1 second (FEV1) at Day 84
    End point description
    FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. The weighted mean was calculated from the pre-dose FEV1 and post-dose FEV1 measurements at 5 and 15 minutes and 1, 3, 6, 9, 12 hours (pre-evening dose), 13, 15, 18, 23, and 24 hours after the morning dose. Baseline is defined as the mean of the assessments made 30 and 5 minutes (min) pre-dose on treatment Day 1. Analysis was performed using an analysis of covariance model with covariates of baseline FEV1 (mean of the two assessments made 30 mins and 5 mins pre-dose on Day 1), smoking status, and treatment. Change from baseline was calculated as the value at Day 84 minus the value at Baseline. Participants analyzed were those with data available at the presented time point; but, all participants without missing covariate information and with >= post BL measurement were included in the analysis.
    End point type
    Primary
    End point timeframe
    Baseline and Day 84
    End point values
    UMEC/VI 62.5/25 µg FSC 250/50 µg
    Number of subjects analysed
    322 [1]
    311 [2]
    Units: Liters
        least squares mean (standard error)
    0.213 ( 0.0137 )
    0.112 ( 0.0139 )
    Notes
    [1] - Intent-to-Treat (ITT) Population
    [2] - ITT Population
    Statistical analysis title
    Analysis 1
    Comparison groups
    UMEC/VI 62.5/25 µg v FSC 250/50 µg
    Number of subjects included in analysis
    633
    Analysis specification
    Pre-specified
    Analysis type
    superiority [3]
    P-value
    < 0.001
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    0.101
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.063
         upper limit
    0.139
    Notes
    [3] - Least squares mean difference=UMEC/VI 62.5/25 µg minus FSC 250/50 µg.

    Secondary: Change from Baseline(BL) in trough forced expiratory volume in one second (FEV1) at Day 85

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    End point title
    Change from Baseline(BL) in trough forced expiratory volume in one second (FEV1) at Day 85
    End point description
    FEV1 is a measure of lung function and is defined as the maximal amount of air that can be forcefully exhaled in one second. BL is defined as the mean of the assessments made 30 and 5 min pre-dose on treatment (trt) Day 1. Trough FEV1 on Day 85 is defined as the mean of the FEV1 values obtained 23 and 24 hours after morning dosing on Day 84. Analysis was performed using a repeated measures model with covariates of trt, BL (mean of the 2 assessments made 30 and 5 min pre-dose on Day 1), smoking status, day, day by BL and day by trt interactions. The model used all available trough FEV1 values recorded on Days 28, 56, 84, and 85. Missing data were not directly imputed in this analysis; however, all non-missing data for a par. were used to estimate the trt effect for trough FEV1 at Day 85. Change from BL=value at Day 84 minus value at BL. Par. analyzed were those with data available at the time point; but, all par. without missing covariate information were included in the analysis.
    End point type
    Secondary
    End point timeframe
    Baseline and Day 85
    End point values
    UMEC/VI 62.5/25 µg FSC 250/50 µg
    Number of subjects analysed
    323 [4]
    311 [5]
    Units: Liters
        least squares mean (standard error)
    0.185 ( 0.0138 )
    0.087 ( 0.014 )
    Notes
    [4] - ITT Population
    [5] - ITT Population
    Statistical analysis title
    Analysis 2
    Comparison groups
    UMEC/VI 62.5/25 µg v FSC 250/50 µg
    Number of subjects included in analysis
    634
    Analysis specification
    Pre-specified
    Analysis type
    other
    P-value
    < 0.001
    Method
    Repeated measures
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.059
         upper limit
    0.137

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Serious adverse events (SAEs) and non-serious adverse events (AEs) collected from the start of study treatment up to the Follow-up Visit or premature withdrawal (up to Day 94)
    Adverse event reporting additional description
    SAEs and non-serious AEs are reported for members of the ITT Population, comprised of all randomized participants who received at least 1 dose of randomized study drug in the treatment period.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    UMEC/VI 62.5/25 µg
    Reporting group description
    Participants received UMEC/VI 62.5/25 µg QD in the morning via a DPI and placebo in the morning and evening via a separate DPI for 12 weeks

    Reporting group title
    FSC 250/50 µg
    Reporting group description
    Participants received FSC 250/50 µg BID in the morning and evening via a DPI and placebo in the morning via a separate DPI for 12 weeks.

    Serious adverse events
    UMEC/VI 62.5/25 µg FSC 250/50 µg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    11 / 349 (3.15%)
    13 / 348 (3.74%)
         number of deaths (all causes)
    2
    3
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Bladder cancer
         subjects affected / exposed
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lung adenocarcinoma
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Small cell lung cancer
         subjects affected / exposed
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    Vascular disorders
    Peripheral artery thrombosis
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (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
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 1
    0 / 0
    Myocardial infarction
         subjects affected / exposed
    1 / 349 (0.29%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 1
    0 / 1
    Respiratory, thoracic and mediastinal disorders
    Pleurisy
         subjects affected / exposed
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumothorax spontaneous
         subjects affected / exposed
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory failure
         subjects affected / exposed
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    4 / 349 (1.15%)
    4 / 348 (1.15%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Alcohol abuse
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lobar pneumonia
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Perirectal abscess
         subjects affected / exposed
    1 / 349 (0.29%)
    0 / 348 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory tract infection viral
         subjects affected / exposed
    0 / 349 (0.00%)
    1 / 348 (0.29%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 349 (0.29%)
    4 / 348 (1.15%)
         occurrences causally related to treatment / all
    0 / 1
    1 / 4
         deaths causally related to treatment / all
    0 / 0
    1 / 1
    Frequency threshold for reporting non-serious adverse events: 3%
    Non-serious adverse events
    UMEC/VI 62.5/25 µg FSC 250/50 µg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    36 / 349 (10.32%)
    28 / 348 (8.05%)
    Nervous system disorders
    Headache
         subjects affected / exposed
    24 / 349 (6.88%)
    23 / 348 (6.61%)
         occurrences all number
    52
    41
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    14 / 349 (4.01%)
    6 / 348 (1.72%)
         occurrences all number
    17
    7

    More information

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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.
    None reported
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    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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