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    Clinical Trial Results:
    A randomised, double-blind, placebo-controlled, parallel group, dose-finding study evaluating efficacy, safety and tolerability of BI 1291583 qd over at least 24 weeks in patients with bronchiectasis (Airleaf™)

    Summary
    EudraCT number
    2021-003304-41
    Trial protocol
    BE   NL   ES   HU   FR   IT   LV   CZ   DE   GR   DK   PL   PT   BG  
    Global end of trial date
    30 May 2024

    Results information
    Results version number
    v1(current)
    This version publication date
    12 Jun 2025
    First version publication date
    12 Jun 2025
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    1397-0012
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT05238675
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Boehringer Ingelheim
    Sponsor organisation address
    Binger Strasse 173, Ingelheim am Rhein, Germany, 55216
    Public contact
    Boehringer Ingelheim, Call Center, Boehringer Ingelheim, 001 18002430127, clintriage.rdg@boehringer-ingelheim.com
    Scientific contact
    Boehringer Ingelheim, Call Center, Boehringer Ingelheim, 001 18002430127, clintriage.rdg@boehringer-ingelheim.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    26 Jun 2024
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    01 May 2024
    Global end of trial reached?
    Yes
    Global end of trial date
    30 May 2024
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective was to demonstrate a non-flat dose response curve and evaluate the dose-response relationship for 3 oral dosing regimens of BI 1291583 versus placebo on the primary endpoint, the time to first pulmonary exacerbation up to week 48. The secondary objective was to demonstrate superiority of BI 1291583 5 mg versus placebo on the primary endpoint, the time to first pulmonary exacerbation up to week 48, as well as on the key secondary endpoint, the rate of pulmonary exacerbations up to week 48.
    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.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    28 Apr 2022
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Australia: 35
    Country: Number of subjects enrolled
    Belgium: 8
    Country: Number of subjects enrolled
    Bulgaria: 21
    Country: Number of subjects enrolled
    Canada: 7
    Country: Number of subjects enrolled
    Czechia: 9
    Country: Number of subjects enrolled
    Denmark: 23
    Country: Number of subjects enrolled
    France: 12
    Country: Number of subjects enrolled
    Germany: 43
    Country: Number of subjects enrolled
    Greece: 1
    Country: Number of subjects enrolled
    Hungary: 21
    Country: Number of subjects enrolled
    Israel: 19
    Country: Number of subjects enrolled
    Italy: 9
    Country: Number of subjects enrolled
    Japan: 51
    Country: Number of subjects enrolled
    Korea, Republic of: 37
    Country: Number of subjects enrolled
    Latvia: 31
    Country: Number of subjects enrolled
    Mexico: 33
    Country: Number of subjects enrolled
    Netherlands: 11
    Country: Number of subjects enrolled
    Poland: 30
    Country: Number of subjects enrolled
    Portugal: 2
    Country: Number of subjects enrolled
    Spain: 13
    Country: Number of subjects enrolled
    Türkiye: 13
    Country: Number of subjects enrolled
    United Kingdom: 9
    Country: Number of subjects enrolled
    United States: 67
    Worldwide total number of subjects
    505
    EEA total number of subjects
    234
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    249
    From 65 to 84 years
    255
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    This was a multi-center, randomised, placebo-controlled, double-blind, parallel group clinical trial in patients with bronchiectasis to investigate the efficacy, safety and tolerability of three different doses of BI 1291583 (orally, once daily). The treatment period was at least 24 and up to 48 weeks, with a follow-up period of 4 weeks.

    Pre-assignment
    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
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Carer, Data analyst, Assessor
    Blinding implementation details
    Patients, investigators, central reviewers, and everyone involved in trial conduct or analysis or with any other interest in this double-blind trial were to remain blinded regarding the randomised treatment assignments until after final database lock.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo
    Arm description
    Patients with bronchiectasis administered placebo matching BI 1291583 as tablets orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo matching BI 1291583 once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first

    Arm title
    BI 1291583 1 mg
    Arm description
    Patients with bronchiectasis administered one 1 milligram (mg) dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.
    Arm type
    Experimental

    Investigational medicinal product name
    BI 1291583
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    1 mg dose of BI 1291583 once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Arm title
    BI 1291583 2.5 mg
    Arm description
    Patients with bronchiectasis administered one 2.5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.
    Arm type
    Experimental

    Investigational medicinal product name
    BI 1291583
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 2.5 mg dose of BI 1291583 once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Arm title
    BI 1291583 5 mg
    Arm description
    Patients with bronchiectasis administered one 5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.
    Arm type
    Experimental

    Investigational medicinal product name
    BI 1291583
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    One 5 mg dose of BI 1291583 once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Number of subjects in period 1 [1]
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Started
    109
    53
    53
    107
    Treated
    109
    53
    53
    107
    Completed
    95
    49
    48
    91
    Not completed
    14
    4
    5
    16
         Consent withdrawn by subject
    6
    3
    4
    12
         Physician decision
    4
    1
    -
    -
         Lost to follow-up
    1
    -
    -
    3
         Other than listed
    3
    -
    1
    1
    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: Out of the 505 enrolled subjects, only 322 were treated.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Patients with bronchiectasis administered placebo matching BI 1291583 as tablets orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 1 mg
    Reporting group description
    Patients with bronchiectasis administered one 1 milligram (mg) dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 2.5 mg
    Reporting group description
    Patients with bronchiectasis administered one 2.5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 5 mg
    Reporting group description
    Patients with bronchiectasis administered one 5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg Total
    Number of subjects
    109 53 53 107 322
    Age categorical
    Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    Units: Subjects
        In utero
    0 0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0 0
        Newborns (0-27 days)
    0 0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0 0
        Children (2-11 years)
    0 0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0 0
        Adults (18-64 years)
    54 31 29 55 169
        From 65-84 years
    55 22 24 51 152
        85 years and over
    0 0 0 1 1
    Age Continuous
    Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    Units: years
        arithmetic mean (standard deviation)
    60.1 ( 16.5 ) 58.1 ( 15.5 ) 60.9 ( 15.1 ) 59.8 ( 15.5 ) -
    Sex: Female, Male
    Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    Units: Subjects
        Female
    67 33 27 64 191
        Male
    42 20 26 43 131
    Race (NIH/OMB)
    Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    Units: Subjects
        American Indian or Alaska Native
    4 1 1 2 8
        Asian
    23 8 14 16 61
        Native Hawaiian or Other Pacific Islander
    0 0 0 1 1
        Black or African American
    1 0 1 0 2
        White
    81 44 37 88 250
        More than one race
    0 0 0 0 0
        Unknown or Not Reported
    0 0 0 0 0
    Ethnicity (NIH/OMB)
    Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    Units: Subjects
        Hispanic or Latino
    12 4 2 6 24
        Not Hispanic or Latino
    97 49 51 101 298
        Unknown or Not Reported
    0 0 0 0 0

    End points

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    End points reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Patients with bronchiectasis administered placebo matching BI 1291583 as tablets orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 1 mg
    Reporting group description
    Patients with bronchiectasis administered one 1 milligram (mg) dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 2.5 mg
    Reporting group description
    Patients with bronchiectasis administered one 2.5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 5 mg
    Reporting group description
    Patients with bronchiectasis administered one 5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Primary: Time to first pulmonary exacerbation up to 48 weeks after first drug administration

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    End point title
    Time to first pulmonary exacerbation up to 48 weeks after first drug administration
    End point description
    The time to first pulmonary exacerbation up to 48 weeks after first drug administration is reported. A pulmonary exacerbation was defined as having 3 or more of the following symptoms for at least 48 hours resulting in a physician’s decision to prescribe antibiotics: increased cough, increased sputum volume or change in sputum consistency, increased sputum purulence, increased breathlessness and/or decreased exercise tolerance, fatigue and/or malaise, hemoptysis. Dose or frequency change of background antibiotic treatment of ≥ 2-fold when administered for ≥ 3 symptoms met the definition of exacerbation. “Onset of exacerbation” was defined by the onset of first recorded symptom. All observed data up to 48 weeks were included in the analysis. 99999 (1mg): Upper limit of 95% Confidence Interval was not estimable due to the lack of events at later time points. 99999 (2.5 and 5 mg): Median was not reached. Upper limit of 95% Confidence Interval was not estimable. TS.
    End point type
    Primary
    End point timeframe
    From first drug administration, up to 48 weeks.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    109
    53
    53
    107
    Units: Week
        median (confidence interval 95%)
    29.6 (23.0 to 37.6)
    31.7 (20.0 to 99999)
    99999 (23.6 to 99999)
    99999 (30.3 to 99999)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    A multiple comparison procedure with modelling technique (MCPMod) was used to test a non-flat dose response relationship for 3 doses vs placebo. Four possible dose-response patterns were simultaneously analyzed at the 1-sided α-level of 0.05. As a basis for the MCPMod analysis, a Cox regression model on the primary endpoint was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline.
    Comparison groups
    Placebo v BI 1291583 1 mg v BI 1291583 2.5 mg v BI 1291583 5 mg
    Number of subjects included in analysis
    322
    Analysis specification
    Pre-specified
    Analysis type
    other [1]
    P-value
    = 0.0448 [2]
    Method
    MCPMod Emax1 model
    Confidence interval
    Notes
    [1] - MCPMod Emax1 model assumption: 50% of the maximum effect is achieved at 2.5 mg dose.
    [2] - Adjusted p-value from multiple contrast test.
    Statistical analysis title
    Statistical analysis 3
    Statistical analysis description
    A multiple comparison procedure with modelling technique (MCPMod) was used to test a non-flat dose response relationship for 3 doses vs placebo. Four possible dose-response patterns were simultaneously analyzed at the 1-sided α-level of 0.05. As a basis for the MCPMod analysis, a Cox regression model on the primary endpoint was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline.
    Comparison groups
    Placebo v BI 1291583 1 mg v BI 1291583 2.5 mg v BI 1291583 5 mg
    Number of subjects included in analysis
    322
    Analysis specification
    Pre-specified
    Analysis type
    other [3]
    P-value
    = 0.1216 [4]
    Method
    MCPMod Exponential model
    Confidence interval
    Notes
    [3] - MCPMod Exponential model assumption: 10% of the maximum effect is achieved at 2.5 mg dose.
    [4] - Adjusted p-value from multiple contrast test.
    Statistical analysis title
    Statistical analysis 7
    Statistical analysis description
    Ratios were obtained from a Cox regression model on the primary endpoint, time to first pulmonary exacerbation up to Week 48 was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline. As per protocol, hypothesis testing was done only on the BI 1291583 5 mg dose group.
    Comparison groups
    Placebo v BI 1291583 5 mg
    Number of subjects included in analysis
    216
    Analysis specification
    Pre-specified
    Analysis type
    other [5]
    P-value
    = 0.0857
    Method
    Wald test
    Parameter type
    Cox proportional hazard
    Point estimate
    0.71
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.48
         upper limit
    1.05
    Notes
    [5] - BI 1291583 5 mg/Placebo
    Statistical analysis title
    Statistical analysis 5
    Statistical analysis description
    Ratios were obtained from a Cox regression model on the primary endpoint, time to first pulmonary exacerbation up to Week 48 was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline. As per protocol, hypothesis testing was done only on the BI 1291583 5 mg dose group.
    Comparison groups
    Placebo v BI 1291583 1 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    other [6]
    Method
    Parameter type
    Cox proportional hazard
    Point estimate
    0.93
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.6
         upper limit
    1.45
    Notes
    [6] - BI 1291583 1 mg/Placebo
    Statistical analysis title
    Statistical analysis 6
    Statistical analysis description
    Ratios were obtained from a Cox regression model on the primary endpoint, time to first pulmonary exacerbation up to Week 48 was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline. As per protocol, hypothesis testing was done only on the BI 1291583 5 mg dose group.
    Comparison groups
    Placebo v BI 1291583 2.5 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    other [7]
    Method
    Parameter type
    Cox proportional hazard
    Point estimate
    0.66
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.4
         upper limit
    1.08
    Notes
    [7] - BI 1291583 2.5 mg/Placebo
    Statistical analysis title
    Statistical analysis 2
    Statistical analysis description
    A multiple comparison procedure with modelling technique (MCPMod) was used to test a non-flat dose response relationship for 3 doses vs placebo. Four possible dose-response patterns were simultaneously analyzed at the 1-sided α-level of 0.05. As a basis for the MCPMod analysis, a Cox regression model on the primary endpoint was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline.
    Comparison groups
    Placebo v BI 1291583 1 mg v BI 1291583 2.5 mg v BI 1291583 5 mg
    Number of subjects included in analysis
    322
    Analysis specification
    Pre-specified
    Analysis type
    other [8]
    P-value
    = 0.0665 [9]
    Method
    MCPMod Emax2 model
    Confidence interval
    Notes
    [8] - MCPMod Emax2 model assumption: 80% of the maximum effect is achieved at 1 mg dose.
    [9] - Adjusted p-value from multiple contrast test.
    Statistical analysis title
    Statistical analysis 4
    Statistical analysis description
    A multiple comparison procedure with modelling technique (MCPMod) was used to test a non-flat dose response relationship for 3 doses vs placebo. Four possible dose-response patterns were simultaneously analyzed at the 1-sided α-level of 0.05. As a basis for the MCPMod analysis, a Cox regression model on the primary endpoint was used. The model included treatment and the stratification factors P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline.
    Comparison groups
    Placebo v BI 1291583 1 mg v BI 1291583 2.5 mg v BI 1291583 5 mg
    Number of subjects included in analysis
    322
    Analysis specification
    Pre-specified
    Analysis type
    other [10]
    P-value
    = 0.0573 [11]
    Method
    MCPMod Linear model
    Confidence interval
    Notes
    [10] - MCPMod Linear model: no assumptions.
    [11] - Adjusted p-value from multiple contrast test.

    Secondary: Key secondary outcome measure: rate of pulmonary exacerbations (number of events per person-time) up to week 48 after first drug administration

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    End point title
    Key secondary outcome measure: rate of pulmonary exacerbations (number of events per person-time) up to week 48 after first drug administration
    End point description
    The rate of pulmonary exacerbations (number of events per person-time) up to week 48 after first drug administration is reported. Adjusted event rates were obtained using a negative binomial regression model adjusting for the categorical variable treatment (all 4 treatment groups), P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as well as the logarithm of the duration of observational time (in years) as an offset. All observed data up to 48 weeks were included in the analysis. Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    End point type
    Secondary
    End point timeframe
    From first drug administration, up to 48 weeks.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    109
    53
    53
    107
    Units: Events per person-year
        number (confidence interval 95%)
    1.25 (0.96 to 1.63)
    1.30 (0.91 to 1.86)
    0.85 (0.56 to 1.28)
    1.11 (0.84 to 1.47)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Adjusted event rate ratios were obtained using a negative binomial regression model adjusting for the categorical variable treatment (all 4 treatment groups), P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as well as the logarithm of the duration of observational time (in years) as an offset.
    Comparison groups
    Placebo v BI 1291583 1 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    other [12]
    Method
    Parameter type
    Adjusted event rate ratio
    Point estimate
    1.034
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.685
         upper limit
    1.563
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.218
    Notes
    [12] - BI 1291583 1 mg/Placebo
    Statistical analysis title
    Statistical analysis 3
    Statistical analysis description
    Adjusted event rate ratios were obtained using a negative binomial regression model adjusting for the categorical variable treatment (all 4 treatment groups), P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as well as the logarithm of the duration of observational time (in years) as an offset.
    Comparison groups
    Placebo v BI 1291583 5 mg
    Number of subjects included in analysis
    216
    Analysis specification
    Pre-specified
    Analysis type
    other [13]
    Method
    Parameter type
    Adjusted event rate ratio
    Point estimate
    0.886
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.626
         upper limit
    1.256
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.158
    Notes
    [13] - BI 1291583 5 mg/Placebo
    Statistical analysis title
    Statistical analysis 2
    Statistical analysis description
    Adjusted event rate ratios were obtained using a negative binomial regression model adjusting for the categorical variable treatment (all 4 treatment groups), P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as well as the logarithm of the duration of observational time (in years) as an offset.
    Comparison groups
    Placebo v BI 1291583 2.5 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    other [14]
    Method
    Parameter type
    Adjusted event rate ratio
    Point estimate
    0.677
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.426
         upper limit
    1.076
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.16
    Notes
    [14] - BI 1291583 2.5 mg/Placebo

    Secondary: Absolute change from baseline in Quality of Life Questionnaire – Bronchiectasis (QOL-B) respiratory symptoms domain score at week 24 after first drug administration

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    End point title
    Absolute change from baseline in Quality of Life Questionnaire – Bronchiectasis (QOL-B) respiratory symptoms domain score at week 24 after first drug administration
    End point description
    Absolute change from baseline in QOL-B respiratory symptoms domain score at week 24 after first drug administration is reported. The QOL-B, a self-administered, patient-reported outcome measure assessing symptoms, functioning and health-related quality of life for subjects with bronchiectasis, contains 37 items on 8 scales (Respiratory Symptoms, Physical, Role, Emotional and Social Functioning, Vitality, Health Perceptions and Treatment Burden). The score range is 0-100, a higher score indicates fewer symptoms or better health status. Adjusted means were obtained using a REML estimation for the QOL-B respiratory symptoms domain based on a ANCOVA model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline QOL-B respiratory symptoms domain score as continuous fixed effect. TS. Patients with baseline and at least one on−treatment post−baseline value were included.
    End point type
    Secondary
    End point timeframe
    Before the first drug administration (baseline, week 0) and 24 weeks after first drug administration.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    103
    52
    51
    99
    Units: Score on a scale
        least squares mean (confidence interval 95%)
    5.87 (3.03 to 8.71)
    8.03 (4.03 to 12.03)
    7.59 (3.55 to 11.63)
    6.82 (3.92 to 9.72)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Adjusted means were obtained using a restricted maximum likelihood (REML) estimation for the QOL-B respiratory symptoms domain based on an analysis of covariance (ANCOVA) model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline QOL-B respiratory symptoms domain score as continuous fixed effect.
    Comparison groups
    Placebo v BI 1291583 1 mg
    Number of subjects included in analysis
    155
    Analysis specification
    Pre-specified
    Analysis type
    other [15]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    2.16
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.75
         upper limit
    7.06
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.49
    Notes
    [15] - BI 1291583 1 mg - Placebo
    Statistical analysis title
    Statistical analysis 3
    Statistical analysis description
    Adjusted means were obtained using a restricted maximum likelihood (REML) estimation for the QOL-B respiratory symptoms domain based on an analysis of covariance (ANCOVA) model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline QOL-B respiratory symptoms domain score as continuous fixed effect.
    Comparison groups
    Placebo v BI 1291583 5 mg
    Number of subjects included in analysis
    202
    Analysis specification
    Pre-specified
    Analysis type
    other [16]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    0.95
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.11
         upper limit
    5.01
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.06
    Notes
    [16] - BI 1291583 5 mg - Placebo
    Statistical analysis title
    Statistical analysis 2
    Statistical analysis description
    Adjusted means were obtained using a restricted maximum likelihood (REML) estimation for the QOL-B respiratory symptoms domain based on an analysis of covariance (ANCOVA) model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline QOL-B respiratory symptoms domain score as continuous fixed effect.
    Comparison groups
    Placebo v BI 1291583 2.5 mg
    Number of subjects included in analysis
    154
    Analysis specification
    Pre-specified
    Analysis type
    other [17]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    1.72
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -3.22
         upper limit
    6.65
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.51
    Notes
    [17] - BI 1291583 2.5 mg - Placebo

    Secondary: Relative change from baseline in neutrophil elastase (NE) activity in sputum at week 12 after first drug administration

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    End point title
    Relative change from baseline in neutrophil elastase (NE) activity in sputum at week 12 after first drug administration
    End point description
    The relative change from baseline in absolute neutrophil elastase (NE) activity in sputum at week 12 after first drug administration is reported. Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment. Patients with baseline and a measurement at week 12 were included.
    End point type
    Secondary
    End point timeframe
    Before the first drug administration (baseline: mean value of Screening and week 0 prior to the first treatment intake) and 12 weeks after first drug administration.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    88
    41
    44
    74
    Units: RFU (Relative Fluorescent Unit)
        arithmetic mean (standard deviation)
    2413.87 ( 19801.27 )
    760.71 ( 2837.37 )
    79.74 ( 549.53 )
    705.40 ( 4960.86 )
    No statistical analyses for this end point

    Secondary: Absolute change from baseline in St. George’s Respiratory Questionnaire (SGRQ) Symptoms score at week 24 after first drug administration

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    End point title
    Absolute change from baseline in St. George’s Respiratory Questionnaire (SGRQ) Symptoms score at week 24 after first drug administration
    End point description
    Absolute change from baseline in SGRQ Symptoms score at week 24 after first drug administration is reported. The SGRQ, designed to measure health impairment in patients with Chronic Obstructive Pulmonary Disease, is divided into 2 parts measuring 3 domains: symptoms (part 1); activity limitation and social and emotional impact of disease (part 2). Total score is calculated by dividing the summed weights from the positive items in the questionnaire by the adjusted maximum possible weight. The result is expressed as a percentage: 100 represents the worst possible, and 0 the best possible health status. Adjusted means were obtained using a REML estimation based on an ANCOVA model. The model included treatment, P. aeruginosa status (positive vs negative) and maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects, baseline SGRQ Symptoms score as a continuous fixed effect. TS. Patients with baseline and at least one on−treatment post−baseline value were included.
    End point type
    Secondary
    End point timeframe
    Before the first drug administration (baseline, week 0) and 24 weeks after first drug administration.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    103
    52
    51
    99
    Units: Score on a scale
        least squares mean (confidence interval 95%)
    -5.64 (-9.11 to -2.16)
    -7.22 (-12.12 to -2.31)
    -8.97 (-13.92 to -4.02)
    -7.92 (-11.47 to -4.37)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Adjusted means were obtained using a REML estimation based on an ANCOVA model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline SGRQ Symptoms score as a continuous fixed effect.
    Comparison groups
    Placebo v BI 1291583 1 mg
    Number of subjects included in analysis
    155
    Analysis specification
    Pre-specified
    Analysis type
    other [18]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    -1.58
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -7.59
         upper limit
    4.43
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.05
    Notes
    [18] - BI 1291583 1 mg - Placebo
    Statistical analysis title
    Statistical analysis 3
    Statistical analysis description
    Adjusted means were obtained using a REML estimation based on an ANCOVA model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline SGRQ Symptoms score as a continuous fixed effect.
    Comparison groups
    Placebo v BI 1291583 5 mg
    Number of subjects included in analysis
    202
    Analysis specification
    Pre-specified
    Analysis type
    other [19]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    -2.29
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -7.26
         upper limit
    2.68
    Variability estimate
    Standard error of the mean
    Dispersion value
    2.53
    Notes
    [19] - BI 1291583 5 mg - Placebo
    Statistical analysis title
    Statistical analysis 2
    Statistical analysis description
    Adjusted means were obtained using a REML estimation based on an ANCOVA model. This model included treatment, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline as discrete fixed effects and baseline SGRQ Symptoms score as a continuous fixed effect.
    Comparison groups
    Placebo v BI 1291583 2.5 mg
    Number of subjects included in analysis
    154
    Analysis specification
    Pre-specified
    Analysis type
    other [20]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    -3.33
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -9.38
         upper limit
    2.72
    Variability estimate
    Standard error of the mean
    Dispersion value
    3.07
    Notes
    [20] - BI 1291583 2.5 mg - Placebo

    Secondary: Absolute change from baseline in percent predicted post-bronchodilator forced expiratory volume in one second (FEV1%pred) at week 24 after first drug administration

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    End point title
    Absolute change from baseline in percent predicted post-bronchodilator forced expiratory volume in one second (FEV1%pred) at week 24 after first drug administration
    End point description
    The absolute change from baseline in percent predicted post-bronchodilator forced expiratory volume in one second (FEV1%pred) at week 24 after first drug administration is reported. A REML based approach using a MMRM was used. The model included fixed, categorical effects of treatment at each visit, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline and the fixed continuous effects of baseline FEV1 % pred at each visit. Visit were treated as the repeated measure with an unstructured covariance structure used to model the within patient measurements. Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment. Patients with baseline and at least one on−treatment post−baseline value were included.
    End point type
    Secondary
    End point timeframe
    Before the first drug administration (baseline, week 0) and 24 weeks after first drug administration.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    105
    53
    53
    99
    Units: % of predicted post-bronchodilator FEV1
        least squares mean (confidence interval 95%)
    -1.05 (-2.38 to 0.28)
    -0.14 (-2.00 to 1.71)
    1.16 (-0.71 to 3.03)
    -0.90 (-2.30 to 0.50)
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    A REML based approach using a MMRM was used. The model included fixed, categorical effects of treatment at each visit, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline and the fixed continuous effects of baseline FEV1 % pred at each visit. Visit were treated as the repeated measure with an unstructured covariance structure used to model the within patient measurements.
    Comparison groups
    Placebo v BI 1291583 1 mg
    Number of subjects included in analysis
    158
    Analysis specification
    Pre-specified
    Analysis type
    other [21]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    0.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.38
         upper limit
    3.19
    Variability estimate
    Standard error of the mean
    Dispersion value
    1.16
    Notes
    [21] - BI 1291583 1 mg - Placebo
    Statistical analysis title
    Statistical analysis 3
    Statistical analysis description
    A REML based approach using a MMRM was used. The model included fixed, categorical effects of treatment at each visit, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline and the fixed continuous effects of baseline FEV1 % pred at each visit. Visit were treated as the repeated measure with an unstructured covariance structure used to model the within patient measurements.
    Comparison groups
    Placebo v BI 1291583 5 mg
    Number of subjects included in analysis
    204
    Analysis specification
    Pre-specified
    Analysis type
    other [22]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    0.15
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.79
         upper limit
    2.08
    Variability estimate
    Standard error of the mean
    Dispersion value
    0.98
    Notes
    [22] - BI 1291583 5 mg - Placebo
    Statistical analysis title
    Statistical analysis 2
    Statistical analysis description
    A REML based approach using a MMRM was used. The model included fixed, categorical effects of treatment at each visit, P. aeruginosa status (positive vs negative) and the maintenance use of macrolides (yes vs no) at baseline and the fixed continuous effects of baseline FEV1 % pred at each visit. Visit were treated as the repeated measure with an unstructured covariance structure used to model the within patient measurements.
    Comparison groups
    Placebo v BI 1291583 2.5 mg
    Number of subjects included in analysis
    158
    Analysis specification
    Pre-specified
    Analysis type
    other [23]
    Method
    Parameter type
    Difference of adjusted means
    Point estimate
    2.21
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.09
         upper limit
    4.51
    Variability estimate
    Standard error of the mean
    Dispersion value
    1.17
    Notes
    [23] - BI 1291583 2.5 mg - Placebo

    Secondary: Occurrence of an exacerbation by week 24 after first drug administration

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    End point title
    Occurrence of an exacerbation by week 24 after first drug administration
    End point description
    The occurrence of an exacerbation by week 24 after first drug administration is reported. The proportion of patients with an exacerbation within 24 weeks after first drug administration was based on a Kaplan Meier analysis. Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    End point type
    Secondary
    End point timeframe
    From first drug administration, up to 24 weeks.
    End point values
    Placebo BI 1291583 1 mg BI 1291583 2.5 mg BI 1291583 5 mg
    Number of subjects analysed
    109
    53
    53
    107
    Units: Proportion of patients
        number (not applicable)
    0.415
    0.442
    0.358
    0.334
    Statistical analysis title
    Statistical analysis 1
    Statistical analysis description
    Kaplan Meier survival probability at week 24 were compared between each BI 1291583 dose and placebo and the variance of each Kaplan Meier estimate was calculated by the Greenwood’s formula.
    Comparison groups
    Placebo v BI 1291583 1 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    other [24]
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    0.027
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.137
         upper limit
    0.19
    Notes
    [24] - BI 1291583 1 mg - Placebo
    Statistical analysis title
    Statistical analysis 3
    Statistical analysis description
    Kaplan Meier survival probability at week 24 were compared between each BI 1291583 dose and placebo and the variance of each Kaplan Meier estimate was calculated by the Greenwood’s formula.
    Comparison groups
    Placebo v BI 1291583 5 mg
    Number of subjects included in analysis
    216
    Analysis specification
    Pre-specified
    Analysis type
    other [25]
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -0.081
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.211
         upper limit
    0.048
    Notes
    [25] - BI 1291583 5 mg - Placebo
    Statistical analysis title
    Statistical analysis 2
    Statistical analysis description
    Kaplan Meier survival probability at week 24 were compared between each BI 1291583 dose and placebo and the variance of each Kaplan Meier estimate was calculated by the Greenwood’s formula.
    Comparison groups
    Placebo v BI 1291583 2.5 mg
    Number of subjects included in analysis
    162
    Analysis specification
    Pre-specified
    Analysis type
    other [26]
    Method
    Parameter type
    Risk difference (RD)
    Point estimate
    -0.057
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.216
         upper limit
    0.103
    Notes
    [26] - BI 1291583 2.5 mg - Placebo

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first administration of study drug until 28 days (residual effect period) after last administration of study drug, up to 52 weeks.
    Adverse event reporting additional description
    Treated set (TS): includes all subjects who were randomized and were documented to have taken at least one dose of investigational treatment.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    27.0
    Reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Patients with bronchiectasis administered placebo matching BI 1291583 as tablets orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 5 mg
    Reporting group description
    Patients with bronchiectasis administered one 5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 2.5 mg
    Reporting group description
    Patients with bronchiectasis administered one 2.5 mg dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Reporting group title
    BI 1291583 1 mg
    Reporting group description
    Patients with bronchiectasis administered one 1 milligram (mg) dose of BI 1291583 as a tablet orally once a day in the morning for at least 24 weeks, and up to 48 weeks or until the end of trial, whichever happens first.

    Serious adverse events
    Placebo BI 1291583 5 mg BI 1291583 2.5 mg BI 1291583 1 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    30 / 109 (27.52%)
    22 / 107 (20.56%)
    6 / 53 (11.32%)
    8 / 53 (15.09%)
         number of deaths (all causes)
    1
    1
    0
    0
         number of deaths resulting from adverse events
    0
    1
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Soft tissue sarcoma
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    1 / 53 (1.89%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Squamous cell carcinoma of skin
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    1 / 53 (1.89%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Small intestine adenocarcinoma
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bowen's disease
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Hernia
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Disease progression
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immune system disorders
    Anaphylactic reaction
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Immunodeficiency
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Ovarian cyst
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Acute respiratory failure
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nasal septum deviation
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Haemoptysis
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dysaesthesia pharynx
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic respiratory failure
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Bronchiectasis
         subjects affected / exposed
    9 / 109 (8.26%)
    5 / 107 (4.67%)
    1 / 53 (1.89%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 9
    0 / 5
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nasal turbinate hypertrophy
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Obstructive sleep apnoea syndrome
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Organising pneumonia
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumomediastinum
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pulmonary embolism
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Suicidal ideation
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Limb injury
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Rib fracture
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Upper limb fracture
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Contusion
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fall
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Urachal abnormality
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    1 / 53 (1.89%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac failure
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Atrial fibrillation
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    1 / 53 (1.89%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Arrhythmia
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Bell's palsy
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Transient ischaemic attack
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Sudden hearing loss
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Eye disorders
    Macular hole
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Macular degeneration
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Retinal tear
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Gastritis
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hepatobiliary disorders
    Cholelithiasis
         subjects affected / exposed
    0 / 109 (0.00%)
    2 / 107 (1.87%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cholecystitis
         subjects affected / exposed
    0 / 109 (0.00%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Cervical spinal stenosis
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Chronic sinusitis
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    COVID-19
         subjects affected / exposed
    2 / 109 (1.83%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infection
         subjects affected / exposed
    0 / 109 (0.00%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    1 / 53 (1.89%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lung abscess
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lower respiratory tract infection viral
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    0 / 109 (0.00%)
    2 / 107 (1.87%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infective exacerbation of bronchiectasis
         subjects affected / exposed
    5 / 109 (4.59%)
    3 / 107 (2.80%)
    1 / 53 (1.89%)
    2 / 53 (3.77%)
         occurrences causally related to treatment / all
    0 / 7
    0 / 3
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    2 / 109 (1.83%)
    5 / 107 (4.67%)
    3 / 53 (5.66%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 5
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia bacterial
         subjects affected / exposed
    3 / 109 (2.75%)
    1 / 107 (0.93%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 6
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia respiratory syncytial viral
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory tract infection
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Lyme disease
         subjects affected / exposed
    1 / 109 (0.92%)
    0 / 107 (0.00%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Parainfluenzae virus infection
         subjects affected / exposed
    0 / 109 (0.00%)
    2 / 107 (1.87%)
    0 / 53 (0.00%)
    0 / 53 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo BI 1291583 5 mg BI 1291583 2.5 mg BI 1291583 1 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    81 / 109 (74.31%)
    69 / 107 (64.49%)
    38 / 53 (71.70%)
    39 / 53 (73.58%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    3 / 109 (2.75%)
    1 / 107 (0.93%)
    4 / 53 (7.55%)
    1 / 53 (1.89%)
         occurrences all number
    3
    1
    4
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    11 / 109 (10.09%)
    6 / 107 (5.61%)
    2 / 53 (3.77%)
    7 / 53 (13.21%)
         occurrences all number
    12
    6
    2
    7
    Dizziness
         subjects affected / exposed
    3 / 109 (2.75%)
    2 / 107 (1.87%)
    3 / 53 (5.66%)
    1 / 53 (1.89%)
         occurrences all number
    3
    2
    3
    2
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    8 / 109 (7.34%)
    5 / 107 (4.67%)
    0 / 53 (0.00%)
    3 / 53 (5.66%)
         occurrences all number
    8
    5
    0
    3
    Pyrexia
         subjects affected / exposed
    6 / 109 (5.50%)
    3 / 107 (2.80%)
    0 / 53 (0.00%)
    4 / 53 (7.55%)
         occurrences all number
    10
    3
    0
    5
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    2 / 109 (1.83%)
    1 / 107 (0.93%)
    3 / 53 (5.66%)
    2 / 53 (3.77%)
         occurrences all number
    2
    1
    3
    2
    Diarrhoea
         subjects affected / exposed
    10 / 109 (9.17%)
    5 / 107 (4.67%)
    1 / 53 (1.89%)
    4 / 53 (7.55%)
         occurrences all number
    12
    5
    1
    4
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    10 / 109 (9.17%)
    10 / 107 (9.35%)
    9 / 53 (16.98%)
    2 / 53 (3.77%)
         occurrences all number
    11
    17
    10
    3
    Bronchiectasis
         subjects affected / exposed
    30 / 109 (27.52%)
    33 / 107 (30.84%)
    15 / 53 (28.30%)
    18 / 53 (33.96%)
         occurrences all number
    40
    61
    22
    35
    Dyspnoea
         subjects affected / exposed
    6 / 109 (5.50%)
    10 / 107 (9.35%)
    2 / 53 (3.77%)
    2 / 53 (3.77%)
         occurrences all number
    6
    14
    2
    2
    Haemoptysis
         subjects affected / exposed
    9 / 109 (8.26%)
    2 / 107 (1.87%)
    1 / 53 (1.89%)
    2 / 53 (3.77%)
         occurrences all number
    14
    2
    2
    2
    Sputum increased
         subjects affected / exposed
    7 / 109 (6.42%)
    9 / 107 (8.41%)
    3 / 53 (5.66%)
    1 / 53 (1.89%)
         occurrences all number
    8
    13
    3
    1
    Oropharyngeal pain
         subjects affected / exposed
    1 / 109 (0.92%)
    3 / 107 (2.80%)
    2 / 53 (3.77%)
    5 / 53 (9.43%)
         occurrences all number
    1
    3
    3
    6
    Skin and subcutaneous tissue disorders
    Skin exfoliation
         subjects affected / exposed
    1 / 109 (0.92%)
    7 / 107 (6.54%)
    1 / 53 (1.89%)
    1 / 53 (1.89%)
         occurrences all number
    2
    9
    1
    1
    Dry skin
         subjects affected / exposed
    3 / 109 (2.75%)
    2 / 107 (1.87%)
    4 / 53 (7.55%)
    0 / 53 (0.00%)
         occurrences all number
    3
    2
    4
    0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    9 / 109 (8.26%)
    3 / 107 (2.80%)
    4 / 53 (7.55%)
    2 / 53 (3.77%)
         occurrences all number
    12
    3
    4
    2
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    3 / 109 (2.75%)
    0 / 107 (0.00%)
    3 / 53 (5.66%)
    1 / 53 (1.89%)
         occurrences all number
    4
    0
    4
    1
    COVID-19
         subjects affected / exposed
    10 / 109 (9.17%)
    5 / 107 (4.67%)
    6 / 53 (11.32%)
    5 / 53 (9.43%)
         occurrences all number
    10
    5
    6
    5
    Infective exacerbation of bronchiectasis
         subjects affected / exposed
    24 / 109 (22.02%)
    16 / 107 (14.95%)
    7 / 53 (13.21%)
    11 / 53 (20.75%)
         occurrences all number
    46
    29
    9
    15
    Influenza
         subjects affected / exposed
    5 / 109 (4.59%)
    2 / 107 (1.87%)
    1 / 53 (1.89%)
    3 / 53 (5.66%)
         occurrences all number
    5
    2
    1
    3
    Urinary tract infection
         subjects affected / exposed
    2 / 109 (1.83%)
    3 / 107 (2.80%)
    1 / 53 (1.89%)
    3 / 53 (5.66%)
         occurrences all number
    2
    4
    1
    3
    Nasopharyngitis
         subjects affected / exposed
    12 / 109 (11.01%)
    11 / 107 (10.28%)
    8 / 53 (15.09%)
    5 / 53 (9.43%)
         occurrences all number
    14
    17
    10
    5

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    03 May 2022
    Global amendment 1 part 1 - The following main changes were introduced: 1) the “rate of pulmonary exacerbations up to 48 weeks”, which had been a secondary endpoint in the initial protocol, was defined as key secondary endpoint. Section 7 was partially re-structured to reflect this change. 2) In the initial protocol, Quality of Life Questionnaire – Bronchiectasis (QOL-B) was a further endpoint. It was changed to ‘QOL-B respiratory symptoms domain score’ as a secondary endpoint, and ‘QOL-B scores except respiratory symptoms domain score’ as further endpoint. 3) Second sampling time point was added for P. aeruginosa at End of treatment (EOT). 4) Updates to the flow chart were made for clarification. 5) Bone metabolism markers were removed from safety parameters and added as biomarkers. It was clarified that sampling was to take place fasting and at the same time of the day, if possible. Sampling frequency was increased and a new additional bone metabolism marker (Tartrate resistant acid phosphatase 5b -TRAP5B) was added. 6) Clarification that chronic treatment with concomitant strong Cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp) inhibitors and inducers was restricted. Examples for such medications were provided. 7) Safety monitoring committee was replaced by Data Monitoring Committee (DMC). No Sponsor-internal personnel was involved in interim analyses. 8) Changes were made in contraception requirements: a) footnote on definition of postmenopausal status: statement added that Follicle stimulating hormone (FSH) level could be used for confirmation in questionable cases; b) Contraception was extended from 30 days to 75 days after last drug intake for both Women of childbearing potential (WOCBP) and male participants with WOCBP partners. 9) For Korea, legal age of 19 was added and Korea was namely mentioned as a country where WOCBP were not allowed to participate.
    03 May 2022
    Global amendment 1 part 2 - 10) Exclusion criterion #1 was changed to: Aspartate aminotransferase (AST) and / or Alanine aminotransferase (ALT) >3.0 x Upper limit of normal (ULN) at Visit 1, or moderate or severe liver disease (defined by Child-Pugh score B or C hepatic impairment). 11) Exclusion criterion #4: it was clarified that patients who may be at risk by participating in the trial were not to be included, and it was added that this judgement was to be made by the investigator based on laboratory and medical examinations. 12) Exclusion criterion #6: it was added that patients with allergic bronchopulmonary aspergillosis being treated or requiring treatment were to be excluded, and clarified that patients with fungal infection and not responsive to treatment should be excluded. 13) Exclusion criterion #7: it was clarified that patients with acute infections in the need of treatment were not to be randomised. 14) Exclusion criterion #17 was changed to: currently enrolled in another investigational device or drug trial, or less than 30 days or 5 half-lives, whichever was longer, prior to Visit 2 since ending another investigational device or drug trial(s). 15) New exclusion criterion #20: Contraindications to the class of drugs under study including known hypersensitivity to the drug or its excipients. 16) Additional discontinuation criterion: The investigator considered that treatment continuation was negatively impacting the well-being of the patient, and that treatment discontinuation was in the best interest of the patient.
    02 Dec 2022
    Global amendment 3 - The following main changes were introduced: 1) addition of new data on embryofoetal developmental toxicology outcomes. 2) The Pharmacokinetic (PK) safety evaluation of brensocatib was referenced. 3) New data from the Phase I trial 1397-0003 were added. 4) The Leicester Cough Questionnaire (LCQ) and Cough and Sputum Assessment Questionnaire (CASA-Q) were removed, and the Chronic Obstructive Pulmonary Disease (COPD) Assessment Test (CAT) was included. 5) A new section was added on Salbutamol/Albuterol as an Auxiliary medicinal product (AxMP). 6) Medications were added that needed to be stable prior to randomisation to reduce variability of bone turnover biomarkers. 7) A new major metabolite was added. 8) Information on Adverse events (AEs) was updated. 9) The wording regarding male and female contraception was revised. 10) Exclusion criteria: ‘acute Severe acute respiratory syndrome coronavirus (SARS CoV) 2 infection’ was deleted as an individual criterion and added into exclusion criterion #7 instead. 11) The contraception requirement after last trial drug intake was prolonged from 75 days to 9 months for WOCBP, and to 6 months for male participants with WOCBP partners. 12) It was added that for Hepatitis C virus (HCV) a Ribonucleic acid (RNA) test was to be performed if Hepatitis C antibodies result was positive, to confirm if the infection was active. Global amendment 3 includes the changes made in the global amendement 2, which was an internal version and never submitted to any Competent Authority (CA)/Institutional Review Board (IRB)/Independent Ethics Committee (IEC).
    14 Apr 2023
    Global amendment 4 - The following main changes were introduced: 1) It was clarified that an interim pharmacodynamic analysis was not planned. 2) The implementation of an adjudication committee was introduced, and a further endpoint ‘rate of adjudicated pulmonary exacerbation’ was added. 3) Periodontal discontinuation criteria were corrected, and assessment procedures clarified. 4) The subgroups with history of pulmonary exacerbations at baseline were changed from ‘0-2, ≥ 3’ to ‘0-1, ≥ 2’. 5) Pre-dose PK time window for trough samples at Visits 3, 5 and 7 was extended from -1 h to -2 h.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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