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    Summary
    EudraCT Number:2017-001074-42
    Sponsor's Protocol Code Number:200879
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2017-10-24
    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 number2017-001074-42
    A.3Full title of the trial
    A Phase IIb, Randomized (Stratified), Double-Blind (Sponsor Open), Parallel-Group, Placebo-Controlled, Dose-Finding Study of Nemiralisib (GSK2269557) Added to Standard of Care (SoC) Versus SoC Alone in Participants Diagnosed with an Acute Moderate or Severe Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
    Estudio fase IIb, aleatorizado (estratificado), doble ciego (abierto para promotor), de grupos paralelos, controlado con placebo, de búsqueda de dosis de nemiralisib (GSK2269557) añadido al estándar de tratamiento frente solo al estándar de tratamiento, en pacientes diagnosticados con una exacerbación aguda moderada o grave de su enfermedad pulmonar obstructiva crónica (EPOC)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Study 200879: A 24-Week Study to Compare the Effectiveness and Safety of Nemiralisib with Placebo, Each Given in Addition to Regular Treatment and Health Care, in Adult Patients with an Acute Exacerbation of COPD
    Es un estudio de 24 semanas que busca comparar la eficacia y seguridad de Nemiralisib frente a placebo cuando se añade al tratamiento estándar para pacientes adultos exacerbación aguda de su EPOC.
    A.3.2Name or abbreviated title of the trial where available
    Ph2b, Dose-Finding, Placebo-Controlled, Efficacy and Safety Study of Nemiralisib (GSK2269557)
    Estudio de fase IIb, controlado con placebo, de búsqueda de dosis, eficacia y seguridad sobre Nemira
    A.4.1Sponsor's protocol code number200879
    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 number34902202700
    B.5.5Fax number34918070479
    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 nameNemiralisib
    D.3.2Product code GSK2269557
    D.3.4Pharmaceutical form Inhalation powder
    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 INNNemiralisib succinate
    D.3.9.1CAS number 1364799-98-3
    D.3.9.2Current sponsor codeGSK2269557H
    D.3.9.3Other descriptive name6-(1H-indol-4-yl)-4-(5-{[4-(1-methylethyl)-1 piperazinyl]methyl}-1,3-oxazol-2-yl)-1H indazole hemi-succinate
    D.3.9.4EV Substance CodeSUB73036
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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 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 nameNemiralisib
    D.3.2Product code GSK2269557
    D.3.4Pharmaceutical form Inhalation powder
    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 INNNemiralisib succinate
    D.3.9.1CAS number 1364799-98-3
    D.3.9.2Current sponsor codeGSK2269557H
    D.3.9.3Other descriptive name6-(1H-indol-4-yl)-4-(5-{[4-(1-methylethyl)-1 piperazinyl]methyl}-1,3-oxazol-2-yl)-1H indazole hemi-succinate
    D.3.9.4EV Substance CodeSUB73036
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 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 nameNemiralisib
    D.3.2Product code GSK2269557
    D.3.4Pharmaceutical form Inhalation powder
    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 INNNemiralisib succinate
    D.3.9.1CAS number 1364799-98-3
    D.3.9.2Current sponsor codeGSK2269557H
    D.3.9.3Other descriptive name6-(1H-indol-4-yl)-4-(5-{[4-(1-methylethyl)-1 piperazinyl]methyl}-1,3-oxazol-2-yl)-1H indazole hemi-succinate
    D.3.9.4EV Substance CodeSUB73036
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    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: 4
    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 nameNemiralisib
    D.3.2Product code GSK2269557
    D.3.4Pharmaceutical form Inhalation powder
    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 INNNemiralisib succinate
    D.3.9.1CAS number 1364799-98-3
    D.3.9.2Current sponsor codeGSK2269557H
    D.3.9.3Other descriptive name6-(1H-indol-4-yl)-4-(5-{[4-(1-methylethyl)-1 piperazinyl]methyl}-1,3-oxazol-2-yl)-1H indazole hemi-succinate
    D.3.9.4EV Substance CodeSUB73036
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    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: 5
    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 nameNemiralisib
    D.3.2Product code GSK2269557
    D.3.4Pharmaceutical form Inhalation powder
    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 INNNemiralisib succinate
    D.3.9.1CAS number 1364799-98-3
    D.3.9.2Current sponsor codeGSK2269557H
    D.3.9.3Other descriptive name6-(1H-indol-4-yl)-4-(5-{[4-(1-methylethyl)-1 piperazinyl]methyl}-1,3-oxazol-2-yl)-1H indazole hemi-succinate
    D.3.9.4EV Substance CodeSUB73036
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number750
    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
    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
    Chronic Obstructive Pulmonary Disease
    Enfermedad Pulmonar Obstructiva Crónica
    E.1.1.1Medical condition in easily understood language
    Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
    Exacerbación aguda de la Enfermedad Pulmonar Obstructiva Crónica (EPOC)
    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 20.0
    E.1.2Level PT
    E.1.2Classification code 10009033
    E.1.2Term Chronic obstructive pulmonary disease
    E.1.2System Organ Class 10038738 - Respiratory, thoracic and mediastinal disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To characterize the dose response of nemiralisib administered in addition to SoC compared with placebo and SoC in participants diagnosed with an acute moderate or severe exacerbation of COPD
    Caracterizar la respuesta a la dosis de nemiralisib administrado adicionalmente al estándar de tratamiento en comparación con placebo y el estándar terapéutico de tratamiento en participantes diagnosticados con una exacerbación aguda moderada o grave de EPOC
    E.2.2Secondary objectives of the trial
    - To characterize the dose response and efficacy of nemiralisib administered in addition to SoC compared with placebo and SoC in participants diagnosed with an acute moderate or severe exacerbation of COPD.
    - To evaluate the treatment effect of nemiralisib in addition to SoC compared with placebo and SoC on symptoms indicative of an exacerbation and on health status using Patient-Reported Outcomes
    (PROs) in participants diagnosed with an acute moderate or severe exacerbation of COPD.
    - To evaluate the usage of rescue medication in patients diagnosed with an acute moderate or severe exacerbation of COPD.
    - To evaluate the population pharmacokinetics of nemiralisib in
    participants diagnosed with an acute moderate or severe exacerbation of COPD.
    - To assess the safety and tolerability of nemiralisib and placebo in participants diagnosed with an acute moderate or severe exacerbation of COPD.
    - Caracterizar la respuesta a la dosis y la eficacia de nemiralisib administrado adicionalmente al estándar de tratamiento en comparación con placebo y el estándar terapéutico de tratamiento en participantes diagnosticados con una exacerbación aguda moderada o grave de EPOC.
    - Evaluar el efecto terapéutico de nemiralisib añadido al estándar de tratamiento en comparación con placebo y el estándar de tratamiento sobre los síntomas que indican una exacerbación y en el estado de salud considerando los resultados referidos por los pacientes (RRP) en participantes diagnosticados con una exacerbación aguda moderada o grave de EPOC.
    - Valorar el uso de fármacos de rescate, evaluar la farmacocinética poblacional de nemiralisib y valorar la seguridad y tolerabilidad de nemiralisib y placebo en pacientes diagnosticados con una exacerbación aguda moderada o grave de EPOC.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Participants are eligible to be included in the study only if all of the following criteria apply:
    Age:
    1. 40 to 80 years of age, inclusive, at Screening (Visit 1).
    Type of Participant and Disease Characteristics:
    2. Diagnosis: An established clinical history of COPD in accordance with the definition by the American Thoracic Society/European Respiratory Society [GOLD, 2017] as follows: “Chronic obstructive pulmonary disease is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases.”
    3. Smoking History: Current or former cigarette smoker with a history of cigarette smoking of >=10 pack-years. Former smokers are defined as those who have stopped smoking for at least 6 months prior to Screening (Visit 1). 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 both equal 10 pack-years)
    4. Current Acute Exacerbation of COPD: Acute exacerbation of COPD requiring an escalation in therapy to include oral/systemic corticosteroid(s) (prednisone 40 mg/day or equivalent) for 5 days and antibiotic(s) for 7 days; the dose and/or duration of prednisone (40 mg/day or equivalent) and/or the antibiotic can be modified according to the Investigator’s/medically qualified designee’s judgement or according to local country/institution practice. Acute exacerbation to be confirmed by an experienced physician and to represent a recent worsening of at least two major and one minor symptoms, one major and two minor symptoms, or all 3 major symptoms.
    i. Major symptoms:
    a. Subjective increase in dyspnea
    b. Increase in sputum volume
    c. Change in sputum colour
    ii. Minor symptoms:
    a. Increased cough
    b. Increased wheeze
    c. Sore throat
    d. Colds (nasal discharge and/or nasal congestion)
    e. Fever (oral temperature >37.5°C) without other cause
    Weight:
    5. Body Mass Index: Body weight >=45 kg and body mass index (BMI) within the range 16-35 kg/m2 (inclusive)
    Sex:
    6. Male and female subjects are eligible to participate in the study.
    a. Female participants: A female participant is eligible to participate if she is not pregnant (see Appendix 5 of the protocol), not breastfeeding, and at least one of the following conditions applies:
    i. Not a woman of childbearing potential (WOCBP) as defined in Appendix 5 of the protocol
    OR
    ii. A WOCBP who agrees to follow the contraceptive guidance in Appendix 5 of the protocol during the 12-Week Double-Blind Treatment Period and for at least 5 halflives (10 days) after the last of double-blind study treatment.
    Informed Consent
    7. Capable of giving signed informed consent as described in Appendix 3 of the protocol, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.
    Los sujetos serán elegibles para ser incluidos en el estudio sólo si cumplen todos los criterios siguientes:
    Edad:
    1. 40-80 años en el momento de la Selección (Visita 1).
    Tipo de sujeto y características de la enfermedad:
    2. Diagnóstico: historia clínica establecida de EPOC de acuerdo con la definición de la American Thoracic Society/European Respiratory Society [GOLD, 2017], que es la siguiente: “La enfermedad pulmonar obstructiva crónica es una enfermedad común, prevenible y tratable, que se caracteriza por síntomas respiratorios persistentes y un flujo de aire limitado debido a anomalías de las vías respiratorias y/o alveolares generalmente causadas por exposición significativa a partículas o gases nocivos.”
    3. Historia de fumador: fumador actual o exfumador con una historia de >=10 paquetes-años. Los exfumadores se definen como aquellos que dejaron de fumar al menos 6 meses antes a la Selección (Visita 1).
    Número de paquetes-años = (número de cigarrillos al día/20) x número de años de fumador (por ejemplo, 20 cigarrillos al día durante 10 años o 10 cigarrillos al día durante 20 años, los dos equivaldrían a 10 paquetes-años).
    4. Exacerbación aguda de EPOC actual: exacerbación aguda de EPOC que requiera un escalado en la terapia para incluir corticosteroide(s) orales/sistémicos (prednisona 40 mg/día o equivalente) durante 5 días y antibiótico(s) durante 7 días; la dosis y/o duración de prednisona (40 mg/día o equivalente) y/o el antibiótico se pueden modificar conforme al juicio del investigador/la persona designada con cualificaciones médicas o según la práctica local de la institución/país. La exacerbación aguda debe ser confirmada por un médico con experiencia y debe presentar un empeoramiento reciente de al menos dos síntomas mayores y uno menor, un síntoma mayor y dos menores, o 3 síntomas mayores.
    i.Síntomas mayores:
    a.Aumento subjetivo de la disnea
    b.Aumento en el volumen de esputo
    c. Cambio en el color del esputo
    ii. Síntomas menores:
    a. Aumento de la tos
    b. Mayor dificultad de respiración
    c. Dolor de garganta
    d. Resfriado (secreción y/o congestión nasal)
    e. Fiebre (temperatura oral >37.5 ºC) sin otra causa
    Peso:
    5. Índice de Masa Corporal: Peso ≥ 45 kg e Índice de Masa Corporal (IMC) dentro del rango 16 – 35 kg/m2 (inclusive).
    Sexo:
    6. Hombres y mujeres son elegibles para participar en el estudio:
    Mujeres: Una mujer es elegible para participar si no está embarazada (ver Apéndice 5 en el protocolo) ni en periodo de lactancia, y si al menos una de las siguientes condiciones se cumple:
    i. No es una mujer potencialmente fértil como se define en el Apéndice 5 del protocolo
    O
    ii. Una mujer potencialmente fértil que está de acuerdo en utilizar los métodos anticonceptivos indicados en el Apéndice 5 del protocolo durante el periodo de tratamiento doble ciego de 12 semanas y durante al menos 5 semividas (10 días) después del último tratamiento doble ciego del estudio.
    Consentimiento informado:
    7. Capacidad de dar el consentimiento informado por escrito como se describe en el Apéndice 3 del protocolo, que incluirá la capacidad de cumplir los requisitos y las limitaciones enumeradas en el documento de consentimiento y en este protocolo.
    E.4Principal exclusion criteria
    Participants are excluded from the study if any of the following criteria apply:

    Medical Conditions
    1. Asthma: Current diagnosis of asthma, according to the Global Initiative for Asthma [GINA, 2017]. Participants with a prior history of asthma are eligible if they have a current diagnosis of COPD.

    2. Acute respiratory acidosis/invasive mechanical ventilation: pH < 7.30 or the need for invasive mechanical ventilation.

    3. Moderate/severe exacerbation of COPD for which SoC was started >48 hours since diagnosis.

    4. Chest X-ray (or CT scan): A chest X-ray (or CT scan) that reveals evidence of clinically significant abnormalities not believed to be due to the presence of COPD. A chest X-ray (or CT scan) must be taken at Screening (Visit 1). For sites in Germany: if a chest X-ray (or CT scan) within 1 year of Screening (Visit 1) is not available, approval to conduct a diagnostic chest X-ray (CT scan) will need to be obtained from the Federal Office for Radiation Protection (BfS).

    5. Pneumonia: Clinically significant pneumonia, identified by chest X-ray (CT scan) at Screening

    6. Other respiratory disorders: A diagnosis of α1-antitrypsin deficiency as the underlying cause of COPD, active tuberculosis, lung cancer, clinically overt bronchiectasis (Note: focal bronchiectasis is not exclusionary), sarcoidosis, pulmonary fibrosis (Note: focal fibrotic pulmonary lesions are not exclusionary), primary pulmonary hypertension, interstitial lung diseases,or any other respiratory condition that might, in the opinion of the investigator, compromise the safety of the subject or affect the interpretation of the results.

    7. Other diseases/abnormalities: A history or current evidence of clinically significant and unstable disease such as cardiovascular (e.g., patients requiring implanted cardioverter defibrillator [ICD], pacemaker requiring a rate set >60bpm, uncontrolled hypertension, New Your Heart Association Class IV [NYHA, 1994], known left ventricular ejection fraction <30%) neurological, psychiatric, renal, hepatic, immunological, endocrine (including uncontrolled diabetes or thyroid disease), peptic ulcer disease, or haematological abnormalities. Significant is defined as any disease that, in the opinion of the investigator, would put the safety of the subject at risk through participation, or which would affect the efficacy or safety analysis if the disease/condition exacerbated during the study. (Note: Participants with adequately treated and well controlled concurrent medical conditions (e.g. hypertension or noninsulin-dependent diabetes mellitus [NIDDM]) are permitted to be entered into the study).

    8. Lung resection: Having undergone lung volume reduction surgery or lung resection for any other reason e.g. lung carcinoma

    9. Liver disease:
    a. ALT > 2xULN
    b. Total Bilirubin > 1.5xULN
    i. Isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated
    and direct bilirubin <35%
    c. Current or chronic history of liver disease or known hepatic or biliary abnormalities (with the exception of Gilbert’s syndrome or asymptomatic gallstones)
    d. Presence of hepatitis B surface antigen (HBsAg) at Screening or within 3 months prior to first dose of study treatment
    e. Positive hepatitis C antibody test result at Screening or within 3 months prior to first dose of study treatment
    f. NOTE: Participants with positive Hepatitis C antibody due to prior resolved disease can be enrolled, only if a confirmatory negative Hepatitis C RNA test is obtained

    10. Positive hepatitis C RNA test result at Screening or within 3 months prior to first dose of study treatment. NOTE: Test is optional and participants with negative Hepatitis C antibody test are not required to also undergo Hepatitis C RNA testing

    11. Cancer: Carcinoma that has not been in complete remission for at least 5 years. Carcinoma in situ of the cervix, squamous cell carcinoma and basal cell carcinoma of the skin are not excluded if the participant has been considered cured within 5 years since diagnosis.

    12. Contraindications: History of allergy or hypersensitivity to any of the study medications (e.g. beta-agonists, PI3Kd inhibitors) or components of the inhalation powder (e.g., lactose). In addition, participants with a history of severe milk protein allergy that, in the opinion of the investigator, contraindicates the participant’s participation are excluded.

    For remaining exclusion criteria points 13 to 27 please refer to the protocol P 44-46.
    Los sujetos serán excluidos del estudio si se cumple cualquiera de los siguientes criterios:
    Condiciones médicas:
    1. Asma: Sujetos con diagnóstico actual de asma, de acuerdo con GINA, 2017. Los sujetos con historia previa de asma son elegibles si su diagnóstico actual es de EPOC.
    2. Acidosis respiratoria aguda/ventilación mecánica invasiva: pH <7.30 o la necesidad de ventilación mecánica invasiva.
    3. Exacerbación moderada/severa de EPOC para la cual el estándar de tratamiento se comenzó >48h antes del diagnóstico
    4. Radiografía de tórax (o una TC): una radiografía de tórax (o una TC) que revela anomalías clínicamente significativas que no se creen debidas a la presencia de EPOC. Una radiografía de tórax (o una TC) debe ser realizada en la Selección (Visita 1). Para centros en Alemania: si una radiografía de tórax (o una TC) no está disponible en el plazo de un año desde la Selección (Visita 1), la aprobación para llevar a cabo una radiografía de tórax diagnostica (o una TC) tendrá que ser obtenida de la Federal Office for Radiation Protection (BfS).
    5. Neumonía: neumonía clínicamente significativa, identificada mediante una radiografía de tórax (o una TC) en la Selección.
    6. Otras enfermedades respiratorias: una deficiencia de α1-antitripsina como causa de la EPOC, tuberculosis activa, cáncer de pulmón, bronquiectasias clínicamente manifestadas (Nota: bronquiectasias focales no son excluyentes), sarcoidosis, fibrosis pulmonar (Nota: lesiones pulmonares fibróticas focales no son excluyentes), hipertensión pulmonar primaria, enfermedades pulmonares intersticiales u otras enfermedades respiratorias que puedan, a juicio del investigador, comprometer la seguridad del sujeto o afectar a la interpretación de los resultados.
    7. Otras enfermedades/anomalías: Sujetos con evidencia histórica o actual de enfermedad clínicamente significativa e inestable de tipo cardiovascular (por ejemplo, pacientes que requieren un Desfibrilador Cardioversor Implantable), marcapasos que requiere una tasa establecida de >60 bpm, hipertensión no controlada, escala IV de la NYHA, 1994, fracción de eyección ventricular izquierda <30% conocida), neurológica, psiquiátrica, renal, hepática, inmunológica, endocrina (incluida la diabetes o la enfermedad tiroidea no controlada), úlcera péptica o anomalías hematológicas. Significativa se define como cualquier enfermedad que, a juicio del investigador, ponga en riesgo la seguridad de un sujeto a través de su participación en el estudio, o que afecte al análisis de eficacia y seguridad si la enfermedad/trastorno se exacerba durante el estudio. (Nota: sujetos con condiciones médicas concomitantes controladas y adecuadamente tratadas.
    8. Resección pulmonar: haberse sometido a cirugía de reducción del volumen pulmonar o resección pulmonar por cualquier otra razón, como por ejemplo carcinoma pulmonar.
    9. Enfermedad hepática:
    a. ALT >2x LSN (Límite Superior de la Normalidad)
    b. Bilirrubina total >1.5x LSN
    - Bilirrubina aislada >1.5xLSN (es aceptable si al fraccionar la bilirrubina directa es <35%)
    c. Historia actual o crónica de enfermedad hepática, o anomalías hepática o biliar conocidas (excepto el síndrome de Gilbert o los cálculos biliares asintomáticos).
    d. Presencia de antígeno de superficie de Hepatitis B (HBsAg) en la Selección o en el plazo de 3 meses previo a la primera dosis del tratamiento del estudio.
    e. Resultado positivo en la prueba de anticuerpo de la Hepatitis C en la Selección o en el plazo de 3 meses previo a la primera dosis de tratamiento del estudio.
    f. Nota: Sujetos que den positivos en la prueba de anticuerpo de la Hespatitis C debido a una enfermedad anterior ya resuelta pueden participar en el estudio, sólo si se obtiene confirmación mediante el resultado negativo de la prueba de ARN de la Hepatitis C.
    10. Resultado positivo en la prueba de ARN de la Hespatitis C en la Selección o en el plazo de 3 meses previo a la primera dosis del tratamiento. Nota: la prueba es opcional y los sujetos que den negativos en la prueba de anticuerpo de la Hepatitis C no tendrán que realizar también la prueba del ARN de la Hespatitis C.
    11. Cáncer: Sujetos con un carcinoma que no haya estado en remisión completa al menos durante 5 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 si se considera que el sujeto está curado en el plazo de 5 años desde el diagnóstico.
    12. Contraindicaciones: Historia de alergia o hipersensibilidad a cualquiera de los medicamentos del estudio o componentes del polvo de inhalación. Además, los sujetos con historia de alergia severa a las proteínas de la leche que, a juicio del investigador, contraindique su participación en el estudio, serán excluidos.
    Para una lista completa de los Criterios de Exclusión ver la Sección 6.2 del Protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    - Change from baseline in Clinic Visit trough forced expiratory volume in one second (FEV1) at Day 84 measured postbronchodilator.
    - Baseline is defined as the postbronchodilator FEV1 measured prior to the first dose of double-blind study treatment and post-bronchodilator on Day 1.
    - Cambio del FEV1 valle post - broncodilatador en el Día 84 frente al valor basal en la consulta médica.
    - El valor basal se define como el FEV1 post - broncodilatador obtenido antes de la primera dosis del tratamiento del estudio doble ciego y obtenido en el Día 1.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Baseline and Day 84
    Visita basal y dia 84
    E.5.2Secondary end point(s)
    - Rate of moderate and severe exacerbations over the 12-Week Treatment Period
    - Time to next moderate/severe exacerbation following index exacerbation
    - Change from baseline in Clinic Visit trough FEV1 measured pre and post-bronchodilator at Days 14, 28, 56, and 84 (Day 84: postbronchodilator is the primary endpoint; prebronchodilator
    is a secondary endpoint) and at hospital discharge (only for participants who are hospitalized for the index exacerbation)
    - Change from hospital discharge in clinic visit trough FEV1 measured pre- and postbronchodilator at Days, 14, 28, 56, and 84 (in participants hospitalized for index exacerbation only)
    EXAcerbations of Chronic Pulmonary Disease Tool (EXACT-PRO)
    - Proportion of participants achieving the EXACT definition of recovery from the index exacerbation by Days 14, 28, 56, and 84
    - Time to recovery from index exacerbation
    - Severity of subsequent HCRU-defined exacerbation(s) defined by EXACT COPD Assessment Test (CAT)
    - Proportion of responders using the CAT at Treatment Days 28, 56, and 84, and following EXACT defined recovery from the index exacerbation
    - Change from baseline (Day 1) in CAT total score at Days 28, 56, and 84 and following EXACT defined recovery from the index exacerbation
    St. George’s Respiratory Questionnaire (SGRQ) Total Score
    - Proportion of responders on the St. SGRQ total score as measured by the SGRQ for COPD Patients (SGRQ-C) at Days 28, 56, and 84
    - Change from baseline (Day 1) in SGRQ total score at Days 28, 56, and 84
    - Rescue medication use (occasions/day), averaged over each week of treatment and over the 84-day treatment period
    - The percentage of rescue-free days (24- hour periods) during each week of treatment and over the 84-day treatment period
    - Plasma nemiralisib concentrations and derived PK parameters (e.g., area under the curve [AUC (0-24) and AUC(0-t)], maximum concentration [Cmax], time at maximum concentration [Tmax], Ctrough) as appropriate will be collected in a subset of randomized participants (approximately 300) at selected sites as follows: trough
    (pre-dose) for the study treatment and postdose for the study treatment from 0-1 hour and >1 to 6 hours on Days 14 and 28 of the 12-Week Treatment Period
    - Incidence of adverse events (AEs; including serious AEs and AE of Special Interest [AESI])
    - Vital signs (pulse rate, systolic and diastolic blood pressure) (measured at each clinic visit up through Visit 7 [Day 112] or Early Withdrawal Visit)
    - 12-lead electrocardiogram (ECG) assessments (performed at clinic Visits 1 [Screening], 3 [Day 14], 6 [Day 84], and 7 [Day 112] or Early Withdrawal Visit)
    - Clinical laboratory tests (hematology and chemistry; performed at each clinic visit up through Visit 7 [Day 112] or Early Withdrawal Visit)
    - Incidence of COPD exacerbations
    - Tasa de exacerbaciones moderadas y graves durante el Periodo de tratamiento de 12 semanas
    - Tiempo hasta la siguiente exacerbación moderada/grave tras la exacerbación inicial
    - Cambio frente al valor basal en el FEV1 pre y post - broncodilatador determinado en la consulta médica los Días 14, 28, 56 y 84 (Día 84: la medición post - broncodilatadora es la variable principal de valoración; la determinación prebroncodilatador se considera una variable secundaria) y en el momento del alta hospitalaria (solo para pacientes hospitalizados por la exacerbación inicial)
    - Cambio en el FEV1 valle pre y post - broncodilatador determinado en consulta médica los Días 14, 28, 56, y 84 frente al valor en el alta hospitalaria (solo en sujetos hospitalizados por la exacerbación inicial)

    EXAcerbations of Chronic Pulmonary Disease Tool (EXACT-PRO);
    - Porcentaje de participantes que cumplen la definición de EXACT de recuperación a partir de la exacerbación inicial los Días 14, 28, 56 y 84
    - Tiempo hasta la recuperación desde la exacerbación inicial
    - Gravedad según EXACT de las exacerbaciones posteriores moderadas y graves conforme a lo definido por la utilización de recursos sanitarios (URS)
    COPD Assessment Test (CAT);
    - Porcentaje de respondedores utilizando la CAT los Días 28, 56 y 84 de tratamiento y tras la recuperación según EXACT de la exacerbación inicial
    - Cambio frente al valor basal (Día 1) en la puntuación total de CAT los Días 28, 56 y 84 y tras la recuperación según EXACT de la exacerbación inicial.

    St. George’s Respiratory Questionnaire (SGRQ) Total Score:
    - Porcentaje de respondedores conforme a la puntuación total del SGRQ según lo determinado por el SGRQ para pacientes con EPOC (SGRQ-C) los Días 28, 56 y 84
    - Cambio frente al valor basal (Día 1) en la puntuación total del SGRQ los Días 28, 56 y 84
    - Uso de fármacos de rescate (ocasional/diario), determinando el promedio a lo largo de una semana de tratamiento y durante un periodo terapéutico de 84 días.
    - Porcentaje de días sin fármacos de rescate (periodos de 24 horas) en cada semana de tratamiento y a lo largo de un periodo terapéutico de 84 días
    - Las concentraciones plasmáticas de nemiralisib y parámetros FC derivados (p. ej., área bajo la curva [ABC (0-24) y
    ABC(0-t)], concentración máxima [Cmáx], tiempo hasta la concentración máxima [Tmáx], Cmín), según corresponda, se determinarán en un subgrupo de participantes aleatorizados (aproximadamente 300) de centros seleccionados tal y como se describe a continuación: valor valle (predosis) para el tratamiento del estudio y posterior a la toma del tratamiento del estudio, de 0 a 1 hora y de >1 hora a 6 horas los Días 14 y 28 del Periodo de tratamiento de 12 semanas
    - Incidencia de acontecimientos adversos (AA; incluyendo AA graves y AA de especial interés [AAEI])
    - Constantes vitales (pulso, tensión arterial sistólica y diastólica) (determinadas en cada consulta médica hasta la Visita 7 [Día 112] o Visita de retirada temprana)
    - Evaluaciones de electrocardiograma (ECG) de 12 derivaciones (realizadas en las Visitas 1 [Selección], 3 [Día 14], 6 [Día 84] y 7 [Día 112] o Visita de retirada temprana)
    - Pruebas clínicas de laboratorio (hematología y bioquímica; realizadas en cada consulta médica hasta la Vista 7 [Día 112] o Visita de retirada temprana)
    - Frecuencia de exacerbaciones de EPOC
    E.5.2.1Timepoint(s) of evaluation of this end point
    Days 14, 28, 56, 84 and 112
    Días 14, 28, 56, 84 y 112
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic Yes
    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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    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 Yes
    E.8.1.7.1Other trial design description
    Sponsor Open
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial6
    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 concerned19
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA99
    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
    Canada
    France
    Germany
    Italy
    Korea, Republic of
    Mexico
    Netherlands
    Poland
    Romania
    Russian Federation
    Spain
    Sweden
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee Yes
    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
    LVLS
    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 months4
    E.8.9.1In the Member State concerned days2
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months4
    E.8.9.2In all countries concerned by the trial days2
    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: 450
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 800
    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 state80
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 652
    F.4.2.2In the whole clinical trial 1250
    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)
    The Investigator is responsible for ensuring that consideration has been given to the care of the participant’s medical condition whether or not GSK is providing specific poststudy treatment following the 12-week Double-Blind Treatment Period and following the 12-Week Post-Treatment Follow-Up Period.

    (Please see protocol P58 for further details.)
    El investigador es responsable de asegurarse de que se le proporciona el tratamiento médico adecuado a los pacientes reciban o no reciban el tratamiento en el periodo doble ciego de 12 semanas y posteriormente en el periodo de 12 semanas de seguimiento.

    (Ver página 58 del Protocolo para más detalles.)
    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 Decision2017-10-17
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-10-05
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2019-01-10
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