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A 12 Week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled Study to Assess the Efficacy, Safety, and Tolerability of Indacaterol Maleate / Glycopyrronium Bromide in COPD Patients With Moderate to Severe Airflow Limitation.

A 12-week Treatment, Multi-center, Randomized, Double-blind, Parallel-group, Placebo and Active Controlled Study to Assess the Efficacy, Safety, and Tolerability of Indacaterol Maleate / Glycopyrronium Bromide in COPD Patients With Moderate to Severe Airflow Limitation.

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01727141
Enrollment
1042
Registered
2012-11-15
Start date
2012-11-30
Completion date
2014-02-28
Last updated
2016-03-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Obstructive Pulmonary Disease (COPD)

Keywords

COPD, QVA149

Brief summary

This study will assess the efficacy, safety and tolerability of QVA149 in patients with moderate to severe airflow limitation.

Detailed description

NOTE: Detailed Description: data not entered

Interventions

DRUGNVA237

NVA237 was supplied in capsule form in blister packs for use in the Novartis Concept1 SDDPI.

DRUGPlacebo

Placebo was supplied in capsule form in blister packs for use in the Novartis Concept1 SDDPI.

DRUGQVA149

QVA149 was supplied in a capsule form in blister packs for use in the Novartis Concept1 SDDPI

DRUGQAB149

QAB149 was supplied in capsule form in blister packs for use in the Novartis Concept1 SDDPI.

Sponsors

Novartis Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Male and female patients that have signed informed consent and are \>/= 40 years of age. * Patients with stable COPD according to GOLD 2011. * Patients with a post-bronchodilator FEV1 of \>/= 30% and \< 80% predicted and a post-bronchodilator FEV1/FVC \<0.70. * Current or ex-smokers who have a smoking history of at least 10 pack years. * Patients with an mMRC grade 2 or greater.

Exclusion criteria

* Patients with Type I or uncontrolled Type II diabetes - Patients with a history of long QT syndrome or whose QTc measured at Visit 101 (Fridericia method) is prolonged (\>450 ms for males and females) and confirmed by a central assessor. (These patients should not be re-screened.) * Patients who have a clinically significant ECG abnormality at Visit 101 or Visit 102. (These patients should not be re-screened.) * Patients with a history of malignancy of any organ system, treated or untreated, within the last five years. * Patients with narrow-angle glaucoma, BPH or bladder-neck obstruction or moderate-severe renal impairment or urinary retention. * Patients who had a COPD exacerbation within 6 weeks prior to screening. * Patients who have a respiratory tract infection within 4 weeks prior to screening. * Patients requiring long term oxygen therapy prescribed for more than 12 hr per day. * Patients with a history of asthma. 8. Patients with an onset of respiratory symptoms, including COPD diagnosis, prior to age 40 years. * Patients with a blood eosinophil count of greater than 600 mm/3 during run-in. * Patients with concomitant pulmonary disease. * Patients with a diagnosis of alpha-1 anti-trypsin deficiency. * Patients with active pulmonary tuberculosis. * Patients in the active phase of a pulmonary rehabilitation programme. * Other protocol-defined inclusion/

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))baseline (BL), 12 WeeksPulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction. Missing values of FEV1 AUC0-12 at Day 1 and Week 12 will not imputed. The trapezoidal rule was used to calculate FEV1 AUC and then normalized to the length of time.

Secondary

MeasureTime frameDescription
Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score12 weeksParticipants reported change in health status by using the SGRQ. The SGRQ contains 50 items divided into 2 parts covering 3 aspects of health related to COPD: Part I covers Symptoms and is concerned with respiratory symptoms, their frequency and severity; Part II covers Activity and is concerned with activities that cause or are limited by breathlessness; Part II is also concerned with Impacts, which covers a range of aspects concerned with social functioning and psychological disturbances resulting from airways disease. A score was calculated for each of these 3 subscales and a Total score was calculated. In each case the lowest possible value is zero and the highest 100. Higher values correspond to greater impairment of health status.
Change From Baseline in Trough FEV1BL, day 2, day 86Pulmonary function assessments were performed using centralized spirometry according to international standards. Trough FEV1 was analyzed using the same MMRM as specified for FEV1. Trough FEV1 was defined as the mean of FEV1 at 23 h 15 min and 23 h 45 min after the morning dose of the previous day. Before the mean was calculated, a time window of 10 - 13 hours post-evening dose was applied to these 2 measurements. Recordings outside the time window were set to missing.
Change From Baseline in Pre-dose Trough FEV1BL, day 85Pulmonary function assessments were performed using centralized spirometry according to international standards. Pre-dose trough FEV1 was analyzed using the same MMRM as specified for FEV1. Pre-dose trough FEV1 was defined as the mean of FEV1 at -45 min and -15 min before the morning dose. Since the time of evening dose of the previous day was not recorded at these visits, no time window was applied.
Change From Baseline in FEV1BL, Day 1:5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h55 min;Day 2: 23h15min, 23h45min;Day 15: -45min, -15min, 1h;Day 29: -45 min, -15min, 1h;Day 57: -45min, -15min, 1h;Day 85: -45min, -15min, 5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h55min;Day 86: 23h15min; 23h45minPulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction.
Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total ScoreBL, 12 WeeksParticipants reported change in health status by using the SGRQ. The SGRQ contains 50 items divided into 2 parts covering 3 aspects of health related to COPD: Part I covers Symptoms and is concerned with respiratory symptoms, their frequency and severity; Part II covers Activity and is concerned with activities that cause or are limited by breathlessness; Part II is also concerned with Impacts, which covers a range of aspects concerned with social functioning and psychological disturbances resulting from airways disease. A score was calculated for each of these 3 subscales and a Total score was calculated. In each case the lowest possible value is zero and the highest 100. Higher values correspond to greater impairment of health status. Missing week 12 data were imputed with Last Observation Carried Forward (LOCF) method but only if measured at day \>= 29. A negative change from baseline indicates improvement.
Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)BL, day 1, week 12Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction. The trapezoidal rule was used to calculate FEV1 AUC and then normalized to the length of time.
Transitional Dyspnea Index (TDI) Focal ScoreBL, 12 weeksThe Baseline Dyspnea Index (BDI) / TDI is an instrument used to assess a participant's level of dyspnea. The BDI and TDI each have three domains: functional impairment, magnitude of task and magnitude of effort. BDI domains were rated from 0 (severe) to 4 (unimpaired) and rates summed for baseline focal score ranged from 0 to 12; lower scores mean worse severity. TDI domains were rated from -3 (major deterioration) to 3 (major improvement) and rates summed for transition focal score ranged from -9 to 9; negative scores indicate deterioration. A TDI focal score of ≥1 was defined as a clinically important improvement from baseline.
Change From Baseline in Mean Daily Number of Puffs of Rescue MedicationBL, 12 WeeksParticipants completed an electronic diary (eDiary) twice daily at the same time in the morning and evening to record the number of puffs of rescue medication taken in the previous 12 hours. A negative change from baseline indicates improvement.
Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreBL, 12 WeeksThe participant recorded symptom scores twice daily in the eDiary. The daily clinical symptoms included: cough, wheezing, shortness of breath, sputum volume, sputum color, and night time awakening. The range of scores for each assessment is 0 to 3 where 0 indications No symptom and 3 indicates a Severe symptom. The maximum daytime total score is 27 and the maximum nighttime total score is 27. The total daily symptom score is obtained by adding the scores for the morning and evening symptoms for each day. The maximum possible total daily score is 54. A negative change from baseline indicated improvement.
Change From Baseline in FVCBL, Day 1: 5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h55 min;Day 2: 23h15min, 23h45min;Day 15: -45min, -15min, 1h;Day 29: -45 min, -15min, 1h;Day 57: -45min, -15min, 1h;Day 85: -45min, -15min, 5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h 55min;Day 86: 23h15min; 23h45minPulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FVC was defined as the average of the pre-dose FVC measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FVC measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction.

Countries

Canada, Philippines, Poland, Romania, Spain, Ukraine, United States, Vietnam

Participant flow

Recruitment details

Participants were randomized to each treatment arm in a 1:1:1:1 ratio.

Pre-assignment details

One thousand forty two participants were randomized. (One participant was randomized twice and was counted twice in the randomized set.) In the safety set, participants were analyzed according to the treatment received.

Participants by arm

ArmCount
QVA149
27.5/12.5 ug twice daily (b.i.d) via Single Dose Dry Powder Inhaler (SDDPI)
260
QAB149
27.5 ug b.i.d.
260
NVA237
12.5 ug b.i.d.
261
Placebo
b.i.d
261
Total1,042

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyDeath0111
Overall StudyLost to Follow-up0200
Overall StudyPhysician Decision0102
Overall StudyProtocol deviation1101
Overall StudyWithdrawal by Subject44211

Baseline characteristics

CharacteristicQVA149QAB149NVA237PlaceboTotal
Age, Continuous63.9 Years
STANDARD_DEVIATION 8.76
63.7 Years
STANDARD_DEVIATION 8.07
63.7 Years
STANDARD_DEVIATION 8.35
63.7 Years
STANDARD_DEVIATION 8.19
63.8 Years
STANDARD_DEVIATION 8.33
Sex: Female, Male
Female
90 Participants74 Participants78 Participants92 Participants334 Participants
Sex: Female, Male
Male
170 Participants186 Participants183 Participants169 Participants708 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —
other
Total, other adverse events
86 / 25887 / 26085 / 26290 / 260
serious
Total, serious adverse events
10 / 25813 / 2608 / 2628 / 260

Outcome results

Primary

Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))

Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction. Missing values of FEV1 AUC0-12 at Day 1 and Week 12 will not imputed. The trapezoidal rule was used to calculate FEV1 AUC and then normalized to the length of time.

Time frame: baseline (BL), 12 Weeks

Population: Full Analysis Set: The full analysis set included all randomized participants who received at least one dose of study treatment. Participants, who were missing day 1 and/or week 12 FEV1 AUC 0-12h measurements, were not included in the analysis.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))0.211 LiterStandard Error 0.014
QAB149Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))0.117 LiterStandard Error 0.014
NVA237Change From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))0.112 LiterStandard Error 0.0141
PlaceboChange From Baseline in Standardized Forced Expiratory Volume in 1 Second (FEV1) Area Under the Curve (AUC) (0-12 Hours (h))-0.021 LiterStandard Error 0.0145
Secondary

Change From Baseline in FEV1

Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction.

Time frame: BL, Day 1:5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h55 min;Day 2: 23h15min, 23h45min;Day 15: -45min, -15min, 1h;Day 29: -45 min, -15min, 1h;Day 57: -45min, -15min, 1h;Day 85: -45min, -15min, 5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h55min;Day 86: 23h15min; 23h45min

Population: Full Analysis Set (FAS): The FAS included all randomized participants who received at least one dose of study medication. Participants, who has both baseline and post baseline values for a given time point, were included in the analysis for that time point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in FEV1Day 85, 6 h (n=253,256,254,248)0.197 LitersStandard Error 0.0154
QVA149Change From Baseline in FEV1Day 15, 1 h (n=258,260,261,258)0.269 LitersStandard Error 0.0133
QVA149Change From Baseline in FEV1Day 1, 8 h (n=253,251,256,248)0.157 LitersStandard Error 0.01
QVA149Change From Baseline in FEV1Day 85, 4 h (n=252,260,256,254)0.242 LitersStandard Error 0.0158
QVA149Change From Baseline in FEV1Day 15, -15 min (n=254,254,256,243)0.185 LitersStandard Error 0.0125
QVA149Change From Baseline in FEV1Day 15, -45min (n=254,254,256,244)0.168 LitersStandard Error 0.0123
QVA149Change From Baseline in FEV1Day 1, 11 h (n=246,250,253,245)0.116 LitersStandard Error 0.0112
QVA149Change From Baseline in FEV1Day 86, 23 h 15 min (n=249,249,254,242)0.196 LitersStandard Error 0.0149
QVA149Change From Baseline in FEV1Day 2, 23h 45min (n= 255,254,258,250)0.194 LitersStandard Error 0.0108
QVA149Change From Baseline in FEV1Day 2, 23h 15 min (n=249,249,254,242)0.176 LitersStandard Error 0.0106
QVA149Change From Baseline in FEV1Day 85, 1 h (n=258,260,261,258)0.250 LitersStandard Error 0.0149
QVA149Change From Baseline in FEV1Day 1, 5 min (n=255,257,260,255)0.111 LitersStandard Error 0.0062
QVA149Change From Baseline in FEV1Day 85, 11 h 55min(n=246,250,253,245)0.143 LitersStandard Error 0.0155
QVA149Change From Baseline in FEV1Day 85, 15 min (n=256,256,261,258)0.242 LitersStandard Error 0.015
QVA149Change From Baseline in FEV1Day 85, 5 min (n=255,257,260,255)0.232 LitersStandard Error 0.0147
QVA149Change From Baseline in FEV1Day 1, 15 min (n=256,256,261,258)0.146 LitersStandard Error 0.007
QVA149Change From Baseline in FEV1Day 85, 8 h (n=253,251,256,248)0.180 LitersStandard Error 0.0152
QVA149Change From Baseline in FEV1Day 85, -15 min (n=254,254,256,243)0.171 LitersStandard Error 0.0144
QVA149Change From Baseline in FEV1Day 85, -45 min (n= 254,254,256,244)0.154 LitersStandard Error 0.0142
QVA149Change From Baseline in FEV1Day 1, 1 h (n=258,260,261,258)0.179 LitersStandard Error 0.0082
QVA149Change From Baseline in FEV1Day 85, 2 h 9n=254,257,261,254)0.265 LitersStandard Error 0.015
QVA149Change From Baseline in FEV1Day 57, 1 h (n=258,260,261,258)0.273 LitersStandard Error 0.0141
QVA149Change From Baseline in FEV1Day 57, -15 min (n=254,254,256,243)0.193 LitersStandard Error 0.0132
QVA149Change From Baseline in FEV1Day 1, 2 h (n=254,257,261,254)0.219 LitersStandard Error 0.0091
QVA149Change From Baseline in FEV1Day 57, -45 min (n=254,254,256,244)0.181 LitersStandard Error 0.0134
QVA149Change From Baseline in FEV1Day 29, 1 h (n=258,260, 261,258)0.271 LitersStandard Error 0.0135
QVA149Change From Baseline in FEV1Day 1, 4 h (n=252,260,256,254)0.207 LitersStandard Error 0.0103
QVA149Change From Baseline in FEV1Day 86, 23 h 45 min (n=255,254,258,250)0.216 LitersStandard Error 0.0144
QVA149Change From Baseline in FEV1Day 29, -15 min (n=254,254,256,243)0.193 LitersStandard Error 0.0128
QVA149Change From Baseline in FEV1Day 29, -45 min (n=254,254,256,244)0.175 LitersStandard Error 0.0123
QVA149Change From Baseline in FEV1Day 1, 6 h (n=253,256,254,248)0.178 LitersStandard Error 0.0105
QAB149Change From Baseline in FEV1Day 29, -45 min (n=254,254,256,244)0.111 LitersStandard Error 0.0124
QAB149Change From Baseline in FEV1Day 85, 1 h (n=258,260,261,258)0.136 LitersStandard Error 0.0149
QAB149Change From Baseline in FEV1Day 85, 8 h (n=253,251,256,248)0.103 LitersStandard Error 0.0152
QAB149Change From Baseline in FEV1Day 1, 5 min (n=255,257,260,255)0.071 LitersStandard Error 0.0062
QAB149Change From Baseline in FEV1Day 1, 15 min (n=256,256,261,258)0.088 LitersStandard Error 0.007
QAB149Change From Baseline in FEV1Day 1, 1 h (n=258,260,261,258)0.085 LitersStandard Error 0.0082
QAB149Change From Baseline in FEV1Day 1, 4 h (n=252,260,256,254)0.105 LitersStandard Error 0.0103
QAB149Change From Baseline in FEV1Day 1, 6 h (n=253,256,254,248)0.102 LitersStandard Error 0.0105
QAB149Change From Baseline in FEV1Day 1, 8 h (n=253,251,256,248)0.081 LitersStandard Error 0.0102
QAB149Change From Baseline in FEV1Day 1, 11 h (n=246,250,253,245)0.047 LitersStandard Error 0.0112
QAB149Change From Baseline in FEV1Day 2, 23h 15 min (n=249,249,254,242)0.104 LitersStandard Error 0.0106
QAB149Change From Baseline in FEV1Day 2, 23h 45min (n= 255,254,258,250)0.119 LitersStandard Error 0.0109
QAB149Change From Baseline in FEV1Day 15, -45min (n=254,254,256,244)0.114 LitersStandard Error 0.0124
QAB149Change From Baseline in FEV1Day 15, -15 min (n=254,254,256,243)0.139 LitersStandard Error 0.0126
QAB149Change From Baseline in FEV1Day 15, 1 h (n=258,260,261,258)0.173 LitersStandard Error 0.0134
QAB149Change From Baseline in FEV1Day 1, 2 h (n=254,257,261,254)0.104 LitersStandard Error 0.0091
QAB149Change From Baseline in FEV1Day 29, -15 min (n=254,254,256,243)0.131 LitersStandard Error 0.0127
QAB149Change From Baseline in FEV1Day 29, 1 h (n=258,260, 261,258)0.167 LitersStandard Error 0.0135
QAB149Change From Baseline in FEV1Day 57, -45 min (n=254,254,256,244)0.097 LitersStandard Error 0.0134
QAB149Change From Baseline in FEV1Day 57, -15 min (n=254,254,256,243)0.117 LitersStandard Error 0.0132
QAB149Change From Baseline in FEV1Day 57, 1 h (n=258,260,261,258)0.150 LitersStandard Error 0.0141
QAB149Change From Baseline in FEV1Day 85, -45 min (n= 254,254,256,244)0.080 LitersStandard Error 0.0142
QAB149Change From Baseline in FEV1Day 85, -15 min (n=254,254,256,243)0.088 LitersStandard Error 0.0144
QAB149Change From Baseline in FEV1Day 85, 5 min (n=255,257,260,255)0.119 LitersStandard Error 0.0148
QAB149Change From Baseline in FEV1Day 85, 15 min (n=256,256,261,258)0.143 LitersStandard Error 0.0151
QAB149Change From Baseline in FEV1Day 85, 2 h 9n=254,257,261,254)0.145 LitersStandard Error 0.015
QAB149Change From Baseline in FEV1Day 85, 4 h (n=252,260,256,254)0.140 LitersStandard Error 0.0155
QAB149Change From Baseline in FEV1Day 85, 6 h (n=253,256,254,248)0.123 LitersStandard Error 0.0155
QAB149Change From Baseline in FEV1Day 85, 11 h 55min(n=246,250,253,245)0.066 LitersStandard Error 0.0154
QAB149Change From Baseline in FEV1Day 86, 23 h 15 min (n=249,249,254,242)0.116 LitersStandard Error 0.0151
QAB149Change From Baseline in FEV1Day 86, 23 h 45 min (n=255,254,258,250)0.128 LitersStandard Error 0.0144
NVA237Change From Baseline in FEV1Day 85, 11 h 55min(n=246,250,253,245)0.055 LitersStandard Error 0.015
NVA237Change From Baseline in FEV1Day 85, 1 h (n=258,260,261,258)0.150 LitersStandard Error 0.015
NVA237Change From Baseline in FEV1Day 85, 5 min (n=255,257,260,255)0.106 LitersStandard Error 0.0149
NVA237Change From Baseline in FEV1Day 57, -15 min (n=254,254,256,243)0.094 LitersStandard Error 0.0132
NVA237Change From Baseline in FEV1Day 1, 5 min (n=255,257,260,255)0.065 LitersStandard Error 0.0062
NVA237Change From Baseline in FEV1Day 29, 1 h (n=258,260, 261,258)0.156 LitersStandard Error 0.0135
NVA237Change From Baseline in FEV1Day 85, 15 min (n=256,256,261,258)0.130 LitersStandard Error 0.0152
NVA237Change From Baseline in FEV1Day 1, 1 h (n=258,260,261,258)0.166 LitersStandard Error 0.0081
NVA237Change From Baseline in FEV1Day 29, -15 min (n=254,254,256,243)0.092 LitersStandard Error 0.0127
NVA237Change From Baseline in FEV1Day 86, 23 h 45 min (n=255,254,258,250)0.100 LitersStandard Error 0.0143
NVA237Change From Baseline in FEV1Day 57, 1 h (n=258,260,261,258)0.161 LitersStandard Error 0.014
NVA237Change From Baseline in FEV1Day 85, 2 h 9n=254,257,261,254)0.171 LitersStandard Error 0.0151
NVA237Change From Baseline in FEV1Day 2, 23h 15 min (n=249,249,254,242)0.106 LitersStandard Error 0.0104
NVA237Change From Baseline in FEV1Day 1, 2 h (n=254,257,261,254)0.179 LitersStandard Error 0.0089
NVA237Change From Baseline in FEV1Day 1, 11 h (n=246,250,253,245)0.073 LitersStandard Error 0.0111
NVA237Change From Baseline in FEV1Day 85, 6 h (n=253,256,254,248)0.109 LitersStandard Error 0.0157
NVA237Change From Baseline in FEV1Day 2, 23h 45min (n= 255,254,258,250)0.119 LitersStandard Error 0.0107
NVA237Change From Baseline in FEV1Day 85, 8 h (n=253,251,256,248)0.086 LitersStandard Error 0.0151
NVA237Change From Baseline in FEV1Day 85, -45 min (n= 254,254,256,244)0.051 LitersStandard Error 0.0142
NVA237Change From Baseline in FEV1Day 57, -45 min (n=254,254,256,244)0.069 LitersStandard Error 0.0133
NVA237Change From Baseline in FEV1Day 15, -45min (n=254,254,256,244)0.067 LitersStandard Error 0.0122
NVA237Change From Baseline in FEV1Day 1, 15 min (n=256,256,261,258)0.117 LitersStandard Error 0.0069
NVA237Change From Baseline in FEV1Day 1, 8 h (n=253,251,256,248)0.106 LitersStandard Error 0.0101
NVA237Change From Baseline in FEV1Day 86, 23 h 15 min (n=249,249,254,242)0.082 LitersStandard Error 0.0151
NVA237Change From Baseline in FEV1Day 15, -15 min (n=254,254,256,243)0.087 LitersStandard Error 0.0125
NVA237Change From Baseline in FEV1Day 29, -45 min (n=254,254,256,244)0.073 LitersStandard Error 0.0123
NVA237Change From Baseline in FEV1Day 1, 6 h (n=253,256,254,248)0.125 LitersStandard Error 0.0104
NVA237Change From Baseline in FEV1Day 85, 4 h (n=252,260,256,254)0.132 LitersStandard Error 0.0158
NVA237Change From Baseline in FEV1Day 15, 1 h (n=258,260,261,258)0.161 LitersStandard Error 0.0133
NVA237Change From Baseline in FEV1Day 85, -15 min (n=254,254,256,243)0.073 LitersStandard Error 0.0143
NVA237Change From Baseline in FEV1Day 1, 4 h (n=252,260,256,254)0.146 LitersStandard Error 0.0101
PlaceboChange From Baseline in FEV1Day 85, 15 min (n=256,256,261,258)-0.020 LitersStandard Error 0.0159
PlaceboChange From Baseline in FEV1Day 29, -45 min (n=254,254,256,244)-0.029 LitersStandard Error 0.0126
PlaceboChange From Baseline in FEV1Day 29, -15 min (n=254,254,256,243)-0.006 LitersStandard Error 0.013
PlaceboChange From Baseline in FEV1Day 1, 2 h (n=254,257,261,254)0.037 LitersStandard Error 0.009
PlaceboChange From Baseline in FEV1Day 1, 6 h (n=253,256,254,248)0.021 LitersStandard Error 0.0107
PlaceboChange From Baseline in FEV1Day 29, 1 h (n=258,260, 261,258)0.006 LitersStandard Error 0.0138
PlaceboChange From Baseline in FEV1Day 57, -45 min (n=254,254,256,244)-0.016 LitersStandard Error 0.0137
PlaceboChange From Baseline in FEV1Day 1, 1 h (n=258,260,261,258)0.016 LitersStandard Error 0.0082
PlaceboChange From Baseline in FEV1Day 85, 6 h (n=253,256,254,248)-0.017 LitersStandard Error 0.0162
PlaceboChange From Baseline in FEV1Day 57, -15 min (n=254,254,256,243)0.006 LitersStandard Error 0.0136
PlaceboChange From Baseline in FEV1Day 85, 1 h (n=258,260,261,258)-0.021 LitersStandard Error 0.0154
PlaceboChange From Baseline in FEV1Day 57, 1 h (n=258,260,261,258)0.008 LitersStandard Error 0.0144
PlaceboChange From Baseline in FEV1Day 1, 15 min (n=256,256,261,258)0.012 LitersStandard Error 0.007
PlaceboChange From Baseline in FEV1Day 85, -45 min (n= 254,254,256,244)-0.038 LitersStandard Error 0.0146
PlaceboChange From Baseline in FEV1Day 85, 8 h (n=253,251,256,248)-0.030 LitersStandard Error 0.0158
PlaceboChange From Baseline in FEV1Day 85, -15 min (n=254,254,256,243)-0.035 LitersStandard Error 0.0149
PlaceboChange From Baseline in FEV1Day 1, 5 min (n=255,257,260,255)0.009 LitersStandard Error 0.0062
PlaceboChange From Baseline in FEV1Day 85, 5 min (n=255,257,260,255)-0.036 LitersStandard Error 0.0154
PlaceboChange From Baseline in FEV1Day 86, 23 h 45 min (n=255,254,258,250)-0.004 LitersStandard Error 0.015
PlaceboChange From Baseline in FEV1Day 85, 4 h (n=252,260,256,254)-0.001 LitersStandard Error 0.0165
PlaceboChange From Baseline in FEV1Day 86, 23 h 15 min (n=249,249,254,242)-0.017 LitersStandard Error 0.0155
PlaceboChange From Baseline in FEV1Day 1, 11 h (n=246,250,253,245)-0.020 LitersStandard Error 0.0113
PlaceboChange From Baseline in FEV1Day 2, 23h 15 min (n=249,249,254,242)0.004 LitersStandard Error 0.0107
PlaceboChange From Baseline in FEV1Day 85, 2 h 9n=254,257,261,254)-0.009 LitersStandard Error 0.0157
PlaceboChange From Baseline in FEV1Day 2, 23h 45min (n= 255,254,258,250)0.022 LitersStandard Error 0.011
PlaceboChange From Baseline in FEV1Day 1, 8 h (n=253,251,256,248)0.004 LitersStandard Error 0.0104
PlaceboChange From Baseline in FEV1Day 85, 11 h 55min(n=246,250,253,245)-0.064 LitersStandard Error 0.0161
PlaceboChange From Baseline in FEV1Day 15, -45min (n=254,254,256,244)-0.023 LitersStandard Error 0.0126
PlaceboChange From Baseline in FEV1Day 15, -15 min (n=254,254,256,243)-0.008 LitersStandard Error 0.0129
PlaceboChange From Baseline in FEV1Day 15, 1 h (n=258,260,261,258)0.004 LitersStandard Error 0.0136
PlaceboChange From Baseline in FEV1Day 1, 4 h (n=252,260,256,254)0.039 LitersStandard Error 0.0103
Secondary

Change From Baseline in FVC

Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FVC was defined as the average of the pre-dose FVC measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FVC measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction.

Time frame: BL, Day 1: 5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h55 min;Day 2: 23h15min, 23h45min;Day 15: -45min, -15min, 1h;Day 29: -45 min, -15min, 1h;Day 57: -45min, -15min, 1h;Day 85: -45min, -15min, 5min, 15min, 1h, 2h, 4h, 6h, 8h, 11h 55min;Day 86: 23h15min; 23h45min

Population: Full Analysis Set (FAS): The FAS included all randomized participants who received at least one dose of study medication. Participants, who has both baseline and post baseline values for a given time point, were included in the analysis for that time point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in FVCDay 2, 23 h 15 min (n=249,249,254,242)0.315 LitersStandard Error 0.0194
QVA149Change From Baseline in FVCDay 85, 6 h (n=253,256,254,248)0.290 LitersStandard Error 0.0263
QVA149Change From Baseline in FVCDay 85, 15 min (n=256,256,261,258)0.378 LitersStandard Error 0.025
QVA149Change From Baseline in FVCDay 1, 8 h (n=253,251,256,248)0.306 LitersStandard Error 0.0189
QVA149Change From Baseline in FVCDay 1, 6 h (n=253,256,254,248)0.319 LitersStandard Error 0.0198
QVA149Change From Baseline in FVCDay 1, 4 h (n=252,260,256,254)0.355 LitersStandard Error 0.0192
QVA149Change From Baseline in FVCDay 85, 11 55 min (n=246,250,253,245)0.209 LitersStandard Error 0.0261
QVA149Change From Baseline in FVCDay 85, -15 min (n=254,254,256,243)0.264 LitersStandard Error 0.0246
QVA149Change From Baseline in FVCDay 1, 2 h (n=254,257,261,254)0.390 LitersStandard Error 0.018
QVA149Change From Baseline in FVCDay 86, 23 h 15 min (n=249,249,254,242)0.295 LitersStandard Error 0.025
QVA149Change From Baseline in FVCDay 85, -45 min (n=254,254,256,244)0.247 LitersStandard Error 0.0245
QVA149Change From Baseline in FVCDay 1, 1 h (n=258,260,261,258)0.329 LitersStandard Error 0.0165
QVA149Change From Baseline in FVCDay 57, -15 min (n=254,254,256,243)0.299 LitersStandard Error 0.0234
QVA149Change From Baseline in FVCDay 1, 15 min (n=256,256,261,258)0.283 LitersStandard Error 0.0146
QVA149Change From Baseline in FVCDay 57, -45 min (n=254,254,256,244)0.286 LitersStandard Error 0.0235
QVA149Change From Baseline in FVCDay 1, 11 h 55 min(n=246,250,253,245)0.240 LitersStandard Error 0.0208
QVA149Change From Baseline in FVCDay 86, 23 h 45 min (n=255,254,258,250)0.315 LitersStandard Error 0.0243
QVA149Change From Baseline in FVCDay 29, 1 h (n=258,260,261,258)0.422 LitersStandard Error 0.0243
QVA149Change From Baseline in FVCDay 57, 1 h (n=258,260,261,258)0.411 LitersStandard Error 0.0241
QVA149Change From Baseline in FVCDay 15, -15 min (n=254,254,256,243)0.307 LitersStandard Error 0.0234
QVA149Change From Baseline in FVCDay 29, -15 min (n=254,254,256,243)0.304 LitersStandard Error 0.0228
QVA149Change From Baseline in FVCDay 15, 1 h (n=258,260,261,258)0.419 LitersStandard Error 0.0241
QVA149Change From Baseline in FVCDay 85, 5 min (n=255,257,260,255)0.350 LitersStandard Error 0.0253
QVA149Change From Baseline in FVCDay 29, -45 min (n=254,254,256,244)0.276 LitersStandard Error 0.0225
QVA149Change From Baseline in FVCDay 15, -45 min (n=254,254,256,244)0.265 LitersStandard Error 0.0227
QVA149Change From Baseline in FVCDay 2, 23 h 45 min (n=255,254,258,250)0.337 LitersStandard Error 0.02
QVA149Change From Baseline in FVCDay 85, 1 h (n=258,260,261,258)0.366 LitersStandard Error 0.025
QVA149Change From Baseline in FVCDay 85, 8h (n=253,251,256,248)0.263 LitersStandard Error 0.0259
QVA149Change From Baseline in FVCDay 85, 2 h (n=254,257,261,254)0.380 LitersStandard Error 0.0255
QVA149Change From Baseline in FVCDay 85, 4 h (n=252,260,256,254)0.326 LitersStandard Error 0.026
QVA149Change From Baseline in FVCDay 1, 5 min (n=255,257,260,255)0.234 LitersStandard Error 0.0131
QAB149Change From Baseline in FVCDay 85, 4 h (n=252,260,256,254)0.201 LitersStandard Error 0.0255
QAB149Change From Baseline in FVCDay 1, 2 h (n=254,257,261,254)0.220 LitersStandard Error 0.018
QAB149Change From Baseline in FVCDay 1, 8 h (n=253,251,256,248)0.188 LitersStandard Error 0.0192
QAB149Change From Baseline in FVCDay 1, 11 h 55 min(n=246,250,253,245)0.122 LitersStandard Error 0.0208
QAB149Change From Baseline in FVCDay 57, -45 min (n=254,254,256,244)0.153 LitersStandard Error 0.0236
QAB149Change From Baseline in FVCDay 57, -15 min (n=254,254,256,243)0.177 LitersStandard Error 0.0234
QAB149Change From Baseline in FVCDay 85, -45 min (n=254,254,256,244)0.106 LitersStandard Error 0.0245
QAB149Change From Baseline in FVCDay 85, 5 min (n=255,257,260,255)0.192 LitersStandard Error 0.0255
QAB149Change From Baseline in FVCDay 85, 1 h (n=258,260,261,258)0.200 LitersStandard Error 0.025
QAB149Change From Baseline in FVCDay 85, 2 h (n=254,257,261,254)0.222 LitersStandard Error 0.0255
QAB149Change From Baseline in FVCDay 85, 6 h (n=253,256,254,248)0.164 LitersStandard Error 0.0265
QAB149Change From Baseline in FVCDay 85, 11 55 min (n=246,250,253,245)0.109 LitersStandard Error 0.0259
QAB149Change From Baseline in FVCDay 86, 23 h 15 min (n=249,249,254,242)0.160 LitersStandard Error 0.0254
QAB149Change From Baseline in FVCDay 1, 5 min (n=255,257,260,255)0.175 LitersStandard Error 0.0132
QAB149Change From Baseline in FVCDay 1, 15 min (n=256,256,261,258)0.200 LitersStandard Error 0.0146
QAB149Change From Baseline in FVCDay 1, 1 h (n=258,260,261,258)0.191 LitersStandard Error 0.0164
QAB149Change From Baseline in FVCDay 1, 4 h (n=252,260,256,254)0.209 LitersStandard Error 0.0192
QAB149Change From Baseline in FVCDay 1, 6 h (n=253,256,254,248)0.214 LitersStandard Error 0.0198
QAB149Change From Baseline in FVCDay 2, 23 h 15 min (n=249,249,254,242)0.214 LitersStandard Error 0.0193
QAB149Change From Baseline in FVCDay 2, 23 h 45 min (n=255,254,258,250)0.232 LitersStandard Error 0.0203
QAB149Change From Baseline in FVCDay 15, -45 min (n=254,254,256,244)0.188 LitersStandard Error 0.0229
QAB149Change From Baseline in FVCDay 15, -15 min (n=254,254,256,243)0.206 LitersStandard Error 0.0236
QAB149Change From Baseline in FVCDay 15, 1 h (n=258,260,261,258)0.274 LitersStandard Error 0.0242
QAB149Change From Baseline in FVCDay 29, -45 min (n=254,254,256,244)0.177 LitersStandard Error 0.0226
QAB149Change From Baseline in FVCDay 29, -15 min (n=254,254,256,243)0.203 LitersStandard Error 0.0228
QAB149Change From Baseline in FVCDay 29, 1 h (n=258,260,261,258)0.259 LitersStandard Error 0.0244
QAB149Change From Baseline in FVCDay 57, 1 h (n=258,260,261,258)0.239 LitersStandard Error 0.0241
QAB149Change From Baseline in FVCDay 85, -15 min (n=254,254,256,243)0.129 LitersStandard Error 0.0247
QAB149Change From Baseline in FVCDay 85, 15 min (n=256,256,261,258)0.226 LitersStandard Error 0.0252
QAB149Change From Baseline in FVCDay 85, 8h (n=253,251,256,248)0.154 LitersStandard Error 0.0259
QAB149Change From Baseline in FVCDay 86, 23 h 45 min (n=255,254,258,250)0.186 LitersStandard Error 0.0242
NVA237Change From Baseline in FVCDay 85, 15 min (n=256,256,261,258)0.226 LitersStandard Error 0.0252
NVA237Change From Baseline in FVCDay 1, 8 h (n=253,251,256,248)0.195 LitersStandard Error 0.0189
NVA237Change From Baseline in FVCDay 1, 11 h 55 min(n=246,250,253,245)0.140 LitersStandard Error 0.0207
NVA237Change From Baseline in FVCDay 2, 23 h 15 min (n=249,249,254,242)0.190 LitersStandard Error 0.019
NVA237Change From Baseline in FVCDay 85, 2 h (n=254,257,261,254)0.285 LitersStandard Error 0.0255
NVA237Change From Baseline in FVCDay 2, 23 h 45 min (n=255,254,258,250)0.201 LitersStandard Error 0.0198
NVA237Change From Baseline in FVCDay 85, 5 min (n=255,257,260,255)0.179 LitersStandard Error 0.0255
NVA237Change From Baseline in FVCDay 15, -45 min (n=254,254,256,244)0.134 LitersStandard Error 0.0225
NVA237Change From Baseline in FVCDay 85, 4 h (n=252,260,256,254)0.203 LitersStandard Error 0.0259
NVA237Change From Baseline in FVCDay 15, -15 min (n=254,254,256,243)0.167 LitersStandard Error 0.0233
NVA237Change From Baseline in FVCDay 85, 6 h (n=253,256,254,248)0.176 LitersStandard Error 0.0268
NVA237Change From Baseline in FVCDay 15, 1 h (n=258,260,261,258)0.269 LitersStandard Error 0.0241
NVA237Change From Baseline in FVCDay 29, -45 min (n=254,254,256,244)0.142 LitersStandard Error 0.0224
NVA237Change From Baseline in FVCDay 85, -45 min (n=254,254,256,244)0.092 LitersStandard Error 0.0245
NVA237Change From Baseline in FVCDay 86, 23 h 45 min (n=255,254,258,250)0.167 LitersStandard Error 0.024
NVA237Change From Baseline in FVCDay 57, -45 min (n=254,254,256,244)0.124 LitersStandard Error 0.0234
NVA237Change From Baseline in FVCDay 57, -15 min (n=254,254,256,243)0.172 LitersStandard Error 0.0234
NVA237Change From Baseline in FVCDay 57, 1 h (n=258,260,261,258)0.265 LitersStandard Error 0.024
NVA237Change From Baseline in FVCDay 29, 1 h (n=258,260,261,258)0.272 LitersStandard Error 0.0243
NVA237Change From Baseline in FVCDay 85, -15 min (n=254,254,256,243)0.134 LitersStandard Error 0.0245
NVA237Change From Baseline in FVCDay 29, -15 min (n=254,254,256,243)0.168 LitersStandard Error 0.0227
NVA237Change From Baseline in FVCDay 1, 5 min (n=255,257,260,255)0.136 LitersStandard Error 0.0131
NVA237Change From Baseline in FVCDay 1, 6 h (n=253,256,254,248)0.230 LitersStandard Error 0.0197
NVA237Change From Baseline in FVCDay 1, 15 min (n=256,256,261,258)0.243 LitersStandard Error 0.0145
NVA237Change From Baseline in FVCDay 86, 23 h 15 min (n=249,249,254,242)0.142 LitersStandard Error 0.0253
NVA237Change From Baseline in FVCDay 1, 1 h (n=258,260,261,258)0.292 LitersStandard Error 0.0163
NVA237Change From Baseline in FVCDay 85, 11 55 min (n=246,250,253,245)0.110 LitersStandard Error 0.0253
NVA237Change From Baseline in FVCDay 1, 2 h (n=254,257,261,254)0.306 LitersStandard Error 0.0177
NVA237Change From Baseline in FVCDay 85, 1 h (n=258,260,261,258)0.243 LitersStandard Error 0.0251
NVA237Change From Baseline in FVCDay 1, 4 h (n=252,260,256,254)0.253 LitersStandard Error 0.019
NVA237Change From Baseline in FVCDay 85, 8h (n=253,251,256,248)0.155 LitersStandard Error 0.0258
PlaceboChange From Baseline in FVCDay 1, 2 h (n=254,257,261,254)0.076 LitersStandard Error 0.0178
PlaceboChange From Baseline in FVCDay 1, 6 h (n=253,256,254,248)0.043 LitersStandard Error 0.0202
PlaceboChange From Baseline in FVCDay 85, 6 h (n=253,256,254,248)-0.033 LitersStandard Error 0.0276
PlaceboChange From Baseline in FVCDay 57, -45 min (n=254,254,256,244)-0.026 LitersStandard Error 0.024
PlaceboChange From Baseline in FVCDay 1, 8 h (n=253,251,256,248)0.040 LitersStandard Error 0.0195
PlaceboChange From Baseline in FVCDay 29, 1 h (n=258,260,261,258)0.046 LitersStandard Error 0.0248
PlaceboChange From Baseline in FVCDay 1, 11 h 55 min(n=246,250,253,245)-0.019 LitersStandard Error 0.021
PlaceboChange From Baseline in FVCDay 85, 4 h (n=252,260,256,254)0.008 LitersStandard Error 0.027
PlaceboChange From Baseline in FVCDay 29, -45 min (n=254,254,256,244)-0.022 LitersStandard Error 0.0231
PlaceboChange From Baseline in FVCDay 1, 1 h (n=258,260,261,258)0.029 LitersStandard Error 0.0164
PlaceboChange From Baseline in FVCDay 2, 23 h 15 min (n=249,249,254,242)0.013 LitersStandard Error 0.0196
PlaceboChange From Baseline in FVCDay 85, 5 min (n=255,257,260,255)-0.031 LitersStandard Error 0.0265
PlaceboChange From Baseline in FVCDay 86, 23 h 15 min (n=249,249,254,242)-0.007 LitersStandard Error 0.0259
PlaceboChange From Baseline in FVCDay 85, 8h (n=253,251,256,248)-0.035 LitersStandard Error 0.0269
PlaceboChange From Baseline in FVCDay 2, 23 h 45 min (n=255,254,258,250)0.056 LitersStandard Error 0.023
PlaceboChange From Baseline in FVCDay 57, 1 h (n=258,260,261,258)0.030 LitersStandard Error 0.0246
PlaceboChange From Baseline in FVCDay 85, 2 h (n=254,257,261,254)0.012 LitersStandard Error 0.0265
PlaceboChange From Baseline in FVCDay 1, 15 min (n=256,256,261,258)0.032 LitersStandard Error 0.0146
PlaceboChange From Baseline in FVCDay 15, -45 min (n=254,254,256,244)-0.016 LitersStandard Error 0.0232
PlaceboChange From Baseline in FVCDay 29, -15 min (n=254,254,256,243)0.017 LitersStandard Error 0.0233
PlaceboChange From Baseline in FVCDay 1, 4 h (n=252,260,256,254)0.072 LitersStandard Error 0.0192
PlaceboChange From Baseline in FVCDay 15, -15 min (n=254,254,256,243)0.032 LitersStandard Error 0.0241
PlaceboChange From Baseline in FVCDay 85, -45 min (n=254,254,256,244)-0.055 LitersStandard Error 0.0252
PlaceboChange From Baseline in FVCDay 85, 1 h (n=258,260,261,258)-0.024 LitersStandard Error 0.0257
PlaceboChange From Baseline in FVCDay 85, -15 min (n=254,254,256,243)-0.058 LitersStandard Error 0.0255
PlaceboChange From Baseline in FVCDay 15, 1 h (n=258,260,261,258)0.034 LitersStandard Error 0.0246
PlaceboChange From Baseline in FVCDay 85, 15 min (n=256,256,261,258)-0.011 LitersStandard Error 0.0263
PlaceboChange From Baseline in FVCDay 86, 23 h 45 min (n=255,254,258,250)0.029 LitersStandard Error 0.0251
PlaceboChange From Baseline in FVCDay 1, 5 min (n=255,257,260,255)0.009 LitersStandard Error 0.0131
PlaceboChange From Baseline in FVCDay 57, -15 min (n=254,254,256,243)0.022 LitersStandard Error 0.0241
PlaceboChange From Baseline in FVCDay 85, 11 55 min (n=246,250,253,245)-0.071 LitersStandard Error 0.0271
Secondary

Change From Baseline in Mean Daily Number of Puffs of Rescue Medication

Participants completed an electronic diary (eDiary) twice daily at the same time in the morning and evening to record the number of puffs of rescue medication taken in the previous 12 hours. A negative change from baseline indicates improvement.

Time frame: BL, 12 Weeks

Population: Full Analysis Set (FAS) The FAS included all randomized participants who received at least one dose of study treatment. Participants, who had both baseline and week 12 values, were included in the analysis.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in Mean Daily Number of Puffs of Rescue Medication-2.22 Number of puffsStandard Error 0.135
QAB149Change From Baseline in Mean Daily Number of Puffs of Rescue Medication-1.72 Number of puffsStandard Error 0.135
NVA237Change From Baseline in Mean Daily Number of Puffs of Rescue Medication-1.65 Number of puffsStandard Error 0.135
PlaceboChange From Baseline in Mean Daily Number of Puffs of Rescue Medication-1.00 Number of puffsStandard Error 0.137
Secondary

Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom Score

The participant recorded symptom scores twice daily in the eDiary. The daily clinical symptoms included: cough, wheezing, shortness of breath, sputum volume, sputum color, and night time awakening. The range of scores for each assessment is 0 to 3 where 0 indications No symptom and 3 indicates a Severe symptom. The maximum daytime total score is 27 and the maximum nighttime total score is 27. The total daily symptom score is obtained by adding the scores for the morning and evening symptoms for each day. The maximum possible total daily score is 54. A negative change from baseline indicated improvement.

Time frame: BL, 12 Weeks

Population: Full Analysis Set (FAS) The FAS included all randomized participants who received at least one dose of study treatment. Participants, who had both baseline and week 12 values, were included in the analysis.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaily (n=251,250,252,240)-1.30 score on a scaleStandard Error 0.104
QVA149Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreNighttime (n=244,248,248,234)-1.07 score on a scaleStandard Error 0.106
QVA149Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaytime (n=245,246,245,238)-1.17 score on a scaleStandard Error 0.102
QAB149Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaily (n=251,250,252,240)-0.97 score on a scaleStandard Error 0.104
QAB149Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreNighttime (n=244,248,248,234)-0.83 score on a scaleStandard Error 0.105
QAB149Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaytime (n=245,246,245,238)-0.85 score on a scaleStandard Error 0.102
NVA237Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaytime (n=245,246,245,238)-0.88 score on a scaleStandard Error 0.102
NVA237Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaily (n=251,250,252,240)-0.99 score on a scaleStandard Error 0.104
NVA237Change From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreNighttime (n=244,248,248,234)-0.85 score on a scaleStandard Error 0.105
PlaceboChange From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaily (n=251,250,252,240)-0.52 score on a scaleStandard Error 0.106
PlaceboChange From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreNighttime (n=244,248,248,234)-0.40 score on a scaleStandard Error 0.107
PlaceboChange From Baseline in Mean Total Daily Symptom Score, Mean Daytime Total Symptom Score and Mean Nighttime Total Symptom ScoreDaytime (n=245,246,245,238)-0.38 score on a scaleStandard Error 0.103
Secondary

Change From Baseline in Pre-dose Trough FEV1

Pulmonary function assessments were performed using centralized spirometry according to international standards. Pre-dose trough FEV1 was analyzed using the same MMRM as specified for FEV1. Pre-dose trough FEV1 was defined as the mean of FEV1 at -45 min and -15 min before the morning dose. Since the time of evening dose of the previous day was not recorded at these visits, no time window was applied.

Time frame: BL, day 85

Population: Full Analysis Set (FAS): The FAS included all randomized participants who received at least one dose of study treatment. Participants, who had both baseline and week 12 values, were included in the analysis.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in Pre-dose Trough FEV10.161 LitersStandard Error 0.014
QAB149Change From Baseline in Pre-dose Trough FEV10.083 LitersStandard Error 0.014
NVA237Change From Baseline in Pre-dose Trough FEV10.061 LitersStandard Error 0.014
PlaceboChange From Baseline in Pre-dose Trough FEV1-0.035 LitersStandard Error 0.0145
Secondary

Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)

Pulmonary function assessments were performed using centralized spirometry according to international standards. Baseline FEV1 was defined as the average of the pre-dose FEV1 measured at -45 minutes (min) and -15 min at day 1. A mixed model for repeated measures (MMRM), used for this analysis, included terms of treatment, baseline FEV1 measurements, smoking status at baseline, baseline inhaled corticosteroid (ICS) use, region, baseline FEV1 \* visit interaction, and visit, treatment \* visit interaction. The trapezoidal rule was used to calculate FEV1 AUC and then normalized to the length of time.

Time frame: BL, day 1, week 12

Population: Full Analysis Set: The FAS included all randomized participants who received at least one dose of study treatment. Participants, who had both baseline and post baseline values for a given time point, were included in the analysis for that time point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 8-12h (n=254,256,259,253)0.164 LitersStandard Error 0.0145
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-12h (n=249,251,250,246)0.171 LitersStandard Error 0.0083
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 4-8h (n=257,260,261,257)0.178 LitersStandard Error 0.0093
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-12h (n=249,251,250,246)0.211 LitersStandard Error 0.014
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-4h (n=249,251,250,246)0.194 LitersStandard Error 0.0077
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-4h (n=249,251,250,246)0.254 LitersStandard Error 0.0144
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 8-12h (n=254,256,259,253)0.138 LitersStandard Error 0.0097
QVA149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 4-8h (n=257,260,261,257)0.205 LitersStandard Error 0.0145
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-4h (n=249,251,250,246)0.096 LitersStandard Error 0.0077
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-4h (n=249,251,250,246)0.141 LitersStandard Error 0.0144
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 4-8h (n=257,260,261,257)0.096 LitersStandard Error 0.0093
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 8-12h (n=254,256,259,253)0.084 LitersStandard Error 0.0144
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-12h (n=249,251,250,246)0.117 LitersStandard Error 0.014
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-12h (n=249,251,250,246)0.083 LitersStandard Error 0.0083
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 8-12h (n=254,256,259,253)0.065 LitersStandard Error 0.0098
QAB149Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 4-8h (n=257,260,261,257)0.121 LitersStandard Error 0.0144
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-4h (n=249,251,250,246)0.149 LitersStandard Error 0.0145
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 8-12h (n=254,256,259,253)0.094 LitersStandard Error 0.0097
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-12h (n=249,251,250,246)0.128 LitersStandard Error 0.0082
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 4-8h (n=257,260,261,257)0.111 LitersStandard Error 0.0145
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 8-12h (n=254,256,259,253)0.072 LitersStandard Error 0.0143
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-12h (n=249,251,250,246)0.112 LitersStandard Error 0.0141
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-4h (n=249,251,250,246)0.158 LitersStandard Error 0.0077
NVA237Change From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 4-8h (n=257,260,261,257)0.125 LitersStandard Error 0.0093
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 4-8h (n=257,260,261,257)-0.016 LitersStandard Error 0.0151
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-4h (n=249,251,250,246)-0.010 LitersStandard Error 0.015
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-12h (n=249,251,250,246)0.016 LitersStandard Error 0.0083
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 8-12h (n=254,256,259,253)-0.006 LitersStandard Error 0.0098
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 4-8h (n=257,260,261,257)0.023 LitersStandard Error 0.0093
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)day 1, FEV1 AUC 0-4h (n=249,251,250,246)0.028 LitersStandard Error 0.0077
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 0-12h (n=249,251,250,246)-0.021 LitersStandard Error 0.0145
PlaceboChange From Baseline in Standardized FEV1 AUC (0-4 h), FEV1 AUC (4-8h), FEV1 AUC (8-12h) and FEV1 AUC (0-12 h)week 12, FEV1 AUC 8-12h (n=254,256,259,253)-0.043 LitersStandard Error 0.0151
Secondary

Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score

Participants reported change in health status by using the SGRQ. The SGRQ contains 50 items divided into 2 parts covering 3 aspects of health related to COPD: Part I covers Symptoms and is concerned with respiratory symptoms, their frequency and severity; Part II covers Activity and is concerned with activities that cause or are limited by breathlessness; Part II is also concerned with Impacts, which covers a range of aspects concerned with social functioning and psychological disturbances resulting from airways disease. A score was calculated for each of these 3 subscales and a Total score was calculated. In each case the lowest possible value is zero and the highest 100. Higher values correspond to greater impairment of health status. Missing week 12 data were imputed with Last Observation Carried Forward (LOCF) method but only if measured at day \>= 29. A negative change from baseline indicates improvement.

Time frame: BL, 12 Weeks

Population: Full Analysis Set: The full analysis set included all randomized participants who received at least one dose of study treatment. Participants missing week 12 data were not included in the analysis.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score-6.4 score on a scaleStandard Error 0.75
QAB149Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score-4.6 score on a scaleStandard Error 0.75
NVA237Change From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score-4.8 score on a scaleStandard Error 0.75
PlaceboChange From Baseline in St. George's Respiratory Questionnaire (SGRQ) Total Score-2.7 score on a scaleStandard Error 0.78
Secondary

Change From Baseline in Trough FEV1

Pulmonary function assessments were performed using centralized spirometry according to international standards. Trough FEV1 was analyzed using the same MMRM as specified for FEV1. Trough FEV1 was defined as the mean of FEV1 at 23 h 15 min and 23 h 45 min after the morning dose of the previous day. Before the mean was calculated, a time window of 10 - 13 hours post-evening dose was applied to these 2 measurements. Recordings outside the time window were set to missing.

Time frame: BL, day 2, day 86

Population: Full Analysis Set (FAS): The FAS included all randomized participants who received at least one dose of study treatment. Participants, who had both baseline and post baseline values for a given time point, were included in the analysis for that time point.

ArmMeasureGroupValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Change From Baseline in Trough FEV1day 20.187 LitersStandard Error 0.0102
QVA149Change From Baseline in Trough FEV1day 860.201 LitersStandard Error 0.0144
QAB149Change From Baseline in Trough FEV1day 860.120 LitersStandard Error 0.0142
QAB149Change From Baseline in Trough FEV1day 20.109 LitersStandard Error 0.0102
NVA237Change From Baseline in Trough FEV1day 20.112 LitersStandard Error 0.0101
NVA237Change From Baseline in Trough FEV1day 860.092 LitersStandard Error 0.0142
PlaceboChange From Baseline in Trough FEV1day 20.015 LitersStandard Error 0.0103
PlaceboChange From Baseline in Trough FEV1day 86-0.012 LitersStandard Error 0.015
Secondary

Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score

Participants reported change in health status by using the SGRQ. The SGRQ contains 50 items divided into 2 parts covering 3 aspects of health related to COPD: Part I covers Symptoms and is concerned with respiratory symptoms, their frequency and severity; Part II covers Activity and is concerned with activities that cause or are limited by breathlessness; Part II is also concerned with Impacts, which covers a range of aspects concerned with social functioning and psychological disturbances resulting from airways disease. A score was calculated for each of these 3 subscales and a Total score was calculated. In each case the lowest possible value is zero and the highest 100. Higher values correspond to greater impairment of health status.

Time frame: 12 weeks

Population: Participants from the full analysis set, who had a SGRQ total score, were included in the analysis. The full analysis set included all randomized participants who received at least one dose of study treatment.

ArmMeasureValue (NUMBER)
QVA149Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score57.3 Percentage of participants
QAB149Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score48.0 Percentage of participants
NVA237Percentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score46.1 Percentage of participants
PlaceboPercentage of Participants With a Clinically Important Improvement of at Least 4 Units in the SGRQ Total Score39.0 Percentage of participants
Secondary

Transitional Dyspnea Index (TDI) Focal Score

The Baseline Dyspnea Index (BDI) / TDI is an instrument used to assess a participant's level of dyspnea. The BDI and TDI each have three domains: functional impairment, magnitude of task and magnitude of effort. BDI domains were rated from 0 (severe) to 4 (unimpaired) and rates summed for baseline focal score ranged from 0 to 12; lower scores mean worse severity. TDI domains were rated from -3 (major deterioration) to 3 (major improvement) and rates summed for transition focal score ranged from -9 to 9; negative scores indicate deterioration. A TDI focal score of ≥1 was defined as a clinically important improvement from baseline.

Time frame: BL, 12 weeks

Population: Full Analysis Set (FAS) The FAS included all randomized participants who received at least one dose of study treatment. Participants, who had both baseline and week 12 scores, were included in the analysis.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
QVA149Transitional Dyspnea Index (TDI) Focal Score1.94 score on a scaleStandard Error 0.211
QAB149Transitional Dyspnea Index (TDI) Focal Score1.30 score on a scaleStandard Error 0.212
NVA237Transitional Dyspnea Index (TDI) Focal Score1.48 score on a scaleStandard Error 0.21
PlaceboTransitional Dyspnea Index (TDI) Focal Score0.71 score on a scaleStandard Error 0.217

Source: ClinicalTrials.gov · Data processed: Feb 22, 2026