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    The EU Clinical Trials Register currently displays   43851   clinical trials with a EudraCT protocol, of which   7283   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    Summary
    EudraCT Number:2015-005212-14
    Sponsor's Protocol Code Number:200812
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2016-02-24
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2015-005212-14
    A.3Full title of the trial
    A phase IIIB, 24-week randomised, double-blind study to compare 'closed' triple therapy (FF/UMEC/VI) with 'open' triple therapy (FF/VI + UMEC), in subjects with chronic obstructive pulmonary disease (COPD)
    Estudio fase IIIB, aleatorizado, doble ciego, de 24 semanas de duración, para comparar la terapia triple 'cerrada' (FF/UMEC/VI) con la terapia triple 'abierta' (FF/VI + UMEC), en sujetos con enfermedad pulmonar obstructiva crónica (EPOC)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A 24 week study comparing 'closed' triple therapy delivered as
    FF/UMEC/VI vs 'open' triple therapy delivered as FF/VI + UMEC in COPD patients.
    Estudio de 24 semanas de duración, para comparar la terapia triple 'cerrada' administrada como FF/UMEC/VI frente a la terapia triple 'abierta' administratda como FF/VI + UMEC, en pacientes con EPOC
    A.3.2Name or abbreviated title of the trial where available
    200812
    A.4.1Sponsor's protocol code number200812
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorGlaxoSmithKline, S.A.
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportGlaxoSmithKline, Research and Development Ltd
    B.4.2CountryUnited Kingdom
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline
    B.5.2Functional name of contact pointCentro de Información
    B.5.3 Address:
    B.5.3.1Street AddressC/Severo Ochoa, 2 (P.T.M.)
    B.5.3.2Town/ cityTres Cantos (Madrid)
    B.5.3.3Post code28760
    B.5.3.4CountrySpain
    B.5.4Telephone number902202700
    B.5.5Fax number918070479
    B.5.6E-mailes-ci@gsk.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameFluticasone Furoate/Umeclidinium/Vilanterol
    D.3.2Product code GW685698/GSK573719/GW642444
    D.3.4Pharmaceutical form Inhalation powder, pre-dispensed
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPInhalation use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNFLUTICASONE FUROATE
    D.3.9.1CAS number 397864-44-7
    D.3.9.2Current sponsor codeGW685698
    D.3.9.4EV Substance CodeSUB26593
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNUmeclidinium
    D.3.9.1CAS number 869113-09-7
    D.3.9.2Current sponsor codeGSK573719
    D.3.9.3Other descriptive nameGSK573719A
    D.3.9.4EV Substance CodeSUB31865
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number62.5
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNVilanterol Trifenatate
    D.3.9.1CAS number 503070-58-4
    D.3.9.2Current sponsor codeGW642444
    D.3.9.3Other descriptive nameGW642444M
    D.3.9.4EV Substance CodeSUB30696
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Relvar Ellipta
    D.2.1.1.2Name of the Marketing Authorisation holderGlaxo Group Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameFluticasone Furoate/Vilanterol
    D.3.2Product code GW685698/GW642444
    D.3.4Pharmaceutical form Inhalation powder, pre-dispensed
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPInhalation use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNFLUTICASONE FUROATE
    D.3.9.1CAS number 397864-44-7
    D.3.9.2Current sponsor codeGW685698
    D.3.9.4EV Substance CodeSUB26593
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNVilanterol Trifenatate
    D.3.9.1CAS number 503070-58-4
    D.3.9.3Other descriptive nameGW642444M
    D.3.9.4EV Substance CodeSUB30696
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Incruse®
    D.2.1.1.2Name of the Marketing Authorisation holderGlaxo Group Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameUMECLIDINIUM BROMIDE
    D.3.2Product code GSK573719
    D.3.4Pharmaceutical form Inhalation powder, pre-dispensed
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPInhalation use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNUmeclidinium
    D.3.9.1CAS number 869113-09-7
    D.3.9.3Other descriptive nameGSK573719A
    D.3.9.4EV Substance CodeSUB31865
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number62.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboInhalation powder, pre-dispensed
    D.8.4Route of administration of the placeboInhalation use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    in subjects with chronic obstructive pulmonary disease (COPD)
    sujetos con enfermedad pulmonar obstructiva crónica (EPOC)
    E.1.1.1Medical condition in easily understood language
    Chronic Obstructive Pulmonary Disease (COPD) is a condition that affects the lungs in which people can: Feel as if they cannot breathe, feel their chest is tight, have coughing, have excess mucus.
    La enfermedad pulmonar obstructiva crónica (EPOC) es un trastorno que afecta a los pulmones en el que la gente puede: sentir dificultad para respirar, opresión en el pecho, tos, mucosidad excesiva.
    E.1.1.2Therapeutic area Diseases [C] - Respiratory Tract Diseases [C08]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.1
    E.1.2Level LLT
    E.1.2Classification code 10010952
    E.1.2Term COPD
    E.1.2System Organ Class 100000004855
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the effect of FF/UMEC/VI with FF/VI + UMEC on lung function after 24 weeks of treatment
    Comparar el efecto de FF/UMEC/VI con el de FF/VI + UMEC sobre la función pulmonar después de 24 semanas de tratamiento.
    E.2.2Secondary objectives of the trial
    - To compare the effects of FF/UMEC/VI with FF/VI + UMEC on health related quality of life and dyspnoea after 24 weeks of treatment.
    - To compare the effect of FF/UMEC/VI with FF/VI + UMEC on time to first moderate or severe exacerbation during 24 weeks of treatment.
    - To compare the PK of FF, UMEC and VI when given as FF/UMEC/VI or FF/VI+UMEC in a subset of subjects.
    - To compare the safety profile of FF/UMEC/VI with FF/VI + UMEC over 24 weeks of treatment.
    - Comparar los efectos de FF/UMEC/VI con el de FF/VI + UMEC sobre la calidad de vida relacionada con la salud y la disnea después de 24 semanas de tratamiento.
    - Comparar el efecto de FF/UMEC/VI con el de FF/VI + UMEC sobre el tiempo hasta la primera exacerbación moderada o grave durante 24 semanas de tratamiento.
    - Comparar la FC de FF, UMEC y VI al administrarlos como FF/UMEC/VI y como FF/VI+UMEC en un subgrupo de pacientes.
    - Comparar el perfil de seguridad de FF/UMEC/VI con el de FF/VI + UMEC a lo largo de 24 semanas de tratamiento.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Hair Sample, Scalp & Finger Secretion PK Sub-Study, Apendix 12.8. of Protocol of main study version 01, dated 25JAN2016. The objective is to To collect hair samples, and scalp and finger sweat, in a non-invasive way, for PK analysis among COPD subjects taking part in PK subset A, in Study 200812.
    Subestudio farmacocinético en muestra de pelo, cuero cabelludo y secreción de los dedos, Apéndice 12.8 del Protocolo del estudio principal v. 01 de fecha 25-ene-2016. El objetivo es recoger muestras de pelo, cuero cabelludo y sudor de los dedos, de forma no invasiva, para el análisis farmacocinético entre los sujetos con EPOC que formen parte del subgrupo A de farmacocinética, en el estudio 200812.
    E.3Principal inclusion criteria
    1. Informed Consent: A signed and dated written informed consent prior to study participation.
    2. Type of subject: Outpatient.
    3. Age: Subjects 40 years of age or older at Screening (V1).
    4. Gender: Male or female subjects.
    Females:
    A female subject is eligible to participate if she is not pregnant (as confirmed by a negative urine human chorionic gonadotrophin (hCG) test), not lactating, and at least one of the following conditions applies:
    a. Non-reproductive potential defined as:
    - Pre-menopausal females with one of the following:
    - Documented tubal ligation
    - Documented hysteroscopic tubal occlusion procedure with follow-up confirmation of bilateral tubal occlusion
    - Hysterectomy
    - Documented Bilateral Oophorectomy
    - Postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) and estradiol levels consistent with menopause (refer to laboratory reference ranges for confirmatory levels)]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the highly effective contraception methods if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrolment.
    b. Reproductive potential and agrees to follow one of the options listed in the Modified List of Highly Effective Methods for Avoiding Pregnancy in Females of Reproductive Potential (FRP) (see Appendix 5) from 30 days prior to the first dose of study treatmentand until after the last dose of study treatmentand completion of the follow-up visit.
    The investigator is responsible for ensuring that subjects understand how to properly use these methods of contraception.
    5. COPD Diagnosis: An established clinical history of COPD in accordance with the definition by the American Thoracic Society/European Respiratory Society [Celli, 2004].
    6. Smoking History: Current or former cigarette smokers with a history of cigarette smoking of ?10 pack-years at Screening (V1) [number of pack years = (number of cigarettes per day/20) x number of years smoked (e.g., 20 cigarettes per day for 10 years, or 10 cigarettes per day for 20 years)]. Previous smokers are defined as those who have stopped smoking for at least 6 months prior to Screening (V1).
    NOTES:
    - Pipe and/or cigar use cannot be used to calculate pack-year history.
    7. Severity of COPD symptoms: A score of ?10 on the COPD Assessment Test (CAT) at Screening (V1).
    8. Severity of COPD Disease: A post-albuterol/salbutamol FEV1/FVC ratio of <0.70 at Screening (V1).
    9. Existing COPD maintenance treatment: Subject must be receiving daily maintenance treatment for their COPD for at least 3 months prior to Screening (V1).
    NOTES:
    - Subjects receiving only PRN COPD medications are not eligible.
    10. History of Exacerbations: Subjects must demonstrate:
    a post-bronchodilator FEV1 < 50% predicted normal at Screening (V1) and a documented history of ? 1 moderate or severe COPD exacerbation in the 12 months prior to Screening
    OR
    a post-bronchodilator 50% ?FEV1 < 80% predicted normal at Screening (V1) and a documented history of ? 2 moderate exacerbations or a documented history of ?1 severe COPD exacerbation (hospitalised) in the 12 months prior to Screening (V1).
    NOTES:
    - Percent predicted will be calculated using the European Respiratory Society Global Lung Function Initiative reference equations [Quanjer, 2012].
    - A documented history of a COPD exacerbation (e.g., medical record verification) is a medical record of worsening COPD symptoms that required systemic/oral corticosteroids and/or antibiotics (for a moderate exacerbation) or hospitalisation (for a severe exacerbation). Prior use of antibiotics alone does not qualify as an exacerbation history unless the use was associated with treatment of worsening symptoms of COPD, such as increased dyspnoea, sputum volume, or sputum purulence (colour). Subject verbal reports are not acceptable.
    11. French subjects: In France, a subject will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category.
    1. Consentimiento informado: Se debe firmar y fechar el consentimiento informado antes de la participación en el estudio.
    2. Tipo de sujeto: Ambulatorio.
    3. Edad: Sujetos de 40 años o mayores en la selección (V1).
    4. Sexo: Hombres y mujeres.
    Mujeres:
    Podrán participar mujeres que no estén embarazadas (confirmado con un resultado negativo para la gonadotropina coriónica humana (hCG) en orina) ni en período de lactancia y que cumplan al menos una de las condiciones siguientes:
    a. Ausencia de capacidad reproductiva, definida como:
    - Mujeres premenopáusicas con alguna de las circunstancias siguientes:
    - Ligadura de trompas documentada.
    - Procedimiento documentado de oclusión histeroscópica de trompas con confirmación de seguimiento de ligadura de trompas bilateral.
    - Histerectomía
    - Ooforectomía bilateral documentada
    - Mujeres posmenopáusicas, definido como 12 meses de amenorrea espontánea [en los casos dudosos, una muestra de sangre con niveles simultáneos de la hormona foliculoestimulante (FSH) y estradiol compatibles con menopausia (consúltense los niveles de confirmación en los valores de referencia del laboratorio)]. A las mujeres que estén recibiendo tratamiento hormonal sustitutivo (THS) y cuya situación menopáusica esté en duda, se les exigirá utilizar uno de los métodos anticonceptivos eficaces si desean continuar con el THS durante el estudio. De lo contrario, deberán interrumpir el THS para poder confirmar la situación posmenopáusica antes de su inclusión en el estudio.
    b. En edad fértil y con el compromiso de seguir una de las opciones enumeradas en la lista modificada de métodos eficaces para evitar el embarazo en mujeres fértiles (véase el Apéndice 5) desde 30 días antes de la primera dosis del tratamiento del estudio y hasta después de la última dosis del tratamiento del estudio y la finalización de la visita de seguimiento.
    El investigador es responsable de garantizar que los pacientes conozcan el modo de uso correcto de estos métodos anticonceptivos.
    5. Diagnóstico de EPOC: Historia clínica establecida de EPOC de acuerdo con la definición de la American Thoracic Society/European Respiratory Society (ERS) [Celli, 2004].
    6. Historia de fumador: Fumador actual o antiguo de ?10 cajetillas-año en la selección (V1) [número de cajetillas-año = (número de cigarrillos al día / 20) x número de años de fumador (p. ej., 20 cigarrillos al día durante 10 años o 10 cigarrillos al día durante 20 años)] en la selección (V1). Los fumadores antiguos se definen como aquellos que han dejado de fumar al menos 6 meses antes de la selección (V1).
    NOTAS:
    - El tabaco de pipa y/o cigarro puro no se pueden utilizar para calcular la historia de paquetes-año.
    7. Gravedad de los síntomas de EPOC: Una puntuación de ? 10 en el cuestionario de evaluación de la EPOC (CAT) en la selección (V1).
    8. Gravedad de la enfermedad EPOC: Cociente FEV1/FVC post-albuterol/salbutamol < 0,70 en la selección (V1).
    9. Tratamiento de mantenimiento de la EPOC: El sujeto debe estar recibiendo tratamiento de mantenimiento diario para la EPOC al menos durante 3 meses antes de la selección (V1).
    NOTA:
    - Los sujetos que solo estén recibiendo medicación a demanda para la EPOC no son elegibles.
    10. Historia de exacerbaciones: Los sujetos deben demostrar:
    un FEV1 post-broncodilatador < 50% del valor teórico en la selección (V1) y una historia documentada de ? 1 exacerbación moderada o grave de la EPOC en los 12 meses previos a la selección.
    O
    un FEV1 post-broncodilatador ? 50% y < 80% del valor teórico en la selección (V1) y una historia documentada de ? 2 exacerbaciones moderadas o una historia documentada de ? 1 exacerbación grave (hospitalización) de la EPOC en los 12 meses previos a la selección (V1).
    NOTAS:
    - El porcentaje teórico se calculará utilizando las ecuaciones de referencia de la European Respiratory Society Global Lung Function Initiative [Quanjer, 2012]
    - Una historia documentada de una exacerbación de la EPOC (p. ej., verificación de un registro médico) es un informe médico de empeoramiento de los síntomas de la EPOC que requiere corticoides sistémicos/orales y/o antibióticos (para una exacerbación moderada) o la hospitalización (para una exacerbación grave). El uso previo de antibióticos solos no se considera antecedente de exacerbación, a menos que estuviera asociado al tratamiento del empeoramiento de los síntomas de la EPOC, como el aumento de la disnea, el volumen del esputo o la purulencia del esputo (color). Los informes verbales del sujeto no son aceptables.
    11. Solo para sujetos franceses: En Francia, solo podrán participar en este estudio sujetos afiliados o beneficiarios de algún régimen de la seguridad social.
    E.4Principal exclusion criteria
    1. Pregnancy: Women who are pregnant or lactating or are planning on becoming pregnant during the study.
    2. Asthma: Subjects with a current diagnosis of asthma. (Subjects with a prior history of asthma are eligible if they have a current diagnosis of COPD, which is the primary cause of their respiratory symptoms).
    3. alfa-1-antitrypsin deficiency: Subjects with alfa-1-antitrypsin deficiency as the underlying cause of COPD.
    4. Other respiratory disorders: Subjects with active tuberculosis are excluded. Subjects with other respiratory disorders are excluded if these conditions are the primary cause of their respiratory symptoms.
    5. Lung resection: Subjects with lung volume reduction surgery (including procedures such as endobronchial valves) within the 12 months prior to Screening (V1).
    6. Risk Factors for Pneumonia: immune suppression (e.g. advanced HIV with high viral load and low CD4 count, Lupus on immunosuppressants that would increase risk of pneumonia) or other risk factors for pneumonia.
    7. Pneumonia and/or moderate or severe COPD exacerbation that has not resolved at least 14 days prior to Screening (V1) and at least 30 days following the last dose of oral/systemic corticosteroids (if applicable).
    8. Other Respiratory tract infections that have not resolved at least 7 days prior to Screening (V1).
    9. Abnormal Chest x-ray: Chest x-ray reveals evidence of pneumonia or a clinically significant abnormality not believed to be due to the presence of COPD, or another condition that would hinder the ability to detect an infiltrate on chest x-ray.
    10. Other diseases/abnormalities: Subjects with historical or current evidence of clinically significant cardiovascular, neurological, psychiatric, renal, hepatic, immunological, gastrointestinal, urogenital, nervous system, musculoskeletal, skin, sensory, endocrine (including uncontrolled diabetes or thyroid disease) or haematological abnormalities that are uncontrolled.
    11. Unstable liver disease: ALT >2xULN; and bilirubin >1.5xULN (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). Current active liver or biliary disease.
    12. Unstable or life threatening cardiac disease: subjects with any of the following at Screening (V1) would be excluded:
    - Myocardial infarction or unstable angina in the last 6 months
    - Unstable or life threatening cardiac arrhythmia requiring intervention in the last 3 months
    - NYHA Class IV Heart failure
    13. Abnormal and clinically significant 12-Lead ECG finding: An abnormal and clinically significant finding that would preclude a subject from entering the trial is defined as a 12-lead tracing that is interpreted as, but not limited to, any of the following:
    - AF with rapid ventricular rate >120 BPM;
    - sustained or nonsustained VT;
    - Second degree heart block Mobitz type II and third degree heart block (unless pacemaker or defibrillator had been inserted)
    14. Contraindications: A history of allergy or hypersensitivity to any corticosteroid, anticholinergic/muscarinic receptor antagonist, beta2-agonist, lactose/milk protein or magnesium stearate or a medical condition such as narrow-angle glaucoma, prostatic hypertrophy or bladder neck obstruction that, in the opinion of the investigator contraindicates study participation.
    15. Cancer: Subjects with carcinoma that has not been in complete remission for at least 3 years. Subjects who have had carcinoma in situ of the cervix, squamous cell carcinoma and basal cell carcinoma of the skin would not be excluded based on the 3 year waiting period if the subject has been considered cured by treatment.
    16. Oxygen therapy: Use of long-term oxygen therapy (LTOT) described as resting oxygen therapy >3L/min (Oxygen use ?3L/min flow is not exclusionary.)
    17. Medication prior to spirometry: Subjects who are medically unable to withhold their albuterol/salbutamol for the 4-hour period required prior to spirometry testing at each study visit.
    18. Drug/alcohol abuse: Subjects with a known or suspected history of alcohol or drug abuse within the last 2 years.
    19. Non-compliance: Subjects at risk of non-compliance, or unable to comply with the study procedures. Any infirmity, disability, or geographic location that would limit compliance for scheduled visits.
    20. Questionable validity of consent: Subjects with a history of psychiatric disease, intellectual deficiency, poor motivation or other conditions that will limit the validity of informed consent to participate in the study.
    21. Affiliation with investigator site.
    22. Inability to read.
    23. Medication prior to Screening: Use of the medications stated in Table 1 of Protocol.
    1. Embarazo: mujeres en estado de gestación o lactancia o que tengan previsto quedarse embarazadas durante el estudio.
    2. Asma: sujetos con un diagnóstico actual de asma. (Los sujetos con historia de asma son elegibles si tienen un diagnóstico actual de EPOC que sea la causa principal de sus síntomas respiratorios).
    3. Deficiencia de alfa-1-antitripsina: sujetos con deficiencia de alfa-1 antitripsina como causa subyacente de la EPOC.
    4. Otros enfermedades respiratorias: quedan excluidos los pacientes con tuberculosis activa. Los pacientes con otras enfermedades respiratorias quedan excluidos si estas enfermedades son la causa principal de sus síntomas respiratorios.
    5. Resección pulmonar: sujetos sometidos a una cirugía de reducción del volumen pulmonar (incluidos procedimientos como la implantación de válvulas endobronquiales) en los 12 meses anteriores a la selección (V1).
    6. Factores de riesgo de neumonía: supresión inmune (p. ej., VIH avanzado con carga viral elevada y recuento de CD4 bajo, lupus con inmunodepresores que aumentarían el riesgo de neumonía) u otros factores de riesgo de neumonía.
    7. Neumonía y/o exacerbación moderada o grave de la EPOC que no se haya resuelto al menos 14 días antes de la selección (V1) y al menos 30 días después de la última dosis de corticosteroides orales/sistémicos (si procede).
    8. Otras infecciones respiratorias que no se hayan resuelto al menos 7 días antes de la selección (V1).
    9. Anomalías en la radiografía de tórax: Radiografía de tórax con evidencia de neumonía o una anomalía clínicamente significativa que no se considere debida a la EPOC, u otro trastorno que impediría la detección de un infiltrado en la radiografía de tórax.
    10. Otras enfermedades o anomalías: Sujetos con evidencia histórica o actual de enfermedad clínicamente significativa de tipo cardiovascular, neurológica, psiquiátrica, renal, hepática, inmunológica, gastrointestinal, urogenital, del sistema nervioso, musculoesquelética, cutánea, sensorial, endocrina (incluida la diabetes o la enfermedad tiroidea no controlada) o anomalías hematológicas no controladas.
    11. Enfermedad hepática inestable: ALT > 2 x LSN y bilirrubina > 1,5 x LSN (un valor aislado de bilirrubina > 1,5 x LSN es aceptable si la bilirrubina está fraccionada y la bilirrubina directa es < 35 %). Enfermedad hepática o biliar activa actual.
    12. Cardiopatía inestable o que amenace la vida: los sujetos con cualquiera de las siguientes en la Selección (Visita 1) serán excluidos:
    - Infarto de miocardio o angina inestable en los 6 últimos meses
    - Arritmia cardiaca inestable o que amenaza la vida que requiere intervención en los 3 últimos meses
    - Insuficiencia cardiaca de Clase IV de la NYHA
    13. Hallazgos anormales y clínicamente significativos en el ECG de 12 derivaciones: Un hallazgo anormal y clínicamente significativo que impida la participación del sujeto en el estudio se define como un trazado de 12 derivaciones que se interpreta, pero no se limita a cualquiera de los siguientes:
    - FA con frecuencia ventricular rápida >120 lpm
    - TV sostenida o no sostenida;
    - Bloqueo cardíaco de 2º grado tipo Mobitz II y bloqueo cardíaco de 3º grado (a menos que se haya colocado un marcapasos o desfibrilador).
    14. Contraindicaciones: Historia de alergia o hipersensibilidad a cualquier corticoide, antagonista de los receptores anticolinérgicos/muscarínicos, beta2-agonista, lactosa/proteínas de la leche o estearato de magnesio o una enfermedad como el glaucoma de ángulo cerrado, la hipertrofia prostática o la obstrucción del cuello de la vejiga que, a juicio del médico del estudio, contraindique la participación en el estudio.
    15. Cáncer: Sujetos con un carcinoma que no haya estado en remisión completa al menos durante 3 años. Los sujetos que hayan tenido carcinoma in situ de cuello de útero, carcinoma de células escamosas y carcinoma cutáneo de células basales no serán excluidos basado en el periodo de espera de 3 años si se considera que el tratamiento ha sido curativo.
    16. Oxigenoterapia: Uso prolongado de oxigenoterapia (LTOT) descrito como oxigenoterapia en reposo de >3 l/min (el uso de ?3 l/min de oxígeno no es excluyente).
    17. Medicación previa a la espirometría: Sujetos que sean incapaces de suspender el albuterol/salbutamol durante el periodo de 4 horas previo a la espirometría realizada en cada visita.
    18. Abuso de alcohol/drogas: Historia conocida o sospecha de abuso de alcohol o drogas en los 2 últimos años.
    19. Incumplimiento: Sujetos con riesgo de incumplimiento o incapaces de cumplir con los procedimientos del estudio. Cualquier enfermedad, minusvalía o localización geográfica que limitaría el cumplimiento de las visitas programadas.
    20. Validez cuestionable del consentimiento.
    21. Afiliación con el centro del investigador.
    22. Incapacidad de leer.
    23. Medicación previa a la selección: Empleo de las medicaciones indicados en la Tabla 1.
    E.5 End points
    E.5.1Primary end point(s)
    Change from baseline in trough FEV1 at 24 weeks.
    Variación del FEV1 valle a las 24 semanas respecto al momento basal
    E.5.1.1Timepoint(s) of evaluation of this end point
    Spirometry will be done at visits 2,3,4 and 5.
    Se hará una espirometría en las visitas 2, 3, 4 y 5.
    E.5.2Secondary end point(s)
    - Proportion of Responders based on the St George Respiratory Questionnaire (SGRQ) Total Score at Week 24
    - Change from baseline in SGRQ Total Score at Week 24
    - Proportion of Responders based on Transitional Dyspnoea Index (TDI) focal score at Week 24
    - TDI focal score at Week 24
    - Time to first moderate or severe exacerbation
    - Population PK (in a subset of approximately 180 subjects)
    - Incidence of adverse events and adverse events of special interest,
    - ECG measurements
    - Vital signs
    - Haematological and clinical chemistry parameters
    - Proporción de pacientes que presenta respuesta, según la puntuación total del Cuestionario Respiratorio de St. George (SGRQ) en la semana 24.
    - Variación de la puntuación total del SGRQ en la semana 24 respecto al momento basal.
    - Proporción de pacientes que presenta respuesta, según la puntuación focal del índice de transición de la disnea (TDI) en la semana 24.
    - Puntuación focal del TDI en la semana 24
    - Tiempo hasta la primera exacerbación moderada o grave.
    - FC poblacional (en un subgrupo de unos 180 pacientes).
    - Incidencia de acontecimientos adversos.
    - Incidencia de acontecimientos adversos de interés especial.
    - Mediciones ECG.
    - Constantes vitales.
    - Parámetros hematológicos y de bioquímica clínica.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Over 24 weeks
    For PK Subgroup A: At week 12 & Week 24
    For PK Subgroup B: over 24 hrs starting at Week 12
    For PK Sub-study: At Baseline, Week 12 and Week 24
    A lo largo de 24 semanas
    Para el subgrupo A de FC: en las semanas 12 y 24
    Para el subgrupo B de FC: a lo largo de 24 horas que comienzan en las semana 12
    Para el subgrupo de FC: en la visita basal, semana 12 y 24
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA55
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Australia
    France
    Germany
    Italy
    Japan
    Korea, Republic of
    Mexico
    Poland
    Romania
    Russian Federation
    Spain
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    LSLV
    Última visita del último paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months7
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months7
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 510
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 510
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state42
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 492
    F.4.2.2In the whole clinical trial 1020
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Subjects will not receive any additional treatment from GSK after completion of the study because other treatment options are available.
    The investigator is responsible for ensuring that consideration has been given to the poststudy
    care of the subject's medical condition, whether or not GSK is providing specific post-study treatment.
    Los sujetos no recibirán ningun tratatmiento adicional de GSK tras completar el estudio porque hay otras opciones de tratamiento disponibles.
    El investigador es responsable de asegurarse de que el sujeto reciba el cuidado adecuado para su enfermedad después del estudio.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2016-04-20
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-04-12
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2017-05-23
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