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A 12-week Safety and Efficacy Study of Beclomethasone Dipropionate (80 and 160 mcg/Day) Delivered Via Breath-Actuated Inhaler (BAI) in Patients >=12 Years Old With Persistent Asthma

A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, 12-Week Clinical Study to Assess the Efficacy and Safety of Beclomethasone Dipropionate (80 and 160 mcg/Day) Delivered Via Breath-Actuated Inhaler (BAI) 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
NCT02040779
Enrollment
273
Registered
2014-01-20
Start date
2013-12-26
Completion date
2014-12-24
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

Persistent Asthma

Keywords

asthma, breath-actuated inhaler, beclomethasone

Brief summary

This is a randomized, double-blind, placebo-controlled parallel-group study. Participants will be randomly assigned to receive treatment with beclomethasone dipropionate at a dosage of 80 or 160 mcg/day delivered via a Breath-Actuated Inhaler (BAI); or a matching BAI placebo, in a 1:1:1 ratio after a 14- to 21-day run-in period. Participants and investigators will remain blinded to randomized treatment assignment during the study

Interventions

DRUGBeclomethasone dipropionate breath-actuated inhaler

Beclomethasone dipropionate (BDP) breath-actuated inhaler (BAI) given in dosages of either 40 mcg/inhalation or 80 mcg/inhalation. Study drug was administered twice each day, in the morning and in the evening, after the completion of the asthma symptom score and the PEF measurements, in that order.

DRUGPlacebo breath-actuated inhaler

Placebo was provided in matching breath-actuated inhaler (BAI) devices. The placebo devices were identical to the devices used to deliver active drug. Placebo was administered twice each day, in the morning and in the evening, after the completion of the asthma symptom score and the PEF measurements, in that order.

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 an 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) reference values at screening visit (SV) (Hankinson et al 1999). * Current asthma therapy: The patient is currently being treated with 1 of the following: 1\) inhaled corticosteroids (ICSs) at a stable daily dose of less than or equal to 220 mcg/day fluticasone propionate via metered dose inhaler (MDI) or equivalent for a minimum of 4 weeks (28 days) before screening visit, or 2) a stable daily dosage of non-corticosteroid therapy, including leukotriene modifiers, theophylline, chromones, or short-acting beta-2 agonists (SABAs) alone or in combination for a minimum of 4 weeks (28 days) before screening visit (SV). * Reversibility of disease: The patient has demonstrated at least 15% 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 SV or on retesting. - 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 a pregnant or lactating female or plans to become pregnant. * 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 may not have used tobacco products within the past year. * The patient has had an asthma exacerbation requiring oral corticosteroids within 1 month before SV, or has had any hospitalization for asthma within 2 months before SV. * 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 One Minute (FEV1) Area Under the Effect Curve From Time Zero to 12 Weeks (AUEC(0-12wk)) by Actual Treatment ReceivedBaseline (Day 1 predose), weeks 2, 4, 8 and 12The primary efficacy variable was the standardized baseline-adjusted trough morning (pre-dose and pre-rescue bronchodilator) FEV1 AUEC(0-12wk). Pulmonary function measurements such as FEV1 were obtained electronically by spirometry at the randomization visit (Day 1), each treatment visit (Weeks 2, 4, 8 and 12) and any unscheduled visit (such as the early termination visit). This summary is based on observed values recorded as 'best attempt'. The least-square (LS) means, difference of LS means and its 95% confidence interval (CI), and p-value represent the results obtained from the analysis of covariance with covariate adjustment for baseline, sex, age, current asthma therapy, and treatment.

Secondary

MeasureTime frameDescription
Change From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-Week Treatment PeriodBaseline (Days -6 to Day 1 pre-dose), daily up 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. The LS means, difference of LS means and its 95% confidence interval, and p value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy, treatment, week, and treatment by week interaction.
Change From Baseline in Weekly Average of Total Daily Use of Albuterol/Salbutamol Inhalation Aerosol Over Weeks 1-12Baseline (Days -6 to Day 1 pre-dose), daily up to Week 12Change from baseline in the use of rescue medication, albuterol/salbutamol, during the treatment period offers an indication of asthma control. The LS means, difference of LS means and its 95% CI, and p-value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy, treatment, week and treatment by week interaction. 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 morning usage at the randomization visit.
Change From Baseline in Weekly Average of Total Daily Asthma Symptom Score Over the 12-Week Treatment PeriodBaseline (Days -6 to Day 1 pre-dose), daily up to Week 12Asthma symptom scores were recorded in the patient's diary each morning and evening before determining FEV1 and PEF and before administration of study or rescue medications. The Daytime Symptom Score was recorded in the evening on a scale of 0 (No symptoms during the day) to 5 (Symptoms so severe that I could not go to work or perform normal daily activities) plus the Nighttime Symptom Score in the morning on a scale of 0 (No symptoms during the night) to 4 (Symptoms so severe that I did not sleep at all) for a total score range of 0-9. Baseline was defined as the average of recorded daily asthma symptom scores (average of daytime and nighttime score) over the 7 days prior to the first dose of study treatment, including the morning assessment at the randomization visit. The LS means, difference of LS means and its 95% CI, and p value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy,
Kaplan-Meier Estimates of Time to Study Drug Treatment Withdrawal Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment PeriodTreatment period: daily from Day 1 up to Week 12The time to patient study drug treatment withdrawal due to worsening asthma was defined as the number of days elapsed from the date of randomization to the date of withdrawal 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 Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Rate Over the 12-Week Treatment PeriodBaseline (Days -6 to Day 1 pre-dose), daily up to Week 12Change from baseline in the weekly average of daily trough morning (pre-dose and pre-rescue bronchodilator) PEF by handheld spirometer over the 12-week treatment period. PEF were determined twice daily, in the morning and in the evening, before administration of study drug or rescue medications. A handheld spirometer was provided to patients and used to determine the morning and evening PEF throughout the study. The spirometer was programmed to record the highest PEF obtained from 3 valid attempts. Baseline was defined as the average of recorded trough morning PEF assessments over the 7 days prior to the first dose of double-blind study treatment, including the morning assessment at the randomization visit. The LS means, difference of LS means and its 95% confidence interval, and p value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy, treatment, week, and treatment by week interaction.
Participants With Treatment-Emergent Adverse Events (TEAEs)Day 1 up to Week 12An adverse event was defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= an inability to carry out usual activities. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical intervention to prevent 1 of the outcomes listed in this definition.
Participants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodBaseline (Day 1 predose), Visits at weeks 2, 4, 8, 12Criteria for the select vital signs that showed a potentially clinically relevant abnormal result are: * Sitting systolic BP (low); \<=90 mm Hg and decrease of \>=20 mm Hg from baseline * Sitting diastolic BP (high): \>=105 mm Hg and increase of \>=15 mm Hg from baseline Baseline is defined as the last available assessment prior to the first dose of double-blind study treatment (usually Day 1 predose).
Participants With Findings During Oropharyngeal Examination During TreatmentVisits at weeks 2, 4, 8, 12Oropharyngeal examinations were performed at every visit by a qualified healthcare professional: during treatment visits are summarized. Any visual evidence of oral candidiasis during the treatment period of the study was evaluated by obtaining and analyzing a swab of the suspect area for culturing. Appropriate therapy was to be initiated immediately at the discretion of the investigator and was not to be delayed for culture confirmation.
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.

Countries

United States

Participant flow

Recruitment details

For this study, 47 sites were activated and screened at least 1 patient, 44 sites screened at least 1 patient who entered the run-in period, and 43 sites randomly assigned a patient. Overall, 273 patients were randomly assigned to treatment

Participants by arm

ArmCount
Placebo BAI
Placebo breath-actuated inhaler (BAI) twice daily.
91
BDP 80 mcg BAI
40 mcg beclomethasone dipropionate (BDP) via breath-actuated inhaler (BAI) twice daily for a total of 80 mcg/day.
90
BDP 160 mcg BAI
80 mcg beclomethasone dipropionate (BDP) via breath-actuated inhaler (BAI) twice daily for a total of 160 mcg/day.
92
Total273

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event100
Overall StudyLack of Efficacy420
Overall StudyLost to Follow-up121
Overall StudyNon-compliance010
Overall StudyProtocol Violation210
Overall StudyWithdrawal by Subject413

Baseline characteristics

CharacteristicBDP 80 mcg BAIBDP 160 mcg BAITotalPlacebo BAI
Age, Continuous38.8 years
STANDARD_DEVIATION 15.02
37.4 years
STANDARD_DEVIATION 16.05
37.8 years
STANDARD_DEVIATION 15.27
37.2 years
STANDARD_DEVIATION 14.82
Body Mass Index29.266 kg/m^2
STANDARD_DEVIATION 7.9371
28.136 kg/m^2
STANDARD_DEVIATION 6.7751
28.591 kg/m^2
STANDARD_DEVIATION 7.2109
28.383 kg/m^2
STANDARD_DEVIATION 6.9051
Current Asthma Therapy
Inhaled corticosteroid
34 Participants35 Participants104 Participants35 Participants
Current Asthma Therapy
Non-corticosteroid
56 Participants57 Participants169 Participants56 Participants
Duration of Asthma
10 years to <15 years
16 Participants18 Participants46 Participants12 Participants
Duration of Asthma
>=15 years
60 Participants62 Participants187 Participants65 Participants
Duration of Asthma
1 year to < 5 years
4 Participants2 Participants10 Participants4 Participants
Duration of Asthma
<3 months
0 Participants0 Participants0 Participants0 Participants
Duration of Asthma
3 months to <6 months
1 Participants0 Participants1 Participants0 Participants
Duration of Asthma
5 years to <10 years
8 Participants10 Participants27 Participants9 Participants
Duration of Asthma
6 months to <1 year
1 Participants0 Participants2 Participants1 Participants
Height170.88 cm
STANDARD_DEVIATION 10.447
168.78 cm
STANDARD_DEVIATION 8.657
169.64 cm
STANDARD_DEVIATION 9.554
169.28 cm
STANDARD_DEVIATION 9.473
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
2 Participants1 Participants6 Participants3 Participants
Race (NIH/OMB)
Black or African American
17 Participants14 Participants44 Participants13 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
Unknown or Not Reported
7 Participants5 Participants13 Participants1 Participants
Race (NIH/OMB)
White
64 Participants72 Participants209 Participants73 Participants
Sex: Female, Male
Female
54 Participants56 Participants156 Participants46 Participants
Sex: Female, Male
Male
36 Participants36 Participants117 Participants45 Participants
Weight85.30 kg
STANDARD_DEVIATION 22.382
80.29 kg
STANDARD_DEVIATION 20.577
82.60 kg
STANDARD_DEVIATION 22.316
82.27 kg
STANDARD_DEVIATION 23.848

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 910 / 900 / 92
other
Total, other adverse events
0 / 910 / 900 / 92
serious
Total, serious adverse events
1 / 910 / 900 / 92

Outcome results

Primary

Standardized Baseline-Adjusted Trough Morning Forced Expiratory Volume in One Minute (FEV1) Area Under the Effect Curve From Time Zero to 12 Weeks (AUEC(0-12wk)) by Actual Treatment Received

The primary efficacy variable was the standardized baseline-adjusted trough morning (pre-dose and pre-rescue bronchodilator) FEV1 AUEC(0-12wk). Pulmonary function measurements such as FEV1 were obtained electronically by spirometry at the randomization visit (Day 1), each treatment visit (Weeks 2, 4, 8 and 12) and any unscheduled visit (such as the early termination visit). This summary is based on observed values recorded as 'best attempt'. The least-square (LS) means, difference of LS means and its 95% confidence interval (CI), and p-value represent the results obtained from the analysis of covariance with covariate adjustment for baseline, sex, age, current asthma therapy, and treatment.

Time frame: Baseline (Day 1 predose), weeks 2, 4, 8 and 12

Population: The full analysis set (FAS) included all patients in the intent to treat (ITT) population who received at least 1 dose of study drug and had at least 1 postbaseline trough morning (pre-dose and pre-rescue bronchodilator) assessment of FEV1.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAIStandardized Baseline-Adjusted Trough Morning Forced Expiratory Volume in One Minute (FEV1) Area Under the Effect Curve From Time Zero to 12 Weeks (AUEC(0-12wk)) by Actual Treatment Received0.048 litersStandard Error 0.0252
BDP 80 mcg BAIStandardized Baseline-Adjusted Trough Morning Forced Expiratory Volume in One Minute (FEV1) Area Under the Effect Curve From Time Zero to 12 Weeks (AUEC(0-12wk)) by Actual Treatment Received0.171 litersStandard Error 0.0254
BDP 160 mcg BAIStandardized Baseline-Adjusted Trough Morning Forced Expiratory Volume in One Minute (FEV1) Area Under the Effect Curve From Time Zero to 12 Weeks (AUEC(0-12wk)) by Actual Treatment Received0.164 litersStandard Error 0.0248
Comparison: A fixed-sequence multiple testing procedure was used while controlling the family-wise error rate at 5%. If the 2-sided p-value resulting from the ANCOVA model for comparing beclomethasone dipropionate BAI 160 mcg/day versus placebo was less than 0.05, then the comparison of the 80 mcg/day versus placebo was to be interpreted inferentially.p-value: 0.00195% CI: [0.048, 0.185]ANCOVA
p-value: 0.000595% CI: [0.054, 0.193]ANCOVA
Secondary

Change From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-Week Treatment Period

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. The LS means, difference of LS means and its 95% confidence interval, and p value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy, treatment, week, and treatment by week interaction.

Time frame: Baseline (Days -6 to Day 1 pre-dose), daily up to Week 12

Population: Full analysis set

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-Week Treatment Period-0.797 L/minuteStandard Error 3.038
BDP 80 mcg BAIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-Week Treatment Period10.105 L/minuteStandard Error 35.0507
BDP 160 mcg BAIChange From Baseline in Weekly Average of Daily Evening Peak Expiratory Flow (PEF) Over the 12-Week Treatment Period4.608 L/minuteStandard Error 2.9908
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.201495% CI: [-2.905, 13.715]mixed model for repeated measures
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.011295% CI: [2.5, 19.303]mixed model for repeated measures
Secondary

Change From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Rate Over the 12-Week Treatment Period

Change from baseline in the weekly average of daily trough morning (pre-dose and pre-rescue bronchodilator) PEF by handheld spirometer over the 12-week treatment period. PEF were determined twice daily, in the morning and in the evening, before administration of study drug or rescue medications. A handheld spirometer was provided to patients and used to determine the morning and evening PEF throughout the study. The spirometer was programmed to record the highest PEF obtained from 3 valid attempts. Baseline was defined as the average of recorded trough morning PEF assessments over the 7 days prior to the first dose of double-blind study treatment, including the morning assessment at the randomization visit. The LS means, difference of LS means and its 95% confidence interval, and p value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy, treatment, week, and treatment by week interaction.

Time frame: Baseline (Days -6 to Day 1 pre-dose), daily up to Week 12

Population: Full analysis set (FAS)

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Rate Over the 12-Week Treatment Period-0.795 L/minuteStandard Error 2.8224
BDP 80 mcg BAIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Rate Over the 12-Week Treatment Period12.849 L/minuteStandard Error 2.8241
BDP 160 mcg BAIChange From Baseline in Weekly Average of Daily Trough Morning Peak Expiratory Flow (PEF) Rate Over the 12-Week Treatment Period7.116 L/minuteStandard Error 2.7735
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.044395% CI: [0.202, 15.621]mixed model for repeated measures
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.000795% CI: [5.843, 21.446]mixed model for repeated measures
Secondary

Change From Baseline in Weekly Average of Total Daily Asthma Symptom Score Over the 12-Week Treatment Period

Asthma symptom scores were recorded in the patient's diary each morning and evening before determining FEV1 and PEF and before administration of study or rescue medications. The Daytime Symptom Score was recorded in the evening on a scale of 0 (No symptoms during the day) to 5 (Symptoms so severe that I could not go to work or perform normal daily activities) plus the Nighttime Symptom Score in the morning on a scale of 0 (No symptoms during the night) to 4 (Symptoms so severe that I did not sleep at all) for a total score range of 0-9. Baseline was defined as the average of recorded daily asthma symptom scores (average of daytime and nighttime score) over the 7 days prior to the first dose of study treatment, including the morning assessment at the randomization visit. The LS means, difference of LS means and its 95% CI, and p value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy,

Time frame: Baseline (Days -6 to Day 1 pre-dose), daily up to Week 12

Population: Full analysis set

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAIChange From Baseline in Weekly Average of Total Daily Asthma Symptom Score Over the 12-Week Treatment Period-0.166 units on a scaleStandard Error 0.046
BDP 80 mcg BAIChange From Baseline in Weekly Average of Total Daily Asthma Symptom Score Over the 12-Week Treatment Period-0.293 units on a scaleStandard Error 0.0463
BDP 160 mcg BAIChange From Baseline in Weekly Average of Total Daily Asthma Symptom Score Over the 12-Week Treatment Period-0.304 units on a scaleStandard Error 0.0454
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.033595% CI: [-0.263, -0.011]mixed model for repeated measures
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.050995% CI: [-0.255, 0.001]mixed model for repeated measures
Secondary

Change From Baseline in Weekly Average of Total Daily Use of Albuterol/Salbutamol Inhalation Aerosol Over Weeks 1-12

Change from baseline in the use of rescue medication, albuterol/salbutamol, during the treatment period offers an indication of asthma control. The LS means, difference of LS means and its 95% CI, and p-value are obtained from the mixed model for repeated measures analysis with covariate adjustment for baseline, sex, age, current asthma therapy, treatment, week and treatment by week interaction. 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 morning usage at the randomization visit.

Time frame: Baseline (Days -6 to Day 1 pre-dose), daily up to Week 12

Population: FAS

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
Placebo BAIChange From Baseline in Weekly Average of Total Daily Use of Albuterol/Salbutamol Inhalation Aerosol Over Weeks 1-12-0.010 inhalationsStandard Error 0.1162
BDP 80 mcg BAIChange From Baseline in Weekly Average of Total Daily Use of Albuterol/Salbutamol Inhalation Aerosol Over Weeks 1-12-0.368 inhalationsStandard Error 0.1155
BDP 160 mcg BAIChange From Baseline in Weekly Average of Total Daily Use of Albuterol/Salbutamol Inhalation Aerosol Over Weeks 1-12-0.398 inhalationsStandard Error 0.1153
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.017595% CI: [-0.708, -0.068]mixed model for repeated measures
Comparison: Treatment comparisons began with am PEF for BDP 160 mcg BAI vs placebo. If the p-value was ≤0.05, the next comparisons of interest were made 1) the next secondary outcome comparison for BDP 160 mcg BAI vs placebo and 2) the am PEF for BDP 80 mcg BAI vs placebo. This procedure allowed for control of the Type I error for comparisons at a particular BAI treatment over the 5 secondary endpoints, as well as comparisons within an endpoint. It did not control the overall Type I error.p-value: 0.028595% CI: [-0.678, -0.038]mixed model for repeated measures
Secondary

Kaplan-Meier Estimates of Time to Study Drug Treatment Withdrawal Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period

The time to patient study drug treatment withdrawal due to worsening asthma was defined as the number of days elapsed from the date of randomization to the date of withdrawal 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: daily from Day 1 up to Week 12

Population: Full analysis set

ArmMeasureValue (MEDIAN)
Placebo BAIKaplan-Meier Estimates of Time to Study Drug Treatment Withdrawal Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment PeriodNA days
BDP 80 mcg BAIKaplan-Meier Estimates of Time to Study Drug Treatment Withdrawal Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment PeriodNA days
BDP 160 mcg BAIKaplan-Meier Estimates of Time to Study Drug Treatment Withdrawal Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment PeriodNA 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 BAINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period5 Participants
BDP 80 mcg BAINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period2 Participants
BDP 160 mcg BAINumber of Participants Withdrawn From Study Due to Meeting Stopping Criteria for Worsening Asthma During the 12-Week Treatment Period0 Participants
p-value: 0.2384Log Rank
p-value: 0.0208Log Rank
Secondary

Participants With Findings During Oropharyngeal Examination During Treatment

Oropharyngeal examinations were performed at every visit by a qualified healthcare professional: during treatment visits are summarized. Any visual evidence of oral candidiasis during the treatment period of the study was evaluated by obtaining and analyzing a swab of the suspect area for culturing. Appropriate therapy was to be initiated immediately at the discretion of the investigator and was not to be delayed for culture confirmation.

Time frame: Visits at weeks 2, 4, 8, 12

Population: Safety population

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Placebo BAIParticipants With Findings During Oropharyngeal Examination During Treatment>=1 evidence of oral candidiasis appearance0 Participants
Placebo BAIParticipants With Findings During Oropharyngeal Examination During TreatmentParticipants with a positive culture0 Participants
BDP 80 mcg BAIParticipants With Findings During Oropharyngeal Examination During Treatment>=1 evidence of oral candidiasis appearance0 Participants
BDP 80 mcg BAIParticipants With Findings During Oropharyngeal Examination During TreatmentParticipants with a positive culture0 Participants
BDP 160 mcg BAIParticipants With Findings During Oropharyngeal Examination During Treatment>=1 evidence of oral candidiasis appearance2 Participants
BDP 160 mcg BAIParticipants With Findings During Oropharyngeal Examination During TreatmentParticipants with a positive culture1 Participants
Secondary

Participants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment Period

Criteria for the select vital signs that showed a potentially clinically relevant abnormal result are: * Sitting systolic BP (low); \<=90 mm Hg and decrease of \>=20 mm Hg from baseline * Sitting diastolic BP (high): \>=105 mm Hg and increase of \>=15 mm Hg from baseline Baseline is defined as the last available assessment prior to the first dose of double-blind study treatment (usually Day 1 predose).

Time frame: Baseline (Day 1 predose), Visits at weeks 2, 4, 8, 12

Population: Safety population

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Placebo BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodSitting systolic BP (low)1 Participants
Placebo BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment Period>=1 abnormality2 Participants
Placebo BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodSitting diastolic BP (high)1 Participants
BDP 80 mcg BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodSitting systolic BP (low)1 Participants
BDP 80 mcg BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment Period>=1 abnormality2 Participants
BDP 80 mcg BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodSitting diastolic BP (high)1 Participants
BDP 160 mcg BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment Period>=1 abnormality2 Participants
BDP 160 mcg BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodSitting diastolic BP (high)1 Participants
BDP 160 mcg BAIParticipants With Potentially Clinically Relevant Abnormal Vital Sign Results During the Treatment PeriodSitting systolic BP (low)1 Participants
Secondary

Participants With Treatment-Emergent Adverse Events (TEAEs)

An adverse event was defined as any untoward medical occurrence that develops or worsens in severity during the conduct of a clinical study and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= an inability to carry out usual activities. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical intervention to prevent 1 of the outcomes listed in this definition.

Time frame: Day 1 up to Week 12

Population: The safety population included all randomly assigned patients (ITT population) who took 1 or more doses of study drug. In this population, treatment was assigned based upon the treatment patients actually received, regardless of the treatment to which they were randomized.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Placebo BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 serious TEAE1 Participants
Placebo BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 treatment-related TEAE1 Participants
Placebo BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 adverse event28 Participants
Placebo BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 severe TEAE2 Participants
Placebo BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 AE causing discontinuation1 Participants
BDP 80 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 treatment-related TEAE1 Participants
BDP 80 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 adverse event32 Participants
BDP 80 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 severe TEAE0 Participants
BDP 80 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 serious TEAE0 Participants
BDP 80 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 AE causing discontinuation0 Participants
BDP 160 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 AE causing discontinuation0 Participants
BDP 160 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 serious TEAE0 Participants
BDP 160 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 adverse event26 Participants
BDP 160 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 treatment-related TEAE2 Participants
BDP 160 mcg BAIParticipants With Treatment-Emergent Adverse Events (TEAEs)>=1 severe TEAE0 Participants

Source: ClinicalTrials.gov · Data processed: Feb 26, 2026