Clinical Trial Results:
INBUILD®: A double-blind, randomised, placebo-controlled
trial evaluating the efficacy and safety of nintedanib over
52 weeks in patients with Progressive Fibrosing Interstitial Lung
Disease (PF-ILD)
Summary
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EudraCT number |
2015-003360-37 |
Trial protocol |
FR ES BE DE GB PL IT |
Global end of trial date |
12 Aug 2019
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Results information
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Results version number |
v2(current) |
This version publication date |
11 Jan 2022
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First version publication date |
23 Aug 2020
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Other versions |
v1 |
Version creation reason |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
1199.247
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT02999178 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Boehringer Ingelheim
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Sponsor organisation address |
Binger Strasse 173, Ingelheim am Rhein, Germany, 55216
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Public contact |
Boehringer Ingelheim Call Center, QRPE Processes and Systems Coordination Clinical Trial Information Disclosure, +1 18002430127, clintriage.rdg@boehringer-ingelheim.com
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Scientific contact |
QRPE Processes and Systems Coordination Clinical Trial Information Disclosure, Boehringer Ingelheim, +1 18002430127, clintriage.rdg@boehringer-ingelheim.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
11 Sep 2019
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
23 Apr 2019
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Global end of trial reached? |
Yes
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Global end of trial date |
12 Aug 2019
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
The aim of the current study was to investigate the efficacy and safety of nintedanib over 52 weeks in patients with Progressive Fibrosing Interstitial Lung Disease (PF-ILD) defined as patients who present with features of diffuse fibrosing lung disease of >10% extent on high-resolution computed tomography (HRCT) and whose lung function and respiratory symptoms or chest imaging have worsened despite treatment with unapproved medications used in clinical practice to treat ILD. There is currently no efficacious treatment available for PF-ILD. Based on its efficacy and safety in Idiopathic Pulmonary Fibrosis (IPF), it is anticipated that Nintedanib will be a new treatment option for patients with PF-ILD.
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Protection of trial subjects |
Only subjects that met all the study inclusion and none of the exclusion criteria were to be entered in the study. All subjects were free to withdraw from the clinical trial at any time for any reason given. Close monitoring of all subjects was adhered to throughout the trial conduct. Rescue medication was allowed for all subjects as required.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
17 Jan 2017
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
China: 25
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Country: Number of subjects enrolled |
Japan: 166
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Country: Number of subjects enrolled |
Korea, Democratic People's Republic of: 39
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Country: Number of subjects enrolled |
Canada: 17
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Country: Number of subjects enrolled |
United States: 211
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Country: Number of subjects enrolled |
Belgium: 29
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Country: Number of subjects enrolled |
Germany: 79
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Country: Number of subjects enrolled |
Spain: 65
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Country: Number of subjects enrolled |
France: 87
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Country: Number of subjects enrolled |
United Kingdom: 43
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Country: Number of subjects enrolled |
Italy: 56
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Country: Number of subjects enrolled |
Poland: 43
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Country: Number of subjects enrolled |
Russian Federation: 55
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Country: Number of subjects enrolled |
Argentina: 43
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Country: Number of subjects enrolled |
Chile: 52
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Worldwide total number of subjects |
1010
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EEA total number of subjects |
359
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
404
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From 65 to 84 years |
593
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85 years and over |
13
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Recruitment
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Recruitment details |
Randomised (1:1 ratio), placebo-controlled, double-blind, parallel-group trial comparing nintedanib to placebo over a 52-week treatment period (Part A). Subjects continued on blinded, randomised treatment beyond 52 weeks (Part B). Data base lock (DBL) one was on 6-June-2019, DBL two was on 11-September-2019. Overall Study Period=Part A and B. | ||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
All subjects were screened for eligibility prior to participation in the trial. Subjects attended a specialist site which ensured that they (the subjects) strictly met all inclusion and none of the exclusion criteria. Subjects were not to be allocated to a treatment group if any of the entry criteria were violated. | ||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||||||||
Roles blinded |
Investigator, Monitor, Carer, Data analyst, Assessor, Subject | ||||||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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150 mg Nintedanib | ||||||||||||||||||||||||||||||
Arm description |
150 milligram (mg) Nintedanib as soft gelatine capsule, administered orally, twice daily (bid), with optional dose reduction to 100 mg bid to manage adverse events (AEs). Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Nintedanib
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Capsule, soft
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Routes of administration |
Oral use
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Dosage and administration details |
150 milligram (mg) Nintedanib as soft gelatine capsule, administered orally, twice daily (bid), with optional dose reduction to 100 mg bid to manage adverse events (AEs). Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B).
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Arm title
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Placebo | ||||||||||||||||||||||||||||||
Arm description |
150 mg Nintedanib matching placebo, soft gelatine capsule, administered orally, bid, with optional dose reduction to 100 mg bid to manage AEs. Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Capsule, soft
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Routes of administration |
Oral use
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Dosage and administration details |
150 mg Nintedanib matching placebo, soft gelatine capsule, administered orally, bid, with optional dose reduction to 100 mg bid to manage AEs. Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B).
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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: Baseline characteristics are based on patients who were randomised after successfully completing the screening period and received at least one dose of the trial medication. |
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Baseline characteristics reporting groups
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Reporting group title |
150 mg Nintedanib
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Reporting group description |
150 milligram (mg) Nintedanib as soft gelatine capsule, administered orally, twice daily (bid), with optional dose reduction to 100 mg bid to manage adverse events (AEs). Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
150 mg Nintedanib matching placebo, soft gelatine capsule, administered orally, bid, with optional dose reduction to 100 mg bid to manage AEs. Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
150 mg Nintedanib
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Reporting group description |
150 milligram (mg) Nintedanib as soft gelatine capsule, administered orally, twice daily (bid), with optional dose reduction to 100 mg bid to manage adverse events (AEs). Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||
Reporting group title |
Placebo
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Reporting group description |
150 mg Nintedanib matching placebo, soft gelatine capsule, administered orally, bid, with optional dose reduction to 100 mg bid to manage AEs. Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, subjects continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). |
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End point title |
Annual rate of decline in Forced Vital Capacity - Overall population | ||||||||||||
End point description |
Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) which can be forcibly exhaled from the lungs after taking the deepest breath possible. Overall population consists of all randomized subjects with High Resolution Computed Tomography (HRCT) fibrotic pattern=UIP-like fibrotic pattern only or HRCT fibrotic pattern= Other fibrotic patterns. Annual rate of decline in Forced Vital Capacity in milliliter (mL) per year in the overall population is based on a random coefficient regression with fixed effects for treatment, HRCT fibrotic pattern, and baseline FVC [mL], and including treatment−by−time and baseline−by−time interactions. Within−subject errors are modelled by an unstructured variance−covariance matrix.
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
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End point type |
Primary
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End point timeframe |
Baseline, 2, 4, 6, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
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Notes [1] - Overall Population [2] - Overall Population |
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Statistical analysis title |
Statistical Analysis 1 | ||||||||||||
Statistical analysis description |
The decrease in FVC was assumed to be linear within each participant over 52 weeks. The intercepts and slopes were assumed to be
normally distributed with unstructured covariance matrix. The within participant error was assumed to be independent and normally
distributed with mean 0 and a common variance. The Kenward-Roger approximation was used to estimate denominator degrees of
freedom and adjust standard errors (SEs).
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Comparison groups |
150 mg Nintedanib v Placebo
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Number of subjects included in analysis |
663
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Analysis specification |
Pre-specified
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Analysis type |
superiority [3] | ||||||||||||
P-value |
< 0.0001 [4] | ||||||||||||
Method |
Mixed models analysis | ||||||||||||
Parameter type |
Difference of adjusted annual rates | ||||||||||||
Point estimate |
106.96
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
65.42 | ||||||||||||
upper limit |
148.5 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
21.15
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Notes [3] - Fixed effects: Treatment, HRCT fibrotic pattern, baseline FVC (mL), treatment-by-time, baseline-by-time interactions. Random effects: time, intercept. Difference of adjusted annual rates of decline was calculated as Nintedanib – Placebo. [4] - Treatment comparison of slopes was assessed through the treatment-by-time interaction coefficient. P-value was not adjusted for multiple comparisons. P-value .0001 is actually <.0001. |
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End point title |
Annual rate of decline in Forced Vital Capacity - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) which can be forcibly exhaled from the lungs after taking the deepest breath possible. Annual rate of decline in Forced Vital Capacity in milliliter (mL) per year in subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only is based on a random coefficient regression with fixed effects for treatment, baseline FVC [mL], and including treatment−by−time and baseline−by−time interactions. Within−subject errors are modelled by an unstructured variance−covariance matrix.
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
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End point type |
Primary
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End point timeframe |
Baseline, 2, 4, 6, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
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Notes [5] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [6] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
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Statistical analysis title |
Statistical Analysis 2 | ||||||||||||
Statistical analysis description |
The decrease in FVC was assumed to be linear within each participant over 52 weeks. The intercepts and slopes were assumed to be
normally distributed with unstructured covariance matrix. The within participant error was assumed to be independent and normally
distributed with mean 0 and a common variance. The Kenward-Roger approximation was used to estimate denominator degrees of
freedom and adjust standard errors (SEs).
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Comparison groups |
150 mg Nintedanib v Placebo
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Number of subjects included in analysis |
412
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Analysis specification |
Pre-specified
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Analysis type |
superiority [7] | ||||||||||||
P-value |
< 0.0001 [8] | ||||||||||||
Method |
Mixed models analysis | ||||||||||||
Parameter type |
Difference of adjusted annual rates | ||||||||||||
Point estimate |
128.2
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
70.81 | ||||||||||||
upper limit |
185.59 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
29.17
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Notes [7] - Fixed effects: Treatment, baseline FVC (mL), treatment-by-time, baseline-by-time interactions. Random effects: time, intercept. Difference of adjusted annual rates of decline was calculated as Nintedanib – Placebo. [8] - Treatment comparison of slopes was assessed through the treatment-by-time interaction coefficient. P-value was not adjusted for multiple comparisons. P-value .0001 is actually <.0001. |
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End point title |
Absolute change from baseline in King's Brief Interstitial Lung Disease Questionnaire (K-BILD) Total score at week 52 - Overall population | ||||||||||||
End point description |
King's Brief Interstitial Lung Disease questionnaire (K-BILD) consists of 15 items and 3 domains: breathlessness and activities, psychological, chest symptoms ranging from 0-100, with 100 representing the best health status. If missing items were >50% per domain, the domain score was set to missing. If any of the domain scores were missing, the total score was set to missing. Absolute change from baseline at week 52 was based on a Mixed Model Repeated Measures (MMRM), with fixed effects for baseline K-BILD Total score, HRCT fibrotic pattern, visit, treatment-by-visit interaction, baseline-by-visit interactions and random effect for subject. Visit was the repeated measure. Within-subject errors were modelled by unstructured variance-covariance matrix.
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
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End point type |
Secondary
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End point timeframe |
Baseline, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
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Notes [9] - Overall Population [10] - Overall Population |
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Statistical analysis title |
Statistical Analysis 3 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
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Number of subjects included in analysis |
662
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Analysis specification |
Pre-specified
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Analysis type |
other [11] | ||||||||||||
P-value |
= 0.1115 | ||||||||||||
Method |
Mixed Model Repeated Measures (MMRM) | ||||||||||||
Parameter type |
Adjusted mean difference | ||||||||||||
Point estimate |
1.34
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.31 | ||||||||||||
upper limit |
2.98 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.84
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Notes [11] - No formal hypotheses were tested. Fixed effects: baseline K-BILD Total score, visit, treatment−by−visit and baseline−by−visit interactions, random effect: participant. Adjusted mean difference was calculated as Nintedanib – Placebo. |
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End point title |
Absolute change from baseline in King's Brief Interstitial Lung Disease (K-BILD) Questionnaire Total score at week 52 - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
King's Brief Interstitial Lung Disease questionnaire (K-BILD) consists of 15 items and 3 domains: breathlessness, activities, psychological, chest symptoms ranging from 0-100, with 100 representing best health status. If missing items were >50% per domain, the domain score was set to missing. If any of the domain scores were missing, the total score was set to missing. Absolute change from baseline at week 52 was based on a Mixed Model Repeated Measures (MMRM), with fixed effects for baseline K-BILD Total score, HRCT fibrotic pattern, visit, treatment-by-visit interaction, baseline-by-visit interactions and random effect for subject and visit as repeated measure. Within-subject errors were modelled by unstructured variance-covariance matrix.
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
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End point type |
Secondary
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End point timeframe |
Baseline, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
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Notes [12] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [13] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
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Statistical analysis title |
Statistical Analysis 4 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
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Number of subjects included in analysis |
411
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Analysis specification |
Pre-specified
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Analysis type |
[14] | ||||||||||||
P-value |
= 0.1747 | ||||||||||||
Method |
Mixed Model Repeated Measures (MMRM) | ||||||||||||
Parameter type |
Adjusted mean difference | ||||||||||||
Point estimate |
1.53
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.68 | ||||||||||||
upper limit |
3.74 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
1.12
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Notes [14] - No formal hypotheses were tested. Fixed effects: baseline K-BILD Total score, visit, treatment−by−visit and baseline−by−visit interactions, random effect: participant. Adjusted mean difference was calculated as Nintedanib – Placebo. |
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End point title |
Time to first acute Interstitial Lung Disease (ILD) exacerbation or death over 52 weeks - Overall population | ||||||||||||
End point description |
Time to first acute ILD exacerbation or death over 52 weeks was defined as time to first acute ILD exacerbation or death due to any cause within the first 52 weeks and was computed as earliest of date of first documented acute ILD exacerbation or death – date of first drug intake + 1. Subjects alive who did not experience any ILD exacerbation event or with unknown status within the first 52 weeks were censored. The value '99999' stands for non-calculable because the 25 percentile was not reached.
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
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End point type |
Secondary
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End point timeframe |
From first drug intake until date of first acute ILD exacerbation or date of death or last contact date, up to 372 days
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Notes [15] - Overall Population [16] - Overall Population |
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Statistical analysis title |
Statistical Analysis 5 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
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Number of subjects included in analysis |
663
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Analysis specification |
Pre-specified
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Analysis type |
[17] | ||||||||||||
P-value |
= 0.3948 | ||||||||||||
Method |
Logrank | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
0.8
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
0.48 | ||||||||||||
upper limit |
1.34 | ||||||||||||
Notes [17] - No formal hypotheses were tested. Stratified by HRCT fibrotic pattern. A Cox proportional hazards model, stratified by HRCT fibrotic pattern, was used to estimate the hazard ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Time to first acute Interstitial Lung Disease (ILD) exacerbation or death over 52 weeks – Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Time to first acute ILD exacerbation or death over 52 weeks was defined as time to first acute ILD exacerbation or death due to any cause within the first 52 weeks and was computed as earliest of date of first documented acute ILD exacerbation or death – date of first drug intake + 1. Subjects alive who did not experience any ILD exacerbation event or with unknown status within the first 52 weeks were censored. The value '99999' stands for non-calculable because the 25 percentile was not reached.
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From first drug intake until date of first acute ILD exacerbation or date of death or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [18] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [19] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
Statistical analysis title |
Statistical Analysis 6 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
412
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[20] | ||||||||||||
P-value |
= 0.1985 | ||||||||||||
Method |
Logrank | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
0.67
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.36 | ||||||||||||
upper limit |
1.24 | ||||||||||||
Notes [20] - No formal hypotheses were tested. A Cox proportional hazards model was used to estimate the hazard ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Time to death over 52 weeks - Overall population | ||||||||||||
End point description |
Time to death over 52 weeks defined as the time from date of first drug intake until date of death from any cause for subjects with known date of death (from any cause) within the first 52 weeks. Subjects with no event (death from any cause) or unknown status within the first 52 weeks were censored. The value '99999' stands for non-calculable because the 25 percentile was not reached.
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From first drug intake until date of death or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [21] - Overall Population [22] - Overall Population |
|||||||||||||
Statistical analysis title |
Statistical Analysis 7 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
663
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[23] | ||||||||||||
P-value |
= 0.8544 | ||||||||||||
Method |
Logrank | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
0.94
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.47 | ||||||||||||
upper limit |
1.86 | ||||||||||||
Notes [23] - No formal hypotheses were tested. Stratified by HRCT fibrotic pattern. A Cox proportional hazards model, stratified by HRCT fibrotic pattern, was used to estimate the hazard ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Time to death over 52 weeks - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Time to death over 52 weeks defined as the time from date of first drug intake until date of death from any cause for subjects with known date of death (from any cause) within the first 52 weeks. Subjects with no event (death from any cause) or unknown status within the first 52 weeks were censored. The value '99999' stands for non-calculable because the 25 percentile was not reached.
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From first drug intake until date of death or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [24] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [25] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
Statistical analysis title |
Statistical Analysis 8 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
412
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[26] | ||||||||||||
P-value |
= 0.3291 | ||||||||||||
Method |
Logrank | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
0.68
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.32 | ||||||||||||
upper limit |
1.47 | ||||||||||||
Notes [26] - No formal hypotheses were tested. A Cox proportional hazards model was used to estimate the hazard ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Time to death due to respiratory cause over 52 weeks - Overall population | ||||||||||||
End point description |
Time to death due to respiratory cause over 52 weeks is defined as the time from date of first drug intake until date of death attributed to respiratory causes (determined by an independent Adjudication Committee) for subjects with known date of death (from respiratory causes) within the first 52 weeks. Subjects with no event (death from respiratory causes) or unknown status within the first 52 weeks were censored. As less than 4.95% of the total of subjects in the analysis population experienced an event, only descriptive statistics were performed, as pre-specified. The value '99999' stands for non-calculable because the 25 percentile was not reached. No statistical analysis provided for Time to death due to respiratory cause over 52 weeks.
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From date of first trial drug intake up to date of death from respiratory causes or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [27] - Overall population [28] - Overall population |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Time to death due to respiratory cause over 52 weeks - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Time to death due to respiratory cause over 52 weeks is defined as the time from date of first drug intake until date of death attributed to respiratory causes (determined by an independent Adjudication Committee) for subjects with known date of death (from respiratory causes) within the first 52 weeks. Subjects with no event (death from respiratory causes) or unknown status within the first 52 weeks were censored. As less than 4.95% of the total of subjects in the analysis population experienced an event, only descriptive statistics were performed, as pre-specified. The value '99999' stands for non-calculable because the 25 percentile was not reached. No statistical analysis provided for Time to death due to respiratory cause over 52.
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From date of first trial drug intake up to date of death from respiratory causes or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [29] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [30] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
No statistical analyses for this end point |
|
|||||||||||||
End point title |
Time to progression or death over 52 weeks - Overall population | ||||||||||||
End point description |
Time to progression or death over 52 weeks is as the time from date of first drug intake to date of progression, or date of death (from any cause) if a subject died earlier. Subjects with no event (progression or death from any cause) or unknown status were censored. Date of progression defined as the date when ≥ 10% of absolute decline in FVC percent predicted compared to baseline occurred for the first time. Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) forcibly exhaled from the lungs after taking the deepest breath possible. Predicted normal values of FVC were calculated according to the Global Lung Initiative. FVC percent predicted (FVC % pred) is the FVC divided by its predicted value in percent. The value '99999' stands for non-calculable because the 50 percentile was not reached.
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From first drug intake until date of progression or date of death or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [31] - Overall Population [32] - Overall Population |
|||||||||||||
Statistical analysis title |
Statistical Analysis 9 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
663
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[33] | ||||||||||||
P-value |
= 0.0017 | ||||||||||||
Method |
Logrank | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
0.65
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.49 | ||||||||||||
upper limit |
0.85 | ||||||||||||
Notes [33] - No formal hypotheses were tested. Stratified by HRCT fibrotic pattern. A Cox proportional hazards model, stratified by HRCT fibrotic pattern, was used to estimate the hazard ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Time to progression or death over 52 weeks - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Time to progression or death over 52 weeks defined as time from date of first drug intake to date of progression, or date of death (from any cause) if a participant died earlier. Subjects with no event (progression or death from any cause) or unknown status were censored. Date of progression defined as the date when ≥ 10% of absolute decline in FVC percent predicted compared to baseline occurred for the first time. FVC is the volume of air (measured in milliliter) forcibly exhaled from the lungs after taking the deepest breath possible. Predicted normal values of FVC were calculated according to the Global Lung Initiative. FVC percent predicted (FVC % pred) is the FVC divided by its predicted value in percent. The value '99999' stands for non-calculable because the 50 percentile was not reached.
Subjects with HRCT fibrotic pattern= UIP-like fibrotic pattern (HRCT=UIP FP) only: All randomised subjects with HRCT=UIP FP only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
From first drug intake until date of progression or date of death or last contact date, up to 372 days
|
||||||||||||
|
|||||||||||||
Notes [34] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [35] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
Statistical analysis title |
Statistical Analysis 10 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
412
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[36] | ||||||||||||
P-value |
= 0.0081 | ||||||||||||
Method |
Logrank | ||||||||||||
Parameter type |
Hazard ratio (HR) | ||||||||||||
Point estimate |
0.64
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.45 | ||||||||||||
upper limit |
0.89 | ||||||||||||
Notes [36] - No formal hypotheses were tested. A Cox proportional hazards model was used to estimate the hazard ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Percentage of subjects with a relative decline from baseline in FVC percent predicted of more than 10 percent at week 52 - Overall population | ||||||||||||
End point description |
Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) which can be forcibly exhaled from the lungs after taking the deepest breath possible. Predicted normal values of FVC were calculated according to the Global Lung Initiative. FVC percent predicted (FVC % pred) is the FVC divided by its predicted value in percent. Subjects with relative decline from baseline in FVC % pred greater than 10% at week 52 were those subjects with a negative relative change from baseline in FVC % pred at week 52 the absolute value of which being greater than 10% and those subjects with missing data (worst case analysis).
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and up to 52 weeks after first drug intake
|
||||||||||||
|
|||||||||||||
Notes [37] - Overall Population [38] - Overall Population |
|||||||||||||
Statistical analysis title |
Statistical Analysis 11 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
663
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[39] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Adjusted Odds Ratio | ||||||||||||
Point estimate |
0.7
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.52 | ||||||||||||
upper limit |
0.96 | ||||||||||||
Notes [39] - No formal hypotheses were tested. Logistic regression model with continuous covariate baseline FVC % pred and binary covariate HRCT fibrotic pattern. Adjusted Odds Ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Percentage of subjects with a relative decline from baseline in FVC percent predicted of more than 10 percent at week 52 - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) which can be forcibly exhaled from the lungs after taking the deepest breath possible. Predicted normal values of FVC were calculated according to the Global Lung Initiative. FVC percent predicted (FVC % pred) is the FVC divided by its predicted value in percent. Subjects with relative decline from baseline in FVC % pred greater than 10% at week 52 were those subjects with a negative relative change from baseline in FVC % pred at week 52 the absolute value of which being greater than 10% and those subjects with missing data (worst case analysis).
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and up to 52 weeks after first drug intake
|
||||||||||||
|
|||||||||||||
Notes [40] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [41] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
Statistical analysis title |
Statistical Analysis 12 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
412
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[42] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Adjusted Odds Ratio | ||||||||||||
Point estimate |
0.63
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.43 | ||||||||||||
upper limit |
0.94 | ||||||||||||
Notes [42] - No formal hypotheses were tested. Logistic regression model with continuous covariate baseline FVC % pred. Ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Percentage of subjects with a relative decline from baseline in FVC percent predicted of more than 5 percent at week 52 - Overall population | ||||||||||||
End point description |
Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) which can be forcibly exhaled from the lungs after taking the deepest breath possible. Predicted normal values of FVC were calculated according to the Global Lung Initiative. FVC percent predicted (FVC % pred) is the FVC divided by its predicted value in percent. Subjects with relative decline from baseline in FVC % pred greater than 5% at week 52 were those subjects with a negative relative change from baseline in FVC % pred at week 52 the absolute value of which being greater than 5% and those subjects with missing data (worst case analysis).
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and up to 52 weeks after first drug intake
|
||||||||||||
|
|||||||||||||
Notes [43] - Overall population [44] - Overall population |
|||||||||||||
Statistical analysis title |
Statistical Analysis 13 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
663
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[45] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Adjusted Odds Ratio | ||||||||||||
Point estimate |
0.5
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.36 | ||||||||||||
upper limit |
0.68 | ||||||||||||
Notes [45] - No formal hypotheses were tested. Logistic regression model with continuous covariate baseline FVC % pred and binary covariate HRCT fibrotic pattern. Ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Percentage of subjects with a relative decline from baseline in FVC percent predicted of more than 5 percent at week 52 - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Forced Vital Capacity (FVC) is the volume of air (measured in milliliter) which can be forcibly exhaled from the lungs after taking the deepest breath possible. Predicted normal values of FVC were calculated according to the Global Lung Initiative. FVC percent predicted (FVC % pred) is the FVC divided by its predicted value in percent. Subjects with relative decline from baseline in FVC % pred greater than 5% at week 52 were those subjects with a negative relative change from baseline in FVC % pred at week 52 the absolute value of which being greater than 5% and those subjects with missing data (worst case analysis).
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline and up to 52 weeks after first drug intake
|
||||||||||||
|
|||||||||||||
Notes [46] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [47] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
Statistical analysis title |
Statistical Analysis 14 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
412
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[48] | ||||||||||||
Method |
Regression, Logistic | ||||||||||||
Parameter type |
Adjusted Odds Ratio | ||||||||||||
Point estimate |
0.46
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.31 | ||||||||||||
upper limit |
0.69 | ||||||||||||
Notes [48] - No formal hypotheses were tested. Logistic regression model with continuous covariate baseline FVC % pred. Ratio calculated as Nintedanib divided by Placebo. |
|
|||||||||||||
End point title |
Absolute change from baseline in Living with Pulmonary Fibrosis (L-PF) Symptoms dyspnea domain score at week 52 - Overall population | ||||||||||||
End point description |
Living with Pulmonary Fibrosis (L-PF) questionnaire with 44 items in two modules: Symptoms (23 items with three domains: dyspnea, cough and fatigue and a total score) and Impacts (21 items as a single score). L-PF Symptoms dyspnea domain score (dyspnea score) ranges from 0-100, with higher scores indicating greater impairment. A score was set to missing if ≥50 % items were missing. Absolute change from baseline at week 52 based on a Mixed Model Repeated Measures, with fixed effects for baseline dyspnea score, HRCT fibrotic pattern, visit, treatment-by-visit interaction, baseline dyspnea score-by-visit interaction and random effect for subject, visit as repeated measure. Adjusted mean is based on all analysed subjects in the model (not only subjects with a baseline and measurement at week 52).
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
|
||||||||||||
|
|||||||||||||
Notes [49] - Overall Population [50] - Overall Population |
|||||||||||||
Statistical analysis title |
Statistical Analysis 15 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
652
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[51] | ||||||||||||
Method |
Mixed Model Repeated Measures | ||||||||||||
Parameter type |
Adjusted mean difference | ||||||||||||
Point estimate |
-3.53
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-6.14 | ||||||||||||
upper limit |
-0.92 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
1.33
|
||||||||||||
Notes [51] - No formal hypotheses were tested. Fixed effects: baseline, HRCT fibrotic pattern, visit, treatment−by−visit interaction, baseline−by−visit interaction, random effect: participant. Adjusted mean difference was calculated as Nintedanib – Placebo. |
|
|||||||||||||
End point title |
Absolute change from baseline in L-PF Symptoms dyspnea domain score at week 52 - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Living with Pulmonary Fibrosis (L-PF) questionnaire with 44 items in two modules: Symptoms (23 items with three domains: dyspnea, cough and fatigue and a total score) and Impacts (21 items as a single score). L-PF Symptoms dyspnea domain score (dyspnea score) ranges from 0-100, with higher scores indicating greater impairment. A score was set to missing if ≥50 % items were missing. Absolute change from baseline at week 52 based on a Mixed Model Repeated Measures, with fixed effects for baseline dyspnea score, visit, treatment-by-visit interaction, baseline dyspnea score treatment-by-visit interaction and random effect for subject, visit as repeated measure. Adjusted mean is based on all analysed subjects in the model (not only subjects with a baseline and measurement at week 52).
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
Baseline, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
|
||||||||||||
|
|||||||||||||
Notes [52] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [53] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
|||||||||||||
Statistical analysis title |
Statistical Analysis 16 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
||||||||||||
Number of subjects included in analysis |
405
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
[54] | ||||||||||||
Method |
Mixed Model Repeated Measures | ||||||||||||
Parameter type |
Adjusted mean difference | ||||||||||||
Point estimate |
-4.18
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-7.48 | ||||||||||||
upper limit |
-0.88 | ||||||||||||
Variability estimate |
Standard error of the mean
|
||||||||||||
Dispersion value |
1.68
|
||||||||||||
Notes [54] - No formal hypotheses were tested. Fixed effects: baseline, visit, treatment−by−visit interaction, baseline−by−visit interaction, random effect: participant. Adjusted mean difference was calculated as Nintedanib – Placebo. |
|
|||||||||||||
End point title |
Absolute change from baseline in L-PF Symptoms cough domain score at week 52 - Overall population | ||||||||||||
End point description |
Living with Pulmonary Fibrosis (L-PF) questionnaire with 44 items in two modules: Symptoms (23 items with three domains: dyspnea, cough and fatigue and a total score) and Impacts (21 items as a single score). L-PF Symptoms cough domain score (cough score) ranges from 0-100, higher scores indicating greater impairment. A score was set to missing if ≥50 % items were missing. Absolute change from baseline at week 52 based on a Mixed Model Repeated Measures, with fixed effects for baseline cough score, HRCT fibrotic pattern, visit, treatment-by-visit interaction, baseline cough score-by-visit interaction and random effect for subject, visit as repeated measure. Adjusted mean is based on all analysed subjects in the model (not only subjects with a baseline and measurement at week 52).
Overall Population: All randomised subjects in the overall population who received at least 1 dose of trial medication.
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End point type |
Secondary
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End point timeframe |
Baseline, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
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Notes [55] - Overall population [56] - Overall population |
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Statistical analysis title |
Statistical Analysis 17 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
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Number of subjects included in analysis |
647
|
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Analysis specification |
Pre-specified
|
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Analysis type |
[57] | ||||||||||||
Method |
Mixed Model Repeated Measures | ||||||||||||
Parameter type |
Adjusted mean difference | ||||||||||||
Point estimate |
-6.09
|
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-9.65 | ||||||||||||
upper limit |
-2.53 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
1.81
|
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Notes [57] - No formal hypotheses were tested. Fixed effects: baseline, HRCT fibrotic pattern, visit, treatment−by−visit interaction, baseline−by−visit interaction, random effect: participant. Adjusted mean difference was calculated as Nintedanib – Placebo. |
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End point title |
Absolute change from baseline in Living with Pulmonary Fibrosis (L-PF) Symptoms cough domain score at week 52 - Subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only | ||||||||||||
End point description |
Living with Pulmonary Fibrosis (L-PF) with 44 items in two modules: Symptoms (23 items with three domains: dyspnea, cough and fatigue and a total score) and Impacts (21 items as a single score). L-PF Symptoms cough domain score (cough score) ranges from 0-100, higher scores indicating greater impairment. A score was set to missing if ≥50 % items were missing. Absolute change from baseline at week 52 based on a Mixed Model Repeated Measures, with fixed effects for baseline cough score, visit, treatment-by-visit interaction, baseline cough score-by-visit interaction and random effect for subject, visit as repeated measure. Adjusted mean is based on all analysed subjects in the model (not only subjects with a baseline and measurement at week 52).
Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only: All randomised subjects with HRCT fibrotic pattern=UIP-like fibrotic pattern only who received at least 1 dose of trial medication.
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End point type |
Secondary
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End point timeframe |
Baseline, 12, 24, 36, 52 weeks after first drug intake (planned post-baseline visits)
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Notes [58] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only [59] - Subjects with HRCT fibrotic pattern = UIP-like fibrotic pattern only |
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Statistical analysis title |
Statistical Analysis 18 | ||||||||||||
Comparison groups |
150 mg Nintedanib v Placebo
|
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Number of subjects included in analysis |
402
|
||||||||||||
Analysis specification |
Pre-specified
|
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Analysis type |
[60] | ||||||||||||
Method |
Mixed Model Repeated Measures | ||||||||||||
Parameter type |
Adjusted mean difference | ||||||||||||
Point estimate |
-7.28
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Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
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lower limit |
-11.86 | ||||||||||||
upper limit |
-2.71 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
2.33
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Notes [60] - No formal hypotheses were tested. Fixed effects: baseline, visit, treatment−by−visit interaction, baseline−by−visit interaction, random effect: participant. Adjusted mean difference was calculated as Nintedanib – Placebo. |
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Adverse events information
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Timeframe for reporting adverse events |
Treatment period plus 28 days (residual effect period), up to 836 days.
Time frame for All-Cause-Mortality: Treatment period plus Follow-up, up to 900 days.
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Adverse event reporting additional description |
All participants who signed the informed consent.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
22.0
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Reporting groups
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Reporting group title |
150 mg Nintedanib
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Reporting group description |
150 milligram (mg) Nintedanib as soft gelatine capsule, administered orally, twice daily (bid), with optional dose reduction to 100 mg bid to manage adverse events (AEs). Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, participants continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
150 mg Nintedanib matching placebo, soft gelatine capsule, administered orally, bid, with optional dose reduction to 100 mg bid to manage AEs. Continuous daily dosing over a 52-week treatment period (Part A). After completion of the 52-week treatment period, participants continued on blinded treatment until the end of the trial or until a reason for treatment withdrawal was met (Part B). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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21 Dec 2016 |
To address a recommendation by the FDA, the primary analysis of the primary endpoint was also planned to be performed in the complementary population of patients with other High Resolution Computed Tomography (HRCT) fibrotic patterns; Serum banking was changed from mandatory to optional to ensure that the trial could be conducted according to regulatory and ethical requirements in the participating countries; Flow chart Part B was updated to ensure that Electrocardiogram (ECG) was also performed at end of trial part B (EOTB); Scoring instructions for Living with Pulmonary Fibrosis (L-PF) domains were updated; Information was added to adapt informed consent handling for specific regulatory requirements in Japan; |
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08 Jun 2018 |
Following main changes were introduced: End of trial (EOT) and roll over in the open-label extension trial: After BI communicated end of the trial, EOTB Visit was performed in all ongoing patients. Patients receiving trial medication until end of Part B could be eligible for open-label treatment with nintedanib in a separate trial. Trial 1199.247 was planned to last until all patients completed EOTB Visit and Follow-up Visit as applicable; End of trial part A (EOTA) was done in cases of premature trial medication discontinuation during Part A of the trial with a Follow-up Visit 4 weeks later. A scheduled visit (V3-V9) could be skipped if EOTA or Follow-up Visit occurred within 4 weeks prior to scheduled visits; In case of premature discontinuation of trial medication during Part B, EOTB was done as soon as possible after last drug intake and a Follow-up Visit was to be completed 4 weeks after EOTB. A scheduled visit could be skipped if EOTB or Follow-up Visit occurred within 4 weeks prior to scheduled visits. For patients completing the trial regularly, EOTB was scheduled after BI’s communication of the end of the trial. For patients not rolling over in the separate open-label trial, a Follow-up Visit was completed 4 weeks after EOTB. The specific time window for EOTB was removed, time intervals for Visits X and Xa corrected, and the need for Interactive Response Technology (IRT) call included; All adverse events (AE)s (non-serious and serious), all AE of special interest (AESIs) were collected after the EOT, including the residual effect period until the individual patient’s end of trial; Additional AE analyses were specified to take the half-life of the trial drug into account: AEs that occurred between start of treatment and up to 7 days after date of last dose of trial medication were analysed in addition; Details were added regarding drug induced liver injury (DILI) handling: Potential DILI cases were defined as AESIs and a DILI checklist had to be completed. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |