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A Safety and Efficacy Study of Beclomethasone Dipropionate Delivered Via Breath-Actuated Inhaler (BAI) or Metered-Dose Inhaler (MDI) in Participants >=12 Years Old With Persistent Asthma

A Randomized, Double-Blind, Double-Dummy, Placebo Controlled, Parallel-Group, 12-Week Clinical Study to Assess the Efficacy and Safety of 320 or 640 mcg/Day of Beclomethasone Dipropionate Delivered Via Breath-Actuated Inhaler (BAI) or Metered-Dose Inhaler (MDI) in Adolescent and Adult Patients 12 Years of Age and Older With Persistent Asthma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02031640
Enrollment
1113
Registered
2014-01-09
Start date
2013-12-31
Completion date
2014-12-31
Last updated
2021-11-09

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

Conditions

Asthma

Keywords

asthma, breath-actuated inhaler, metered-dose inhaler

Brief summary

This is a Phase 3, randomized, placebo-controlled, double-blind,double-dummy, parallel-group, 12-week study in male and female patients, 12 years of age and older, with persistent asthma.

Interventions

DRUGBeclomethasone dipropionate
DRUGPlacebo
DRUGAlbuterol/salbutamol

Rescue medication (albuterol/salbutamol hydrofluoroalkane (HFA) MDI \[90 mcg ex-actuator\] or equivalent) for use on an as-needed basis for the immediate relief of asthma symptoms throughout the treatment period.

Sponsors

Teva Branded Pharmaceutical Products R&D, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

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

Inclusion criteria

* Severity of disease: The patient has persistent asthma, with a forced expiratory volume in 1 second (FEV1) 40%-85% of the value predicted for age, height, sex, and race as per the National Health and Nutrition Examination Survey (NHANES III) (Hankinson et al 1999) reference values at screening visit. * Current asthma therapy: The patient must be on a stable dose of an inhaled corticosteroid (ICS) of at least 440 mcg/day of fluticasone propionate or equivalent for a minimum of 4 weeks before screening visit, or any inhaled corticosteroid/long-acting beta2-agonist (ICS/LABA) combination for a minimum of 4 weeks before the prescreening visit. * Reversibility of disease: The patient has demonstrated at least 12% reversibility of FEV1 and at least 200 mL increase from baseline FEV1 (patients age 18 and older) within 30 minutes after 2-4 inhalations of albuterol/salbutamol hydrofluoroalkane (HFA) MDI (90 mcg ex-actuator) or equivalent at the screening visit * If female, the patient is currently not pregnant, breast feeding, or attempting to become pregnant. If of childbearing potential, has a negative serum pregnancy test and is willing to commit to using a consistent and acceptable method of birth control. * Other criteria apply, please contact the investigator for more information

Exclusion criteria

* The patient has a history of life-threatening asthma, defined for this protocol as an asthma episode that required intubation and/or was associated with hypercapnea, respiratory arrest, or hypoxic seizures. * The patient is pregnant or lactating, or plans to become pregnant during the study period or for 30 days after the patient's last study-related visit (for eligible patients only, if applicable). Eligible female patients unwilling to employ appropriate contraceptive measures to ensure that pregnancy will not occur during the study will be excluded. Any patient becoming pregnant during the study will be withdrawn from the study. * The patient has a known hypersensitivity to any corticosteroid or any of the excipients in the study drug or rescue medication formulation. * The patient currently smokes or has a smoking history of 10 pack-years or more (a pack-year is defined as smoking 1 pack of cigarettes/day for 1 year). * The patient has had an asthma exacerbation requiring oral corticosteroids within 30 days before the screening visit, or has had any hospitalization for asthma within 2 months before the screening visit. * The patient has historical or current evidence of a clinically significant disease. Significant disease is defined as any disease that in the medical judgment of the investigator would put the safety of the patient at risk through participation or that could affect the efficacy or safety analysis if the disease/condition worsened during the study. * Other criteria apply, please contact the investigator for more information

Design outcomes

Primary

MeasureTime frameDescription
Standardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )Day 1 (baseline), Weeks 2, 4, 8, 12Trough morning FEV1 measurements were taken pre-dose and pre-rescue bronchodilator treatment for asthma. The baseline pulmonary function measurement was defined as the measurement obtained at randomization visit (Day 1). Pulmonary function measurements (including FEV1) were obtained electronically by spirometry. All pulmonary function test data were submitted to a central reading center for evaluation. The highest FEV1 value from 3 acceptable and 2 repeatable maneuvers (maximum of 5 attempts) was used. Baseline-adjusted FEV1 AUEC(0-12wk) were calculated using the trapezoidal rule. The standardized baseline-adjusted FEV1 AUEC(0-12 wk) accommodates participants who dropped out of the study. Baseline-adjusted FEV1 AUEC(0-t weeks)/t, where t =12 weeks for patients who complete the FEV1 assessment at Week 12. For participants who dropped out early, t \<12 weeks (2, 4, or 8 weeks).

Secondary

MeasureTime frameDescription
Change From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)Baseline: Days -6 to Day 1 (pre-randomization), Treatment: Day 2 to Week 12A hand-held peak flow meter was provided to patients at the screening visit and used to determine the morning and evening PEF throughout the course of the study. Daily trough morning PEF assessments were taken pre-dose and pre-rescue bronchodilator over the 12-week treatment period. The patient recorded the highest value of 3 measurements obtained in the morning and evening in the patient diary. Baseline in trough morning PEF is defined as the average of recorded trough morning PEF assessments over the 7-day window before randomization, including the morning assessment on Day 1 before randomization. Weekly average PEF data was generated using 7-day windows based on analysis days (before the first dose of double-blind study treatment). PEF over the 12 week treatment period was performed using a mixed-model for repeated measures (MMRM) with effects due to baseline weekly average of daily trough morning PEF, sex, age, treatment, time, and time by treatment interaction.
Change From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)Baseline: Days -7 to Day -1, Treatment: Day 1 to Week 12A hand-held peak flow meter was provided to patients at the screening visit and used to determine the morning and evening PEF throughout the course of the study. The patient recorded the highest value of 3 measurements obtained in the morning and evening in the patient diary. Baseline in evening PEF is defined as the average of recorded evening PEF assessments over the 7-day window before randomization. Weekly average PEF data was generated using 7-day windows based on analysis days (after the first dose of double-blind study treatment). PEF over the 12 week treatment period was performed using a mixed-model for repeated measures (MMRM) with effects due to baseline weekly average of daily evening peak PEF, sex, age, treatment, time, and time by treatment interaction.
Number of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment PeriodTreatment period: Day 1 up to Week 12A count of participants who were withdrawn from the study due to meeting stopping criteria. Alert criteria for individual patients with worsening asthma were designed to ensure patient safety. The investigator determined whether the patient's overall clinical picture is consistent with worsening asthma and if the patient should be withdrawn from study drug treatment (but not the study) and be placed on appropriate asthma therapy in the interest of patient safety. An example of alert criteria is: * FEV1 as measured at the study center is below the FEV1 stability limit value calculated at randomization visit (Day 1). * Other criteria as defined in the protocol.
Change From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)Days -6 to Day 1 (pre-randomization), Treatment: Day 1 to Week 12Asthma symptom scores are recorded in the patient's diary each morning and each evening before determining PEF and before administration of study or rescue medications. The Daytime Symptom Score (determined in the evening) has a range from 0=No symptoms during the day to 5=Symptoms so severe that I could not go to work or perform normal daily activities. The Nighttime Symptom Score (determined in the morning) has a range from 0=No symptoms during the night to 4=Symptoms so severe that I did not sleep at all. The total daily asthma symptom score is the average of the daytime and the nighttime scores (full scale is 0 - 4.5). The total daily asthma symptom score is missing if either the daytime or nighttime score is missing. Baseline was the average of recorded daily asthma symptom scores over 7 days prior to the first dose of study treatment. The weekly average was the sum of total daily asthma symptom scores over the 7 days divided by the number of non-missing assessments.
Kaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening AsthmaDay 1 - Week 12Time to withdrawal due to meeting stopping criteria is defined as number of days elapsed from the date of the first dose of double-blind study treatment to the date of withdrawal due to meeting stopping criteria. Stopping criteria are: * FEV1 as measured at the study center is below the FEV1 stability limit value calculated at RV. * Based upon review of patient diary data, the patient has experienced any of the following during any 7-day period: * 4+ days in which the highest (of 3 efforts) am PEF fall below the PEF stability limit calculated when randomized. The patient meets with the investigator who determines whether the FEV1 is consistent with worsening asthma; * 3+ days in which 12+ inhalations/day of rescue medication were used * 2+ days in which the patient experienced a nighttime asthma symptom score of more than 2 * Clinical asthma exacerbation requiring (for example) the use of systemic corticosteroids, or the emergency room or hospitalization.
Change From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)Baseline: Days -6 to Day 1 (pre-randomization), Treatment: Day 1 to Week 12Change from baseline in the use of rescue medication, albuterol/salbutamol, during the treatment period offers an indication of asthma control. Baseline was defined as the average of recorded daily usage of albuterol/salbutamol inhalation aerosol over the 7 days prior to the first dose of double-blind study treatment, including the morning usage at the randomization visit. Weekly average rescue medication data was generated using 7-day windows based on analysis days (after the first dose of double-blind study treatment). Weekly average over the 12 week treatment period was performed using a mixed-model for repeated measures (MMRM) with effects due to baseline value, sex, age, time, treatment, and time-by-treatment interaction.

Countries

Germany, Hungary, Poland, United States

Participant flow

Recruitment details

For this study, 125 sites were activated, 115 sites screened at least 1 patient (91 centers in the United States, 10 centers in Germany, 10 centers in Hungary, and 4 centers in Poland), and 97 sites randomized at least 1 patient.

Pre-assignment details

There were two periods prior to treatment assignment: a screening period and a run-in period.

Participants by arm

ArmCount
Placebo BAI and MDI
Placebo breath-actuated inhaler (BAI), twice daily. Plus placebo metered dose inhaler (MDI), twice daily. Rescue medication (albuterol/salbutamol hydrofluoroalkane (HFA) MDI \[90 mcg ex-actuator\] or equivalent) for use on an as-needed basis for the immediate relief of asthma symptoms throughout the treatment period.
106
BDP 320 mcg BAI
Beclomethasone dipropionate (BDP) via breath-actuated inhaler (BAI) twice daily. Placebo MDI for blinding. Rescue medication (albuterol/salbutamol hydrofluoroalkane (HFA) MDI \[90 mcg ex-actuator\] or equivalent) for use on an as-needed basis for the immediate relief of asthma symptoms throughout the treatment period.
106
BDP 640 mcg BAI
Beclomethasone dipropionate (BDP) via breath-actuated inhaler (BAI) twice daily. Placebo MDI for blinding. Albuterol/salbutamol: Rescue medication (albuterol/salbutamol hydrofluoroalkane (HFA) MDI \[90 mcg ex-actuator\] or equivalent) for use on an as-needed basis for the immediate relief of asthma symptoms throughout the treatment period.
106
BDP 320 mcg MDI
Beclomethasone dipropionate (BDP) via metered dose inhaler (MDI) twice daily. Placebo BAI for blinding. Rescue medication (albuterol/salbutamol hydrofluoroalkane (HFA) MDI \[90 mcg ex-actuator\] or equivalent) for use on an as-needed basis for the immediate relief of asthma symptoms throughout the treatment period.
107
BDP 640 mcg MDI
Beclomethasone dipropionate (BDP) via metered dose inhaler (MDI) twice daily. Placebo BAI for blinding. Rescue medication (albuterol/salbutamol hydrofluoroalkane (HFA) MDI \[90 mcg ex-actuator\] or equivalent) for use on an as-needed basis for the immediate relief of asthma symptoms throughout the treatment period.
107
Total532

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Double-blind Treatment PeriodAdverse Event000200
Double-blind Treatment PeriodLack of Efficacy0143251
Double-blind Treatment PeriodLost to Follow-up030010
Double-blind Treatment PeriodNon-compliance010110
Double-blind Treatment PeriodProtocol deviation020131
Double-blind Treatment PeriodWithdrawal by Subject023111
Run-In PeriodAdverse Event400000
Run-In PeriodExclusion criteria met800000
Run-In PeriodInclusion criteria not met3800000
Run-In PeriodRandomization criteria not met8500000
Run-In PeriodVarious administrative reasons1700000
Run-In PeriodWithdrawal by Subject1700000
Screening PeriodAdverse Event100000
Screening PeriodEnrollment closed2600000
Screening PeriodExclusion criteria met3000000
Screening PeriodInclusion criteria not met31200000
Screening PeriodLost to Follow-up1400000
Screening PeriodWithdrawal by Subject2900000

Baseline characteristics

CharacteristicTotalPlacebo BAI and MDIBDP 320 mcg BAIBDP 640 mcg BAIBDP 320 mcg MDIBDP 640 mcg MDI
Age, Categorical
<=18 years
26 Participants4 Participants5 Participants7 Participants4 Participants6 Participants
Age, Categorical
>=65 years
49 Participants8 Participants15 Participants7 Participants10 Participants9 Participants
Age, Categorical
Between 18 and 65 years
457 Participants94 Participants86 Participants92 Participants93 Participants92 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
99 Participants27 Participants18 Participants14 Participants16 Participants24 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
18 Participants6 Participants3 Participants5 Participants2 Participants2 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
415 Participants73 Participants85 Participants87 Participants89 Participants81 Participants
Sex: Female, Male
Female
335 Participants68 Participants69 Participants67 Participants65 Participants66 Participants
Sex: Female, Male
Male
197 Participants38 Participants37 Participants39 Participants42 Participants41 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
0 / 1060 / 1060 / 1070 / 1070 / 1060 / 532
other
Total, other adverse events
9 / 10611 / 1069 / 10712 / 1072 / 1068 / 532
serious
Total, serious adverse events
1 / 1061 / 1061 / 1072 / 1070 / 1061 / 532

Outcome results

Primary

Standardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )

Trough morning FEV1 measurements were taken pre-dose and pre-rescue bronchodilator treatment for asthma. The baseline pulmonary function measurement was defined as the measurement obtained at randomization visit (Day 1). Pulmonary function measurements (including FEV1) were obtained electronically by spirometry. All pulmonary function test data were submitted to a central reading center for evaluation. The highest FEV1 value from 3 acceptable and 2 repeatable maneuvers (maximum of 5 attempts) was used. Baseline-adjusted FEV1 AUEC(0-12wk) were calculated using the trapezoidal rule. The standardized baseline-adjusted FEV1 AUEC(0-12 wk) accommodates participants who dropped out of the study. Baseline-adjusted FEV1 AUEC(0-t weeks)/t, where t =12 weeks for patients who complete the FEV1 assessment at Week 12. For participants who dropped out early, t \<12 weeks (2, 4, or 8 weeks).

Time frame: Day 1 (baseline), Weeks 2, 4, 8, 12

Population: Full analysis set- randomized patients with at least 1 dose of drug and 1 postbaseline trough am FEV1

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAI and MDIStandardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )0.056 LitersStandard Error 0.0219
BDP 320 mcg BAIStandardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )0.09 LitersStandard Error 0.0221
BDP 640 mcg BAIStandardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )0.101 LitersStandard Error 0.0221
BDP 320 mcg MDIStandardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )0.041 LitersStandard Error 0.0217
BDP 640 mcg MDIStandardized Baseline-adjusted Trough Morning Forced Expiratory Volume in 1 Second (FEV1) Area Under the Effect Curve From Time 0 to 12 Weeks (AUEC(0-12wk) )0.096 LitersStandard Error 0.0216
p-value: 0.27295% CI: [-0.027, 0.095]ANCOVA
p-value: 0.141595% CI: [-0.015, 0.106]ANCOVA
p-value: 0.635695% CI: [-0.075, 0.046]ANCOVA
p-value: 0.193295% CI: [-0.02, 0.1]ANCOVA
Secondary

Change From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)

Asthma symptom scores are recorded in the patient's diary each morning and each evening before determining PEF and before administration of study or rescue medications. The Daytime Symptom Score (determined in the evening) has a range from 0=No symptoms during the day to 5=Symptoms so severe that I could not go to work or perform normal daily activities. The Nighttime Symptom Score (determined in the morning) has a range from 0=No symptoms during the night to 4=Symptoms so severe that I did not sleep at all. The total daily asthma symptom score is the average of the daytime and the nighttime scores (full scale is 0 - 4.5). The total daily asthma symptom score is missing if either the daytime or nighttime score is missing. Baseline was the average of recorded daily asthma symptom scores over 7 days prior to the first dose of study treatment. The weekly average was the sum of total daily asthma symptom scores over the 7 days divided by the number of non-missing assessments.

Time frame: Days -6 to Day 1 (pre-randomization), Treatment: Day 1 to Week 12

Population: Full analysis set. Analysis used a MMRM with effects due to baseline score, sex, age, time, treatment, and time-by-treatment interaction.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAI and MDIChange From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.058 units on a scaleStandard Error 0.0425
BDP 320 mcg BAIChange From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.207 units on a scaleStandard Error 0.0417
BDP 640 mcg BAIChange From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.159 units on a scaleStandard Error 0.0415
BDP 320 mcg MDIChange From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.247 units on a scaleStandard Error 0.0417
BDP 640 mcg MDIChange From Baseline in the Weekly Average of the Total Daily Asthma Symptom Score Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.274 units on a scaleStandard Error 0.0411
p-value: 0.011995% CI: [-0.265, -0.033]Mixed Models Analysis
p-value: 0.085495% CI: [-0.217, 0.014]Mixed Models Analysis
p-value: 0.001695% CI: [-0.306, -0.072]Mixed Models Analysis
p-value: 0.000395% CI: [-0.332, -0.101]Mixed Models Analysis
Secondary

Change From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)

Change from baseline in the use of rescue medication, albuterol/salbutamol, during the treatment period offers an indication of asthma control. Baseline was defined as the average of recorded daily usage of albuterol/salbutamol inhalation aerosol over the 7 days prior to the first dose of double-blind study treatment, including the morning usage at the randomization visit. Weekly average rescue medication data was generated using 7-day windows based on analysis days (after the first dose of double-blind study treatment). Weekly average over the 12 week treatment period was performed using a mixed-model for repeated measures (MMRM) with effects due to baseline value, sex, age, time, treatment, and time-by-treatment interaction.

Time frame: Baseline: Days -6 to Day 1 (pre-randomization), Treatment: Day 1 to Week 12

Population: Full analysis set

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAI and MDIChange From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)0.478 number of inhalationsStandard Error 0.1232
BDP 320 mcg BAIChange From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.226 number of inhalationsStandard Error 0.1235
BDP 640 mcg BAIChange From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.213 number of inhalationsStandard Error 0.1221
BDP 320 mcg MDIChange From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.173 number of inhalationsStandard Error 0.1246
BDP 640 mcg MDIChange From Baseline in the Weekly Average of Total Daily (24-hour) Use of Albuterol/Salbutamol Inhalation Aerosol (Number of Inhalations) Over Weeks 1-12 Using a Mixed Model for Repeated Measures (MMRM)-0.323 number of inhalationsStandard Error 0.1206
p-value: <0.000195% CI: [-1.044, -0.363]Mixed Model for repeated measures
p-value: <0.000195% CI: [-1.029, -0.352]Mixed Model for repeated measures
p-value: 0.000295% CI: [-0.994, -0.309]Mixed Model for repeated measures
p-value: <0.000195% CI: [-1.138, -0.464]Mixed Model for repeated measures
Secondary

Change From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)

A hand-held peak flow meter was provided to patients at the screening visit and used to determine the morning and evening PEF throughout the course of the study. The patient recorded the highest value of 3 measurements obtained in the morning and evening in the patient diary. Baseline in evening PEF is defined as the average of recorded evening PEF assessments over the 7-day window before randomization. Weekly average PEF data was generated using 7-day windows based on analysis days (after the first dose of double-blind study treatment). PEF over the 12 week treatment period was performed using a mixed-model for repeated measures (MMRM) with effects due to baseline weekly average of daily evening peak PEF, sex, age, treatment, time, and time by treatment interaction.

Time frame: Baseline: Days -7 to Day -1, Treatment: Day 1 to Week 12

Population: Full Analysis Set

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAI and MDIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)-4.708 Liters/minuteStandard Error 2.6503
BDP 320 mcg BAIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)4.439 Liters/minuteStandard Error 2.6199
BDP 640 mcg BAIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)4.462 Liters/minuteStandard Error 2.6092
BDP 320 mcg MDIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)-0.62 Liters/minuteStandard Error 2.6145
BDP 640 mcg MDIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)5.594 Liters/minuteStandard Error 2.5848
p-value: 0.013995% CI: [1.866, 16.429]Mixed Model for repeated measures
p-value: 0.013395% CI: [1.914, 16.425]Mixed Model for repeated measures
p-value: 0.270495% CI: [-3.191, 11.367]Mixed Model for repeated measures
p-value: 0.005395% CI: [3.073, 17.53]Mixed Model for repeated measures
Secondary

Change From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)

A hand-held peak flow meter was provided to patients at the screening visit and used to determine the morning and evening PEF throughout the course of the study. Daily trough morning PEF assessments were taken pre-dose and pre-rescue bronchodilator over the 12-week treatment period. The patient recorded the highest value of 3 measurements obtained in the morning and evening in the patient diary. Baseline in trough morning PEF is defined as the average of recorded trough morning PEF assessments over the 7-day window before randomization, including the morning assessment on Day 1 before randomization. Weekly average PEF data was generated using 7-day windows based on analysis days (before the first dose of double-blind study treatment). PEF over the 12 week treatment period was performed using a mixed-model for repeated measures (MMRM) with effects due to baseline weekly average of daily trough morning PEF, sex, age, treatment, time, and time by treatment interaction.

Time frame: Baseline: Days -6 to Day 1 (pre-randomization), Treatment: Day 2 to Week 12

Population: Full Analysis Set

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAI and MDIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)-5.524 Liters/minuteStandard Error 2.5944
BDP 320 mcg BAIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)5.092 Liters/minuteStandard Error 2.5625
BDP 640 mcg BAIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)2.895 Liters/minuteStandard Error 2.559
BDP 320 mcg MDIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)0.480 Liters/minuteStandard Error 2.558
BDP 640 mcg MDIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Over the 12-week Treatment Period Using a Mixed Model for Repeated Measures (MMRM)6.988 Liters/minuteStandard Error 2.5298
p-value: 0.003695% CI: [3.489, 17.744]Mixed Model for repeated measures
Comparison: The analysis of change from baseline in weekly average of daily trough morning (pre-dose and pre-rescue bronchodilator) PEF over the 12-week treatment period was performed using a repeated measures mixed model with effects due to baseline weekly average of daily trough morning PEF, sex, age, treatment, time, and time-by-treatment interactionp-value: 0.020495% CI: [1.309, 15.53]Mixed Model for repeated measures
Comparison: The analysis of change from baseline in weekly average of daily trough morning (pre-dose and pre-rescue bronchodilator) PEF over the 12-week treatment period was performed using a repeated measures mixed model with effects due to baseline weekly average of daily trough morning PEF, sex, age, treatment, time, and time-by-treatment interactionp-value: 0.098495% CI: [-1.121, 13.129]Mixed Model for repeated measures
Comparison: The analysis of change from baseline in weekly average of daily trough morning (pre-dose and pre-rescue bronchodilator) PEF over the 12-week treatment period was performed using a repeated measures mixed model with effects due to baseline weekly average of daily trough morning PEF, sex, age, treatment, time, and time-by-treatment interactionp-value: 0.000695% CI: [5.435, 19.589]Mixed Model for repeated measures
Secondary

Kaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening Asthma

Time to withdrawal due to meeting stopping criteria is defined as number of days elapsed from the date of the first dose of double-blind study treatment to the date of withdrawal due to meeting stopping criteria. Stopping criteria are: * FEV1 as measured at the study center is below the FEV1 stability limit value calculated at RV. * Based upon review of patient diary data, the patient has experienced any of the following during any 7-day period: * 4+ days in which the highest (of 3 efforts) am PEF fall below the PEF stability limit calculated when randomized. The patient meets with the investigator who determines whether the FEV1 is consistent with worsening asthma; * 3+ days in which 12+ inhalations/day of rescue medication were used * 2+ days in which the patient experienced a nighttime asthma symptom score of more than 2 * Clinical asthma exacerbation requiring (for example) the use of systemic corticosteroids, or the emergency room or hospitalization.

Time frame: Day 1 - Week 12

Population: Full analysis set; unable to calculate as few patients met stopping criteria

ArmMeasureValue (MEDIAN)
Placebo BAI and MDIKaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening AsthmaNA days
BDP 320 mcg BAIKaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening AsthmaNA days
BDP 640 mcg BAIKaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening AsthmaNA days
BDP 320 mcg MDIKaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening AsthmaNA days
BDP 640 mcg MDIKaplan-Meier Estimates for Time to Withdrawal From Study Treatment Due to Meeting Stopping Criteria for Worsening AsthmaNA days
Secondary

Number of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period

A count of participants who were withdrawn from the study due to meeting stopping criteria. Alert criteria for individual patients with worsening asthma were designed to ensure patient safety. The investigator determined whether the patient's overall clinical picture is consistent with worsening asthma and if the patient should be withdrawn from study drug treatment (but not the study) and be placed on appropriate asthma therapy in the interest of patient safety. An example of alert criteria is: * FEV1 as measured at the study center is below the FEV1 stability limit value calculated at randomization visit (Day 1). * Other criteria as defined in the protocol.

Time frame: Treatment period: Day 1 up to Week 12

Population: Full analysis set

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Placebo BAI and MDINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period15 Participants
BDP 320 mcg BAINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period3 Participants
BDP 640 mcg BAINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period3 Participants
BDP 320 mcg MDINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period5 Participants
BDP 640 mcg MDINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period1 Participants

Source: ClinicalTrials.gov · Data processed: Mar 1, 2026